Knowledge and perceptions of monkeypox among university students in Riyadh, Saudi Arabia: implications for public health preparedness

Introduction: The 2022 multi-country outbreak of Mpox highlighted its emergence as a global public health concern. However, evidence regarding Mpox awareness and perceptions among university students in the Middle East remains limited, creating an important gap for targeted health education and outbreak preparedness. This study aimed to assess knowledge, perceptions, and attitudes toward Mpox disease, vaccination, and preventive practices among undergraduate students in Riyadh, Saudi Arabia. Methods: ≤ 0.05. Results: Overall awareness of Mpox was high; however, important knowledge gaps were identified regarding transmission routes, vaccine availability, and treatment options. While most students had heard of Mpox, uncertainty remained regarding specific transmission pathways and clinical features. The internet and social media were the most reported sources of information, whereas higher knowledge levels were significantly associated with exposure to television/news and public health awareness campaigns. Multivariable logistic regression identified female sex (OR = 1.42), age ≥25 years (OR = 1.91), enrollment in medical programs (OR = 1.68), and exposure to television/news (OR = 1.95) or public health campaigns (OR = 2.28) as significant predictors of moderate-to-good Mpox knowledge. Preventive attitudes were generally positive, with moderate willingness to receive vaccination and stronger support for mandatory vaccination among healthcare workers than the general population. Conclusion: University students demonstrated high general awareness of Mpox but limited depth of knowledge in key areas related to transmission, vaccination, and treatment. Targeted health education strategies are therefore needed, particularly for non-medical students, male students, and younger age groups. Public health communication should combine the wide reach of digital platforms with credible messaging through traditional media and structured awareness campaigns to improve knowledge and preparedness for emerging infectious diseases.

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