Knowledge and Readiness for Mpox Among Primary Healthcare Workers in Malaysia and Their Associated Factors: A Cross-Sectional Study

Mpox has re-emerged as a public health concern, highlighting the need to strengthen frontline preparedness. Primary healthcare workers require adequate knowledge to recognise symptoms, understand transmission, differentiate mpox from other conditions, and follow appropriate management protocols. They must also be prepared to implement appropriate infection prevention and control measures. This study aimed to assess knowledge and readiness regarding mpox management among primary healthcare workers in Malaysia and identify associated factors. A newly developed questionnaire underwent content and face validation, followed by psychometric evaluation using two-parameter logistic item response theory for the knowledge domain and exploratory factor analysis and confirmatory factor analysis for the readiness domain. The questionnaire was then administered in a cross-sectional study among 333 primary healthcare workers in Malaysia. The total knowledge and readiness scores were converted to percentage scores. Descriptive statistics and linear regression analyses were conducted. Mean percentage scores were 78.0% for knowledge and 75.5% for readiness. Among the readiness domains, attitude towards mpox management had the highest mean percentage score (88.8%), followed by intention to take action (81.0%), perceived behavioural control (65.4%), and perceived risk (45.9%). The knowledge score was significantly associated with the presence of a medical illness (adjusted β = -1.01; 95% CI: -1.73, -0.30; p = 0.006), being a medical assistant (adjusted β = -1.62; 95% CI: -2.36, -0.87; p < 0.001) or nurse (adjusted β = -1.32; 95% CI: -2.05, -0.59; p < 0.001), attendance at an mpox-related course (adjusted β = 1.31; 95% CI: 0.43, 2.19; p = 0.004), and the readiness score (adjusted β = 0.14; 95% CI: 0.11, 0.18; p < 0.001). The readiness score was significantly associated with having a master’s degree (adjusted β = 5.76; 95% CI: 0.11, 11.41; p = 0.046), being a medical assistant (adjusted β = 4.54; 95% CI: 1.37, 7.72; p = 0.005) or nurse (adjusted β = 3.28; 95% CI: 0.01, 6.55; p = 0.049), working in a clinic with a moderate (adjusted β = 2.76; 95% CI: 0.76, 4.77; p = 0.007) or high workload (adjusted β = 2.44; 95% CI: 0.26, 4.63; p = 0.029), previous experience managing suspected mpox cases (adjusted β = 3.53; 95% CI: 0.36, 6.70; p = 0.029), and the knowledge score (adjusted β = 0.87; 95% CI: 0.61, 1.13; p < 0.001). Primary healthcare workers demonstrated relatively favourable mean scores for knowledge and overall readiness regarding mpox management, although gaps remained in specific knowledge areas, perceived behavioural control, and perceived risk. These findings may help health authorities develop profession-specific training to address the identified gaps and routinely monitor frontline preparedness using the validated questionnaire.