Misconceptions, Stigma, and Mpox Prevention and Control Practices in Sierra Leone: A Cross-Sectional Study

Abstract Background Misconceptions and stigma can undermine disease prevention and control efforts during disease outbreaks. Evidence on their influence on mpox prevention and control practices in Sierra Leone remains limited. This study examined the role of misconceptions and stigma in shaping mpox prevention and control practices among community members in Sierra Leone. Methods A community-based cross-sectional survey was conducted among 6,096 participants across eight districts in Sierra Leone. Data were collected using interviewer-administered structured questionnaires. Modified Poisson regression models were used to examine factors associated with mpox prevention and control practices. Results Among respondents, 21.5% agreed that mpox is a curse from God and healed through prayers, 13.7% agreed that mpox is government propaganda and not real, and 26.0% agreed that it is right to discriminate against people with mpox. Overall, only 50.4% had good mpox prevention and control practices. Respondents who agreed that mpox is a curse from God and healed through prayers had a lower prevalence of good prevention and control practices than those who disagreed (adjusted prevalence ration [aPR] = 0.70, 95% confidence interval [CI]: 0.53–0.91). Respondents who were uncertain whether mpox is government propaganda and not real also had a lower prevalence of good prevention and control practices (aPR = 0.86, 95% CI: 0.76–0.97). Stigma was not independently associated with prevention and control practices. Conclusion Misconceptions about mpox were associated with prevention and control practices, whereas stigma was not independently associated with prevention and control practices. Addressing misconceptions through targeted risk communication and community engagement may strengthen preparedness for future infectious disease outbreaks.