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Awareness, Attitude, and Knowledge Among the Healthcare Workers in China at the Onset of the Oversea Monkeypox Outbreak

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Abstract

Background

The outbreak of monkeypox in several nonendemic countries has been reported since May 2022. In the context of the COVID-19 pandemic, it is important to examine how healthcare workers (HCWs) respond to the monkeypox epidemic. Having been involved in the fight against COVID-19 resurgence for nearly 3 years, how HCWs in China respond to the oversea monkeypox outbreak remains unclear.

Objective

To investigate the awareness, perceived risk, attitude and knowledge about monkeypox among HCWs in China.

Design

A cross-sectional survey.

Participants

Physicians and nurses from 13 hospitals in Suizhou, China, were contacted through membership of the Physicians’ and Nurses’ Association.

Main Measures

Responses regarding their awareness, risk perception, attitude, behavior, and knowledge about the outbreak of monkeypox were collected anonymously during the second month of the outbreak between 15 and 21 June 2022.

Key Results

Of the 395 physician and 1793 nurse respondents, most had heard of the oversea monkeypox outbreak (physicians 93%, nurses 88%). More than 30% thought there existed an infection risk for themselves or family members (physicians 42%, nurses 32%). Most agreed that HCWs should pay attention to the outbreak (physicians 98%, nurses 98%). More than half had actively sought expertise (physicians 62%, nurses 52%). Approximately half believed that monkeypox may be transmitted through sexual activity or respiratory droplets, or from mother to fetus in utero (physicians 50%, 62%, 55%; nurses 40%, 60%, and 48%, respectively). Some believed that mask-wearing, hand-washing, and glove-wearing can prevent monkeypox transmission (physicians 78%, 89%, 83%; nurses 77%, 86%, 76%, respectively).

Conclusions

This study identified high awareness, high perceived risk, and pro-prevention attitudes among HCWs in China at the onset of the oversea multi-country monkeypox outbreak, but low levels of monkeypox-related knowledge. Immediate efforts are needed to fill in their knowledge gap, particularly regarding the transmission routes and prevention measures.

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Data Availability

The datasets analyzed for this study are available from the corresponding author upon reasonable request.

References

  1. Word Health Organitation. Multi-country monkeypox outbreak: situation update. Available online: https://www.who.int/emergencies/diseaseoutbreak-news/item/2022-DON393 (accessed on 8 October 2022).

  2. Lum FM, Torres-Ruesta A, Tay MZ, et al. Monkeypox: disease epidemiology, host immunity and clinical interventions. Nat Rev Immunol, 2022;22(10): 597-613.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Silva NIO, de Oliveira JS, Kroon EG, et al. Here, There, and Everywhere: The Wide Host Range and Geographic Distribution of Zoonotic Orthopoxviruses. Viruses, 2020;13(1).

  4. Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Multi-Country Monkeypox Outbreak. https://www.who.int/news/item/25-06-2022-meeting-of-the-international-health-regulations-(2005)-emergency-committee--regarding-the-multi-country-monkeypox-outbreak (accessed on 14 October 2022).

  5. Gonzalez Mendez MJ, Ma L, Alvarado R, et al. A Multi-Center Study on the Negative Psychological Impact and Associated Factors in Chinese Healthcare Workers 1 Year After the COVID-19 Initial Outbreak. Int J Public Health, 2022;67: 1604979.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ouyang H, Geng S, Zhou Y, et al. The increase of PTSD in front-line health care workers during the COVID-19 pandemic and the mediating role of risk perception: a one-year follow-up study. Transl Psychiatry, 2022;12(1): 180.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. ** L, Zhang N, and Zhu J. Healthy lifestyle changes and mental health of healthcare workers during the COVID-19 pandemic in China. Curr Psychol, 2022;1–10.

  8. Barrett E, Hingle ST, Smith CD, et al. Getting Through COVID-19: Kee** Clinicians in the Workforce. Ann Intern Med, 2021;174(11): 1614-1615.

    Article  PubMed  Google Scholar 

  9. Larese Filon F, Pesce M, Paulo MS, et al. Incidence of occupational contact dermatitis in healthcare workers: a systematic review. J Eur Acad Dermatol Venereol, 2021;35(6): 1285-1289.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Cretu S, Dascalu M, Georgescu SR, et al. Personal protective equipment use and face acne in health care providers during the COVID-19 pandemic in Romania: A new occupational acne type? J Eur Acad Dermatol Venereol, 2022;36(1): e18-e20.

    Article  CAS  PubMed  Google Scholar 

  11. Ackerman JM, Tybur JM, and Blackwell AD. What Role Does Pathogen-Avoidance Psychology Play in Pandemics? Trends Cogn Sci, 2021;25(3): 177-186.

    Article  PubMed  Google Scholar 

  12. World Health Organization. Multi-country monkeypox outbreak: situation update. https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON396. (accessed on 8 October 2022).

  13. Cuzick J. A Wilcoxon-type test for trend. Stat Med, 1985;4(1): 87-90.

    Article  CAS  PubMed  Google Scholar 

  14. World Health Organization (WHO). WHO Director-General's statement at the press conference following IHR Emergency Committee regarding the multi-country outbreak of monkeypox - 23 July 2022. https://www.who.int/director-general/speeches/detail/who-director-general-s-statement-on-the-press-conference-following-IHR-emergency-committee-regarding-the-multi--country-outbreak-of-monkeypox--23-july-2022 (accessed on October 14, 2022).

  15. Liu J, Liu M, and Liang W. Persevere in the Dynamic COVID-Zero Strategy in China to Gain a Precious Time Window for the Future. China CDC Wkly, 2022;4(18): 393-394.

    PubMed  PubMed Central  Google Scholar 

  16. Tong Y, Zhang Q, Wang X, et al. Dynamic changes in mental health status related to the COVID-19 pandemic among health care workers and inpatients in China. Front Psychiatry, 2022;13: 956068.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Brehon A, Shourick J, Hua C, et al. Dermatological emergency unit, day-care hospital and consultations in time of COVID-19: the impact of teledermatology. J Eur Acad Dermatol Venereol, 2022;36(3): e175-e177.

    Article  CAS  PubMed  Google Scholar 

  18. Feng X, Yang C, Yang H, et al. Anxiety, depression, and somatic symptom disorders in health care workers at high altitude during the rapid spread of the SARS-CoV-2 Omicron variant: A prospective cohort study. Front Psychiatry, 2022;13: 1018391.

    Article  PubMed  Google Scholar 

  19. Liu Y, Hou T, Gu H, et al. Resilience and Anxiety Among Healthcare Workers During the Spread of the SARS-CoV-2 Delta Variant: A Moderated Mediation Model. Front Psychiatry, 2022;13: 804538.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kiely LF, O'Connor C, O'Briain G, et al. Maskne prevalence and associated factors in Irish healthcare workers during the COVID-19 pandemic. J Eur Acad Dermatol Venereol, 2022;36(7): e506-e508.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Li Y, Tan J, Tan S, et al. Infection rate and factors affecting close contacts of COVID-19 cases: A systematic review. J Evid Based Med, 2022;15(4): 385-397.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Reynolds MG and Damon IK. Outbreaks of human monkeypox after cessation of smallpox vaccination. Trends Microbiol, 2012;20(2): 80-87.

    Article  CAS  PubMed  Google Scholar 

  23. Fine PE, Jezek Z, Grab B, et al. The transmission potential of monkeypox virus in human populations. Int J Epidemiol, 1988;17(3): 643-650.

    Article  CAS  PubMed  Google Scholar 

  24. Jezek Z, Szczeniowski M, Paluku KM, et al. Human monkeypox: clinical features of 282 patients. J Infect Dis, 1987;156(2): 293-298.

    Article  CAS  PubMed  Google Scholar 

  25. Thornhill JP, Barkati S, Walmsley S, et al. Monkeypox Virus Infection in Humans across 16 Countries - April-June 2022. N Engl J Med, 2022;387(8): 679-691.

    Article  CAS  PubMed  Google Scholar 

  26. Karem KL, Reynolds M, Hughes C, et al. Monkeypox-induced immunity and failure of childhood smallpox vaccination to provide complete protection. Clin Vaccine Immunol, 2007;14(10): 1318-1327.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Kaur A, Goel R, Singh R, et al. Identifying monkeypox: do dental professionals have adequate knowledge and awareness? Rocz Panstw Zakl Hig, 2022;73(3): 365-371.

    PubMed  Google Scholar 

  28. Harapan H, Setiawan AM, Yufika A, et al. Knowledge of human monkeypox viral infection among general practitioners: a cross-sectional study in Indonesia. Pathog Glob Health, 2020;114(2): 68-75.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Laine C, Moyer DV, and Cotton D, Monkeypox. Challenging Clinical Questions. Ann Intern Med, 2022;175(12): 1754-1755.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Graduate School, **zhou Medical University, **zhou, China

    Heng-Cui Zhou & Zhi-Jiang Zhang

  2. Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China

    Zhi-Jiang Zhang

  3. Graduate School, **zhou Medical University, **zhou, China

    Zhi-Jiang Zhang

Authors
  1. Heng-Cui Zhou
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  2. Zhi-Jiang Zhang
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Contributions

Z.-J.Z. concepted study, analyzed data, drafted manuscript; H.-C.Z. collected data, analyzed data, drafted manuscript.

Corresponding author

Correspondence to Zhi-Jiang Zhang.

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Zhou, HC., Zhang, ZJ. Awareness, Attitude, and Knowledge Among the Healthcare Workers in China at the Onset of the Oversea Monkeypox Outbreak. J GEN INTERN MED 38, 2914–2920 (2023). https://doi.org/10.1007/s11606-023-08159-7

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  • DOI: https://doi.org/10.1007/s11606-023-08159-7

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