Only 6% of Primary Care Physicians in North-Western Nigeria Show Good Knowledge of Mpox, Survey Finds

Only 5.8% of primary care physicians surveyed in North-Western Nigeria demonstrated good knowledge of Mpox, according to an online cross-sectional study published in BMC Health Services Research. The finding, drawn from 155 doctors working in family medicine and pediatric outpatient settings across all seven states of the zone, points to a substantial gap in the preparedness of the clinicians most likely to encounter the first suspicious cases of a re-emerging zoonotic disease. The study set out to quantify how well this frontline workforce in northwestern Nigeria understands the disease, and to identify which sociodemographic and professional characteristics are associated with better knowledge.

The participants were an experienced group. Their mean age was 38.8 years with a standard deviation of 7.4, and 60.7% were men. Most respondents, 77.4%, worked in general outpatient clinics, 63.2% had accumulated at least ten years of practice experience, and 36.1% were senior registrars.

Despite this seniority profile, only 18.9% reported any prior experience diagnosing or managing a Mpox case, a detail that helps contextualize the knowledge results that followed. When knowledge was scored, the results were strikingly low. Just nine of the 155 participants, or 5.8%, achieved the threshold the investigators defined as good knowledge of Mpox.

The mean overall knowledge score across the cohort was 61.7%, with a standard deviation of 12.5 percentage points, indicating that the typical physician answered roughly three-fifths of the knowledge items correctly. The authors conclude that this represents a significant gap in participants’ understanding of the various aspects of the disease. The inferential analysis identified three factors associated with higher mean knowledge scores.

Physicians with ten or more years of practice experience scored significantly higher than their less experienced colleagues, with a p-value of 0.049. Senior professional cadres also performed better, an association that reached statistical significance at p = 0.031. Most notably, doctors who had been involved in diagnosing or managing Mpox at some point in their careers showed higher knowledge scores, with p = 0.021.

Even so, the authors emphasize that these higher scores remained suboptimal, meaning that experience and seniority improved knowledge only partially and did not bring most clinicians to a good-knowledge standard. The cross-sectional design imposes important limits on how these findings can be interpreted. Because data were collected at a single point in time through an online survey, the study can describe associations but cannot establish causal relationships between professional characteristics and knowledge.

The sample, while adequate for the calculated minimum of 153 participants at a 5% margin of error and 95% confidence level, was drawn from one geopolitical zone of Nigeria, and the authors note that the scarcity of comparable studies in northwestern Nigeria makes it difficult to benchmark these results against regional or national patterns. The finding that only about one in five participants had ever been directly involved in Mpox diagnosis or management suggests that many physicians in the region have had little practical exposure to reinforce whatever theoretical training they received.

The survey employed a multi-stage sampling technique to reach physicians in Family Medicine/General Outpatient and Pediatric Outpatient Clinics across hospitals in the seven states, with the initial sample size target raised from 153 to 170 to allow for a 10% non-response buffer; 155 physicians ultimately completed the pretested online questionnaire, a completion rate of 91.2%. Data were analyzed descriptively and inferentially using Epi Info version 7.

The authors call for targeted educational interventions to enhance the preparedness of primary care physicians to identify and coordinate Mpox cases in primary care settings. As primary care physicians serve as gatekeepers in the healthcare system, the study’s central message is a measured but sobering one: the frontline clinicians expected to serve as the system’s early warning for this zoonotic disease, at least in North-Western Nigeria, currently demonstrate limited knowledge of it, and closing that gap will require deliberate training rather than assumptions that experience alone will suffice.

Subject of Research: Knowledge of Mpox among primary care physicians in North-Western Nigeria

Article Title: Examining knowledge of Mpox among primary care physicians in North-Western Nigeria: an online cross-sectional study

Article References: Michael, G. C., Grema, B. A., Magaji, H. Y., Nwosu, C., Lawal, T. O., Usman, M. B., Abubakar, R., Falaki, F. A., Maude, M., Abdulkadir, Z., Olawumi, A. L., Abdulazeez, Z. U., Mahmud, M. B., & Badamasi, A. K. (2026). Examining knowledge of Mpox among primary care physicians in North-Western Nigeria: an online cross-sectional study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15473-3

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15473-3

Keywords: Mpox, primary care, Nigeria, cross-sectional study, knowledge assessment, zoonotic disease, family medicine, physician preparedness, North-West Nigeria, public health, Examining, knowledge