Knowledge, attitudes, and practices of community health workers regarding Mpox in Mbarara City, Uganda, February 2025

Abstract

Introduction: Mpox is a re-emerging zoonotic viral disease with significant public health implications due to its potential for human-to-human transmission and outbreaks in urban areas. Community health workers (CHWs) play a critical role in surveillance, case detection, and health education; however, their preparedness for mpox control is not well documented. This study assessed the knowledge, attitudes, and practices (KAP) of CHWs regarding mpox transmission, detection, reporting, and referral in Mbarara City, February 2025. Methods: We conducted a cross-sectional study in Mbarara City, southwestern Uganda, from February 1–15, 2025. Eligible participants were CHWs aged ≥18 years with at least one year of experience. Those unavailable during data collection were excluded. Using simple random sampling, CHWs were selected from a list of all CHWs across city wards. A self-administered, researcher-developed questionnaire comprising 26 mpox-related KAP items was used. Knowledge was assessed using 11 items, attitude with 5 items, and practice with 7 items, each worth 1 point. Scores >60% were classified as good knowledge, positive attitude, or good practices. Multivariate logistic regression was used to identify KAP-associated factors. Results: Among 206 CHWs, 159 (77%) were female, and 127 (62%) had >10 years of experience. Four participants had not heard about mpox. In total, 64% (129/202) of participants had good knowledge, 90% (181/202) had positive attitudes, and seven (3%) demonstrated good practices. Regarding practices, 143 (73%) engaged in health education, 55 (28%) referred suspected cases, and 51 (26%) consistently reported to health authorities when a suspected case was identified. Having attended mpox-specific training (aOR=5.0; 95%CI: 2.2–11) and having good knowledge (aOR=9.0, 95%CI: 2.6–30) were significantly associated with a positive attitude. Conclusions: While most CHWs showed positive attitudes about mpox, just about two-thirds had good knowledge. Serious gaps remain in case referral and reporting. Targeted CHWs training and mentorship could improve outbreak response effectiveness.