"Monkeypox: What Do You Know about That?" Italian Adults' Awareness of a New Epidemic

Knowledge gap of human monkeypox among high-risk individuals receiving preexposure vaccination in Taiwan

BACKGROUND

With the widespread outbreak of monkeypox, it is crucial to enhance awareness and understanding of the disease, especially among high-risk individuals. This study aimed to investigate the knowledge levels of individuals seeking preexposure vaccination in Taiwan.

METHODS

This descriptive cross-sectional questionnaire survey was conducted online, and included a nationwide sample of high-risk adults receiving preexposure vaccination. The questionnaire comprised 30 items with six aspects and explanatory variables. A multivariate logistic regression model was used to identify the factors that influenced participants' knowledge of human monkeypox.

RESULTS

Among 2,604 participants, 97.3 % were male, 76.4 % identified as homosexual, and 24.4 % had a history of HIV infection. Approximately half of the participants displayed inadequate knowledge of human monkeypox, with weaker performance in diagnosis and treatment aspects. Using a multivariate logistic model, we found that those with a medical background or higher education level had a better understanding after adjustment for potential confounding factors. Among those with an educational level of college or below, men who had sex with men (MSM) without HIV displayed significantly lower knowledge levels (OR: 0.68; 95 % CI 0.51-0.91).

CONCLUSIONS

The existence of a knowledge gap within subgroups of MSM highlights the necessity for targeted educational interventions.

Assessment of the knowledge, attitude, and perception of the world's population towards monkeypox and its vaccines: A systematic review and descriptive analysis of cross-sectional studies

Background

Prevention and treatment of the monkeypox virus (Mpox) remain challenging in areas where it is endemic. This systematic review and meta-analysis aimed to collect this information from various studies in one study to give a comprehensive view of people's opinions, fears, and behaviors about this virus.

Methods

We searched PubMed, Scopus, Web of Science, the Cochrane Library, and Google Scholar for descriptive cross-sectional study designs conducted in 2022 and 2023 addressing knowledge, attitude, perception, preparedness, willingness to get vaccinated, and practices against Mpox infection.

Results

Among the included studies, 16 studies assessed the level of knowledge of study participants regarding Mpox with a total of 9066 participants. Among them, 4222 (46.6 %) were reported to have good knowledge, and 4844 (53.4%) were reported to have poor knowledge about Mpox. Regarding willingness to get vaccinated against Mpox, 14 studies with a total of 10,696 participants were included. Among them, 7006 (65 %) were willing to get vaccinated while 3690 (35 %) weren't willing to be vaccinated.

Conclusion

Knowledge about Mpox should be increased and awareness should be spread regarding the importance of preventive measures such as vaccination to protect the population from another COVID-19-like pandemic.

The Mpox Vaccine Hesitancy Scale for Mpox: Links with Vaccination Intention among Men Who Have Sex with Men in Six Cities of China

BACKGROUND

Vaccine hesitancy is a significant barrier to achieving high vaccination rates, particularly among men who have sex with men (MSM), a group at increased risk for Mpox. This study aimed to develop and validate a Mpox vaccine hesitancy scale specifically tailored for Chinese MSM, grounded in the protection motivation theory (PMT).

METHODS

An online survey through snowball sampling was conducted from October 2023 to March 2024, collecting 2403 valid responses across six representative regions in China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to evaluate the scale's construct validity, while reliability was assessed using Cronbach's α coefficient. The predictive validity of the scale was analyzed using Receiver Operating Characteristic (ROC) analysis.

RESULTS

EFA ultimately retained 22 items in the Mpox vaccination scale and identified four distinct dimensions: Maladaptive Rewards (seven items), Self-efficacy (seven items), Response Efficacy (four items), and Response Costs (four items). These dimensions were confirmed by CFA, which demonstrated satisfactory model fit indices (χ²/df = 4.382, RMSEA = 0.053, SRMR = 0.048, GFI = 0.935, CFI = 0.967, NFI = 0.958, TLI = 0.963, and IFI =0.967). All indices were within acceptable ranges. The scale exhibited good internal consistency, with a Cronbach's alpha of 0.906, and strong content validity, with an S-CVI/Ave of 0.952. The scale's predictive accuracy was evaluated using Receiver Operating Characteristic (ROC) analysis. When used to evaluate the scale's predictive accuracy, it yielded an area under the curve (AUC) of 0.854 after adjustments, indicating good predictive ability between high and low hesitancy.

CONCLUSIONS

This scale provides a reliable and valid tool for assessing Mpox vaccine hesitancy among MSM and can be used to gauge Mpox vaccination intention within this group.

Global prevalence and correlates of mpox vaccine acceptance and uptake: a systematic review and meta-analysis

BACKGROUND

Vaccination has been recommended as one of the most potent ways of controlling the mpox (formerly, monkeypox) outbreak, particularly among high-risk groups. Here, we evaluated the prevalence of mpox vaccine acceptance and uptake globally.

METHODS

We searched multiple databases for peer-reviewed studies published in English from May 2022 to 25th November 2023 that evaluated mpox vaccine acceptance and/or uptake. We fit a random-effects model meta-analysis to calculate the pooled mpox vaccine acceptance and uptake rates, with their 95% confidence intervals (CI) across population outcomes. We performed subgroup analyses among the six World Health Organization (WHO) regions (Africa [AFR], Region of the Americas [AMR], South-East Asia Region [SEAR], European Region [EUR], Eastern Mediterranean Region [EMR], and the Western Pacific Region [WPR]), as well as among select population subgroups.

RESULTS

Of the 2531 studies screened, 61 studies, with a cumulative sample size of 263,857 participants from 87 countries were eligible for inclusion. The overall vaccine acceptance and uptake rates were 59.7% and 30.9% globally. Acceptance and uptake rates among the LGBTQI+ community were 73.6% vs 39.8% globally, 60.9% vs. 37.1% in AMR, 80.9% vs. 50.0% in EUR, and 75.2% vs. 33.5% in WPR. Among PLHIV, vaccine acceptance and uptake rates were 66.4% vs. 35.7% globally, 64.0% vs. 33.9% in AMR, 65.1% vs. 27.0% in EUR, and 69.5% vs. 46.6% in WPR. Among healthcare workers, vaccination intention was 51.0% globally.

CONCLUSIONS

Tailored interventions are needed to bolster confidence in the mpox vaccine, maximize vaccine uptake, and increase vaccine access to close the gaps between acceptance and uptake especially among key populations residing in regions with low rates of acceptance and uptake.

Assessing healthcare workers' confidence level in diagnosing and managing emerging infectious virus of human mpox in hospitals in Amhara Region, Northwest Ethiopia: multicentre institution-based cross-sectional study

OBJECTIVE

To assess healthcare workers' (HCWs) confidence level in diagnosing and managing mpox disease and its associated factors in hospitals in the Amhara Region.

DESIGN

Institution-based cross-sectional study.

SETTING

Hospitals in the Amhara Region, Northwest Ethiopia.

PARTICIPANTS

A total of 640 HCWs, with a response rate of 96.9%, participated from 1 October to 30 December 2022. A multistage stratified random sampling technique with proportional allocation was used to recruit study participants. Data were collected using the KoboCollect toolbox and exported to STATA V.17 for analysis. Descriptive statistics were used to describe data. Ordinal logistic regression analysis was used to identify predictors of confidence level to diagnose and manage mpox at p<0.05.

PRIMARY OUTCOME

HCWs' confidence level in diagnosing and managing mpox disease and its associated factors.

RESULTS

The overall proportion of HCWs who had high confidence level in diagnosing and managing mpox disease was found to be 31.5% (95% CI: 27.9%, 35.2%). Similarly, 26.8% (95% CI: 23.2%, 30.3%) and 41.8% (95% CI: 38.1%, 45.4%) of HCWs expressed medium and low confidence level to diagnose and manage the disease, respectively. The odds of higher confidence versus lower or medium confidence level in diagnosing and managing mpox were greater for HCWs who regularly visit amenable websites (adjusted OR (AOR)=1.59, 95% CI: 1.16, 2.2), were physicians (AOR=1.9, 95% CI: 1.32, 2.73), were aged 30-35 years old (AOR=1.64, 95% CI: 1.12, 2.39), had got public health emergency epidemic disease management training (AOR=2.8, 95% CI: 1.94, 4.04) and had positive attitudes (AOR=1.72, 95% CI: 1.26, 2.36) compared with their counterparts.

CONCLUSION

The overall confidence level of HCWs in diagnosing and managing mpox disease in the study area was low. Therefore, the HCWs should be regularly updated about mpox disease through morning sessions and training in the diagnosis and clinical management of mpox disease including infection prevention and control.

Assessment of Knowledge and Concern of People Living with HIV Regarding Human Mpox and Vaccination

INTRODUCTION

Mpox virus is an orthopoxvirus that causes the zoonotic infectious disease known as mpox. The disease can also spread from humans to humans. It can be transmitted through contact with bodily fluids, lesions on the skin, or internal mucosal surfaces.

METHOD

The number of mpox cases increased during the COVID-19 pandemic. Early diagnosis and prompt management of mpox are critical in people living with HIV (PLHIV). In this study, a cross-sectional survey was conducted among PLHIV followed at the outpatient clinic between 20 April-20 August 2023. A questionnaire was used to assess the knowledge and anxiety levels of patients as well as their opinions about vaccination against mpox. The severity of symptoms in the past two weeks was assessed using the Generalised Anxiety Disorder 7-item scale. A total of 203 PLHIV were interviewed for this survey study.

RESULT

The mean age was 39.37±11.93. The majority of them were male (86.7%), and 41.4% were men who have sex with men (MSM). Only 21 of the surveyed participants (10.4%) had a "good knowledge" score about mpox. The mean knowledge score on human Mpox was 2.05 (min:0-max:8), and 107 (52.7%) had a score of 0.

CONCLUSION

The future study should focus on continuous education, promoting awareness through programs and establishing measures to successfully overcome identified variables that contribute to mpox pandemic understanding and attitudes. Applying the lessons learned from the COVID-19 pandemic will help the management of mpox virus.

Monkeypox Emergence Post-COVID: Insight into Egyptian Older Adult's Awareness, Concern, and Mental Health

Aim: To identify Egyptian older adults' awareness, concerns, and mental health about the monkeypox outbreak. Background: In light of the ongoing COVID-19 pandemic, monkeypox disease is receiving more attention. The monkeypox virus outbreak has posed a global concern, especially to older adults with comorbidities. Natural disasters, and endemic affect older persons' mental health. Design: A cross-sectional descriptive design was followed. Methods: 254 older adults were recruited from three outpatient clinics using consecutive sampling using four tools. Results: 74.0% of older study participants were unaware of monkeypox. Gender, level of education, residence, worry about contracting monkeypox infection, and mental distress are predictors of awareness about monkeypox (p < .001). Worry of contracting monkeypox infection was common among female participants (p = .038), highly educated (p = .001), who had a low level of awareness and high level of mental distress (p = .001 for both). Conclusion: Awareness of monkeypox was associated with worry and mental distress. Gerontological nurses have a vital role in contacting older adults and providing care and education that decreases worry and preserves minds and feelings, improving their quality of life. Establishing a national strategic planning and crisis prevention framework to alleviate psychological distress and prevent mental health issues from deteriorating in this group is crucial.

Monkeypox (Mpox) Vaccine Hesitancy Among Mpox Cases: A Qualitative Study

Human mpox has been an increasing concern in the United States and California since late 2022. While the Jynneos vaccine offers a degree of cross-protection against the disease, vaccine hesitancy is common among those recommended for vaccination. The purpose of this study was to assess vaccine knowledge, facilitators, and barriers to vaccine uptake among individuals previously diagnosed with mpox, or mpox cases, in Santa Clara County, California. In-depth interviews were conducted by public health department staff among mpox cases diagnosed in Santa Clara County between July and September 2022. Responses were analyzed using a grounded theory data analysis approach. Among the 47 participants, 36 (77%) had heard of mpox before diagnosis, and of these, 20 (56%) did not think they were at risk of developing mpox, and 28 (78%) were aware that a vaccine was available. Those who did not receive the vaccine stated vaccine access and availability were the main barriers. Among the six participants not interested in the vaccine, the main hesitancies were lack of perceived risk, stigma of being branded by scarring and labeled gay, and vaccine safety. Overall, the following themes were attributed to reasons for vaccine hesitancy: (a) lack of awareness of the disease and vaccine, including perceived risks; (b) lack of vaccine availability and accessibility; and (c) stigma associated with receiving the vaccine, including being publicly labeled as "gay" and the scarring on forearm potentially seen as branding. We recommend tailoring outreach and educational campaigns to address reasons for mpox vaccine hesitancy.

Fear of a new pandemic: perception and prediction of monkeypox among the middle east general population

Background

Monkeypox is a zoonotic disease caused by the monkeypox virus, an Orthopox virus. The 2022 monkeypox outbreak provoked fear among the public. Public awareness about the disease could be an important factor in its control. The authors conducted this study to assess the perception and prediction of monkeypox among the Middle East public.

Methods

This cross-sectional study was conducted in August 2022. Data were conveniently collected from eight Middle Eastern countries using an online self-administered questionnaire distributed through educational and social media platforms. Statistical analysis was conducted using R software.

Results

Approximately 11 016 individuals participated in this study. The participants' overall knowledge score indicated poor knowledge about monkeypox. Most of the participants knew the causative organism (66.7%). However, numerous participants were not aware of the disease mode of transmission, symptoms, complications, and vaccination. Participants' awareness was mostly gained from social media (61.8%). The majority predicted acquiring monkeypox when protective measures are not taken (72.7%), progression to a pandemic with economic consequences (50.8 and 52%, respectively), and the ability of the Ministry of Health to control the epidemic (51.5%).

Conclusion

In the Middle East, public knowledge about monkeypox is poor. Raising awareness about monkeypox would be of benefit in controlling the epidemic. This study constitutes evidence upon which health education programs could be designed.

Perceptions and Knowledge of Public Towards Emerging Human Monkeypox in Yemen: A Cross-Sectional Study

Background

The spread of monkeypox (mpox) worldwide poses a severe threat to human life. This virus leads to a disease with symptoms similar to smallpox in humans. To combat this threat, improving public knowledge and perception toward mpox is vital for public health preventive measures.

Methods

A cross-sectional survey was carried out in Yemen from December 2022 to March 2023 to investigate public perception and knowledge of mpox. Individuals were approached through social media platforms using a convenient sampling approach. Linear regression was used to determine the association between participants' knowledge (dependent variable) and explanatory variables.

Results

A total of 853 individuals consented to take part in the study. A significant proportion of respondents had a low knowledge level (N=572, 67.06%). Most participants knew about the nature of the diseases (75%, n=641), transmission mode (78.1%, n=668), hand sanitizer preventive measures, and skin- related symptoms. However, only 20.8% (n= 178) knew that diarrhea is not a symptom, and 25.4% (n= 217) knew antibiotics are unnecessary for mpox management. A proportion of 57.7% (n=492) of the participants feared human mpox, and 47.7% (n= 407) thought it was a conspiracy. Most participants had a good perception of local and international health authorities controlling the disease. Age, education level, having a health-related certificate, and receiving a 2-dose vaccination for COVID-19 had statistically significant associations with mpox knowledge level (P < 0.05). Social media platforms were the most often used information source about mpox (78.3%, n= 668), followed by articles (41.1%, n=351).

Conclusion

The study reveals a low public knowledge about mpox in Yemen, emphasizing the need for targeted educational campaigns, especially via social media, to strengthen public health measures and disease control. Addressing Knowledge gaps and correcting misconceptions is crucial for improving preparedness and response to the disease.

Knowledge and Attitude of Human Monkeypox Viral Infection Among Healthcare Practitioners and Students in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Human monkeypox (Mpox) is a viral zoonotic infectious disease occurs mostly in central and western Africa that can be transmitted to humans and animal. On July 2022, the World Health Organization declared the global Mpox outbreak, which considered as a huge health issue. The prevalence of Mpox in Saudi Arabia has been very low until now.

AIM

This research aims to assess knowledge and attitudes of healthcare practitioners and students toward human Mpox in Saudi Arabia.

METHODS

 A cross-sectional study conducted among healthcare practitioners and students in Saudi Arabia assessing knowledge, practice and attitudes towards Mpox infection. We conducted descriptive statistics for all variables.

RESULTS

A total of 212 participants were included in the study. The majority of participants provided correct responses about the type of microorganisms that cause human Mpox infection and were aware about the low prevalence of the Mpox in Saudi Arabia, but they were not able to identify the correct number of cases in Saudi Arabia. About the symptoms of Mpox, participants showed good knowledge about the common symptoms like skin rash but poor knowledge about less common symptoms like lymph-node swelling. About 70% of participants were aware of the effectiveness of antiviral drugs to treat Mpox.

CONCLUSION

Gaps in knowledge were detected among participants. Therefore, increasing knowledge of Mpox by providing educational courses for healthcare practitioners and healthcare students is crucial.

Belarusian Healthcare Professionals' Views on Monkeypox and Vaccine Hesitancy

BACKGROUND

Despite the low transmission risk of Monkeypox (mpox) in Belarus, this study is vital as it contributes to our understanding of vaccine hesitancy among healthcare professionals (HCPs). It aims to assess vaccination perceptions and evaluate the willingness to pay for the vaccine among Belarusian HCPs, thereby enhancing pandemic preparedness.

METHODS

in October 2022, a cross-sectional survey-based study was conducted among Belarusian HCPs using a self-administered questionnaire (SAQ). Invitations were disseminated via social media platforms using a snowball sampling method. The SAQ encompassed various categories, including sociodemographic details, medical history, sources of mpox information, perceived and factual mpox knowledge, and perceptions of the mpox vaccine according to the health belief model (HBM), mpox vaccine acceptance and willingness to pay (WTP).

RESULTS

while a large proportion of respondents had good knowledge of mpox epidemiology and its clinical manifestations, their awareness of available vaccines and treatment options was limited. Consequently, a significant correlation was found between the history of influenza vaccination and mpox-related knowledge. Furthermore, the study showed that just over half of the participants (51.4%) were willing to receive the mpox vaccine if offered for free, safely, and effectively, with their decision largely influenced by perceived benefits (Spearman's rho = 0.451) and cues to action (Spearman's rho = 0.349). However, a considerable degree of hesitancy (30.6%) and resistance (18.1%) towards the mpox vaccine was observed, underscoring the need for targeted interventions to address these issues.

CONCLUSIONS

this study highlights a significant knowledge gap among Belarusian HCPs about mpox vaccines and treatments, despite a general awareness of the disease's epidemiology and symptoms, and it underscores the need for targeted interventions to enhance mpox knowledge and vaccine acceptance.

Are Saudi Healthcare Workers Willing to Receive the Monkeypox Virus Vaccine? Evidence from a Descriptive-Baseline Survey

Since Saudi Arabia has already confirmed multiple monkeypox (Mpox) cases, it is essential to initiate timely preventive measures, including the implementation of vaccines. In this cross-sectional study, an online survey was conducted among healthcare workers (HCWs) in Saudi Arabia to understand their willingness to receive the Mpox vaccine. A structured questionnaire was used to gather the data. The study comprised 734 samples. Our study found that among study participants, 52.7% were willing to receive the Mpox vaccine and showed that sociodemographic factors were not significantly associated with vaccine willingness. Previous vaccination history (such as influenza and COVID-19) was significantly associated with Mpox vaccine willingness. The respondents reported that the main reasons for receiving the Mpox vaccine were their trust in the Saudi Health Ministry (57.7%) and their understanding that the vaccine was a social responsibility (44.6%). Furthermore, the majority of the respondents (74.7%) reported that they were motivated by the need to protect themselves, their family and their friends. Insufficient vaccine information and fear of unknown adverse reactions were the most reported reasons for an unwillingness to receive the Mpox vaccine. In conclusion, increasing Mpox vaccine-related awareness and focusing on greater information dissemination to reduce fear and increase vaccine uptake is highly recommended.

Assessment of vaccine perception and vaccination intention of Mpox infection among the adult males in Bangladesh: A cross-sectional study findings

BACKGROUND

Mpox (monkeypox) infection has become a global concern for healthcare authorities after spreading in multiple non-endemic countries. Following the sudden multi-country outbreak of Mpox, the World Health Organization (WHO) declared a public health emergency of international concern. We do not have any vaccines approved for the prevention of Mpox infection. Therefore, international healthcare authorities endorsed smallpox vaccines for the prevention of Mpox disease. Here we intended to perform this cross-sectional study among the adult males in Bangladesh to assess the Mpox vaccine perception and vaccination intention.

METHODS

We conducted this web-based survey among the adult males in Bangladesh from September 1, 2022, to November 30, 2022, using Google Forms. We assessed the Mpox vaccine perception and vaccination intention. We performed a chi-square test to compare vaccine perception and vaccination intention levels. Also, we performed multiple logistic regression analyses to determine the association between the study parameters and the sociodemographic profile of the participants.

RESULTS

According to the present study, the Mpox vaccine perception was high among 60.54% of the respondents. Also, 60.05% of respondents showed medium vaccination intention. Mpox vaccine perception and vaccination intention were strongly associated with the sociodemographic profiles of the participants. Furthermore, we discovered a significant association between the level of education and vaccination intention among the respondents. Also, age and marital status played a role in the Mpox vaccine perception and vaccination intention.

CONCLUSION

Our findings showed a significant association between sociodemographic characteristics and the Mpox vaccine perception/vaccination intention. Along with the country's long experience in mass immunization, campaigns about Covid-19 vaccines and high vaccination rates might play a role in Mpox vaccine perception and vaccination intention. We recommend more social awareness and educational communications or seminars for the target population to bring more positive changes in their attitude towards Mpox prevention.

Assessment of risk perception and subjective norms related to Mpox (monkeypox) among adult males in Bangladesh: A cross-sectional study

Background and Aims

Monkeypox (Mpox) has become a concern worldwide after spreading into nonendemic countries. The World Health Organization (WHO) has declared this a public health emergency of international concern and recommended to get vaccinated first who are at the highest risk. Risk perception and subjective norms can influence the decision of vaccine uptake. Therefore, we intended to perform a cross-sectional study on the male population in our country to assess their risk perception and subjective norms on Mpox.

Methods

We measured participants' risk perception and subjective norms using Google form. Demographic profile of participants was obtained using a structured questionnaire. We performed a χ 2 test to compare the levels of risk perception and subjective norm perception and multiple logistic regression analysis to determine the association between the study parameters and the sociodemographic profile of the participants.

Results

Among the participants, 93 (23.72%), 288 (73.47%), and 11 (2.81%) had high, medium, and low-risk perceptions, respectively. For subjective norms, we observed 288 (58.16%) participants had a medium, 117 (29.85%) had high, and 47 (11.99%) had low levels of subjective norms, respectively. Most participants possessed medium risk perception (73.47%) and subjective norms (58.16%). Moreover, we observed that moderate risk perception was prevalent in people with body mass index (BMI) level between 18.5 and 25 (73.3%), married (63.5%), low economic background (94.1%), living with a family (77.1%), smokers (68.4%), heterosexuals (99%), people with no/little impact of coronavirus disease 2019 (Covid-19) on life (91%). Proportions of people with moderate subjective norms BMI level of 18.5-25 (73.2%), married (60.5%), low economic status (93.9%), rural (58.8%), living with family (77.2%), nonsmokers (71.1%), and people with no/little impact of Covid-19 in their lives (91.2%).

Conclusion

The majority of participants perceived medium risk perception and subjective norms related to Mpox. Furthermore, we observed a significant association between the study parameters and the sociodemographic characteristics of our study participants. We recommend that further longitudinal studies to yield more accurate results.

Factors Influencing Monkeypox Vaccination: A Cue to Policy Implementation

BACKGROUND

Following the mpox 2022 outbreak, several high-income countries have developed plans with inclusion criteria for vaccination against the mpox disease. This study was carried out to map the factors influencing mpox vaccination uptake to help address the challenges and increase vaccination confidence.

METHODS

This was a study based on Tweet analysis. The VADER, Text Blob, and Flair analyzers were adopted for sentiment analysis. The "Levesque conceptual framework for healthcare access" was adopted to evaluate the factors impacting access and the decision to get mpox vaccination. Consolidated Criteria for Reporting Qualitative Research (COREQ) criteria were adopted.

FINDINGS

A total of 149,133 tweets were extracted between 01/05/2022 and 23/09/2022. Around 1% of the random tweets were used for qualitative analysis. Of the 149,113, tweets were classified as positive, negative and neutral, respectively, by (a) VADER: (55,040) 37.05%, (44,395) 29.89%, and (49,106) 33.06%, (b) TextBlob: (70,900) 47.73%, (22,729) 15.30%, and (54,921) 36.97%, and (c) Flair: (31,389) 21.13%, (117,152) 78.87%, and 0.00%. Sentiment trajectories revealed that communication, stigmatization, accessibility to and availability of vaccines, and concerns about vaccine safety as factors influencing decision-making in the content and flow of tweets.

INTERPRETATION

Twitter is a key surveillance tool for understanding factors influencing decisions and access to mpox vaccination. To address vaccine mistrust and disinformation, a social media-based risk communication plan must be devised. Adopting measures to remove logistical vaccination hurdles is needed. Obtaining fact-based information from credible sources is key to improving public confidence.

Mpox Perceptions and Vaccine Advocacy among the Healthcare Workers of Solid Organ Transplant Centers: A Multicenter, Cross-Sectional Survey in Saudi Arabia

BACKGROUND

In response to the global Mpox outbreaks, this survey aimed to assess the knowledge, perceptions, and advocacy of Mpox vaccines among solid organ transplant healthcare workers (HCWs) in Saudi Arabia.

METHODS

A cross-sectional survey was conducted among solid organ transplant HCWs in Saudi Arabia from 15 August to 5 September 2022. A total of 199 responses were received from participants primarily working in the kidney (54.8%) and liver (14.6%) transplant units.

RESULTS

The survey found that most participants were aware of the 2022 Mpox outbreak, but the majority were more concerned about COVID-19 than Mpox. While the majority of participants thought laboratory personnel and HCWs in direct contact with Mpox patients should receive the vaccine, less than 60% believed that all HCWs should be vaccinated. Additionally, over half of the participants lacked knowledge of animal-human transmission of the virus.

CONCLUSION

The results highlight the need for increased education on Mpox among transplant HCWs in Saudi Arabia, particularly regarding the virus's transmission dynamics and vaccines. This education is crucial to improve HCWs' understanding of this emerging disease, especially given their vulnerability during the COVID-19 pandemic.

Public awareness, specific knowledge, and worry about mpox (monkeypox): A preliminary community-based study in Shenzhen, China

Background

The mpox (monkeypox) outbreak has been declared to be a public health emergency of international concern by the Director-General of World Health Organization in July 2022. However, evidence regarding the awareness, knowledge, and worry about mpox in the general population remains scant.

Methods

A community-based survey targeting community residents was preliminarily conducted in Shenzhen, China in August 2022 by using a convenience sampling method. Information on mpox-related awareness, knowledge, and worry was collected from each participant. Binary logistic regression analyses with the stepwise procedure were applied to explore the factors associated with awareness, knowledge, and worry about mpox.

Results

A total of 1028 community residents were included in the analysis (mean age: 34.70 years). Among these participants, 77.9% had ever heard of mpox, and 65.3% were aware of the global outbreak of mpox. However, only about half of them had a high level of knowledge regarding mpox (56.5%) and related symptoms (49.7%). More than one-third of them (37.1%) expressed a high level of worry about mpox. Having high knowledge levels of mpox and related symptoms were positively associated with a high level of worry (OR: 1.79, 95%CI: 1.22~2.63 for a single high knowledge level; OR: 1.98, 95%CI: 1.47~2.66 for both high knowledge levels).

Conclusions

This study identified the gaps in public awareness and specific knowledge of mpox in Chinese people, providing scientific evidence for the prevention and control network of mpox at the community level. Targeted health education programs are of urgent need, which should be implemented along with psychological interventions to release public worry if necessary.

Knowledge, Attitude and Conspiracy Beliefs of Healthcare Workers in Lebanon towards Monkeypox

The emergence of a monkeypox (MPOX) outbreak in 2022 represented the most recent recognizable public health emergency at a global level. Improving knowledge and attitude towards MPOX, particularly among healthcare workers (HCWs), can be a valuable approach in public health preventive efforts aiming to halt MPOX virus spread. The aim of the current study was to evaluate the knowledge and attitude of HCWs in Lebanon towards MPOX and to assess their conspiratorial attitude towards emerging virus infections (EVIs). The current study was based on a cross-sectional online survey distributed via Google Forms during September-December 2022 implementing a convenience sampling approach. The final study sample comprised a total of 646 HCWs: physicians (n = 171, 26.5%), pharmacists (n = 283, 43.8%), and nurses (n = 168, 26.0%), among others (n = 24, 3.7%). Variable defects in MPOX knowledge were detected, with a third of the participants having MPOX knowledge above the 75th percentile (n = 218, 33.7%). Satisfactory attitude towards MPOX (>75th percentile) was observed in less than a third of the participants (n = 198, 30.7%), while a quarter of the study sample endorsed conspiracy beliefs towards EVIs at a high level (>75th percentile, n = 164, 25.4%). Slightly more than two thirds of the participants agreed that MPOX vaccination should be used in disease prevention (n = 440, 68.1%). Better levels of MPOX knowledge and attitude were significantly associated with postgraduate education and older age. Physicians had significantly higher MPOX knowledge compared to other occupational categories. Less endorsement of conspiracies towards EVIs was significantly associated with male sex, occupation as a physician, and postgraduate education. Higher MPOX knowledge was associated with better attitude towards the disease. The current study showed unsatisfactory MPOX knowledge among Lebanese HCWs. Educational efforts can be valuable to improve the attitude towards the disease. Despite the relatively low level of embracing conspiracy beliefs regarding EVIs among HCWs in this study compared to previous studies, this area should be considered based on its potential impact on health-seeking behavior.

Monkeypox (MPOX)-Related Knowledge and Vaccination Hesitancy in Non-Endemic Countries: Concise Literature Review

In May 2022, the world witnessed the emergence of human monkeypox (MPOX), a new zoonotic viral disease in multiple non-endemic countries. This health threat has been associated with increased anxiety, especially after the COVID-19 catastrophe. In addition, people are exposed to an unprecedented amount of information, making them vulnerable to misinformation that may lead to embracing conspiracy theories. This literature review was conducted to evaluate the levels of MPOX-related knowledge and attitudes toward its vaccination by reviewing studies indexed in MEDLINE^® until 15 November 2022. A total of 16 studies conducted in non-endemic countries were included in this review, predominantly in Europe, the Middle East, and Asia. Nine studies investigated exclusively MPOX-related knowledge and awareness, and two studies were exclusively related to MPOX vaccines, while five studies dealt with both topics. The target populations were mainly healthcare professionals and the general adult population. The results revealed an unsatisfactory level of knowledge and awareness among certain groups. Regarding vaccination, the results showed that vaccine hesitancy is still common for healthcare professionals except among Chinese healthcare professionals, where the rate of vaccine acceptance was estimated at 90.1%. This review could help understand the MPOX-related knowledge and awareness and vaccine hesitancy in the first months of the emergence of the MPOX by comparing their evolution in recent studies.

Monkeypox Cross-Sectional Survey of Knowledge, Attitudes, Practices, and Willingness to Vaccinate among University Students in Pakistan

This study aimed to explore knowledge, attitude, perceptions, and willingness regarding vaccination among university students in Pakistan. This cross-sectional study was carried out using an open online self-administered survey via Google Forms. The survey data were collected between the 15 to 30 of October 2022. A total of 946 respondents participated in the study, of which the majority were female (514, 54.3%). Most students belonged to a medical background, specifically pharmaceutical sciences. Most of the respondents did not know about monkeypox before 2022 (646, 68.3%). Regarding overall knowledge of monkeypox, most of the respondents had average knowledge (726, 76.7%), with very few having good knowledge (60, 6.3%). Regarding overall attitudes towards monkeypox, most of the respondents had neutral attitudes (648, 68.5%). There was a significant association between knowledge of Monkeypox with the type of academic degree (p < 0.001), type of discipline (p < 0.001), and region of respondents (p < 0.001). The willingness to vaccinate among the population was (67.7%). The current study pointed out that the overall knowledge of monkeypox was average in most respondents, with considerable knowledge gaps in most aspects. The overall attitude towards monkeypox was neutral. Further, the knowledge about monkeypox was strongly associated with academic degree, study discipline, and region of respondents. Our findings emphasize the need to raise public awareness by educating students on the monkeypox virus. This will improve adherence to preventative recommendations.

Conspiratorial Attitude of the General Public in Jordan towards Emerging Virus Infections: A Cross-Sectional Study Amid the 2022 Monkeypox Outbreak

Conspiracy theories accompany the emergence of infectious diseases and the 2022 multi-country monkeypox (MPX) outbreak is no exception. It is possible that the adoption of conspiracy beliefs negatively impacts health behavior. We aimed to assess the prevalence of conspiratorial attitudes towards emerging virus infections (EVIs) and the response measures aiming to control these infections among the general public in Jordan. In addition, we assessed MPX knowledge and the belief in the role of men who have sex with men (MSM) in virus spread. The online survey data were collected during 24 May 2022-28 June 2022. The survey instrument was based on previously published scales designed to measure MPX knowledge and EVI conspiracies. A total of 611 respondents formed the final study sample, with a mean age of 44 years and a majority of females (n = 433, 70.9%). On a scale ranging from -10 to +10, the median MPX knowledge score in the study sample was +3 (interquartile range: +1 to +5). Educational level was a determinant of MPX knowledge in multivariate analysis. More than 50% of the participants agreed at least to some extent with 9 out of 12 of the EVI conspiracy items. Multivariate analysis showed that embracing conspiracy beliefs about EVIs was associated with being female, and agreeing with or having no opinion regarding the role of MSM in MPX spread. The current study revealed the high prevalence of belief in conspiracies surrounding EVIs, and its accompanying intervention measures, among the general public in Jordan. In addition, a lower level of MPX knowledge was observed compared to previous studies among university students and health professionals in the country. We recommend evaluating the impact of the widely prevalent conspiracy beliefs on health aspects in future studies. This aim is particularly relevant in the Middle Eastern countries where embracing specific conspiracy ideas is a common occurrence.