Mpox knowledge and positive attitudes in Sub-Saharan African healthcare workers after 2022 outbreak of disease: A systematic review and meta-analysis

Abstract

BACKGROUND: 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. METHODS: 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 I2 statistic. Data were extracted using a standardized protocol, and a random-effects model was used to calculate pooled prevalence estimates with 95% confidence intervals. RESULTS: 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's test, p = 0.14; Begg's test, p = 0.19) indicated no significant publication bias. CONCLUSION: 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' 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.