{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:57:09Z","timestamp":1787021829592,"version":"build-2736575974"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013977","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000}}],"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n Mpox remains a public health emergency of international concern, especially in regions beyond its usual endemic areas in Africa. Assessing healthcare workers good knowledge and positive attitudes is essential for effective prevention and control efforts. This systematic review and meta-analysis aim to determine the pooled good knowledge and positive attitudes toward mpox among healthcare workers in Sub-Saharan Africa after the 2022 outbreak.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We searched major databases for relevant studies published up to June 25, 2025. Studies reporting knowledge and\/or attitudes toward mpox were included. Study quality was assessed using a standardized appraisal tool, and heterogeneity was assessed using the\n I<\/jats:italic>\n \n 2<\/jats:italic>\n <\/jats:sup>\n statistic. Data were extracted using a standardized protocol, and a random-effects model was used to calculate pooled prevalence estimates with 95% confidence intervals.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The meta-analysis included sixteen and eight studies in knowledge and attitude analyses, respectively, to estimate the pooled prevalence. The pooled prevalence of good knowledge and positive attitudes toward monkeypox was 45.3% (95% CI: 36.8, 53.9) and 53.8% (95% CI: 43.0, 64.7), respectively. Significant heterogeneity was observed across studies; however, both statistical tests (Egger\u2019s test, p\u2009=\u20090.14; Begg\u2019s test, p\u2009=\u20090.19) indicated no significant publication bias.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The good knowledge and positive attitudes of healthcare workers toward mpox were low and unsatisfactory in sub-Saharan Africa. The review result underscores the need for targeted interventions to improve healthcare providers\u2019 understanding of mpox transmission, prevention, and management. Targeted educational programs and training are needed to improve the preparedness of healthcare workers for mpox outbreaks and other emerging diseases.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013977","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:39:01Z","timestamp":1770662341000},"page":"e0013977","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mpox knowledge and positive attitudes in Sub-Saharan African healthcare workers after 2022 outbreak of disease: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9852-9871","authenticated-orcid":true,"given":"Melaku","family":"Laikemariam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemayehu Molla","family":"Wollie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amare Mebrat","family":"Delie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebe","family":"Yenesew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abateneh","family":"Melkamu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habtamu","family":"Ayele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihalem","family":"Abeje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"pntd.0013977.ref001","volume-title":"Monkeypox Technical Factsheet","author":"African Union, Centres for Disease Control and Prevention","year":"2022"},{"key":"pntd.0013977.ref002","article-title":"Monkeypox Outbreak Reflecting Rising Search Trend and Concern in Nonendemic Countries: A Google Trend Analysis","volume":"17","author":"M Jokar","year":"2022","journal-title":"Disaster Med Public Health Prep"},{"key":"pntd.0013977.ref003","article-title":"Human monkeypox: an emerging zoonosis","author":"DB Di Giulio","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"pntd.0013977.ref004","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00705-022-05677-3","article-title":"The changing epidemiology of monkeypox and preventive measures: an update","volume":"168","author":"S Sabeena","year":"2023","journal-title":"Arch Virol"},{"key":"pntd.0013977.ref005","volume-title":"First meeting of the International Health Regulations (2005) emergency committee","author":"World Health Organization WHO","year":"2024"},{"issue":"1","key":"pntd.0013977.ref006","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s41182-024-00678-1","article-title":"Understanding the resurgence of mpox: key drivers and lessons from recent outbreaks in Africa","volume":"53","author":"A Akingbola","year":"2025","journal-title":"Trop Med Health"},{"key":"pntd.0013977.ref007","volume-title":"Multi\u2010country outbreak of mpox, external situation report 33\u201031 May 2024","author":"World Health Organization WHO","year":"2024"},{"key":"pntd.0013977.ref008","volume-title":"Vaccines and immunization for monkeypox: interim guidance","author":"World Health Organization WHO","year":"2022"},{"key":"pntd.0013977.ref009","volume-title":"Mpox multi-country external situation report no.53","author":"World Health Organization WHO","year":"2025"},{"issue":"4","key":"pntd.0013977.ref010","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/inthealth\/iht029","article-title":"Enhancing health care worker ability to detect and care for patients with monkeypox in the Democratic Republic of the Congo","volume":"5","author":"J Bass","year":"2013","journal-title":"Int Health"},{"key":"pntd.0013977.ref011","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3389\/fpubh.2018.00241","article-title":"Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans","volume":"6","author":"N Sklenovsk\u00e1","year":"2018","journal-title":"Front Public Health"},{"issue":"1","key":"pntd.0013977.ref012","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1186\/s12884-023-05560-2","article-title":"Global knowledge, attitude, and practice towards COVID-19 among pregnant women: a systematic review and meta-analysis","volume":"23","author":"AS Jahromi","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"issue":"9","key":"pntd.0013977.ref013","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1080\/10410236.2017.1331305","article-title":"Starting Off on the Best Foot: A Review of Message Framing and Message Tailoring, and Recommendations for the Comprehensive Messaging Strategy for Sustained Behavior Change","volume":"33","author":"JP Pope","year":"2018","journal-title":"Health Commun"},{"issue":"5","key":"pntd.0013977.ref014","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1093\/inthealth\/ihad094","article-title":"Global knowledge and attitudes towards mpox (monkeypox) among healthcare workers: a systematic review and meta-analysis","volume":"16","author":"AS Jahromi","year":"2024","journal-title":"Int Health"},{"issue":"8","key":"pntd.0013977.ref015","article-title":"Knowledge and attitude towards mpox: Systematic review and meta-analysis","volume":"19","author":"DA Le\u00f3n-Figueroa","year":"2024","journal-title":"PLoS One"},{"issue":"2","key":"pntd.0013977.ref016","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3390\/idr16020013","article-title":"Assessment of Monkeypox (MPOX) Knowledge and Vaccination Intention among Health and Life Sciences Students in Algeria: A Cross-Sectional Study","volume":"16","author":"M Lounis","year":"2024","journal-title":"Infect Dis Rep"},{"issue":"1","key":"pntd.0013977.ref017","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3390\/vaccines11010019","article-title":"Knowledge and Attitudes of Turkish Physicians towards Human Monkeypox Disease and Related Vaccination: A Cross-Sectional Study","volume":"11","author":"TK Sahin","year":"2022","journal-title":"Vaccines (Basel)"},{"issue":"1","key":"pntd.0013977.ref018","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"10","author":"MJ Page","year":"2021","journal-title":"Syst Rev"},{"key":"pntd.0013977.ref019","volume-title":"Checklist for Critical Appraisal Tools for Use in JBI Systematic Reviews","author":"JBI Manual for Evidence Synthesis","year":"2020"},{"issue":"7","key":"pntd.0013977.ref020","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-080791","article-title":"Assessing healthcare workers\u2019 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","volume":"14","author":"AG Yeshiwas","year":"2024","journal-title":"BMJ Open"},{"key":"pntd.0013977.ref021","first-page":"2390","article-title":"Knowledge, attitude and associated factors of monkeypox infection among healthcare workers in Injibara General Hospital, Northwest Ethiopia","author":"ZB Aynalem","year":"2025","journal-title":"J Multidiscip Healthc"},{"key":"pntd.0013977.ref022","article-title":"Assessment of healthcare workers knowledge and attitudes towards Mpox infection at University of Gondar Comprehensive Specialized Referral Hospital","volume":"10","author":"AT Beyna","year":"2025","journal-title":"Front Public Heal"},{"key":"pntd.0013977.ref023","first-page":"1","article-title":"Improving control of the Mpox outbreak: a national cross-sectional study on the knowledge, attitudes, and influencing factors among frontline healthcare professionals in Ethiopia","author":"G Fetensa","year":"2025","journal-title":"Front Public Heal"},{"key":"pntd.0013977.ref024","first-page":"1","article-title":"Assessment of knowledge, attitude, and associated factors of mpox among healthcare professionals at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia","author":"T Kiros","year":"2025","journal-title":"Heal Sci Reports Orig"},{"issue":"5","key":"pntd.0013977.ref025","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.4269\/ajtmh.24-0247","article-title":"Knowledge of Human Monkeypox Virus Infection among Healthcare Providers and Associated Factors in Addis Ababa, Ethiopia","volume":"111","author":"SG Bekele","year":"2024","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0013977.ref026","article-title":"Knowledge, perception and safety practices of monkeypox infection among healthcare workers in a tertiary health facility in southwest Nigeria","author":"AK Abdulmumin","year":"2023","journal-title":"Int J Community Med Public Heal"},{"issue":"1","key":"pntd.0013977.ref027","doi-asserted-by":"crossref","first-page":"15","DOI":"10.61386\/imj.v17i1.371","article-title":"Knowledge and preventive practices related to Monkey pox among medical doctors in Sokoto metropolis of Sokoto State, Nigeria","volume":"17","author":"OM Oche","year":"2024","journal-title":"Ibom Med J"},{"issue":"1","key":"pntd.0013977.ref028","doi-asserted-by":"crossref","first-page":"27604","DOI":"10.1038\/s41598-024-79396-x","article-title":"Assessment of knowledge and attitude of healthcare professionals towards Mpox in a Nigerian hospital","volume":"14","author":"E Orok","year":"2024","journal-title":"Sci Rep"},{"issue":"6","key":"pntd.0013977.ref029","doi-asserted-by":"crossref","first-page":"245","DOI":"10.4103\/1995-7645.378566","article-title":"Knowledge and awareness of human mpox infection among healthcare workers","volume":"16","author":"PO Ajayi","year":"2023","journal-title":"Asian Pacific Journal of Tropical Medicine"},{"key":"pntd.0013977.ref030","first-page":"1","article-title":"Assessment of the knowledge of healthcare workers on monkeypox in Nigeria Bewertung der Kenntnisse des Gesundheitspersonals \u00fcber Affenpocken","volume":"19","author":"UE Eze","year":"2024","journal-title":"GMS Hyg Infect Control"},{"issue":"1","key":"pntd.0013977.ref031","first-page":"29","article-title":"Assessing medical doctors\u2019 knowledge and their confidence in spot diagnosing monkeypox in","volume":"1","author":"AA Iwuafor","year":"2023","journal-title":"Covenant J Heal LIFE Sci"},{"issue":"1","key":"pntd.0013977.ref032","doi-asserted-by":"crossref","first-page":"99884","DOI":"10.12998\/wjcc.v13.i1.99884","article-title":"Assessing healthcare workers\u2019 knowledge and confidence in the diagnosis, management and prevention of Monkeypox","volume":"13","author":"E Ntawuyamara","year":"2025","journal-title":"World J Clin Cases"},{"issue":"2","key":"pntd.0013977.ref033","article-title":"Mpox knowledge, vaccine attitudes, and vaccine concerns among healthcare workers, Kampala Metropolitan Area","volume":"10","author":"NO Namakula","year":"2025","journal-title":"Uganda Public Heal Bull"},{"issue":"1","key":"pntd.0013977.ref034","first-page":"1","article-title":"Knowledge attitude and practices toward mpox among healthcare workers in Kasese and Mayuge districts, Uganda","volume":"10","author":"KO Joyce","year":"2025","journal-title":"Uganda Public Heal Bull"},{"key":"pntd.0013977.ref035","doi-asserted-by":"crossref","first-page":"1288139","DOI":"10.3389\/fpubh.2024.1288139","article-title":"Current knowledge of human Mpox viral infection among healthcare workers in Cameroon calls for capacity-strengthening for pandemic preparedness","volume":"12","author":"AD Nka","year":"2024","journal-title":"Front Public Health"},{"issue":"4","key":"pntd.0013977.ref036","article-title":"Healthcare Providers\u2019 Knowledge, Attitude, and Practices Regarding Prevention of Mpox in Vietnam","volume":"14","author":"HTN Nguyen","year":"2024","journal-title":"Sage Open"},{"issue":"12","key":"pntd.0013977.ref037","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.3390\/vaccines10122099","article-title":"Knowledge and Attitude Regarding Monkeypox Virus among Physicians in Saudi Arabia: A Cross-Sectional Study","volume":"10","author":"NZ Alshahrani","year":"2022","journal-title":"Vaccines (Basel)"},{"key":"pntd.0013977.ref038","doi-asserted-by":"crossref","first-page":"1339352","DOI":"10.3389\/fcimb.2024.1339352","article-title":"Grasping knowledge, attitude, and perception towards monkeypox among healthcare workers and medical students: an Egyptian cross-sectional study","volume":"14","author":"FA Amer","year":"2024","journal-title":"Front Cell Infect Microbiol"},{"key":"pntd.0013977.ref039","first-page":"1","article-title":"Socio-demographic determinants of the knowledge and attitude of Nepalese healthcare workers toward human monkeypox: a cross-sectional study","author":"AJ Rodriguez-morales","year":"2023","journal-title":"Front Public Heal"},{"key":"pntd.0013977.ref040","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12889-024-17741-5","article-title":"Sources of information on monkeypox virus infection. A systematic review with meta-analysis","volume":"24","author":"DA Leo\u00b4n-Figueroa","year":"2024","journal-title":"BMC Public Health"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013977","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013977","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T18:57:14Z","timestamp":1770922634000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013977"}},"subtitle":[],"editor":[{"given":"Elvina","family":"Viennet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013977","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}