Background: Ghana ranked 31st worldwide and 3rd in Africa in the number of confirmed cases worldwide. We aimed to assess the intention to receive the monkeypox (MPOX) vaccine and its associated psychological antecedents among the Ghanaian population. Methods: A cross-sectional online survey was conducted in Ghana from November to December 2022. Snowball sampling was used to recruit participants via social media platforms, such as WhatsApp, LinkedIn, Telegram, and Facebook. The validated 5C scale was used to assess five psychological factors that influence vaccination behavior and intent: confidence, complacency, constraints, calculation, and collective responsibility. Results: The study drew 605 participants; their mean age was 30.0 ± 6.8; 68.1% were single; 60.8 % were males, and 51.9% were living in Greater Accra (The capital and largest city of Ghana). About 53.9% of the studied Ghanaian population did not intend to receive the MPOX vaccination. Vaccine acceptance among non-healthcare workers (non-HCWs) was significantly lower than among HCWs (41.7 vs. 55.3, p < 0.001). The determinants of vaccine acceptance were male gender (AOR = 1.48, 95% CI, 1.00–2.18, p = 0.049), urban residence (AOR = 0.63, 95% CI, 0.41–0.96, p = 0.033), refusal of coronavirus 2019 vaccine (AOR = 0.29, 95% CI, 0.16–0.52, p < 0.001), confidence in vaccination ((AOR = 2.45, 95% CI, 1.93–3.15, and p < 0.001), and collective responsibility (AOR = 1.34, 95% CI, 1.02–1.75, p = 0.034)). Conclusions: The participants in this study did not show high levels of intention to accept the MPOX vaccination. Consequently, tailoring the efforts aiming to promote MPOX vaccination is needed especially among non-HCWs through increasing their confidence in vaccine effectiveness and safety and promoting the importance of self-vaccination to protect others.

Background: Fostering a culture of clinical effectiveness among healthcare professionals (HCPs) is crucial to achieving optimal patient health outcomes. To our knowledge, there is a lack of robust evidence-based practice (EBP) tools to assess the competence of HCPs in EBP in the Eastern Mediterranean Region (EMR). Aim: This study aims to comprehensively investigate the construct validity and internal reliability of the evidence-based practice questionnaire (EBPQ) among HCPs in the EMR. Methods: This multinational and multi-disciplinary cross-sectional study was conducted between 27 April and 11 May 2023. Convenience and snowball sampling methods were used to recruit a sample of HCPs (physicians, nurses, physiotherapists, dentists, and pharmacists) using an electronic survey questionnaire for data capture. To assess the reliability of the instrument, Cronbach’s alpha, inter-item reliability, and split-half reliability analyses were conducted. Furthermore, the convergent and discriminant validity of the questionnaire was ensured by calculating the average variance extracted (AVE) and the correlation coefficient between the different constructs, respectively. Factor loadings and cross-loadings of different indicators within each construct were calculated by performing both exploratory and confirmatory factor analyses. Results: A total of 1536 HCPs from 18 countries in the EMR (response rate = 96.786%) with a median age of 28 years participated; 47% were female, and 55% had Arabic as their first language. English was the most common language for a bachelor’s degree in science (54%). The construct validity of the EBPQ was investigated using exploratory factor analysis (EFA), which yielded four loaded factors. The confirmatory factor analysis (CFA) confirmed the four loaded factors. The CFA model showed that the root mean square error of approximation = 0.066, comparative fit index = 0.95, Tucker–Lewis’s index = 0.94, standardized root mean square residual = 0.033, normal fit index = 0.94, goodness of fit = 0.91, and χ² test statistic= 22,553, with p < 0.001. The AVE values of the four factors were close to 1 (knowledge = 0.6, practice = 0.6, attitude = 0.5, and sharing = 0.7), thus supporting the convergent validity of the EBPQ. The four domains had Cronbach’s alpha coefficients and Omega ≥ 0.7 (knowledge = 0.9, practice = 0.9, attitude = 0.7, and sharing = 0.8), suggesting that the items within each domain had good internal consistency. These results support the discriminant validity of the EBPQ. Conclusions: The EBPQ is a robust questionnaire that can be completed in less than 10 min by EMR HCPs and can be used as a gold-standard questionnaire to collect valid data on the attitudes, knowledge, and proficiency of HCPs in making clinical decisions based on evidence. Future studies are recommended to investigate the retest reliability.

Background: The variation in the reported vaccine safety and effectiveness could contribute to the high rates of vaccine hesitancy among the general population and healthcare workers in areas where monkeypox (mpox) is circulating. In this review, our objective was to evaluate the safety, immunogenicity, effectiveness, and efficacy of the mpox vaccines. Methods: An extensive search for articles across multiple databases was performed, including searching six databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Cochrane, ProQuest), two pre-print databases (European PMC Preprint and MedRxiv), and Google Scholar. Results: A total of 4290 citations were retrieved from the included databases. Following the removal of duplicates and the initial screening of records, a total of 36 studies were included into the analysis. Additionally, we identified five more studies through manual searches, resulting in a total of 41 eligible articles for qualitative synthesis. The study findings revealed that mpox vaccines demonstrate the ability to generate adequate antibodies; however, their effectiveness may decrease over time, exhibiting varying safety profiles. Most of the included studies consistently reported substantial levels of effectiveness and efficacy against mpox. Interestingly, the number of vaccine doses administered was found to influence the degree of immunogenicity, subsequently impacting the overall effectiveness and efficacy of the vaccines. Furthermore, we found that smallpox vaccines exhibited a form of cross-protection against mpox. Conclusions: Vaccines can be used to prevent mpox and effectively control its spread.

Background: Historically, epidemics have been accompanied by the concurrent emergence of stigma, prejudice, and xenophobia. This scoping review aimed to describe and map published research targeting ethical values concerning monkeypox (mpox). In addition, it aimed to understand the research gaps related to mpox associated stigma. Methods: We comprehensively searched databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Ovid, and Google Scholar) to identify published literature concerning mpox ethical issues and stigma from May 6, 2022, to February 15, 2023. The key search terms used were “monkeypox”, “ethics”, “morals”, “social stigma”, “privacy”, “confidentiality”, “secrecy”, “privilege”, “egoism”, and “metaethics”. This scoping review followed the framework proposed by Arksey and O’Malley in 2005 and was further improved by the recommendations of Levac et al. in 2010. Results: The search strategies employed in the scoping review yielded a total of 454 articles. We analyzed the sources, types, and topics of the retrieved articles/studies. The authors were able to identify 32 studies that met inclusion criteria. Six of the 32 included studies were primary research. The study revealed that the ongoing mpox outbreak is contending with a notable surge in misinformation and societal stigma. It highlights the adverse impacts of stigma and ethical concerns associated with mpox, which can negatively affect people with the disease. Conclusion: The study’s findings underscore the imperative need to enhance public awareness; involve civil society; and promote collaboration among policymakers, medical communities, and social media platforms. These collective endeavors are crucial for mitigating stigma, averting human-to-human transmission, tackling racism, and dispelling misconceptions associated with the outbreak.

Wars profoundly impact mental health with growing long lasting consequences. This study assessed the prevalence of post-traumatic stress disorder (PTSD) and well-being among Sudanese affected by the ongoing conflict, with a specific focus on healthcare workers (HCWs). A cross-sectional study was conducted between April 1 and June 30, 2024, using the validated Arabic versions of PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5) and the World Health Organization (WHO)-5 Well-Being Index. A total of 1022 participants were included, and 44% were recruitted through online questionnaire and face-to-face interviews. Their mean age was 31.4 ± 12.5 years, 63.4% were females, 16.3% were HCWs and 83.3% were displaced due to conflict. The mean score of PTSD was 35 ± 21.3 with 56.9% having PTSD. The mean well-being score was 55.0 ± 23.9 with 40% reporting poor well-being. Among HCWs, 60.5% suffered from PTSD and 27.5% experienced poor well-being. A significant negative correlation was observed between PTSD and well-being scores (r=-0.273, p < 0.001). Predictors of PTSD were being male [β = -10.91, 95% confidence interval (CI) (-13.44, -8.38); p < 0.001], urban area resident [β = -10.38, 95%CI (-18.78, -1.98); p = 0.016], non-medical profession [β = 5.07, 95%CI (1.46, 8.67); p = 0.006], living with 2 to 10 households [β = 6.69, 95%CI (0.46, 12.91); p = 0.035], living with more than 20 households [β = 13.20, 95%CI (4.17, 22.23); p = 0.004], insufficient income [β = 4.32, 95% CI (1.84,6.81); p = 0.001], living in conflict zones [β = 13.38 95%CI (8.83,17.92); p < 0.001], refugee resettlement [β = 13.18, 95%CI (9.98,16.38); p < 0.001], and well-being score [β = -0.20, 95%CI (-0.25, -0.15); p < 0.001]. Predictors of well-being scores were living with more than 20 households [β = -17.44, 95%CI (-28.83, -6.04); p = 0.003], being a HCW [β =-6.22, 95%CI (-11.87, -0.57); p = 0.031], being a student [β = -7.55, 95%CI (-12.94, -2.16), p = 0.006, insufficient income [β = -5.04, 95%CI (-8.17, -1.90); p = 0.002], and living in conflict zones [β = -8.22, 95%CI (-13.96, -2.48); p = 0.005]. The study highlights an alarmingly high prevalence of PTSD among Sudanese including HCWs, with significant mental health consequences. These findings emphasize the urgent need for mental health interventions and humanitarian support to mitigate the psychological challenges faced by the conflict affected population.