Background: Monkeypox (Mpox) is a re-emerging infectious disease representing a new global challenge. It poses a substantial threat to countries, particularly those with a low number of cases. Due to its popularity as a tourist destination and its proximity to many African refugees, Egypt is potentially at risk of Mpox importation. Therefore, effective disease management necessitates healthcare workers (HCWs) to possess adept knowledge, along with a positive attitude and behavior. The study aimed to assess the knowledge, attitude, and perception of Egyptian HCWs and medical students towards human Mpox. Methods: The present cross-sectional study data was collected from participants between October and December 2022 via a questionnaire. The questionnaire comprised 31 questions in the knowledge section, 11 questions in the attitude section, and 14 in the perception section. Results: The present study involved a total of 1,034 HCWs and medical students. It was found that 55.3% of the participants demonstrated adequate knowledge about Mpox, whereas 44.5% and 39.8% of the respondents exhibited favorable attitudes and perceptions towards the disease, respectively. Binary logistic regression analysis revealed that adequate knowledge was significantly Frontiers in Cellular and Infection Microbiology 01 frontiersin.org OPEN ACCESS EDITED BY Mohd Ahmar Rauf, Wayne State University, United States REVIEWED BY Mazharul Islam, Ministry of Environment, Qatar Mohamed Lounis, Ziane Achour University of Djelfa, Algeria *CORRESPONDENCE Noha M. Hammad nmhammad@medicine.zu.edu.eg RECEIVED 16 November 2023 ACCEPTED 24 January 2024 PUBLISHED 12 February 2024 CITATION Amer FA, Nofal HA, Gebriel MG, Bedawy AM, Allam AA, Khalil HES, Elahmady M, Nofal H, Saeed MA, Shaltout SW, Behiry A, Attia O, Bahgat SM, Ali AA, Ahmed FM, Abdelrahman AM and Hammad NM (2024) Grasping knowledge, attitude, and perception towards monkeypox among healthcare workers and medical students: an Egyptian cross-sectional study. Front. Cell. Infect. Microbiol. 14:1339352. doi: 10.3389/fcimb.2024.1339352 COPYRIGHT © 2024 Amer, Nofal, Gebriel, Bedawy, Allam, Khalil, Elahmady, Nofal, Saeed, Shaltout, Behiry, Attia, Bahgat, Ali, Ahmed, Abdelrahman and Hammad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. TYPE Original Research PUBLISHED 12 February 2024 DOI 10.3389/fcimb.2024.1339352 observed in ages older than 40 years (p < 0.001), married participants (p < 0.001), and doctors (p < 0.001). The positive attitude was significantly observed among the male sex (p = 0.045), urban residents (p = 0.002), and nurses (p = 0.002). Conversely, married participants (p = 0.013), doctors (p < 0.001), and individuals employed in pharmacy and laboratory departments (p < 0.001) experienced an increase in positive perception. Conclusion: Knowledge, attitude, and perception towards Mpox among Egyptian HCWs and medical students exhibit suboptimal levels. Addressing these gaps is crucial to controlling and effectively preventing disease transmission. KEYWORDS Egypt, healthcare workers, KAP study, medical students, Mpox 1 Introduction The monkeypox (Mpox) virus is an enveloped, brick-shaped DNA virus. Two virus clades are identified through genomic sequencing: West African (WA) and Congo Basin (CB) clades. According to virulence, the WA clade is thought to be less virulent and less transmissible than CB (Sale et al., 2006). Although human￾to-human transmission is likely, humans are deemed incidental hosts. The Mpox virus can be transmitted to humans via contaminated fomites, respiratory droplets, direct contact with infected animals or humans, ingesting infected meat (Brown and Leggat, 2016), and sexual contact, particularly among gay communities (Amer et al., 2022). In May 2022, the Mpox disease, previously referred to as monkeypox (World Health Organization [WHO], 2022b), emerged as an epidemic. It infected more than 91,788 confirmed cases and resulted in a total of 167 deaths as of the time of writing this article (WHO, 2023) A total of 89,358 cases were identified in countries and territories where the disease was not previously common, in addition to 1970 cases reported in endemic countries (Centers for Disease Control and Prevention [CDC], 2022a). In September 2022, Egypt officially announced the detection of the first case of Mpox in a 42-year-old man who arrived from Spain. According to WHO Mpox Global Trends, the number of confirmed cases has stood at three until the present (WHO, 2023). This epidemic began to decline following the provision of vaccination programs and the implementation of relevant infection control (IPC) procedures (WHO, 2023). Notably, this does not imply the conclusion of the epidemic, as there is a possibility of the re￾emergence. Although less frequent with DNA viruses, the occurrence of mutation leads to new variants, as was the case of the May outbreak strain (Giorgi et al., 2022). This phenomenon is also observed in other viruses. The lack of understanding of various factors during the initial outbreak in non-endemic countries can contribute to re-emergence of the disease (Amer et al., 2023). Despite the extensive utilization of vaccination, recent studies have reported several breakthrough infections after using the modified vaccinia Ankara–Bavaria Nordic (MVA–BN) vaccine in preventing Mpox infection (Hazra et al., 2022; Bertran et al., 2023; Taha et al., 2023). According to WHO, a contributing factor to the resurgence of Mpox in non-endemic countries is the inadequate knowledge among HCWs. Furthermore, the close contact between HCWs and infected patients increases their risk of contracting the disease (WHO, 2022a). Several reports evaluated the public and HCWs’ knowledge, attitudes, and perceptions (KAP). Studies conducted in Jordan and the Kingdom of Saudi Arabia (KSA) revealed inadequate knowledge regarding Mpox among HCWs and medical students, respectively (Sallam et al., 2022). For Egypt, a non-endemic country of Mpox, several factors require attention in order to prevent the importation of Mpox. In addition to being a popular tourist destination worldwide, its strategic geographic location in North Africa renders it a convenient host country for African refugees and international students (United Nations High Commissioner for Refugees [UNHCR], 2023; Ghaffar, 2022). Therefore, the cornerstone of preventing the disease, with potential dissemination to other areas of the world, is to ensure that HCWs are equipped with sound knowledge and have positive attitudes and perceptions towards Mpox infection. That applies to medical students recognized for their significant contributions to public health efforts during epidemics (Lazarus et al., 2020; Stachteas et al., 2021). The study aimed to assess the KAP towards Mpox infection among Egyptian HCWs and medical students to increase awareness of Mpox. 2 Methods 2.1 Study design This study adopted a cross-sectional design involving HCWs and medical students. The survey tool was developed and pre-tested by reviewing ten HCWs of different positions and by 12 students in Amer et al. 10.3389/fcimb.2024.1339352 Frontiers in Cellular and Infection Microbiology 0