{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T09:05:21Z","timestamp":1784019921059,"version":"3.55.0"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Human T-cell lymphotropic virus type 1 (HTLV-1) is an oncogenic retrovirus that infects an estimated 5\u201310 million people worldwide. In Gabon, despite a high seroprevalence (7.3\u20138.7%), documented cases of associated pathologies remain rare, suggesting significant underdiagnosis driven by a lack of clinical awareness. This study evaluated the knowledge, attitudes, and practices (KAP) concerning HTLV-1 among Gabonese healthcare professionals. Methods: A descriptive cross-sectional study was conducted among 392 healthcare professionals across four provinces in Gabon using a standardized questionnaire. Bivariate comparisons were performed using chi-square (\u03c72) and Mann\u2013Whitney U tests, followed by multivariable binary logistic regression to identify independent predictors of HTLV-1 awareness. Results: Overall, 79.9% of the participants had never heard of HTLV-1. Awareness of the virus was critically low among nursing and obstetric staff (7.2%), whereas physicians demonstrated the highest level of knowledge (57.1%). In the multivariable analysis, independent predictors of higher HTLV-1 awareness included being male (aOR = 2.93; 95% CI: 1.60\u20135.39; p &lt; 0.001), holding a university degree (aOR = 3.43; 95% CI: 1.66\u20136.89; p &lt; 0.001), and working as a physician (aOR = 2.75; 95% CI: 1.24\u20136.10; p = 0.013). Conclusions: A critical HTLV-1 knowledge deficit exists among healthcare professionals in Gabon, particularly among frontline nursing staff, which likely explains the low reporting of associated diseases. Integrating HTLV-1 into medical and paramedical curricula, launching targeted educational campaigns, and implementing national screening protocols are urgently required to improve diagnosis and prevent transmission.<\/jats:p>","DOI":"10.3390\/diseases14070253","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:04:31Z","timestamp":1784016271000},"page":"253","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Critical Assessment of Knowledge, Attitudes, and Practices (KAP) Concerning HTLV-1 Infection Among Healthcare Professionals in Gabon"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6500-6958","authenticated-orcid":false,"given":"Hanneke Fanhole","family":"Moussonda-Mouele","sequence":"first","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldridge Fedricksen","family":"Oloumbou","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otniel","family":"Adjala-Ond\u00e9m\u00e9","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5832-0750","authenticated-orcid":false,"given":"Jeordy Dimitri","family":"Engone-Ondo","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christ Eddy","family":"Ognari-Ayoumi","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moussa","family":"Yaro","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roseanne","family":"Mounanga-Mourimarodi","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krist","family":"Makosso","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan Sosth\u00e8ne","family":"Mfouo-Tynga","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3143-1060","authenticated-orcid":false,"given":"Augustin","family":"Mouinga-Ond\u00e9m\u00e9","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Infections R\u00e9trovirales et Pathologies Associ\u00e9es, Centre Interdisciplinaire de Recherches M\u00e9dicales de Franceville (CIRMF), Franceville BP 769, Gabon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","article-title":"Detection and Isolation of Type C Retrovirus Particles from Fresh and Cultured Lymphocytes of a Patient with Cutaneous T-Cell Lymphoma","volume":"77","author":"Poiesz","year":"1980","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gessain, A., Ramassamy, J.-L., Afonso, P.V., and Cassar, O. (2023). Geographic Distribution, Clinical Epidemiology and Genetic Diversity of the Human Oncogenic Retrovirus HTLV-1 in Africa, the World\u2019s Largest Endemic Area. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1043600"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00042560-199606010-00013","article-title":"Mother-to-Child Transmission of Human T-Cell Lymphotropic Virus Types I and II (HTLV-I\/II) in Gabon: A Prospective Follow-up of 4 Years","volume":"12","author":"Nyambi","year":"1996","journal-title":"J. Acquir. Immune Defic. Syndr. Hum. Retrovirol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Nunes Da Silva, A., Ara\u00fajo, T.H.A., Boa-Sorte, N., Farias, G., Galv\u00e3o-Barroso, A.K., De Carvalho, A., Vicente, A.C., Galv\u00e3o-Castro, B., and Rios Grassi, M.F. (2023). Epidemiological and Molecular Evidence of Intrafamilial Transmission through Sexual and Vertical Routes in Bahia, the State with the Highest Prevalence of HTLV-1 in Brazil. PLoS Negl. Trop. Dis., 17.","DOI":"10.1371\/journal.pntd.0011005"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/trf.15838","article-title":"High Prevalence of Human T-cell Leukemia Virus Type-1b Genotype among Blood Donors in Gabon, Central Africa","volume":"60","author":"Ramassamy","year":"2020","journal-title":"Transfusion"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1093\/cid\/civ145","article-title":"A Severe Bite from a Nonhuman Primate Is a Major Risk Factor for HTLV-1 Infection in Hunters from Central Africa","volume":"60","author":"Filippone","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Gessain, A., and Cassar, O. (2012). Epidemiological Aspects and World Distribution of HTLV-1 Infection. Front. Microbiol., 3.","DOI":"10.3389\/fmicb.2012.00388"},{"key":"ref_8","unstructured":"World Health Organization (2021). Human T-Lymphotropic Virus Type 1: Technical Report, World Health Organization. [1st ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s11899-007-0035-x","article-title":"Adult T-Cell Leukemia\/Lymphoma and HTLV-1","volume":"2","author":"Mahieux","year":"2007","journal-title":"Curr. Hematol. Malig. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s13149-011-0174-4","article-title":"Le r\u00e9trovirus humain oncog\u00e8ne HTLV-1: \u00c9pid\u00e9miologie descriptive et mol\u00e9culaire, origine, \u00e9volution et aspects diagnostiques et maladies associ\u00e9es","volume":"104","author":"Gessain","year":"2011","journal-title":"Bull. Soc. Pathol. Exot."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1093\/tropej\/fmx039","article-title":"Early Onset of HTLV-1 Associated Myelopathy\/Tropical Spastic Paraparesis (HAM\/TSP) and Adult T-Cell Leukemia\/Lymphoma (ATL): Systematic Search and Review","volume":"64","author":"Oliveira","year":"2018","journal-title":"J. Trop. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/S0140-6736(89)91840-0","article-title":"HTLV-I Infection in Western Equatorial Africa","volume":"334","author":"Delaporte","year":"1989","journal-title":"Lancet"},{"key":"ref_13","first-page":"424","article-title":"Blood Transfusion as a Major Risk Factor for HTLV-I Infection among Hospitalized Children in Gabon (Equatorial Africa)","volume":"6","author":"Delaporte","year":"1993","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00042560-199812010-00018","article-title":"HIV-1, HTLV-I, and HTLV-II in a Semiurban Population in East Gabon","volume":"19","author":"Bertherat","year":"1998","journal-title":"J. Acquir. Immune Defic. Syndr. Hum. Retrovirol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1128\/jvi.71.2.1317-1333.1997","article-title":"Molecular Epidemiology of 58 New African Human T-Cell Leukemia Virus Type 1 (HTLV-1) Strains: Identification of a New and Distinct HTLV-1 Molecular Subtype in Central Africa and in Pygmies","volume":"71","author":"Mahieux","year":"1997","journal-title":"J. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1089\/aid.2005.21.28","article-title":"New Insights in HTLV-I Phylogeny by Sequencing and Analyzing the Entire Envelope Gene","volume":"21","author":"Capdepont","year":"2005","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/ijc.2910530110","article-title":"Non-hodgkin Lymphoma in Gabon and Its Relation to HTLV-I","volume":"53","author":"Delaporte","year":"1993","journal-title":"Int. J. Cancer"},{"key":"ref_18","first-page":"66","article-title":"Mycosis fungoides in a Gabonese patient infected with HTLV-I","volume":"56","author":"Perret","year":"1996","journal-title":"Med. Trop."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3607","DOI":"10.1128\/JCM.01249-08","article-title":"New Insights into Prevalence, Genetic Diversity, and Proviral Load of Human T-Cell Leukemia Virus Types 1 and 2 in Pregnant Women in Gabon in Equatorial Central Africa","volume":"46","author":"Etenna","year":"2008","journal-title":"J. Clin. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Caron, M., Besson, G., Padilla, C., Makuwa, M., Nkoghe, D., Leroy, E., and Kazanji, M. (2018). Revisiting Human T-Cell Lymphotropic Virus Types 1 and 2 Infections among Rural Population in Gabon, Central Africa Thirty Years after the First Analysis. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006833"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Djuicy, D.D., Mouinga-Ond\u00e9m\u00e9, A., Cassar, O., Ramassamy, J.-L., Idam Mamimandjiami, A., Bikangui, R., Fontanet, A., and Gessain, A. (2018). Risk Factors for HTLV-1 Infection in Central Africa: A Rural Population-Based Survey in Gabon. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006832"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mouinga-Ond\u00e9m\u00e9, A., Boundenga, L., Koumba Koumba, I.P., Idam Mamimandjiami, A., Dian\u00e9, A., Engone-Ondo, J.D., Djuicy, D.D., Sica, J., Mombo, L.E., and Gessain, A. (2022). Human T-Lymphotropic Virus Type 1 and Human Immunodeficiency Virus Co-Infection in Rural Gabon. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0271320"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Oloumbou, E.F., Ledaga Lentombo, L., Obame-Nkoghe, J., Iba-Ba, J., Engone Ondo, J.D., Ognari Ayoumi, C., Yaro, M., Dian\u00e9, A., Kouna Ndouongo, P., and Boguikouma, J.-B. (2025). Clinical and Molecular Evidences of HTLV-1 Infection in Inpatients Diagnosed with Diseases Previously Described as Associated to This Infection: A Case Series in Gabon, Central Africa. PLoS Negl. Trop. Dis., 19.","DOI":"10.1371\/journal.pntd.0013075"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2171185","DOI":"10.1080\/21645515.2023.2171185","article-title":"COVID-19 Vaccination Hesitancy among Italian Parents: A Systematic Review and Meta-Analysis","volume":"19","author":"Bianchi","year":"2023","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2450858","DOI":"10.1080\/21645515.2025.2450858","article-title":"Influenza Vaccination Hesitancy and Related Factors among Pregnant and Breastfeeding Women: A Cross-Sectional Study","volume":"21","author":"Comparcini","year":"2025","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"172","DOI":"10.11604\/pamj.2018.31.172.16320","article-title":"Connaissances, Attitudes et Pratiques Des Femmes En \u00c2ge de Procr\u00e9er Du District de Sant\u00e9 de La Mifi Sur La Pr\u00e9vention Du Cancer Du Col de l\u2019ut\u00e9rus, Cameroun","volume":"31","author":"Dakenyo","year":"2018","journal-title":"Pan Afr. Med. J."},{"key":"ref_27","first-page":"35","article-title":"HTLV-1 Related Knowledge, Attitude and Behaviour Patterns among Mothers Who Participated in the Jamaica Breastfeeding Intervention Study (1996\u20132000)","volume":"59","author":"Cooper","year":"2010","journal-title":"West. Indian. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1258\/ijsa.2009.009447","article-title":"Knowledge and Attitudes of Physicians in Private Practice towards HIV\/AIDS in Mashhad, Iran","volume":"23","author":"Marjaneh","year":"2012","journal-title":"Int. J. STD AIDS"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1080\/21645515.2019.1638727","article-title":"Knowledge, Practice and Attitude towards HPV Vaccination among College Students in Beijing, China","volume":"16","author":"Liu","year":"2020","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e70234","DOI":"10.1002\/hem3.70234","article-title":"Strengthening Awareness and Response to HTLV-1 Infection in Africa: A Neglected Threat to Blood Safety and Public Health","volume":"9","author":"Twizere","year":"2025","journal-title":"HemaSphere"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Oloumbou, E.F., Engone-Ondo, J.D., Mamimandjiami Idam, I., Moussavou-Boudzanga, P., Mfouo-Tynga, I., and Mouinga-Ondeme, A. (2022). Human T-Cell Leukemia Virus Type 1-Related Diseases May Constitute a Threat to the Elimination of Human Immunodeficiency Virus, by 2030, in Gabon, Central Africa. Viruses, 14.","DOI":"10.3390\/v14122808"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e6093","DOI":"10.55905\/cuadv16n10-162","article-title":"Human T-Cell Lymphotropic Virus: Knowledge of Academics from a Higher Education Institution","volume":"16","author":"Jesus","year":"2024","journal-title":"Cuad. Ed. Desar."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/phn.70051","article-title":"Healthcare Providers\u2019 Insights Into Human T-Cell Lymphotropic Virus Type 1: A Descriptive Cross-Sectional Analysis of Knowledge and Practice Gaps","volume":"43","author":"Salimi","year":"2026","journal-title":"Public Health Nurs."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e069316","DOI":"10.1136\/bmjopen-2022-069316","article-title":"Vaccine Coverage for Recommended Vaccines among Splenectomised Patients in Apulia, South Italy: A Retrospective Cohort Study","volume":"13","author":"Bianchi","year":"2023","journal-title":"BMJ Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1111\/bjh.18731","article-title":"Burden of COVID-19 Disease and Vaccine Coverages in Apulian Splenectomized Patients: A Retrospective Observational Study","volume":"201","author":"Bianchi","year":"2023","journal-title":"Br. J. Haematol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4057","DOI":"10.1016\/j.vaccine.2023.04.047","article-title":"Prevalence of Poliovirus Neutralizing Antibodies in Italian Population: A Systematic Review and Meta-Analysis","volume":"41","author":"Tafuri","year":"2023","journal-title":"Vaccine"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Itabashi, K., Miyazawa, T., Sekizawa, A., Tokita, A., Saito, S., Moriuchi, H., Nerome, Y., Uchimaru, K., and Watanabe, T. (2020). A Nationwide Antenatal Human T-Cell Leukemia Virus Type-1 Antibody Screening in Japan. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.00595"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Itabashi, K., and Miyazawa, T. (2021). Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention. Cancers, 13.","DOI":"10.3390\/cancers13164100"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"102683","DOI":"10.1016\/j.ijedudev.2022.102683","article-title":"Educational Gender Gap in Sub-Saharan Africa: Does the Estimation Method Matter? A Comparison Using a Sample of Opposite Sex Twins","volume":"95","author":"Delprato","year":"2022","journal-title":"Int. J. Educ. Dev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e71860","DOI":"10.1002\/hsr2.71860","article-title":"Assessment of Awareness and Knowledge Regarding Human T-Lymphotropic Virus Type 1 (HTLV-1) Among Healthcare Workers at Imam Khomeini Hospital Complex, Tehran, in 2023\u20132024, A Cross-Sectional Descriptive-Analytical Study","volume":"9","author":"Letafati","year":"2026","journal-title":"Health Sci. Rep."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/7\/253\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:20:14Z","timestamp":1784017214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/7\/253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["diseases14070253"],"URL":"https:\/\/doi.org\/10.3390\/diseases14070253","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]}}}