MPOX KNOWLEDGE, PERCEIVED RISK FACTORS, AND PREVENTIVE PRACTICES AMONG ADULTS IN RURAL COMMUNITIES OF RIVERS STATE, NIGERIA: A COMMUNITY-BASED CROSS-SECTIONAL STUDY

Abstract

Background: The global re-emergence of Mpox is of great concern, with Nigeria as one of the hotspots in West Africa. Data on knowledge and preventive measures in rural communities within Rivers State are limited. This study therefore examined knowledge of mpox, risk perception and preventive behavior among adults in rural communities in Rivers State, Nigeria, to inform future educational interventions. Methods: A community-based cross-sectional study (November 2025–February 2026) was conducted in three rural Local Government Areas (LGAs) of Rivers State, where 441 adults were recruited through multistage sampling. An interviewer-administered validated questionnaire was used to collect data on sociodemographics, knowledge, risk perception, and practice. Descriptive statistics and multivariable logistic regression (Hosmer-Lemeshow, Nagelkerke R², AUROC) were performed with SPSS v27.0 and R v4.3. Results: The mean age was 41.2 ± 14.7 years, median household size was 6 (IQR:4–8); 55.3% were female. 22.9% had good mpox knowledge (median score 4/15), 12.5% were aware of zoonotic transmission, and 8.4% knew about smallpox vaccine cross-protection. 19.7% reported good preventive practices (≥70%), with 24.5% for handwashing and 18.6% for avoidance of bushmeat at events. 78.9% perceived risk from handling bushmeat and 74.6% from contact with rodents, whereas 34.5% recognized person-to-person transmission as a risk. Of these, 78.9% perceived risk from handling bushmeat and 74.6% from contact with rodents, whereas only 34.5% recognized person-to-person transmission as a risk. Independent predictors of knowledge were secondary education (AOR=6.42), trading (AOR=2.89), higher income (AOR=2.54), and prior mpox awareness (AOR=5.11). Good knowledge strongly predicted good practices (AOR=4.87). The knowledge model reported Hosmer-Lemeshow p=0.412; R²=0.384; AUROC=0.81. The Practices model reported p=0.545; R²=0.291; AUROC=0.74. Conclusion: Mpox knowledge and preventive practices are very low among adults in rural communities of Rivers State, despite high perceived animal risks: education, occupation, income, and prior awareness influence knowledge, which affects practices. Urgent targeted health education through community health workers and locally adapted materials in indigenous languages is needed