Knowledge, Attitude and Associated Factors of Monkeypox Infection Among Healthcare Workers in Injibara General Hospital, Northwest Ethiopia

Figures & data

Table 1 General Characteristics of Healthcare Workers Working at Injibara General Hospital, Northwest Ethiopia, 2022 (n = 200)

Variables	Category	Frequency	%
Age (in years)	< 30	104	52.0
	≥ 30	96	48.0
Sex	Male	112	56.0
	Female	88	44.0
Marital status	Single	69	34.5
	Married	131	65.5
Educational status	Diploma	27	13.5
	BSc degree	154	77.0
	MSc and above	19	9.5
Work experience (in years)	<5	93	46.5
	≥ 10	107	53.5
Profession	Nurses	97	48.5
	Midwives	48	24.0
	Doctors	30	15.0
	Others	25	12.5
Salary per month (Ethiopian Birr)	3600–6193	24	12.0
	6193–8017	69	34.5
	8017–9057	56	28.0
	9057–15,390	51	25.5
History of COVID-19 infection	Yes	12	6.0
	No	188	94.0
Contact history with COVID-19-diagnosed people	Yes	57	28.5
	No	143	71.5
Being vaccinated against COVID-19	Yes	74	37.0
	No	126	63.0
Having known chronic medical illness	Yes	11	5.5
	No	189	94.5
Having information access to mpox	Yes	147	73.5
	No	53	26.5
Source of information about human mpox (more than one answer is possible)	Social media	130	65.0
	Television and radio	72	36.0
	Colleagues	44	22.0
	Medical books, or during studying	24	12.0

Note: Others, pharmacy, laboratory, anesthesia, public health, and emergency surgery officers.

Table 2 Healthcare Workers’ Responses to Knowledge Questions About Human Mpox in Injibara General Hospital, Northwest Ethiopia, 2022 (n = 200)

	Knowledge Questions	N (%)
		Correct	Incorrect
Q1	Mpox is prevalent in Western and Central Africa	141 (57.0)	86 (43.0)
Q2	There is/are confirmed human mpox cases in Ethiopia	160 (80.0)	40 (20.0)
Q3	Mpox disease is a viral infection	111 (55.5)	89 (44.5)
Q4	Mpox disease is a bacterial infection	155 (77.5)	45 (22.5)
Q5	Mpox is easily transmitted from person to person	122 (61.0)	78 (39.0)
Q6	Mpox is transmitted by the bite of an infected animal	142 (71.0)	58 (29.0)
Q7	Mpox is transmitted through skin-to-skin contact	106 (53.0)	94 (47.0)
Q8	Mpox is transmitted through respiratory droplets	108 (54.0)	92 (46.0)
Q9	Mpox can be transmitted by eating insufficiently cooked meat from an infected animal	89 (44.5)	111 (55.5)
Q10	International travel is the main source of imported cases of mpox infection	110 (55.0)	90 (45.0)
Q11	Mpox and smallpox have almost similar signs and symptoms	117 (58.5)	83 (41.5)
Q12	Flu-like symptoms (fever, chills, cough, runny nose, fatigue, headache, muscle, and backache) are the early signs or symptoms of human mpox	119 (59.5)	81 (40.5)
Q13	Rashes on the skin are one of the signs or symptoms of mpox	136 (68.0)	64 (32.0)
Q14	Vesicles on the skin are one of the signs or symptoms of human mpox	122 (61.0)	78 (39.0)
Q15	Diarrhea is one of the signs or symptoms of human mpox	138 (69.0)	62 (31.0)
Q16	Lymphadenopathy (swollen lymph nodes) is one clinical sign or symptom that could be used to differentiate between mpox and smallpox cases	115 (57.5)	85 (42.5)
Q17	Hand sanitizers and face masks are important in preventing mpox	109 (54.5)	91 (45.5)
Q18	One management option for symptomatic mpox patients is to use paracetamol	95 (47.5)	105 (52.5)
Q19	Antiviral drugs are required in the management of human mpox patients	76 (38.0)	124 (62.0)
Q20	Antibiotics required in the management of human mpox patients	80 (40.0)	120 (60.0)
Q21	People who got the smallpox vaccine are immunized against mpox	117 (58.5)	83 (41.5)
Q22	There is a specific vaccine for mpox	95 (47.5)	105 (52.5)
Q23	There is a specific treatment for mpox	74 (37.0)	126 (63.0)
	Mean score (± SD)	13.05 (± 3.95)

Figure 1 Knowledge and attitude towards monkeypox among healthcare workers at Injibara General Hospital, Northwest Ethiopia, 2022 (n = 200).

Notes: In the attitude graph, green color signifies a positive attitude, while the red color represents a negative attitude.

Table 3 Binary Logistic Regression Analyses for Factors Associated with Mpox Knowledge Among HCWs in Injibara General Hospital, Northwest Ethiopia, 2022 (n = 200)

Variable	Monkeypox Knowledge		COR (95% CI)	AOR (95% CI)	P
	Good n (%)	Poor n (%)
Age in years
≥ 30	43 (21.5)	53 (26.5)	1.67 (0.94, 2.97)
< 30	34 (17.0)	70 (35.0)	1
Sex
Male	50 (25.0)	62 (31.0)	1.82 (1.02, 3.28)	1.44 (0.75, 2.79)	0.276
Female	27 (13.5)	61 (30.5)	1	1
Marital status
Single	30 (15.0)	39 (19.5)	1.38 (0.76, 2.50)
Married	47 (23.5)	84 (42.0)	1
Level of education
MSc and above	14 (7.0)	5 (2.5)	22.40 (4.63, 108.30)	11.25 (2.03, 62.33)	0.008*
BSc	60 (30.0)	94 (47.0)	5.11 (1.47, 17.70)	2.28 (0.56, 9.21)
Diploma	3 (1.5)	24 (12.0)	1	1
Work experience (in years)
≥ 10	45 (22.5)	62 (31.0)	1.38 (0.78, 2.46)
<5	32 (16.0)	61 (30.5)	1
Profession type
Nurse	49 (24.5)	48 (24.0)	5.36 (1.71, 16.77)	2.05 (0.51, 8.15)	0.076
Midwife	11 (5.5)	37 (18.5)	1.56 (0.44, 5.52)	3.65 (0.87, 15.30)
Doctor	13 (6.5)	17 (8.5)	4.02 (1.11, 14.59)	1.82 (0.96, 7.31)
Others	4 (2.0)	21 (10.5)	1	1
History of COVID-19 infection
Yes	10 (5.0)	2 (1.0)	9.03 (1.92, 42.43)	3.43 (0.67, 17.64)	0.140
No	67 (33.5)	121 (60.5)	1	1
Contact history with COVID-19-diagnosed people
Yes	21 (10.5)	36 (18.0)	1.10 (0.59, 2.08)
No	56 (28.0)	87 (43.5)	1
Being vaccinated against COVID-19
Yes	40 (20.0)	34 (17.0)	2.83 (1.56, 5.14)	2.60 (1.37, 4.94)	0.003*
No	37 (18.5)	89 (44.5)	1	1
Having known chronic medical illness
Yes	8 (4.0)	3 (1.5)	4.64 (1.19, 18.06)	2.04 (0.44, 9.45)
No	69 (34.5)	120 (60.0)	1	1
Having information access to mpox
Yes	69 (34.5)	78 (39.0)	4.98 (2.19, 11.29)	3.37 (1.33, 8.50)	0.010*
No	8 (4.0)	45 (22.5)	1	1

Notes: Others, pharmacy, laboratory, anesthesia, public health and emergency surgery officers; *Implies significant association.

Abbreviations: CI, confidence interval; COR, crude odds ratio; AOR, adjusted odds ratio; mpox, monkeypox.

Figure 2 Participants agreement level towards human monkeypox prevention among healthcare workers at Injibara General Hospital, Northwest Ethiopia, 2022 (n = 200).

Notes: A = I am interested in learning more about monkeypox disease, B = I am interested in learning more about the epidemiology of the new emerging diseases, C = Monkeypox disease can be transmitted to my country, D = I have bad feelings that monkeypox virus might become a worldwide pandemic, E = Monkeypox can add new burden on healthcare system of the affected countries, F = Traveling to monkeypox disease-infected countries is risky and should be restricted, G = I have reservations/doubt about the virus's genesis as it is now explained, H = The spread of viruses is a deliberate attempt to reduce the size of the global population, I = Monkeypox will finally be successfully controlled globally, J = I will receive monkeypox vaccine if made available.

Table 4 Binary Logistic Regression Analyses for Factors Associated with Mpox Attitude Among HCWs in Injibara General Hospital, Northwest Ethiopia, 2022 (n = 200)

Variable	Monkeypox Attitude		COR (95% CI)	AOR (95% CI)	P
	Positive n (%)	Negative n (%)
Age in years
≥ 30	74 (37.0)	22 (11.0)	3.63 (1.97, 6.70)	2.95 (1.55, 5.60)*	0.001*
< 30	50 (25.0)	54 (27.0)	1	1
Sex
Male	70 (35.0)	42 (21.0)	1.05 (0.59, 1.87)
Female	54 (27.0)	34 (17.0)	1
Marital status
Married	84 (42.0)	47 (23.5)	1.30 (0.71, 2.35)
Single	40 (20.0)	29 (14.5)	1
Level of education
MSc and above	13 (6.5)	6 (3.0)	7.58 (2.01, 28.57)	2.31 (0.51, 10.48)	0.214
BSc	105 (52.5)	49 (24.5)	7.50 (2.85.19.76)	2.69 (0.89, 8.16)
Diploma	6 (3.0)	21 (10.5)	1	1
Work experience (in years)
≥ 10	75 (37.5)	32 (16.0)	2.11 (1.18, 3.76)	0.87 (0.40, 1.92)	0.730
<5	49 (24.5)	44 (22.0)	1	1
Profession type
Nurse	56 (28.0)	41 (20.5)	0.64 (0.25, 1.63)	0.47 (0.15, 1.46)	0.258
Midwife	23 (11.5)	25 (12.5)	0.43 (0.16, 1.19)	0.46 (0.14, 1.50)
Doctor	28 (14.0)	2 (1.0)	6.59 (1.25, 34.74)	4.36 (0.71, 26.94)
Others	17 (8.5)	8 (4.0)	1	1
History of COVID-19 infection
Yes	9 (4.5)	3 (1.5)	1.90 (0.50, 7.27)
No	115 (57.5)	73 (36.5)	1
Contact history with COVID-19-diagnosed people
Yes	43 (21.5)	14 (7.0)	2.35 (1.18, 4.68)	1.80 (0.85, 3.814)	0.125
No	81 (40.5)	62 (31.0)	1	1
Having known chronic medical illness
Yes	7 (3.5)	4 (2.0)	1.08 (0.31, 3.81)
No	117 (58.5)	72 (36.0)	1
Having information access to mpox
Yes	106 (53.0)	41 (20.5)	5.03 (2.56, 9.86)	4.14 (2.06, 8.30)	0.001*
No	18 (9.0)	35 (17.5)	1	1
Mpox Knowledge
Good	55 (27.5)	22 (11.5)	1.96 (1.06, 3.60)	1.27 (0.63, 2.56)
Poor	69 (34.5)	54 (27.0)	1	1

Notes: Others, pharmacy, laboratory, anesthesia, public health and emergency surgery officers; *Implies significant association.

Abbreviations: CI, confidence interval; COR, crude odds ratio; AOR, adjusted odds ratio; mpox, monkeypox.