Mpox knowledge and attitudes among tertiary-educated young adults in Selangor, Malaysia: a cross-sectional study

Background Mpox is a re-emerging zoonotic disease and an ongoing global health concern. In Malaysia, sporadic cases have been reported from July 2023 onward, yet mpox knowledge outside healthcare populations remains insufficiently described. This study assessed mpox knowledge and attitudes, and examined associated factors among purposively sampled tertiary-educated adults aged 18–44 years residing in Selangor, Malaysia, who had previously heard of mpox.Methods A cross-sectional survey was conducted between October and December 2023, using a validated questionnaire covering sociodemographics, mpox knowledge and attitudes. Good knowledge was defined as ≥70% and positive attitude as ≥80%. Univariable and multivariable logistic regression were used to identify factors associated with poor knowledge (<70%) and negative attitude (<80%).Results Among 401 respondents (mean age 23.8±5.1 years), 68.6% were female, 72.1% earned ≤RM1,500/month, and 66.6% were unemployed. Only 8.5% demonstrated good knowledge and 91.5% had poor knowledge, whereas 80.5% reported positive attitudes. Older age (AOR = 0.94 per year; 95% CI 0.89–0.99) and a history of chickenpox (AOR = 0.48; 95% CI 0.23–0.99) were associated with lower odds of poor knowledge. Male gender (AOR = 1.91; 95% CI 1.14–3.20) and employment (unemployed vs employed: AOR = 0.48; 95% CI 0.29–0.80) were associated with negative attitudes.Conclusions Despite generally favourable attitudes, mpox knowledge was low in this tertiary-educated, mpox-aware young-adult sample. Targeted, evidence-based risk communication for younger individuals, males and workplace populations may strengthen preparedness and promote preventive behaviours.