Awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Nigeria: a cross-sectional study

Awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Nigeria: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Nigeria: a cross-sectional study Daniel Chikaodiri Ogudu, Luke Oche Peter, Babatunde Ishola Omotowo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9130713/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Mpox remains an emerging public health threat, particularly in endemic regions like Nigeria. Health workers play a critical role in outbreak detection and response. This study assessed awareness, risk perception, and preparedness for mpox outbreaks among health workers in Abakaliki, Nigeria. Methods A descriptive cross-sectional study was conducted among 258 health workers at Alex Ekwueme Federal University Teaching Hospital and the National Obstetric Fistula Centre, Abakaliki. Data were collected using a structured self-administered questionnaire and analyzed with IBM SPSS Statistics v20. Descriptive statistics summarized key variables, while chi-square tests and ordinal logistic regression identified predictors of preparedness at p<.05. Results Awareness of mpox was very high (98.1%), though only 20.5% of respondents reported being very familiar with its symptoms. Most participants perceived mpox as a significant public health threat (88.4%). However, preparedness level was very low as only 4.7% were highly prepared for an outbreak. Only 8.9% of respondents reported facility-provided training and 14.0% reported established protocols for mpox management. Years of experience and department of work were predictors of preparedness. Health workers with 11–15 years of experience were significantly more likely to report higher preparedness (AOR = 13.6, 95% CI: 1.42–129.3, p = 0.024). Conclusion Despite very high awareness and substantial concern about mpox among health workers, this awareness did not translate into adequate preparedness. Strengthening structured training programs, improving access to guidelines and resources, and establishing clear facility-level preparedness strategies are essential to enhance health workers’ readiness for future mpox outbreaks. Clinical trial number: not applicable Mpox outbreak monkeypox zoonotic disease emerging and re-emerging disease awareness risk perception preparedness outbreak readiness public health response 1. Background Mpox (formerly Monkeypox) is a viral zoonotic disease caused by the monkeypox virus (MPXV). It is a member of the Orthopoxvirus genus in the Poxviridae family, which also includes variola, cowpox, and vaccinia viruses [ 1 ]. The disease typically presents with fever, lymphadenopathy, headache, myalgia, and a characteristic rash, with most infections being self-limiting but occasionally progressing to severe illness [ 2 ]. Transmission occurs through close contact with infected individuals via skin lesions, bodily fluids, respiratory droplets, or contaminated materials, and through spillover from infected animals in endemic regions of Central and West Africa [ 3 , 4 ]. Historically confined largely to parts of Africa, mpox has increasingly attracted global attention due to its expanding geographic distribution and rising case numbers. Following the cessation of routine smallpox vaccination after eradication in 1980, population immunity against orthopoxviruses declined, contributing to the re-emergence of mpox in several African countries [ 5 ]. Nigeria experienced a notable resurgence beginning in 2017, with sustained transmission reported in multiple states. More recently, the 2022 multinational outbreak marked an unprecedented spread of mpox across Europe, the Americas, and other regions, with cases reported in over 120 countries and more than 100,000 confirmed infections globally by 2024 [ 4 ]. This evolving epidemiology highlights the growing potential for widespread outbreaks and underscores the need for strengthened surveillance and preparedness. Health workers play a critical role in the early detection, diagnosis, and management of emerging infectious diseases such as mpox. Their level of awareness, perception of risk, and preparedness to respond to suspected cases directly influence the effectiveness of outbreak control measures [ 6 ]. In resource-limited health systems, inadequate training, limited availability of personal protective equipment, and weak institutional protocols may hinder rapid response to emerging infections. Despite Nigeria’s experience with mpox outbreaks, empirical data on the readiness of frontline health workers to respond to potential mpox outbreaks remain limited, particularly in southeastern Nigeria. Therefore, this study assessed the awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Ebonyi State, Nigeria. This is essential for understanding the capacity of the local health system to respond effectively to a potential mpox outbreak. 2. Methods 2.1 Study area The study was conducted at the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and the National Obstetric Fistula Centre (NOFIC), Abakaliki, Ebonyi State, Nigeria. Ebonyi State is located in the southeastern region of Nigeria and has an estimated population of over three million people. The state serves as a major healthcare hub in the region that provide referral services to surrounding states. AEFUTHA and NOFIC are key tertiary institutions responsible for specialized clinical care, training of health professionals, and public health service delivery in the state. 2.2 Study design The study adopted a descriptive cross-sectional design using a quantitative approach. 2.3 Study population The study population comprised health workers, including medical doctors, nurses, laboratory scientists, pharmacists, and public health officers working in the selected facilities. Participants were eligible if they were currently employed at the study sites, had at least six months of work experience, were aged 18 years or older, and provided informed consent to participate. Health workers on temporary contracts or internships, as well as individuals unable to participate due to cognitive or health-related limitations, were excluded from the study. 2.4 Sample size determination The minimum sample for the study was calculated using Fisher’s formula for single proportions in cross-sectional studies: $$n=\frac{{Z}^{2}p(1-p)}{{d}^{2}}$$ where n is the minimum required sample size, Z is the standard normal deviate corresponding to a 95% confidence level (1.96), p is the estimated proportion of health workers aware of mpox (0.89) based on a previous Nigerian study [ 7 ], and d is the margin of error set at 0.05. Substituting these values yielded a minimum sample size of approximately 150 participants. To account for a potential 10% non-response rate, the sample size was adjusted to 165. However, a total of 258 health workers ultimately participated in the study. 2.5 Sampling technique The study adopted a consecutive sampling technique. All health workers at the selected health facilities who met the inclusion criteria during the study period were invited to participate, and recruitment continued until the minimum sample size was exceeded. Participants were drawn from both facilities without restriction on cadre or department. 2.6 Instrument for data collection Data were collected using a structured, self-administered questionnaire comprising four sections: demographic characteristics, awareness of mpox, perceptions of mpox, and preparedness for mpox. To ensure clarity, relevance, and alignment with existing literature, the questionnaire underwent content validation by two experts in Epidemiology prior to administration. 2.8 Data management and analysis Completed questionnaires were coded and entered into IBM SPSS Statistics version 20. Data was checked for completeness and consistency prior to analysis. Descriptive statistics were used to summarize socio-demographic characteristics, awareness, risk perceptions, and preparedness indicators. A composite preparedness score was generated for each respondent based on responses to preparedness-related questions, including facility-provided training/resources, type of training received, self-reported confidence in managing suspected mpox cases, presence of facility protocols, familiarity with preventive measures, and availability of relevant equipment and resources. Each positive response was scored as 1, while negative or “not sure” responses were scored as 0, yielding a total score ranging from 0 to 29, with higher scores indicating better preparedness. The composite score was categorized into three levels: low preparedness (0–14 points), moderate preparedness (15–21 points), and high preparedness (22–29 points). Associations between categorical variables and preparedness levels were initially assessed using Chi-square tests. Variables with p < 0.2 in bivariate analysis were subsequently included in a multivariate ordinal logistic regression model to identify independent predictors of higher preparedness. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at p < 0.05. 3. Results 3.1 Demographic characteristics of respondents Table 1 shows the demographic characteristics of the health workers. Majority were aged 25–34 years (53.1%) with mean age of 31.1 ± 7.6 years. Females constituted nearly two-thirds of respondents (65.5%). The majority held a bachelor's degree (84.9%), and the largest professional group was medical laboratory scientists (41.9%), followed by nurses (29.8%) and doctors (13.2%). Most participants had less than five years of healthcare experience (63.6%), and the largest proportion were affiliated with laboratory services (41.9%) or other clinical departments (43.8%). Table 1 Demographic characteristics of respondents (n = 258) Variable Category Frequency (n) Percent (%) Age (years) Mean ± SD * 31.1 ± 7.6 18–24 46 17.8 25–34 137 53.1 35–44 60 23.3 ≥ 45 15 5.8 Gender Female 169 65.5 Male 89 34.5 Level of Education Diploma/Certificate 9 3.5 Bachelor's degree 219 84.9 Postgraduate degree 30 11.6 Professional Role Doctor 34 13.2 Medical Laboratory Scientist 108 41.9 Nurse 77 29.8 Pharmacist 20 7.8 Public Health Officer 6 2.3 Others 12 4.7 Years of Experience 15 years 13 5 Department Emergency Care 17 6.6 Infectious Diseases 4 1.6 Laboratory Services 108 41.9 Pediatrics 15 5.8 Others 113 43.8 *Standard deviation; Results are presented as frequencies and percentages. 3.2 Awareness of mpox Awareness of mpox was very high (Table 2 ), with 98.1% of health workers reporting they had heard of the disease. Social media (29.1%) and TV/radio (26.0%) were the most common sources of information, followed by colleagues/workplace interactions (22.9%). While most respondents (64.0%) were somewhat familiar with mpox symptoms, only 20.5% reported being very familiar, and 15.5% were not familiar at all. Table 2 Awareness of mpox among health workers (n = 258) Awareness Indicator Category Frequency (n) Percent (%) Have you heard about mpox? Yes 253 98.1 No 5 1.9 Source of first information Social media 75 29.1 TV/Radio 67 26 Colleagues/workplace 59 22.9 Scientific journals 26 10.1 Others 26 10.1 Familiarity with mpox symptoms Very familiar 53 20.5 Somewhat familiar 165 64 Not familiar at all 40 15.5 Results are presented as frequencies and percentages 3.3 Perceptions of mpox Results in Table 3 reveals that most respondents perceived mpox as a significant public health threat, with 88.4% indicating it poses a major risk in Nigeria. Nearly two-thirds (62.0%) believed the disease could cause widespread outbreaks if not properly managed, and a large majority (74.4%) expressed strong concern about occupational exposure. However, perceptions of the disease’s seriousness relative to other infections were mixed, with 43.4% rating it equally serious and 37.2% expressing uncertainty. Most respondents (69.0%) believed that public awareness of mpox in Nigeria is insufficient, while almost all supported vaccine availability for health workers, with 98.1% agreeing or strongly agreeing. Table 3 Perceptions of mpox among respondents (n = 258) Perception Question Response Option Frequency (n) Percent (%) Do you think mpox poses a significant public health risk in Nigeria? Yes 228 88.4 No 9 3.5 Not sure 15 5.8 Don’t know / No opinion 6 2.3 Compared to other infectious diseases (e.g., COVID-19, Ebola), how would you rate the seriousness of mpox? Equally serious 112 43.4 Less serious 29 11.2 More serious 19 7.4 Not serious at all 2 0.8 Don’t know / No opinion 96 37.2 Do you believe mpox can cause widespread outbreaks in Nigeria if not properly managed? Yes 160 62 No 2 0.8 Not sure 3 1.2 Don’t know / No opinion 93 36 How concerned are you about the possibility of contracting mpox while working in healthcare? Very concerned 192 74.4 Moderately concerned 49 19 Not concerned at all 10 3.9 Don’t know / No opinion 7 2.7 Do you think there is sufficient public awareness about mpox in Nigeria? No 178 69 Not sure 43 16.7 Yes 32 12.4 Don’t know / No opinion 5 1.9 Do you believe mpox vaccines should be made available to health workers in high-risk areas? Strongly agree 201 77.9 Agree 52 20.2 Strongly disagree 1 0.4 Don’t know / No opinion 4 1.6 Results are presented as frequencies and percentages 3.4 Preparedness for mpox outbreak Results from Table 4 reveals that only a small proportion reported that their healthcare facilities had provided mpox-related training or resources (8.9%), with very few having received in-person training (3.9%), online training (2.7%), or printed guidelines (0.8%). Similarly, only 14.0% indicated that their facility had established protocols for managing mpox outbreaks. However, more than half of the respondents (54.7%) expressed confidence in their ability to manage a suspected mpox case, and a large majority reported familiarity with key preventive measures such as isolation of infected patients (83.7%), use of personal protective equipment (PPE) (82.9%), disinfection of surfaces (71.7%), and quarantine of suspected cases (66.7%), although familiarity with mpox vaccination was comparatively lower (55.8%). Table 4 Institutional preparedness and familiarity with mpox prevention measures among health workers in Abakaliki (n = 258) Preparedness Indicator Frequency Percent (%) Healthcare facility has provided training/resources on mpox 23 8.9 Received in-person training on mpox 10 3.9 Received online training on mpox 7 2.7 Received printed guidelines 2 0.8 Confident in ability to manage suspected mpox case 141 54.7 Facility has protocols in place for mpox outbreaks 36 14.0 Familiar with isolation of infected patients 216 83.7 Familiar with use of PPE 214 82.9 Familiar with disinfection of surfaces 185 71.7 Familiar with quarantine of suspected cases 172 66.7 Familiar with mpox vaccination 144 55.8 Not familiar with any preventive measure 10 3.9 Results are presented as frequencies and percentages Table 5 shows the availability of resources to support mpox outbreak management. Basic infection prevention materials were relatively common, with handwashing stations (81.4%), personal protective equipment (79.8%), alcohol-based sanitizers (74.0%), and disinfectants (70.2%) reported by most respondents. Isolation wards were reported by just over half of respondents (55.8%), while ambulance services (50.8%) and waste disposal systems (48.8%) were reported by about half. In contrast, mpox-specific outbreak resources were limited: diagnostic kits (10.5%), vaccine stock (13.0%), antiviral medications (12.8%), treatment guidelines (15.8%), and training programs on mpox management (13.6%) were rarely reported. Coordination and communication infrastructure, including rapid response teams (20.2%) and reporting tools (32.9%), were also scarce. Table 5 Availability of equipment and resources for mpox outbreak management in health facilities (n = 258) Resource/Facility Available Frequency (n) Percent (%) Isolation wards/rooms 144 55.8 Personal protective equipment (gloves, masks, gowns) 206 79.8 Handwashing stations with soap and water 210 81.4 Alcohol-based hand sanitizers 191 74 Disinfectants for surface cleaning 181 70.2 Laboratory facilities for diagnostic testing 112 43.4 Mpox-specific diagnostic kits 26 10.5 Mpox vaccine stock 32 13 Antiviral medications for mpox treatment 33 12.8 Rapid response team or outbreak taskforce 52 20.2 Communication and reporting tools 85 32.9 Standard treatment guidelines/protocol for mpox 39 15.8 Training programs for health workers on mpox 35 13.6 Adequate waste disposal system 126 48.8 Ambulance services for patient transfer 131 50.8 Adequate electricity supply/backup generators 112 43.4 Cold chain storage for vaccines/specimens 68 26.4 Community awareness materials on mpox prevention 40 15.5 Emergency funds/budget for outbreak response 30 11.6 Responses are reported as frequencies and percentages Results in Table 6 reveals that most health workers (75.6%) demonstrated low preparedness for a potential mpox outbreak, while 19.8% had moderate preparedness, and only 4.7% were classified as highly prepared. The overall mean preparedness score was 11.1 ± 5.9. Table 6 Level of preparedness for mpox outbreak among health workers in Abakaliki (n = 258) Indicator Frequency Percent (%) Overall mean preparedness score ± SD * (range) 11.1 ± 5.9 (0–29) Preparedness Level Low 195 75.6 Moderate 51 19.8 High 12 4.7 Total 258 100 *Standard deviation. See section 2.8 for scoring system 3.5 Determinants of preparedness for mpox outbreak The associations between health workers’ socio-demographic characteristics, mpox awareness, and their preparedness levels were first examined using chi-square tests. Professional role (χ² = 37.502, p < 0.001), years of experience in healthcare (χ² = 15.955, p = 0.014), and department of work (χ² = 22.440, p = 0.013) were strongly associated with preparedness. However, age group (χ² = 4.426, p = 0.619), gender (χ² = 0.760, p = 0.684), level of education (χ² = 3.525, p = 0.474), and prior mpox awareness (χ² = 1.647, p = 0.439) were not significantly associated with preparedness. To identify independent predictors, an ordinal logistic regression was conducted. The model was statistically significant (χ² = 64.52, p < 0.001) and demonstrated good fit (Pearson χ² = 51.71, p = 0.796; Deviance χ² = 31.32, p = 0.999). After adjustment, years of experience in healthcare was significantly associated with preparedness. Health workers with 11–15 years of experience were approximately 13.6 times more likely to report higher levels of preparedness compared to those with more than 15 years of experience (AOR = 13.6, 95% CI: 1.42–129.3, p = 0.024). Department of work also influenced preparedness. Staff in Infectious Diseases had significantly lower odds of reporting higher preparedness compared to in the reference departments (Laboratory Services and Other departments combined) (AOR = 0.104, 95% CI: 0.012–0.925, p = 0.043). 4. Discussion The socio-demographic characteristics of respondents (Table 1 ) indicate that the healthcare workforce surveyed was predominantly composed of young professionals. This finding is consistent with a previous observation which highlight the growing representation of early-career health workers within Nigeria’s healthcare system [ 8 ]. A relatively young workforce may have advantages for outbreak preparedness, as younger professionals are often more adaptable to new surveillance systems, digital health tools, and evolving infection control protocols required for emerging infectious diseases such as mpox [ 9 ]. However, this demographic structure also underscores the need for sustained mentorship and structured capacity-building to compensate for limited clinical experience in managing emerging outbreaks. The predominance of female respondents reflects the broader gender distribution observed in the Nigerian health sector, particularly within nursing and allied health professions, as reported in previous studies [ 7 , 8 ]. Gender dynamics may influence risk perception, communication patterns, and engagement with infection prevention practices, all of which are important for coordinated responses during public health emergencies [ 10 ]. A high level of educational attainment was also observed, with most participants holding at least a bachelor’s degree. Higher educational qualifications have been associated with improved knowledge and responsiveness to emerging health threats among healthcare workers [ 11 ]. This suggests that the workforce possesses the foundational capacity to adopt evidence-based practices and participate effectively in outbreak response initiatives when adequate training and institutional support are provided. Medical laboratory scientists and nurses constituted the largest professional groups in this study. These cadres play a pivotal role in disease surveillance, laboratory diagnosis, and frontline patient care, making their awareness and preparedness essential for effective detection and containment of emerging infections. Notably, the majority of respondents had fewer than five years of healthcare experience, which may partly explain gaps in outbreak preparedness. As highlighted by Eze et al. [ 8 ], years of professional experience can influence familiarity with emerging infectious diseases and outbreak response procedures. This underscores the importance of targeted training programs and continuous professional development to strengthen preparedness among early-career health workers. The present study (Table 2 ) demonstrated a high level of awareness of mpox among healthcare workers in Abakaliki. This finding aligns with the study by Al-Mustapha et al. [ 7 ], which reported that a large proportion of educated Nigerians were aware of the disease. The high awareness observed may reflect increasing global and regional attention to mpox following recent outbreaks, as well as intensified media coverage and public health messaging. Social media, television/radio, and workplace interactions were the primary sources of information among respondents, highlighting the growing role of both digital and interpersonal communication channels in disseminating health information. Similar patterns were reported in Saudi Arabia, where social media and traditional media served as key information sources among physicians and the general population [ 12 ]. While these channels enable rapid dissemination of outbreak-related information, heavy reliance on them also raises concerns regarding the accuracy and quality of information received, particularly in settings where misinformation can spread quickly through digital platforms. Despite the high level of general awareness observed in this study, only a relatively small proportion of respondents reported being very familiar with mpox. This suggests that awareness may remain largely superficial and may not necessarily translate into adequate clinical knowledge or infection prevention competencies. Similar knowledge gaps among healthcare workers have been documented by Alshahrani et al. [ 12 ], underscoring the need for structured institutional training and continuous professional education to ensure that awareness is complemented by practical knowledge required for effective outbreak response. The findings in Table 3 indicate that healthcare workers in Abakaliki generally perceive mpox as a significant public health threat. This aligns with previous studies reporting high perceived risk of mpox among healthcare professionals, reflecting growing awareness of the disease’s potential public health implications [ 8 , 13 , 14 ]. Most respondents believed that mpox could lead to widespread outbreaks if not properly managed, underscoring concern about uncontrolled transmission and supporting evidence that adequate knowledge often increases perception of outbreak risk [ 15 , 16 ]. A considerable proportion of participants also regarded mpox as comparable in seriousness to other major infectious diseases, suggesting recognition of its potential for nosocomial and community transmission despite relatively lower case fatality rates [ 17 ]. Personal risk perception was similarly high, with many respondents expressing concern about occupational exposure. Such perceptions are important because healthcare workers who recognize their susceptibility are more likely to adopt preventive behaviors, including appropriate use of personal protective equipment and early reporting of suspected cases [ 13 , 14 ]. Nevertheless, a substantial proportion of respondents perceived public awareness of mpox to be inadequate, highlighting a gap between professional understanding and community-level knowledge that could hinder early detection and response during outbreaks. Strong support for vaccination among respondents further reflects recognition of occupational risk and aligns with evidence showing high vaccine acceptability among healthcare workers when perceived threat levels are elevated [ 13 , 14 ]. These findings suggest that healthcare workers recognize the public health significance of mpox and perceive themselves to be at risk. However, translating this risk perception into effective preparedness requires strengthened institutional measures, including improved risk communication, community education, vaccination strategies, and enhanced health system readiness for emerging infectious disease outbreaks. The findings (Tables 4 – 6 ) demonstrate a pronounced gap between healthcare workers’ awareness of mpox and institutional preparedness to manage potential outbreaks. Although awareness and perceived risk were high, only a very small percentage of respondents were classified as highly prepared. Only a small proportion of respondents reported receiving mpox-related training, with very few accessing in-person sessions, online modules, or printed guidelines, highlighting deficiencies in proactive capacity-building. Confidence in managing suspected cases was limited, reflecting inadequate hands-on preparedness. Structural and systemic readiness was similarly insufficient: less than half reported standardized case reporting procedures, approximately one-third had access to functional isolation units, and fewer than half had sufficient personal protective equipment. Outbreak protocols were notably sparse, despite recognition of mpox as a significant public health threat. These findings align with previous studies documenting limited healthcare preparedness and inadequate infection prevention infrastructure in settings managing emerging infectious diseases [ 18 , 19 ]. The disconnect between high awareness and low preparedness underscores that, without systemic improvements, healthcare workers remain vulnerable, and Nigeria’s capacity to respond effectively to mpox outbreaks may be compromised. Strengthening preparedness requires coordinated investment in staff training, functional infrastructure, sufficient PPE, and clearly defined protocols, with policymakers and hospital administrators prioritizing resource allocation and routine capacity-building to safeguard frontline healthcare services and public health. The current study identified professional role, years of healthcare experience, and department of work as key determinants of preparedness for mpox among health workers in Abakaliki. Notably, years of experience emerged as a strong predictor, with health workers having 11–15 years of experience being more likely to report higher preparedness than those with more than 15 years. This suggests that mid-career professionals may possess a balance of practical experience and recent training that enhances their confidence and capacity to respond to emerging infections. Comparable findings have been reported in previous studies where work experience significantly influenced knowledge and perceived readiness for mpox and other infectious diseases [ 8 , 13 , 14 ]. Departmental differences further highlighted vulnerabilities in institutional readiness. Staff in Infectious Diseases reported markedly lower preparedness compared to those in laboratory services or other departments. While seemingly counterintuitive, this may reflect systemic gaps, including insufficient training, inadequate outbreak protocols, and limited access to protective equipment. In the current study, demographic factors and prior mpox awareness were not significantly associated with preparedness. This underscores a critical disconnect between knowledge and actionable preparedness: high awareness or perceived risk does not automatically translate into the ability to respond effectively, echoing observations from Bangladesh and Saudi Arabia where positive attitudes toward mpox prevention did not consistently align with confidence or practical readiness [ 20 , 21 ]. Policy implications are clear in this study: interventions must go beyond information dissemination to address structural and capacity gaps. Targeted training, routine simulations, provision of adequate PPE, and standardized outbreak protocols are essential. Furthermore, professional development programs should prioritize mid- to late-career staff and high-risk departments to ensure a uniformly prepared workforce capable of responding effectively to future mpox outbreaks. Strengthening these systemic supports aligns with global recommendations for proactive preparedness in healthcare settings experiencing emerging infectious threats [ 16 ]. 5. Conclusions This study demonstrates that although health workers in Abakaliki exhibit high awareness of mpox and perceive it as a significant public health threat, overall preparedness for outbreak response remains low. Only a small fraction demonstrated high readiness for a potential outbreak. Professional role, years of healthcare experience, and departmental affiliation significantly influenced preparedness, whereas demographic factors and prior awareness did not. Notably, mid-career health workers were more likely to report higher preparedness, while staff in Infectious Diseases departments were less prepared despite their frontline role. These findings highlight a critical gap between knowledge and actionable readiness, emphasizing that awareness alone is insufficient to ensure effective outbreak response. Therefore, healthcare institutions should prioritize systematic capacity-building through regular, practical training, accessible outbreak protocols, and adequate provision of PPE and isolation facilities. Targeted interventions should focus on departments and staff identified as less prepared, including infectious diseases units and early- and late-career personnel. Strengthening institutional infrastructure, coupled with evidence-based risk communication, can enhance frontline preparedness and mitigate the impact of future mpox outbreaks. Subsequent research should explore the effectiveness of targeted training interventions and simulation exercises on improving health worker preparedness, as well as longitudinal monitoring to evaluate whether preparedness translates into rapid and effective outbreak management. Integrating One Health approaches, including collaboration with animal health and community surveillance, may further strengthen systemic readiness for emerging zoonotic threats. Lessons from this study are applicable beyond Abakaliki. The findings offer evidence-based guidance for strengthening preparedness in other mpox-endemic regions across Nigeria and sub-Saharan Africa, where healthcare systems face similar structural and training challenges. Abbreviations AOR Adjusted Odds Ratio MPXV Monkeypox Virus AEFUTHA Alex Ekwueme Federal University Teaching Hospital Abakaliki NOFIC National Obstetric Fistula Centre, Abakaliki CI Confidence Interval SD Standard Deviation PPE Personal Protective Equipment Declarations Ethics approval and consent to participate The study adhered strictly to international ethical guidelines as enshrined in the Declaration of Helsinki. Ethical approval was obtained from the Health Research Ethics Committee of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State (reference number NHREC/05/01/2008B-FWA00002458-1RB00002323) before commencement of the study. Participation was voluntary, with written informed consent obtained from all respondents. Confidentiality was ensured through anonymized coding and secure data handling, with results reported only in aggregate form. Consent for publication Not applicable Availability of data and materials The datasets supporting the conclusions of this article are included within the article (and its additional files). Competing interests The authors declare that they have no competing interests. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors’ contributions Daniel Chikaodiri Ogudu contributed to the conceptualization of the study, study design, data collection, data management, provision of resources, and critical revision of the manuscript. Luke Oche Peter contributed to the conceptualization and research design, performed data analysis, drafted the manuscript, and participated in manuscript revision. Babatunde Ishola Omotowo supervised the study, contributed to the conceptualization and study design, participated in instrument validation, and critically revised the manuscript. All authors read and approved the final manuscript. Acknowledgments The authors sincerely appreciate the management and staff of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and the National Obstetric Fistula Centre (NOFIC) for granting access to their facilities and supporting the data collection process for this study. Their cooperation and facilitation were invaluable to the successful completion of this research. References Awadi S, Al-Shami K, Alkhoun HA, Al-Eitan SF, Alsheikh AM, Saeed A, et al. Human monkeypox virus in the shadow of the COVID-19 pandemic. J Infect Public Health. 2023;16(8):1149–57. Alissa M, Alghamdi A, Alghamdi SA. Overview of reemerging mpox infection with a focus on neurological manifestations. Rev Med Virol. 2024;34(2):e2527. Eren E, Çelik İ. Mpox: Travel medicine and infection control. Lokman Hekim Health Sci. 2024;4(2):121–30. World Health Organization. Mpox [Internet]. 2024 Aug 26 [cited 2026 Mar 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/mpox Klingelhöfer D, Braun M, Groneberg DA, Brüggmann D. Global mpox research in the light of the current outbreak: demands, drivers, and obstacles. Emerg Microbes Infect. 2023;12(1):2210696. Fetensa G, Wakuma B, Besho M, Yadesa G, Gugsa J, Tufa DG, et al. Improving control of the Mpox outbreak: a national cross-sectional study on the knowledge, attitudes, and influencing factors among frontline healthcare professionals in Ethiopia. Front Public Health . 2025;13:1551163. Al-Mustapha AI, Ogundijo OA, Sikiru NA, Kolawole B, Oyewo M, El-Nadi H, et al. A cross-sectional survey of public knowledge of the monkeypox disease in Nigeria. BMC Public Health. 2023;23(1):591. Eze U, Okafor N, Ozota G, Nworie K, Asogwa C, Richard I, et al. Assessment of the knowledge of healthcare workers on monkeypox in Nigeria. GMS Hyg Infect Control. 2024;19. Özatkan Y, Şenel Tekin P. Determinants of digital health literacy of healthcare professionals: A systematic review. J Telemed Telecare . 2025;1357633X261426228. Gurman T, Ballard SA, Villanueva LF, Luis D, Hunter G, Maloney S, et al. The role of gender in Zika prevention behaviors in the Dominican Republic: Findings and programmatic implications from a qualitative study. PLoS Negl Trop Dis. 2020;14(3):e0007994. Tegegne GT, Kefale B, Engidaw MT, Degu A, Tesfa D, Ewunetei A, et al. Knowledge, attitude, and practice of healthcare providers toward novel coronavirus 19 during the first months of the pandemic: a systematic review. Front Public Health . 2021;9:606666. Alshahrani NZ, Alzahrani F, Alarifi AM, Algethami MR, Alhumam MN, Ayied HAM, et al. Assessment of knowledge of monkeypox viral infection among the general population in Saudi Arabia. Pathogens. 2022;11(8):904. Awoyomi OJ, Njoga EO, Jaja IF, Oyeleye FA, Awoyomi PO, Ibrahim MA, et al. Mpox in Nigeria: perceptions and knowledge of the disease among critical stakeholders—Global public health consequences. PLoS One . 2023;18(3):e0283571. AbdulMumin AK, Adeniyi MA, Temitayo-Oboh AO, Abdullah A, Ojo OY. Knowledge, perception and safety practices of monkeypox infection among healthcare workers in a tertiary health facility in southwest Nigeria. Int J Community Med Public Health. 2023;10(9):3059. Ugwu SE, Abolade SA, Ofeh AS, Awoyinka TB, Okolo BO, Ayeni ET, et al. Knowledge, attitude, and perception of monkeypox among medical/health students across media space in Nigeria. Int J Community Med Public Health. 2022;9(12):4391. Wang B, Peng X, Li Y, Fu L, Tian T, Liang B, et al. Perceptions, precautions, and vaccine acceptance related to monkeypox in the public in China: a cross-sectional survey. J Infect Public Health. 2023;16(2):163–70. Peng X, Wang B, Li Y, Chen Y, Wu X, Fu L, et al. Perceptions and worries about monkeypox, and attitudes towards monkeypox vaccination among medical workers in China: A cross-sectional survey. J Infect Public Health . 2023;16(3):346–53. Precious ND, Agboola P, Oluwatimilehin O, Olakunle OK, Olaniyi P, Adiatu AI, et al. Re-emergence of monkeypox virus outbreak in Nigeria: epidemic preparedness and response (Review-Commentary). Ann Med Surg (Lond). 2023;85:3990–6. Yang ZS, Lin CY, Urbina AN, Wang WH, Assavalapsakul W, Tseng SP, et al. The first case of monkeypox virus infection detected in Taiwan: awareness and preparation. Int J Infect Dis. 2022;122:991–5. Hasan M, Hossain MA, Chowdhury S, Das P, Jahan I, Rahman MF, et al. Human monkeypox and preparedness of Bangladesh: a knowledge and attitude assessment study among medical doctors. J Infect Public Health . 2023;16(1):90–5. Shafei AM, Al-Mosaa KM, Alshahrani NZ, ALAmmari MHM, Almuhlafi MOO, Draim NHAA, et al. Resident Physicians’ knowledge and preparedness regarding human monkeypox: a cross-sectional study from Saudi Arabia. Pathogens. 2023;12(7):872. Additional Declarations No competing interests reported. Supplementary Files AWARENESSPERCEPTIONSANDPREPAREDNESSFORMPOX.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9130713","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":606468789,"identity":"248a445f-f3a5-4a9e-a95c-a056ed6cfc20","order_by":0,"name":"Daniel Chikaodiri Ogudu","email":"","orcid":"","institution":"National Obstetric Fistula Center","correspondingAuthor":false,"prefix":"","firstName":"Daniel","middleName":"Chikaodiri","lastName":"Ogudu","suffix":""},{"id":606468793,"identity":"744b8528-856b-47a8-ad70-2567ee35cb15","order_by":1,"name":"Luke Oche Peter","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYBCDBAZ2BmYGhgogk5m5gYBiZqgWZhDrDEiAkRQtjG0gNgEt5uz9Bx9XVNjl8TPzGBt8nFcbzd8O1PKjYhtOLZY9h5kNz5xJLpZs5jFOnLnteO6Mw4wNjD1nbuPUYnAjmU2yse1A4obDPMaHebcdy20AamFmbMOj5f5j9p8gLftBWv7OOZY7n6CWG8xsjGBbgH5JZmyoyd1ASItlT7KxZMOZ5MQZh9mKDXuOHcjdCNRyEJ9fzNkPPvzYUGGX2N/evFniR01d7rzzhw8++FGBx2Fo/MNg8gBO9Vi01OFTPApGwSgYBSMUAAAIf1uh+SZnoQAAAABJRU5ErkJggg==","orcid":"","institution":"University of Nigeria","correspondingAuthor":true,"prefix":"","firstName":"Luke","middleName":"Oche","lastName":"Peter","suffix":""},{"id":606468794,"identity":"f2833e6b-e18f-456c-8f4f-b4571a2a2796","order_by":2,"name":"Babatunde Ishola Omotowo","email":"","orcid":"","institution":"University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Babatunde","middleName":"Ishola","lastName":"Omotowo","suffix":""}],"badges":[],"createdAt":"2026-03-15 19:08:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9130713/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9130713/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104910381,"identity":"c72c03ef-770b-4abb-92f8-821682a51b7f","added_by":"auto","created_at":"2026-03-18 14:57:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1350454,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9130713/v1/a53d22e8-d7d3-429d-b65b-6d6a0576f06c.pdf"},{"id":104716762,"identity":"b45a06dc-1883-41e5-a9fc-6dc2df462f05","added_by":"auto","created_at":"2026-03-16 11:28:56","extension":"xlsx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":92654,"visible":true,"origin":"","legend":"","description":"","filename":"AWARENESSPERCEPTIONSANDPREPAREDNESSFORMPOX.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9130713/v1/1c9da622cc759665735f240f.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Nigeria: a cross-sectional study","fulltext":[{"header":"1. Background","content":"\u003cp\u003eMpox (formerly Monkeypox) is a viral zoonotic disease caused by the monkeypox virus (MPXV). It is a member of the Orthopoxvirus genus in the Poxviridae family, which also includes variola, cowpox, and vaccinia viruses [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The disease typically presents with fever, lymphadenopathy, headache, myalgia, and a characteristic rash, with most infections being self-limiting but occasionally progressing to severe illness [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Transmission occurs through close contact with infected individuals via skin lesions, bodily fluids, respiratory droplets, or contaminated materials, and through spillover from infected animals in endemic regions of Central and West Africa [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHistorically confined largely to parts of Africa, mpox has increasingly attracted global attention due to its expanding geographic distribution and rising case numbers. Following the cessation of routine smallpox vaccination after eradication in 1980, population immunity against orthopoxviruses declined, contributing to the re-emergence of mpox in several African countries [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Nigeria experienced a notable resurgence beginning in 2017, with sustained transmission reported in multiple states. More recently, the 2022 multinational outbreak marked an unprecedented spread of mpox across Europe, the Americas, and other regions, with cases reported in over 120 countries and more than 100,000 confirmed infections globally by 2024 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This evolving epidemiology highlights the growing potential for widespread outbreaks and underscores the need for strengthened surveillance and preparedness.\u003c/p\u003e \u003cp\u003eHealth workers play a critical role in the early detection, diagnosis, and management of emerging infectious diseases such as mpox. Their level of awareness, perception of risk, and preparedness to respond to suspected cases directly influence the effectiveness of outbreak control measures [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In resource-limited health systems, inadequate training, limited availability of personal protective equipment, and weak institutional protocols may hinder rapid response to emerging infections. Despite Nigeria\u0026rsquo;s experience with mpox outbreaks, empirical data on the readiness of frontline health workers to respond to potential mpox outbreaks remain limited, particularly in southeastern Nigeria. Therefore, this study assessed the awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Ebonyi State, Nigeria. This is essential for understanding the capacity of the local health system to respond effectively to a potential mpox outbreak.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study area\u003c/h2\u003e \u003cp\u003eThe study was conducted at the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and the National Obstetric Fistula Centre (NOFIC), Abakaliki, Ebonyi State, Nigeria. Ebonyi State is located in the southeastern region of Nigeria and has an estimated population of over three million people. The state serves as a major healthcare hub in the region that provide referral services to surrounding states. AEFUTHA and NOFIC are key tertiary institutions responsible for specialized clinical care, training of health professionals, and public health service delivery in the state.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study design\u003c/h2\u003e \u003cp\u003eThe study adopted a descriptive cross-sectional design using a quantitative approach.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Study population\u003c/h2\u003e \u003cp\u003eThe study population comprised health workers, including medical doctors, nurses, laboratory scientists, pharmacists, and public health officers working in the selected facilities. Participants were eligible if they were currently employed at the study sites, had at least six months of work experience, were aged 18 years or older, and provided informed consent to participate. Health workers on temporary contracts or internships, as well as individuals unable to participate due to cognitive or health-related limitations, were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Sample size determination\u003c/h2\u003e \u003cp\u003eThe minimum sample for the study was calculated using Fisher\u0026rsquo;s formula for single proportions in cross-sectional studies:\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$n=\\frac{{Z}^{2}p(1-p)}{{d}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003ewhere \u003cem\u003en\u003c/em\u003e is the minimum required sample size, \u003cem\u003eZ\u003c/em\u003e is the standard normal deviate corresponding to a 95% confidence level (1.96), \u003cem\u003ep\u003c/em\u003e is the estimated proportion of health workers aware of mpox (0.89) based on a previous Nigerian study [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], and \u003cem\u003ed\u003c/em\u003e is the margin of error set at 0.05. Substituting these values yielded a minimum sample size of approximately 150 participants. To account for a potential 10% non-response rate, the sample size was adjusted to 165. However, a total of 258 health workers ultimately participated in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Sampling technique\u003c/h2\u003e \u003cp\u003eThe study adopted a consecutive sampling technique. All health workers at the selected health facilities who met the inclusion criteria during the study period were invited to participate, and recruitment continued until the minimum sample size was exceeded. Participants were drawn from both facilities without restriction on cadre or department.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Instrument for data collection\u003c/h2\u003e \u003cp\u003eData were collected using a structured, self-administered questionnaire comprising four sections: demographic characteristics, awareness of mpox, perceptions of mpox, and preparedness for mpox. To ensure clarity, relevance, and alignment with existing literature, the questionnaire underwent content validation by two experts in Epidemiology prior to administration.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.8 Data management and analysis\u003c/h2\u003e \u003cp\u003eCompleted questionnaires were coded and entered into IBM SPSS Statistics version 20. Data was checked for completeness and consistency prior to analysis. Descriptive statistics were used to summarize socio-demographic characteristics, awareness, risk perceptions, and preparedness indicators. A composite preparedness score was generated for each respondent based on responses to preparedness-related questions, including facility-provided training/resources, type of training received, self-reported confidence in managing suspected mpox cases, presence of facility protocols, familiarity with preventive measures, and availability of relevant equipment and resources. Each positive response was scored as 1, while negative or \u0026ldquo;not sure\u0026rdquo; responses were scored as 0, yielding a total score ranging from 0 to 29, with higher scores indicating better preparedness. The composite score was categorized into three levels: low preparedness (0\u0026ndash;14 points), moderate preparedness (15\u0026ndash;21 points), and high preparedness (22\u0026ndash;29 points).\u003c/p\u003e \u003cp\u003eAssociations between categorical variables and preparedness levels were initially assessed using Chi-square tests. Variables with p\u0026thinsp;\u0026lt;\u0026thinsp;0.2 in bivariate analysis were subsequently included in a multivariate ordinal logistic regression model to identify independent predictors of higher preparedness. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Demographic characteristics of respondents\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the demographic characteristics of the health workers. Majority were aged 25\u0026ndash;34 years (53.1%) with mean age of 31.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6 years. Females constituted nearly two-thirds of respondents (65.5%). The majority held a bachelor's degree (84.9%), and the largest professional group was medical laboratory scientists (41.9%), followed by nurses (29.8%) and doctors (13.2%). Most participants had less than five years of healthcare experience (63.6%), and the largest proportion were affiliated with laboratory services (41.9%) or other clinical departments (43.8%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of respondents (n\u0026thinsp;=\u0026thinsp;258)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma/Certificate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePostgraduate degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProfessional Role\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical Laboratory Scientist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePublic Health Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYears of Experience\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;15 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;15 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepartment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInfectious Diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLaboratory Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePediatrics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e*Standard deviation; Results are presented as frequencies and percentages.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Awareness of mpox\u003c/h2\u003e \u003cp\u003eAwareness of mpox was very high (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), with 98.1% of health workers reporting they had heard of the disease. Social media (29.1%) and TV/radio (26.0%) were the most common sources of information, followed by colleagues/workplace interactions (22.9%). While most respondents (64.0%) were somewhat familiar with mpox symptoms, only 20.5% reported being very familiar, and 15.5% were not familiar at all.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAwareness of mpox among health workers (n\u0026thinsp;=\u0026thinsp;258)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness Indicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHave you heard about mpox?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSource of first information\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTV/Radio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eColleagues/workplace\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScientific journals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFamiliarity with mpox symptoms\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery familiar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSomewhat familiar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot familiar at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Perceptions of mpox\u003c/h2\u003e \u003cp\u003eResults in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e reveals that most respondents perceived mpox as a significant public health threat, with 88.4% indicating it poses a major risk in Nigeria. Nearly two-thirds (62.0%) believed the disease could cause widespread outbreaks if not properly managed, and a large majority (74.4%) expressed strong concern about occupational exposure. However, perceptions of the disease\u0026rsquo;s seriousness relative to other infections were mixed, with 43.4% rating it equally serious and 37.2% expressing uncertainty. Most respondents (69.0%) believed that public awareness of mpox in Nigeria is insufficient, while almost all supported vaccine availability for health workers, with 98.1% agreeing or strongly agreeing.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePerceptions of mpox among respondents (n\u0026thinsp;=\u0026thinsp;258)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerception Question\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse Option\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you think mpox poses a significant public health risk in Nigeria?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know / No opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCompared to other infectious diseases (e.g., COVID-19, Ebola), how would you rate the seriousness of mpox?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEqually serious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess serious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore serious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot serious at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know / No opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you believe mpox can cause widespread outbreaks in Nigeria if not properly managed?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know / No opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow concerned are you about the possibility of contracting mpox while working in healthcare?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery concerned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerately concerned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot concerned at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know / No opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you think there is sufficient public awareness about mpox in Nigeria?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know / No opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you believe mpox vaccines should be made available to health workers in high-risk areas?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e77.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know / No opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e\u003cb\u003e3.4 Preparedness for mpox outbreak\u003c/b\u003e\u003c/h2\u003e \u003cp\u003eResults from Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e reveals that only a small proportion reported that their healthcare facilities had provided mpox-related training or resources (8.9%), with very few having received in-person training (3.9%), online training (2.7%), or printed guidelines (0.8%). Similarly, only 14.0% indicated that their facility had established protocols for managing mpox outbreaks. However, more than half of the respondents (54.7%) expressed confidence in their ability to manage a suspected mpox case, and a large majority reported familiarity with key preventive measures such as isolation of infected patients (83.7%), use of personal protective equipment (PPE) (82.9%), disinfection of surfaces (71.7%), and quarantine of suspected cases (66.7%), although familiarity with mpox vaccination was comparatively lower (55.8%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInstitutional preparedness and familiarity with mpox prevention measures among health workers in Abakaliki (n\u0026thinsp;=\u0026thinsp;258)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreparedness Indicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare facility has provided training/resources on mpox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReceived in-person training on mpox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReceived online training on mpox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReceived printed guidelines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfident in ability to manage suspected mpox case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFacility has protocols in place for mpox outbreaks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamiliar with isolation of infected patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamiliar with use of PPE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamiliar with disinfection of surfaces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamiliar with quarantine of suspected cases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamiliar with mpox vaccination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot familiar with any preventive measure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the availability of resources to support mpox outbreak management. Basic infection prevention materials were relatively common, with handwashing stations (81.4%), personal protective equipment (79.8%), alcohol-based sanitizers (74.0%), and disinfectants (70.2%) reported by most respondents. Isolation wards were reported by just over half of respondents (55.8%), while ambulance services (50.8%) and waste disposal systems (48.8%) were reported by about half. In contrast, mpox-specific outbreak resources were limited: diagnostic kits (10.5%), vaccine stock (13.0%), antiviral medications (12.8%), treatment guidelines (15.8%), and training programs on mpox management (13.6%) were rarely reported. Coordination and communication infrastructure, including rapid response teams (20.2%) and reporting tools (32.9%), were also scarce.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAvailability of equipment and resources for mpox outbreak management in health facilities (n\u0026thinsp;=\u0026thinsp;258)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResource/Facility Available\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsolation wards/rooms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal protective equipment (gloves, masks, gowns)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHandwashing stations with soap and water\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol-based hand sanitizers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisinfectants for surface cleaning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaboratory facilities for diagnostic testing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMpox-specific diagnostic kits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMpox vaccine stock\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntiviral medications for mpox treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRapid response team or outbreak taskforce\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunication and reporting tools\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStandard treatment guidelines/protocol for mpox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraining programs for health workers on mpox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdequate waste disposal system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmbulance services for patient transfer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdequate electricity supply/backup generators\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCold chain storage for vaccines/specimens\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity awareness materials on mpox prevention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmergency funds/budget for outbreak response\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eResponses are reported as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eResults in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e reveals that most health workers (75.6%) demonstrated low preparedness for a potential mpox outbreak, while 19.8% had moderate preparedness, and only 4.7% were classified as highly prepared. The overall mean preparedness score was 11.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevel of preparedness for mpox outbreak among health workers in Abakaliki (n\u0026thinsp;=\u0026thinsp;258)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall mean preparedness score\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003csup\u003e\u003cb\u003e*\u003c/b\u003e\u003c/sup\u003e \u003cb\u003e(range)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9 (0\u0026ndash;29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePreparedness Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e*Standard deviation. See section \u003cspan refid=\"Sec9\" class=\"InternalRef\"\u003e2.8\u003c/span\u003e for scoring system\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Determinants of preparedness for mpox outbreak\u003c/h2\u003e \u003cp\u003eThe associations between health workers\u0026rsquo; socio-demographic characteristics, mpox awareness, and their preparedness levels were first examined using chi-square tests. Professional role (χ\u0026sup2; = 37.502, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), years of experience in healthcare (χ\u0026sup2; = 15.955, p\u0026thinsp;=\u0026thinsp;0.014), and department of work (χ\u0026sup2; = 22.440, p\u0026thinsp;=\u0026thinsp;0.013) were strongly associated with preparedness. However, age group (χ\u0026sup2; = 4.426, p\u0026thinsp;=\u0026thinsp;0.619), gender (χ\u0026sup2; = 0.760, p\u0026thinsp;=\u0026thinsp;0.684), level of education (χ\u0026sup2; = 3.525, p\u0026thinsp;=\u0026thinsp;0.474), and prior mpox awareness (χ\u0026sup2; = 1.647, p\u0026thinsp;=\u0026thinsp;0.439) were not significantly associated with preparedness.\u003c/p\u003e \u003cp\u003eTo identify independent predictors, an ordinal logistic regression was conducted. The model was statistically significant (χ\u0026sup2; = 64.52, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and demonstrated good fit (Pearson χ\u0026sup2; = 51.71, p\u0026thinsp;=\u0026thinsp;0.796; Deviance χ\u0026sup2; = 31.32, p\u0026thinsp;=\u0026thinsp;0.999). After adjustment, years of experience in healthcare was significantly associated with preparedness. Health workers with 11\u0026ndash;15 years of experience were approximately 13.6 times more likely to report higher levels of preparedness compared to those with more than 15 years of experience (AOR\u0026thinsp;=\u0026thinsp;13.6, 95% CI: 1.42\u0026ndash;129.3, p\u0026thinsp;=\u0026thinsp;0.024). Department of work also influenced preparedness. Staff in Infectious Diseases had significantly lower odds of reporting higher preparedness compared to in the reference departments (Laboratory Services and Other departments combined) (AOR\u0026thinsp;=\u0026thinsp;0.104, 95% CI: 0.012\u0026ndash;0.925, p\u0026thinsp;=\u0026thinsp;0.043).\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe socio-demographic characteristics of respondents (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) indicate that the healthcare workforce surveyed was predominantly composed of young professionals. This finding is consistent with a previous observation which highlight the growing representation of early-career health workers within Nigeria\u0026rsquo;s healthcare system [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. A relatively young workforce may have advantages for outbreak preparedness, as younger professionals are often more adaptable to new surveillance systems, digital health tools, and evolving infection control protocols required for emerging infectious diseases such as mpox [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, this demographic structure also underscores the need for sustained mentorship and structured capacity-building to compensate for limited clinical experience in managing emerging outbreaks. The predominance of female respondents reflects the broader gender distribution observed in the Nigerian health sector, particularly within nursing and allied health professions, as reported in previous studies [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Gender dynamics may influence risk perception, communication patterns, and engagement with infection prevention practices, all of which are important for coordinated responses during public health emergencies [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A high level of educational attainment was also observed, with most participants holding at least a bachelor\u0026rsquo;s degree. Higher educational qualifications have been associated with improved knowledge and responsiveness to emerging health threats among healthcare workers [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This suggests that the workforce possesses the foundational capacity to adopt evidence-based practices and participate effectively in outbreak response initiatives when adequate training and institutional support are provided. Medical laboratory scientists and nurses constituted the largest professional groups in this study. These cadres play a pivotal role in disease surveillance, laboratory diagnosis, and frontline patient care, making their awareness and preparedness essential for effective detection and containment of emerging infections. Notably, the majority of respondents had fewer than five years of healthcare experience, which may partly explain gaps in outbreak preparedness. As highlighted by Eze et al. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], years of professional experience can influence familiarity with emerging infectious diseases and outbreak response procedures. This underscores the importance of targeted training programs and continuous professional development to strengthen preparedness among early-career health workers.\u003c/p\u003e \u003cp\u003eThe present study (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) demonstrated a high level of awareness of mpox among healthcare workers in Abakaliki. This finding aligns with the study by Al-Mustapha et al. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], which reported that a large proportion of educated Nigerians were aware of the disease. The high awareness observed may reflect increasing global and regional attention to mpox following recent outbreaks, as well as intensified media coverage and public health messaging. Social media, television/radio, and workplace interactions were the primary sources of information among respondents, highlighting the growing role of both digital and interpersonal communication channels in disseminating health information. Similar patterns were reported in Saudi Arabia, where social media and traditional media served as key information sources among physicians and the general population [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. While these channels enable rapid dissemination of outbreak-related information, heavy reliance on them also raises concerns regarding the accuracy and quality of information received, particularly in settings where misinformation can spread quickly through digital platforms. Despite the high level of general awareness observed in this study, only a relatively small proportion of respondents reported being very familiar with mpox. This suggests that awareness may remain largely superficial and may not necessarily translate into adequate clinical knowledge or infection prevention competencies. Similar knowledge gaps among healthcare workers have been documented by Alshahrani et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], underscoring the need for structured institutional training and continuous professional education to ensure that awareness is complemented by practical knowledge required for effective outbreak response.\u003c/p\u003e \u003cp\u003eThe findings in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e indicate that healthcare workers in Abakaliki generally perceive mpox as a significant public health threat. This aligns with previous studies reporting high perceived risk of mpox among healthcare professionals, reflecting growing awareness of the disease\u0026rsquo;s potential public health implications [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Most respondents believed that mpox could lead to widespread outbreaks if not properly managed, underscoring concern about uncontrolled transmission and supporting evidence that adequate knowledge often increases perception of outbreak risk [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A considerable proportion of participants also regarded mpox as comparable in seriousness to other major infectious diseases, suggesting recognition of its potential for nosocomial and community transmission despite relatively lower case fatality rates [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Personal risk perception was similarly high, with many respondents expressing concern about occupational exposure. Such perceptions are important because healthcare workers who recognize their susceptibility are more likely to adopt preventive behaviors, including appropriate use of personal protective equipment and early reporting of suspected cases [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Nevertheless, a substantial proportion of respondents perceived public awareness of mpox to be inadequate, highlighting a gap between professional understanding and community-level knowledge that could hinder early detection and response during outbreaks. Strong support for vaccination among respondents further reflects recognition of occupational risk and aligns with evidence showing high vaccine acceptability among healthcare workers when perceived threat levels are elevated [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. These findings suggest that healthcare workers recognize the public health significance of mpox and perceive themselves to be at risk. However, translating this risk perception into effective preparedness requires strengthened institutional measures, including improved risk communication, community education, vaccination strategies, and enhanced health system readiness for emerging infectious disease outbreaks.\u003c/p\u003e \u003cp\u003eThe findings (Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e) demonstrate a pronounced gap between healthcare workers\u0026rsquo; awareness of mpox and institutional preparedness to manage potential outbreaks. Although awareness and perceived risk were high, only a very small percentage of respondents were classified as highly prepared. Only a small proportion of respondents reported receiving mpox-related training, with very few accessing in-person sessions, online modules, or printed guidelines, highlighting deficiencies in proactive capacity-building. Confidence in managing suspected cases was limited, reflecting inadequate hands-on preparedness. Structural and systemic readiness was similarly insufficient: less than half reported standardized case reporting procedures, approximately one-third had access to functional isolation units, and fewer than half had sufficient personal protective equipment. Outbreak protocols were notably sparse, despite recognition of mpox as a significant public health threat. These findings align with previous studies documenting limited healthcare preparedness and inadequate infection prevention infrastructure in settings managing emerging infectious diseases [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The disconnect between high awareness and low preparedness underscores that, without systemic improvements, healthcare workers remain vulnerable, and Nigeria\u0026rsquo;s capacity to respond effectively to mpox outbreaks may be compromised. Strengthening preparedness requires coordinated investment in staff training, functional infrastructure, sufficient PPE, and clearly defined protocols, with policymakers and hospital administrators prioritizing resource allocation and routine capacity-building to safeguard frontline healthcare services and public health.\u003c/p\u003e \u003cp\u003eThe current study identified professional role, years of healthcare experience, and department of work as key determinants of preparedness for mpox among health workers in Abakaliki. Notably, years of experience emerged as a strong predictor, with health workers having 11\u0026ndash;15 years of experience being more likely to report higher preparedness than those with more than 15 years. This suggests that mid-career professionals may possess a balance of practical experience and recent training that enhances their confidence and capacity to respond to emerging infections. Comparable findings have been reported in previous studies where work experience significantly influenced knowledge and perceived readiness for mpox and other infectious diseases [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Departmental differences further highlighted vulnerabilities in institutional readiness. Staff in Infectious Diseases reported markedly lower preparedness compared to those in laboratory services or other departments. While seemingly counterintuitive, this may reflect systemic gaps, including insufficient training, inadequate outbreak protocols, and limited access to protective equipment. In the current study, demographic factors and prior mpox awareness were not significantly associated with preparedness. This underscores a critical disconnect between knowledge and actionable preparedness: high awareness or perceived risk does not automatically translate into the ability to respond effectively, echoing observations from Bangladesh and Saudi Arabia where positive attitudes toward mpox prevention did not consistently align with confidence or practical readiness [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePolicy implications are clear in this study: interventions must go beyond information dissemination to address structural and capacity gaps. Targeted training, routine simulations, provision of adequate PPE, and standardized outbreak protocols are essential. Furthermore, professional development programs should prioritize mid- to late-career staff and high-risk departments to ensure a uniformly prepared workforce capable of responding effectively to future mpox outbreaks. Strengthening these systemic supports aligns with global recommendations for proactive preparedness in healthcare settings experiencing emerging infectious threats [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis study demonstrates that although health workers in Abakaliki exhibit high awareness of mpox and perceive it as a significant public health threat, overall preparedness for outbreak response remains low. Only a small fraction demonstrated high readiness for a potential outbreak. Professional role, years of healthcare experience, and departmental affiliation significantly influenced preparedness, whereas demographic factors and prior awareness did not. Notably, mid-career health workers were more likely to report higher preparedness, while staff in Infectious Diseases departments were less prepared despite their frontline role.\u003c/p\u003e \u003cp\u003eThese findings highlight a critical gap between knowledge and actionable readiness, emphasizing that awareness alone is insufficient to ensure effective outbreak response. Therefore, healthcare institutions should prioritize systematic capacity-building through regular, practical training, accessible outbreak protocols, and adequate provision of PPE and isolation facilities. Targeted interventions should focus on departments and staff identified as less prepared, including infectious diseases units and early- and late-career personnel. Strengthening institutional infrastructure, coupled with evidence-based risk communication, can enhance frontline preparedness and mitigate the impact of future mpox outbreaks.\u003c/p\u003e \u003cp\u003eSubsequent research should explore the effectiveness of targeted training interventions and simulation exercises on improving health worker preparedness, as well as longitudinal monitoring to evaluate whether preparedness translates into rapid and effective outbreak management. Integrating One Health approaches, including collaboration with animal health and community surveillance, may further strengthen systemic readiness for emerging zoonotic threats. Lessons from this study are applicable beyond Abakaliki. The findings offer evidence-based guidance for strengthening preparedness in other mpox-endemic regions across Nigeria and sub-Saharan Africa, where healthcare systems face similar structural and training challenges.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMPXV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMonkeypox Virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAEFUTHA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAlex Ekwueme Federal University Teaching Hospital Abakaliki\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNOFIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Obstetric Fistula Centre, Abakaliki\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence Interval\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStandard Deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePPE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePersonal Protective Equipment\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adhered strictly to international ethical guidelines as enshrined in the Declaration of Helsinki. Ethical approval was obtained from the Health Research Ethics Committee of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State (reference number NHREC/05/01/2008B-FWA00002458-1RB00002323) before commencement of the study. Participation was voluntary, with written informed consent obtained from all respondents. Confidentiality was ensured through anonymized coding and secure data handling, with results reported only in aggregate form.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNot applicable\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets supporting the conclusions of this article are included within the article (and its additional files).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDaniel Chikaodiri Ogudu contributed to the conceptualization of the study, study design, data collection, data management, provision of resources, and critical revision of the manuscript. Luke Oche Peter contributed to the conceptualization and research design, performed data analysis, drafted the manuscript, and participated in manuscript revision. Babatunde Ishola Omotowo supervised the study, contributed to the conceptualization and study design, participated in instrument validation, and critically revised the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors sincerely appreciate the management and staff of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and the National Obstetric Fistula Centre (NOFIC) for granting access to their facilities and supporting the data collection process for this study. Their cooperation and facilitation were invaluable to the successful completion of this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAwadi S, Al-Shami K, Alkhoun HA, Al-Eitan SF, Alsheikh AM, Saeed A, et al. Human monkeypox virus in the shadow of the COVID-19 pandemic. \u003cem\u003eJ Infect Public Health.\u003c/em\u003e 2023;16(8):1149\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlissa M, Alghamdi A, Alghamdi SA. Overview of reemerging mpox infection with a focus on neurological manifestations. \u003cem\u003eRev Med Virol.\u003c/em\u003e 2024;34(2):e2527.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEren E, \u0026Ccedil;elik İ. Mpox: Travel medicine and infection control. \u003cem\u003eLokman Hekim Health Sci.\u003c/em\u003e 2024;4(2):121\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. Mpox [Internet]. 2024 Aug 26 [cited 2026 Mar 15]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/mpox\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/mpox\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKlingelh\u0026ouml;fer D, Braun M, Groneberg DA, Br\u0026uuml;ggmann D. Global mpox research in the light of the current outbreak: demands, drivers, and obstacles. \u003cem\u003eEmerg Microbes Infect.\u003c/em\u003e 2023;12(1):2210696.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFetensa G, Wakuma B, Besho M, Yadesa G, Gugsa J, Tufa DG, et al. Improving control of the Mpox outbreak: a national cross-sectional study on the knowledge, attitudes, and influencing factors among frontline healthcare professionals in Ethiopia. \u003cem\u003eFront Public Health\u003c/em\u003e. 2025;13:1551163.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Mustapha AI, Ogundijo OA, Sikiru NA, Kolawole B, Oyewo M, El-Nadi H, et al. A cross-sectional survey of public knowledge of the monkeypox disease in Nigeria. \u003cem\u003eBMC Public Health.\u003c/em\u003e 2023;23(1):591.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEze U, Okafor N, Ozota G, Nworie K, Asogwa C, Richard I, et al. Assessment of the knowledge of healthcare workers on monkeypox in Nigeria. \u003cem\u003eGMS Hyg Infect Control.\u003c/em\u003e 2024;19.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ouml;zatkan Y, Şenel Tekin P. Determinants of digital health literacy of healthcare professionals: A systematic review. \u003cem\u003eJ Telemed Telecare\u003c/em\u003e. 2025;1357633X261426228.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGurman T, Ballard SA, Villanueva LF, Luis D, Hunter G, Maloney S, et al. The role of gender in Zika prevention behaviors in the Dominican Republic: Findings and programmatic implications from a qualitative study. \u003cem\u003ePLoS Negl Trop Dis.\u003c/em\u003e 2020;14(3):e0007994.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTegegne GT, Kefale B, Engidaw MT, Degu A, Tesfa D, Ewunetei A, et al. Knowledge, attitude, and practice of healthcare providers toward novel coronavirus 19 during the first months of the pandemic: a systematic review. \u003cem\u003eFront Public Health\u003c/em\u003e. 2021;9:606666.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlshahrani NZ, Alzahrani F, Alarifi AM, Algethami MR, Alhumam MN, Ayied HAM, et al. Assessment of knowledge of monkeypox viral infection among the general population in Saudi Arabia. \u003cem\u003ePathogens.\u003c/em\u003e 2022;11(8):904.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAwoyomi OJ, Njoga EO, Jaja IF, Oyeleye FA, Awoyomi PO, Ibrahim MA, et al. Mpox in Nigeria: perceptions and knowledge of the disease among critical stakeholders\u0026mdash;Global public health consequences. \u003cem\u003ePLoS One\u003c/em\u003e. 2023;18(3):e0283571.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdulMumin AK, Adeniyi MA, Temitayo-Oboh AO, Abdullah A, Ojo OY. Knowledge, perception and safety practices of monkeypox infection among healthcare workers in a tertiary health facility in southwest Nigeria. \u003cem\u003eInt J Community Med Public Health.\u003c/em\u003e 2023;10(9):3059.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUgwu SE, Abolade SA, Ofeh AS, Awoyinka TB, Okolo BO, Ayeni ET, et al. Knowledge, attitude, and perception of monkeypox among medical/health students across media space in Nigeria. \u003cem\u003eInt J Community Med Public Health.\u003c/em\u003e 2022;9(12):4391.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang B, Peng X, Li Y, Fu L, Tian T, Liang B, et al. Perceptions, precautions, and vaccine acceptance related to monkeypox in the public in China: a cross-sectional survey. \u003cem\u003eJ Infect Public Health.\u003c/em\u003e 2023;16(2):163\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeng X, Wang B, Li Y, Chen Y, Wu X, Fu L, et al. Perceptions and worries about monkeypox, and attitudes towards monkeypox vaccination among medical workers in China: A cross-sectional survey. \u003cem\u003eJ Infect Public Health\u003c/em\u003e. 2023;16(3):346\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrecious ND, Agboola P, Oluwatimilehin O, Olakunle OK, Olaniyi P, Adiatu AI, et al. Re-emergence of monkeypox virus outbreak in Nigeria: epidemic preparedness and response (Review-Commentary). \u003cem\u003eAnn Med Surg\u003c/em\u003e (Lond). 2023;85:3990\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang ZS, Lin CY, Urbina AN, Wang WH, Assavalapsakul W, Tseng SP, et al. The first case of monkeypox virus infection detected in Taiwan: awareness and preparation. \u003cem\u003eInt J Infect Dis.\u003c/em\u003e 2022;122:991\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHasan M, Hossain MA, Chowdhury S, Das P, Jahan I, Rahman MF, et al. Human monkeypox and preparedness of Bangladesh: a knowledge and attitude assessment study among medical doctors. \u003cem\u003eJ Infect Public Health\u003c/em\u003e. 2023;16(1):90\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShafei AM, Al-Mosaa KM, Alshahrani NZ, ALAmmari MHM, Almuhlafi MOO, Draim NHAA, et al. Resident Physicians\u0026rsquo; knowledge and preparedness regarding human monkeypox: a cross-sectional study from Saudi Arabia. \u003cem\u003ePathogens.\u003c/em\u003e 2023;12(7):872.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mpox outbreak, monkeypox, zoonotic disease, emerging and re-emerging disease, awareness, risk perception, preparedness, outbreak readiness, public health response","lastPublishedDoi":"10.21203/rs.3.rs-9130713/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9130713/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMpox remains an emerging public health threat, particularly in endemic regions like Nigeria. Health workers play a critical role in outbreak detection and response. This study assessed awareness, risk perception, and preparedness for mpox outbreaks among health workers in Abakaliki, Nigeria.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted among 258 health workers at Alex Ekwueme Federal University Teaching Hospital and the National Obstetric Fistula Centre, Abakaliki. Data were collected using a structured self-administered questionnaire and analyzed with IBM SPSS Statistics v20. Descriptive statistics summarized key variables, while chi-square tests and ordinal logistic regression identified predictors of preparedness at p\u0026lt;.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAwareness of mpox was very high (98.1%), though only 20.5% of respondents reported being very familiar with its symptoms. Most participants perceived mpox as a significant public health threat (88.4%). However, preparedness level was very low as only 4.7% were highly prepared for an outbreak. Only 8.9% of respondents reported facility-provided training and 14.0% reported established protocols for mpox management. Years of experience and department of work were predictors of preparedness. Health workers with 11\u0026ndash;15 years of experience were significantly more likely to report higher preparedness (AOR\u0026thinsp;=\u0026thinsp;13.6, 95% CI: 1.42\u0026ndash;129.3, p\u0026thinsp;=\u0026thinsp;0.024).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDespite very high awareness and substantial concern about mpox among health workers, this awareness did not translate into adequate preparedness. Strengthening structured training programs, improving access to guidelines and resources, and establishing clear facility-level preparedness strategies are essential to enhance health workers\u0026rsquo; readiness for future mpox outbreaks.\u003c/p\u003e\u003ch2\u003eClinical trial number:\u003c/h2\u003e \u003cp\u003enot applicable\u003c/p\u003e","manuscriptTitle":"Awareness, risk perception, and preparedness for mpox outbreak among health workers in Abakaliki, Nigeria: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-16 11:28:46","doi":"10.21203/rs.3.rs-9130713/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2d2c051c-259f-4357-8c8b-807c0976978e","owner":[],"postedDate":"March 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-18T14:57:02+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-16 11:28:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9130713","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9130713","identity":"rs-9130713","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}