Knowledge, attitudes, and practices of community health workers regarding mpox in Mbarara City, Uganda, February 2025: a cross-sectional study

Background: During December 2024 and January 2025, Mbarara City in central Uganda recorded a steep increase in new mpox cases amid an ongoing outbreak. During the outbreak, community health workers (CHWs) conducted community surveillance, case detection, and community education. We assessed knowledge, attitudes, and practices (KAP) of CHWs regarding mpox transmission, detection, reporting, and referral in Mbarara City. Methods We conducted a cross-sectional study from February 1–15, 2025 among CHWs selected through simple random sampling from a list of CHWs in all city wards. Data were collected using a questionnaire comprising 26 KAP-related items. 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. In total, 129 (64%) participants had good knowledge, 181 (90%) 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 a positive attitude (aOR = 9.0, 95%CI: 2.6–30) were significantly associated with good knowledge. Conclusion Meaningful gaps remained in CHW practices around mpox. particularly case referral and reporting. Targeted CHW training and mentorship could improve outbreak response effectiveness.