Knowledge, Attitudes, and Risk Perceptions Regarding Mpox among Medical and Non-Medical University Students in Karimnagar, Telangana, India: A Comparative Cross-Sectional Study

Background: Following the multi-country Mpox outbreaks and the Public Health Emergencies of International Concern (PHEIC) declared by the World Health Organization (WHO) in 2022 and 2024, understanding public and clinical awareness of Mpox is vital. University students, especially future healthcare professionals, are key cohorts for epidemic preparedness and community communication. Methods: A comparative cross-sectional institutional study was conducted among 400 undergraduate students (200 medical and 200 non-medical) in Karimnagar, Telangana, India, between August and November 2024 (Ethics approval: IEC/PIMS/57/2024). A validated, pre-tested, structured questionnaire assessed socio-demographics, knowledge domains (etiology, transmission, clinical manifestations, therapeutics and prevention), attitudes and risk perceptions. Pearson’s chi-square tests and multivariable logistic regression were used to identify independent predictors of adequate knowledge (cut-off ≥70%). Results: Overall, 58.25% (n = 233) of participants had adequate knowledge. Adequate knowledge was significantly more common among medical (78.5%, n = 157) than non-medical students (38.0%, n = 76; p < 0.001). Marked gaps were seen for viral clade identification (28.0%), antiviral therapy with tecovirimat (29.0%) and lymphadenopathy as a distinguishing sign (24.0% of non-medical students). Independent predictors of adequate knowledge were a medical academic stream (aOR = 4.82; 95% CI 3.12–7.45; p < 0.001), advanced academic level or internship (aOR = 2.15; 95% CI 1.34–3.45; p = 0.002) and reliance on official scientific sources (aOR = 1.88; 95% CI 1.18–3.01; p = 0.008). Vaccine acceptance was high (71.0%), but fear of stigmatization was substantial (48.5%). Conclusion: Medical students had satisfactory baseline awareness, whereas non-medical students showed marked vulnerability to misinformation, diagnostic confusion and stigma. Structured institutional education, verified social-media communication and destigmatizing messaging are urgently needed to close this gap.

Keywords: Mpox; Monkeypox; Zoonoses; Public health emergency of international concern; Students, medical; Knowledge, attitudes, practice; India