Knowledge and attitude toward monkeypox (mpox) among healthcare providers in Sub-Saharan Africa: a systematic review...

Mpox is an emerging global health threat with increasing frequency and geographic spread recently. Healthcare providers play a pivotal role in outbreak prevention, early detection, isolation, and response. This systematic review and meta-analysis aimed to assess the pooled prevalence of knowledge and attitude toward Mpox among healthcare providers in Sub-Saharan Africa (SSA).

This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. A comprehensive literature search was performed in PubMed, ScienceDirect, Hinari, and Google Scholar to identify eligible studies published between 2 July 2015 and 2 July 2025. Data were extracted and managed using Microsoft Excel and analyzed using STATA version 17. Pooled prevalence estimates were calculated using a random-effects model. The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Publication bias was examined using funnel plots and Egger's regression test, and statistical heterogeneity was assessed using the I² statistic. The review protocol was registered in PROSPERO (CRD420251123652).

This systematic review and meta-analysis included seven studies from Sub-Saharan Africa, comprising a total of 3379 healthcare providers. The pooled prevalence of adequate knowledge and a positive attitude toward Mpox was 40.52% (95% CI, 30.17-50.88) and 51.20% (95% CI, 44.48-57.91), respectively, with high heterogeneity (I² > 90%). Factors associated with higher knowledge included age over 40 years (AOR = 5.90; 95% CI, 1.27-27.41), being married (AOR = 1.58; 95% CI, 1.24-2.01), being a physician (AOR = 6.82; 95% CI, 1.38-33.56), having 5-10 years of work experience (AOR = 7.02; 95% CI, 1.51-32.74), prior information about Mpox (AOR = 1.82; 95% CI, 1.11-2.97), and a history of COVID-19 vaccination (AOR = 1.98; 95% CI, 1.47-2.68). Regarding attitude, higher education (AOR = 2.09; 95% CI, 1.38-3.18) and male sex (AOR = 1.50; 95% CI, 1.12-1.91) were positively associated. Prevalence was pooled through meta-analysis, while associated factors were reported individually from each study, as pooling adjusted odds ratios was not appropriate due to differences in covariates and outcome definitions. These findings should be interpreted with caution due to high heterogeneity, the small number of studies, and uneven geographic representation.

The findings of this systematic review and meta-analysis indicate that knowledge and attitudes toward Mpox among healthcare providers in Sub-Saharan Africa are generally suboptimal. However, these results should be interpreted with caution due to high heterogeneity across studies, the limited number of included studies, and uneven geographic representation. Nonetheless, the findings underscore the need for context-specific capacity-building interventions, including targeted training, improved access to up-to-date clinical guidelines, and enhanced preparedness strategies to support healthcare providers in responding to Mpox and other emerging infectious diseases.