Community knowledge and perceptions of social, ecological, and behavioural risk factors for mpox in Burundi: A nationwide cross-sectional survey
9 affiliations
- 1National Reference Laboratory, National Public Health Institute, Bujumbura, Burundi
- 2National Public Health Institute, Bujumbura, Burundi
- 3Africa Centres for Disease Control and Prevention, Bujumbura, Burundi
- 4Department of Global Health Security, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- 5Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
- 6Research Laboratory of Microbiology, Infectious Diseases, Allergology and Pathogen Surveillance (LARMIAS), Mohammed VI Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
- 7Mohammed VI Higher Institute of Biosciences and Biotechnologies, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
- 8Mohammed VI Center for Research and Innovation (CM6RI), Rabat, Morocco
- 9Faculty of Medicine, University of Burundi, Bujumbura, Burundi
Abstract
Mpox remains an important public health concern in Africa, particularly following the spread of clade Ib in several countries. In Burundi, limited information is available on population knowledge, risk perception, preventive behaviours, and willingness to accept mpox vaccination. This study assessed social and behavioural factors associated with mpox preparedness among the general population. We conducted a nationwide cross-sectional survey between March and December 2025 across five provinces of Burundi. A total of 5,177 participants aged 15 years and older were interviewed using a structured questionnaire adapted from the Africa CDC behavioural and social sciences framework for mpox. Sampling weights were not applied; therefore, findings should be interpreted as estimates among surveyed participants rather than nationally weighted population estimates. Univariate analyses were conducted to describe key variables, while bivariate and multivariable analyses using modified Poisson regression models with generalized estimating equations were performed to identify factors associated with mpox knowledge and prevention and control practices. Overall, most participants had heard about mpox (94.7%). Many correctly identified skin rash (94.4%) and fever (84.3%) as common symptoms, and most recognized direct contact as a mode of transmission (86.6%). However, 21.4% of participants incorrectly identified bacteria as the causative agent and 24.5% did not know the causative agent. Radio was the main source of information (82.0%) and the most trusted source (87.0%). Higher income was associated with better mpox knowledge. Prevention and control practices varied by knowledge level, income, marital status, and HIV status. Although most participants (86.1%) were unaware of the availability of a vaccine, 76.5% reported willingness to accept vaccination if available. Despite high awareness and willingness to accept vaccination, important gaps in mpox knowledge remain, particularly among lower-income groups. Strengthening accessible and targeted risk communication strategies will be essential to improve mpox preparedness in Burundi.
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BibTeX
@article{nzoyikorera2026community,
title = {{Community knowledge and perceptions of social, ecological, and behavioural risk factors for mpox in Burundi: A nationwide cross-sectional survey}},
author = {Néhémie Nzoyikorera and Emmanuelline Mukama and Jonas Ngendakumana and Ferdinand Nsengimana and Roger Ciza and Marie Noelle Uwineza and Alain Tamba Yombouno and Duncan Kabiito Matovu and Rodgers R. Ayebare and Cathy Asiimwe Tabaro and Anatole Nkeshimana and Idrissa Diawara and Mosoka Papa Fallah and Joseph Nyandwi},
journal = {PLOS Global Public Health},
year = {2026},
month = oct,
doi = {10.1371/journal.pgph.0007383},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007383},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Community knowledge and perceptions of social, ecological, and behavioural risk factors for mpox in Burundi: A nationwide cross-sectional survey
AU - Néhémie Nzoyikorera
AU - Emmanuelline Mukama
AU - Jonas Ngendakumana
AU - Ferdinand Nsengimana
AU - Roger Ciza
AU - Marie Noelle Uwineza
AU - Alain Tamba Yombouno
AU - Duncan Kabiito Matovu
AU - Rodgers R. Ayebare
AU - Cathy Asiimwe Tabaro
AU - Anatole Nkeshimana
AU - Idrissa Diawara
AU - Mosoka Papa Fallah
AU - Joseph Nyandwi
PY - 2026
DA - 2026/10/27
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0007383
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007383
AB - Mpox remains an important public health concern in Africa, particularly following the spread of clade Ib in several countries. In Burundi, limited information is available on population knowledge, risk perception, preventive behaviours, and willingness to accept mpox vaccination. This study assessed social and behavioural factors associated with mpox preparedness among the general population. We conducted a nationwide cross-sectional survey between March and December 2025 across five provinces of Burundi. A total of 5,177 participants aged 15 years and older were interviewed using a structured questionnaire adapted from the Africa CDC behavioural and social sciences framework for mpox. Sampling weights were not applied; therefore, findings should be interpreted as estimates among surveyed participants rather than nationally weighted population estimates. Univariate analyses were conducted to describe key variables, while bivariate and multivariable analyses using modified Poisson regression models with generalized estimating equations were performed to identify factors associated with mpox knowledge and prevention and control practices. Overall, most participants had heard about mpox (94.7%). Many correctly identified skin rash (94.4%) and fever (84.3%) as common symptoms, and most recognized direct contact as a mode of transmission (86.6%). However, 21.4% of participants incorrectly identified bacteria as the causative agent and 24.5% did not know the causative agent. Radio was the main source of information (82.0%) and the most trusted source (87.0%). Higher income was associated with better mpox knowledge. Prevention and control practices varied by knowledge level, income, marital status, and HIV status. Although most participants (86.1%) were unaware of the availability of a vaccine, 76.5% reported willingness to accept vaccination if available. Despite high awareness and willingness to accept vaccination, important gaps in mpox knowledge remain, particularly among lower-income groups. Strengthening accessible and targeted risk communication strategies will be essential to improve mpox preparedness in Burundi.
SN - 2767-3375
ER -