Sociodemographic factors of knowledge, conspiracy beliefs, and attitudes toward Mpox among healthcare workers in Sierra Leone

Mpox, a re-emerging zoonotic disease, poses a global health threat. In Sierra Leone, healthcare workers (HCWs) are central to outbreak response, yet little is known about their knowledge, conspiracy beliefs, and attitudes. This study assessed these factors and identified associated sociodemographic predictors. This cross-sectional study recruited 318 HCWs from three hospitals in Freetown using stratified random sampling. Eligible participants had at least one year of professional experience; those on leave or unwilling to participate were excluded. Data was collected using a researcher-developed questionnaire. Multivariable logistic regression identified predictors, while correlation and linear regression examined interrelationships, with significance set at p < 0.05. The mean knowledge score was 65.8% (±23.7), with 53.8% showing good knowledge. Urban residence (AOR: 5.70, 95% CI: 3.01–10.80) and older age (AOR: 8.92, 95% CI: 1.76–45.15) predicted better knowledge, while clinical staff scored lower (AOR: 0.06, 95% CI: 0.02–0.15). Conspiracy beliefs were high in 44.7% of HCWs, with females more susceptible (AOR: 2.41, 95% CI: 1.31–4.43), while higher education was protective (AOR: 0.32, 95% CI: 0.16–0.63). Attitudes were polarized (49.7% positive, 50.3% negative), with good knowledge (AOR: 3.90, 95% CI: 2.01–7.54) and urban residence (AOR: 2.13, 95% CI: 1.24–3.67) predicting positive attitudes. Knowledge and attitudes were positively correlated ( r = 0.323, p < 0.001). Moderate knowledge, widespread conspiracy beliefs, and divided attitudes among HCWs highlight the need for targeted training and communication strategies. Addressing misinformation and strengthening knowledge, particularly among rural and clinical staff, are essential for Mpox preparedness in resource-limited settings.