Mitigating the surge of mpox in Africa: capacity building through public outreach, sample and case management training for healthcare workers and veterinarians

The global mpox outbreak and the current surge in Africa underscore the need for innovative epidemic preparedness/response strategies. We describe a comprehensive One Health capacity-building program for mpox response/control for healthcare workers (HCWs) and veterinarians in West Africa. The study design entailed prospective pre- and post-intervention assessments during a train-the-trainer program. Between March and October 2022, four mpox workshops were conducted for HCWs and veterinarians in Nigeria and Guinea. Additionally, two step-down trainings were conducted in Nigeria. Training modules comprised didactic and practical sessions on human and veterinary mpox epidemiology and management. Participants' knowledge of mpox was assessed with self-administered pre- and post-training questionnaires. A 5-point Likert scale was used to capture participants' feedback on eight training outcome parameters. Wilcoxon signed-rank test was used to assess differences between pre-training and post-training scores. Of all participants (152), 146 participants (96.1%) completed all training components, including 104 HCWs (71.2%) and 42 veterinarians (28.8%). Participants' median age (interquartile range, IQR) was 43.0 (36.0-49.0) years, with 99 males (67.8%). Participant scores on mpox knowledge assessments improved from pre-training to post-training (median 55.0% [IQR 45.0-60.0%] to 80.0% [70.0-90.0%], p<0.001). High post-training satisfaction was observed: 83.3% (85/102) strongly agreed that "I am satisfied with the training event," while 64.1% (66/103) strongly agreed that "training quality and content met my expectations." Median scores improved during step-down trainings (N=66) from 65.0% (55.0-75.0%) at pre-training to 85.0% (75.0- 90.0%) post-training, p<0.0001. The train-the-trainer program successfully achieved its objectives and could serve as a model for regional/global mpox epidemic preparedness/response.