Int. J. One Health  Vol.11   No.2  Article - 7 

Knowledge, attitudes, and practices toward monkeypox among university students in Khyber Pakhtunkhwa, Pakistan: A cross-sectional study from Gomal University

Saifur Rehman¹ , Shakeeb Ullah¹ , Mustofa Helmi Effendi² , Muhammad Kamal Shah³ , Danial Aziz⁴ , Budiastuti Budiastuti⁵ , Sana Ullah³ , Anila Khan⁶ , Muhammad Inam Ullah Malik¹ , Wasiq Ur Rehman³ , and Muhammad Irfan Anwar³

Background and Aim: The re-emergence of monkeypox (mpox) as a global public health concern necessitates assessing awareness and preparedness, particularly among educated youth who can act as health knowledge multipliers. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) regarding mpox among undergraduate and postgraduate students at Gomal University, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan.

Materials and Methods: A cross-sectional study was conducted from December 2024 to March 2025 among 443 university students selected through a simple random sampling method. A structured, prevalidated questionnaire was used to assess knowledge (18 items), attitudes (8 items), and practices (10 items). Data were analyzed using descriptive statistics and Chi-square tests to identify associations between demographic factors and KAP domains, with a significance level set at p < 0.05.

Results: Most participaints were male (75.2%) and from urban areas (58.0%). Overall, 94.6% recognized mpox as a viral disease, while 77.7% identified it as a zoonotic disease. However, misconceptions persisted; only 55.8% acknowledged airborne transmission and 47.2% recognized possible reverse zoonosis. Concern about contracting mpox was expressed by 53.3% of students, and 61.6% were willing to receive vaccination. Knowledge levels were significantly associated with academic year (p = 0.003) and major (p = 0.010), with medical students demonstrating better knowledge (55.0%) compared to their non-medical peers (25.4%). Gender significantly influenced attitudes (p < 0.001) and practices (p = 0.025), with females showing lower positive attitudes and practice scores. Common preventive behaviors included handwashing (93.9%) and seeking medical attention (84.9%), while only 34.1% were vaccinated.

Conclusion: Although awareness about mpox was high among Gomal University students, notable gaps existed regarding the transmission and prevention of the disease. Gender, academic discipline, and study year had a significant influence on knowledge and attitudes. Integrating zoonotic disease education into university curricula, campus health promotion, and social media-based awareness programs could strengthen students’ preventive practices and outbreak preparedness.

Keywords: knowledge, attitudes, and practices, monkeypox, Pakistan, public health, university students, vaccination, zoonosis.

How to cite this article: Rehman S, Ullah S, Effendi MH, Shah MK, Aziz D, Budiastuti B, Ullah S, Khan A, Malik MIU, Rehman WU, and Anwar MI (2025) Knowledge, attitudes, and practices toward monkeypox among university students in Khyber Pakhtunkhwa, Pakistan: A cross-sectional study from Gomal University, Int. J. One Health, 11(2):271-284.

Received: 25-06-2025   Accepted: 16-09-2025   Published online: 23-11-2025

Corresponding author: Mustofa Helmi Effendi    E-mail: mhelmieffendi@gmail.com

DOI: 10.14202/IJOH.2025.271-284

Copyright: Rehman, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.