{
  "abstract": "Background Historically, the Democratic Republic of the Congo (DRC) has faced the greatest public health burden from mpox, including more than 70 000 probable cases from 1 January 2024 to 2 February 2025. However, there has been a relative paucity of investigation focused on mpox community engagement in DRC, including assessments of disease knowledge and risk perception.Methods Given the ongoing Clade I mpox public health emergency of international concern, and the linkage between sustained human-to-human transmission and dense sexual networks, we sought to investigate mpox knowledge and sexual behaviours among key populations. Between 20 March 2024 and 25 August 2024, we recruited 2794 participants distributed across Kinshasa, Kwango and North Kivu provinces, with a focus in urban centres where mpox risk was considered high.Results Most participants were considered other at-risk populations (948; 33.9%), followed by men who have sex with men (MSM, 828; 29.6%) and sex workers (897; 32.1%). Mpox knowledge, including transmission routes as well as sexual and health-seeking behaviours, was evaluated through questionnaires led by peer educators. Overall, only 6.1% of all participants reported prior mpox knowledge. Among this participant subset, zoonosis (‘direct contact with infected animals’) and ‘people living in high-risk areas’ were the most frequently selected options in regard to mpox transmission and populations at risk, respectively. When considering at-risk behaviours for mpox, those who identified as sex workers reported significantly higher risk sexual activities, including multiple sexual partners (80.3% of sex work participants), engaging in transactional sex (84.7%) and anonymous sex (80.8%) compared with MSM. However, both sex workers (44.8%) and MSM (56.7%) reported the highest health seeking behaviours for a suspected sexually transmitted infection.Conclusions Our results highlight the need to evaluate knowledge in high-risk communities, especially in an endemic setting. Community engagement, which incorporates both mpox knowledge and risk perception activities, is inclusive of at-risk populations and is needed for ongoing mpox containment and mitigation efforts.",
  "authors": [
    {
      "affiliations": [
        "Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada"
      ],
      "name": "Candice Lemaille"
    },
    {
      "affiliations": [
        "Department of Epidemiology, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA"
      ],
      "name": "Megan Halbrook"
    },
    {
      "affiliations": [
        "Department of Epidemiology, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA"
      ],
      "name": "Sydney Merritt"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Yvon Anta"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Lygie Lunyanga"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Patrick K Mukadi"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Emmanuel Hasivirwe Vakaniaki"
    },
    {
      "affiliations": [
        "National Program for the Control of Mpox and Viral Hemorrhagic Fevers, Ministry of Health, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Thierry Kalonji"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Michel Kenye"
    },
    {
      "affiliations": [
        "National Program for the Control of Mpox and Viral Hemorrhagic Fevers, Ministry of Health, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Cris Kacita"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Sylvie Linsuke"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Isaac I Bogoch"
    },
    {
      "affiliations": [
        "Division of Infection and Global Health, University of St Andrews, St Andrews, UK"
      ],
      "name": "Muge Cevik"
    },
    {
      "affiliations": [
        "Department of Epidemiology of Microbial Diseases, Yale University Yale School of Public Health, New Haven, Connecticut, USA",
        "Public Health Modeling Unit, Yale University Yale Law School, New Haven, Connecticut, USA"
      ],
      "name": "Gregg S Gonsalves"
    },
    {
      "affiliations": [
        "Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada",
        "Department of Community Health Sciences, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"
      ],
      "name": "Mikayla Hunter"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"
      ],
      "name": "Laurens Liesenborghs"
    },
    {
      "affiliations": [
        "Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada",
        "Department of Community Health Sciences, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada"
      ],
      "name": "Souradet Y Shaw"
    },
    {
      "affiliations": [
        "National Program for the Control of Mpox and Viral Hemorrhagic Fevers, Ministry of Health, Kinshasa, Congo (the Democratic Republic of the)"
      ],
      "name": "Robert L Shongo"
    },
    {
      "affiliations": [
        "Zoonotic and Emerging Disease Research Unit, National Bio and Agro-Defense Facility, Agricultural Research Service, United States Department of Agriculture (USDA), Manhattan, Kansas, USA"
      ],
      "name": "Lisa E Hensley"
    },
    {
      "affiliations": [
        "Department of Epidemiology, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA"
      ],
      "name": "Nicole A Hoff"
    },
    {
      "affiliations": [
        "Department of Epidemiology, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA"
      ],
      "name": "Anne W Rimoin"
    },
    {
      "affiliations": [
        "Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)",
        "University of Kinshasa Medical School, Kinshasa, Democratic Republic of Congo",
        "South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa",
        "Department of Virology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan"
      ],
      "name": "Placide Mbala-Kingebeni"
    },
    {
      "affiliations": [
        "Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada",
        "Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada",
        "Manitoba Centre for Proteomics and Systems Biology, Health Science Centre, Winnipeg, Manitoba, Canada"
      ],
      "name": "Jason Kindrachuk"
    }
  ],
  "title": "Assessing mpox knowledge and sexual behaviours within high-risk populations in the Democratic Republic of the Congo",
  "uid": "48a8a41a-2325-584b-9a87-94b83f4aaf51"
}