Assessment of Frontline Health Workers’ Capacity for Mpox Case Identification in Emergency Departments of Benin

Introduction. Monkeypox (MPOX) was declared a Public Health Emergency of International Concern (PHEIC) in 2022. In Benin, early identification of suspected cases by Frontline Health Workers (FHWs) in Emergency Departments (ED) is vital to stopping the chain of transmission and preventing community and nosocomial spread. This study aimed to assess the capacity of FHWs to identify Mpox in three strategic hospital facilities in Benin. Methods. We conducted a cross-sectional descriptive study with a qualitative component from February to May 2025 in three hospitals (Oueme Plateau Departmental Hospital Center, Zou Departmental Hospital Center, and Save Zone Hospital). A total of 43 FHWs (physicians, nurses, midwives, nursing assistants) were selected using a non-probability purposive sampling technique. Data on knowledge, attitudes, and practices (KAP) were collected via semi-structured interviews and analyzed using descriptive statistics. Institutional Standard Operating Procedures (SOPs) were assessed via document review. Results. The majority of participants were nurses (34.9%), with an average emergency department seniority of 4.1 years. Overall, 83.7% of staff demonstrated "good" theoretical knowledge for identifying suspected cases. However, only 65.1% explicitly identified sexual transmission as a route of infection, with a notable disparity between physicians (90%) and nursing assistants (37.5%). While risk perception was high (93.0%), only 55.8% trusted the hospital's isolation capacity, and 58.1% reported constant Personal Protective Equipment (PPE) availability. Discrepancies were found in institutional preparedness, with one hospital lacking updated SOPs. Conclusion. Frontline healthcare workers have a high theoretical ability to identify MPOX, but operational capacity is hindered by logistical challenges and gaps in knowledge regarding sexual transmission among non-medical staff. Limitations include the small sample size.