Co esponding au ho : TSHIKUNG KAMBOL MOSSES Didie
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
Skills and knowledge o clinical e e ina ians ega ding monkeypox in he
Democ a ic Republic o he Congo
TSHIKUNG KAMBOL MOSSES Didie 1, *, NDONGO KATENGO E udi 1, KAYIBA KYEZI Shekinah 2, KANYIMBU
MBAL Ma co 1, KALAMBA KAMBA Be y 1 and TSHASUMA KEDI Alain 1
1 Depa men o Biology, Sys ema ics and Wildli e, Facul y o Ve e ina y Medicine, Uni e si y o Lubumbashi, P.O. Box 1825,
Lubumbashi, Democ a ic Republic o Congo.
2 DMV, Ve e ina y Clinician, Lubumbashi, Democ a ic Republic o Congo
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 667-679
Publica ion his o y: Recei ed on 27 June 2025; e ised on 05 Augus 2025; accep ed on 07 Augus 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.2.2799
Abs ac
In oduc ion: Monkeypox, an O hopox i us zoonosis, is caused by a i us belonging o he O hopox i us genus. This
eme ging zoono ic disease ep esen s a g owing h ea o public heal h in he Democ a ic Republic o he Congo (DRC)
and o he egions. Gi en he zoono ic na u e o his disease, e e ina ians play a c ucial ole in i s de ec ion,
managemen , p e en ion, and su eillance. Assessing he skills and knowledge o hese p o essionals is he e o e
essen ial o iden i y gaps and s eng hen he esponse o zoono ic diseases.
Objec i e: The aim o his s udy was o assess he knowledge and skills o clinical e e ina ians in he DRC ega ding
speci ic zoono ic diseases such as monkeypox.
Me hods: A c oss-sec ional online su ey was conduc ed o e alua e he knowledge and skills o clinical e e ina ians
in he DRC conce ning Mpox. Semi-s uc u ed ques ionnai es we e dis ibu ed ia Google Fo ms. Da a we e collec ed
om 79 clinical e e ina ians egis e ed wi h he Ve e ina y Medical Associa ion o Congo, ac oss 14 p o inces o he
DRC. The s udy was conduc ed be ween Sep embe and Oc obe 2024.
Resul s: The majo i y o esponden s we e male (85%) and aged be ween 30 and 50 yea s. Mos o he su eyed
e e ina ians had a leas i e yea s o p o essional expe ience. Rega ding he knowledge o ansmission ou es, 93.7%
o pa icipan s we e awa e o hem, and 93.3% we e amilia wi h he symp oms o he disease. The mos equen ly
ci ed diagnos ic me hods included molecula analyses and clinical signs e alua ion.
Conclusion: Al hough he o e all le el o knowledge abou monkeypox among clinical e e ina ians is high, mos o
hem ha e ne e ecei ed speci ic aining on he managemen o his disease. Clinical symp oms, ansmission ou es,
and he mos a ec ed species a e gene ally well known. Howe e , e y ew e e ina ians pa icipa e in epidemiological
su eillance p og ams o monkeypox in he DRC. Classical p e en i e measu es such as hygiene and disin ec ion,
isola ion o suspec ed cases, and he use o pe sonal p o ec i e equipmen (PPE) emain e ec i e in comba ing he
sp ead o Mpox.
Keywo ds: Knowledge; Skills; P ac ice; Ve e ina ian; Monkeypox; DR Congo
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 667-679
668
1. In oduc ion
Monkeypox is a zoono ic disease caused by a i us belonging o he O hopox i us genus [1]. I is conside ed an
eme ging disease in Cen al and Wes A ica. T ansmission occu s p ima ily h ough di ec con ac wi h he bodily luids
o skin lesions o in ec ed animals, as well as ia espi a o y d ople s be ween humans [2]. These cha ac e is ics make
monkeypox a po en ial h ea in bo h public heal h and e e ina y con ex s.
In he Democ a ic Republic o he Congo (DRC), monkeypox is endemic, wi h human cases egula ly epo ed [3].
Howe e , he disease has been d awing inc eased in e na ional a en ion since cases we e epo ed in se e al coun ies
ou side o A ica, aising conce ns abou he su eillance and managemen o his zoonosis. Clinical e e ina ians play
a key ole in he ea ly de ec ion, su eillance, and p e en ion o zoono ic diseases such as monkeypox, pa icula ly due
o hei di ec in e ac ion wi h bo h domes ic and wild animals [4].
Ve e ina ians’ abili y o iden i y, ea , and p e en zoono ic diseases la gely depends on hei knowledge and skills in
speci ic a eas [5].
The le el o knowledge among e e ina ians ega ding monkeypox in he DRC is p esumed o be a iable. Se e al
s udies on zoonoses ha e shown ha e e ina ians in sub-Saha an A ica a e o en well-in o med abou ce ain endemic
diseases such as abies, b ucellosis, and bo ine ube culosis [6]; [7]; [8]; [9]), bu much less so abou eme ging diseases
like monkeypox. Ve e ina ians wo king in close con ac wi h wildli e pa icula ly in u al a eas nea opical o es s
may ha e a be e unde s anding o his disease due o hei equen exposu e o po en ial ese oi species [10].
The s udy by Nka [11] e ealed e y limi ed knowledge o he monkeypox i us among heal hca e wo ke s, ega dless
o hei sociodemog aphic o p o essional cha ac e is ics. Consequen ly, o ensu e op imal p epa edness and imely
esponses o Mpox and o he simila eme ging pa hogens, capaci y-building p og ams should be implemen ed o
heal h p o essionals. In he DRC, aining o e e ina ians on he managemen o suspec ed monkeypox cases emains
limi ed. The e a e no o mal p og ams o egula wo kshops speci ically dedica ed o he managemen o his disease
in mos e e ina y schools o p o essional associa ions. Fu he mo e, clinical guidelines o ecognizing and managing
monkeypox a e s ill la gely based on human heal h p o ocols, making hem di icul o apply in he e e ina y ield [12].
Clinical e e ina ians gene ally pe cei e hei ole in he su eillance and p e en ion o zoono ic diseases as c ucial
[13]. Howe e , se e al obs acles limi hei abili y o ully ca y ou his mission. In he DRC, limi ed esou ces, he lack
o speci ic guidelines, and he absence o ins i u ional collabo a ion be ween animal and human heal h se ices o en
hinde hei ac i e pa icipa ion in zoonosis p e en ion, including monkeypox [14].
Since i s iden i ica ion in he DRC, monkeypox has ep esen ed a g owing public heal h isk, especially conside ing he
key ole e e ina ians play in zoono ic disease su eillance. Mos esea ch on disease su eillance, howe e , has ocused
p ima ily on human heal h p o essionals. The o e all objec i e o his s udy is o assess he knowledge and skills o
clinical e e ina ians in he DRC ega ding speci ic zoono ic diseases such as monkeypox.
2. Ma e ials and me hods
2.1. S udy A ea
Ou esea ch was conduc ed in he Democ a ic Republic o he Congo (DRC), a coun y loca ed in he hea o A ica,
co e ing an a ea o 2,345,410 km², si ua ed a app oxima ely 4°00′00.00″ Sou h la i ude and 21°00′00.00″ Eas
longi ude. The coun y is cu en ly di ided in o 26 p o inces and is geog aphically s uc u ed in o h ee main zones:
• The cen al basin, wi h he lowes ele a ion, co e s abou one- hi d o he na ional e i o y. I is cha ac e ized
by al e na ing equa o ial o es s and swampy lands, wa e ed yea - ound by he Congo Ri e and i s ibu a ies.
• The pla eaus su ounding he basin, mainly co e ed by sa annas.
• The eas e n moun ain anges, loca ed in he p o inces o No h Ki u and Sou h Ki u.
The DRC is bo de ed o he sou h by Zambia and Angola; o he eas by Zambia, Tanzania, Rwanda, Bu undi, and Uganda;
o he no h by he Cen al A ican Republic and Sou h Sudan; and o he wes by he Republic o he Congo, he Angolan
p o ince o Cabinda, and he A lan ic Ocean.
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Figu e 1 Map o he Democ a ic Republic o he Congo [15].
3. Me hods
We conduc ed a c oss-sec ional and p ospec i e s udy wi h desc ip i e objec i e, based on he use o ques ionnai es,
in e iews, and analysis o da a collec ed di ec ly in he ield. This s udy was ca ied ou in he DRC be ween Sep embe
and Oc obe 2024 and ocused on he knowledge and skills o clinical e e ina ians ega ding Mpox.
The s udy popula ion consis ed en i ely o clinical e e ina ians a ilia ed wi h he Ve e ina y Medical Associa ion o
Congo. A andom sampling me hod was used, and 79 clinical e e ina ians om 14 di e en p o inces o he DRC
esponded o he su ey [16].
3.1. S udy Va iables
3.1.1. Independen a iables
We assessed ou main g oups o independen a iables ha could in luence knowledge and skills: sociodemog aphic
s a us (Age, Sex, P o ince), cha ac e is ics o he wo k a ea (u ban, u al, pe i-u ban), medical p o essional
de elopmen cha ac e is ics, p o essional expe ience (in yea s) [16, 17]
3.1.2. Dependen Va iables
In his s udy, he dependen a iables we e he knowledge and skills o clinical e e ina ians in he DRC ega ding Mpox.
Ques ions we e asked o assess hei knowledge and compe encies, ocusing on: he zoono ic na u e o Mpox, i s modes
o ansmission, clinical symp oms, a ailable diagnos ic me hods, isk o ansmission, he mos a ec ed animal species,
ea men o con i med cases, speci ic aining ecei ed, applicable p e en i e measu es, use o pe sonal p o ec i e
equipmen (PPE) and accessibili y o accines o animals [16, 17]
3.1.3. Su ey and Da a Collec ion
A link o he su ey ques ionnai e was sha ed on Wha sApp pla o ms used by e e ina y doc o s. Responses we e
collec ed anonymously, and o ensu e da a con iden iali y, access o pa icipan s’ esponses was managed solely by he
p incipal in es iga o . The su ey ques ions ocused on sociodemog aphic in o ma ion, and he knowledge and skills o
clinical e e ina ians ega ding monkeypox.
Responden s p o ided ee and in o med consen on he i s page o he ques ionnai e.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 667-679
670
• The ques ionnai e was designed o assess e e ina ians' knowledge o monkeypox, including ques ions on
symp oms, modes o ansmission, p e en i e measu es, and he managemen o suspec ed cases.
• Semi-s uc u ed in e iews we e also conduc ed o explo e e e ina ians' pe cep ions o zoono ic isks and o
iden i y gaps in aining.
• Field obse a ions we e ca ied ou h ough isi s o e e ina y clinics and o ices, whe e we obse ed
biosa e y p ac ices and he a ailabili y o diagnos ic ools.
3.2. Da a Analysis
The da a collec ed we e analyzed using an Excel sp eadshee (EpiCollec 5), equencies we e calcula ed. Key hemes,
opinions, and expe iences eco ded in he da ase we e explo ed using basic s a is ical calcula ions o de e mine he
p opo ions e lec ing e e ina ians’ knowledge and skills ega ding monkeypox in he DRC.
3.3. E hical Conside a ions and Da a Con iden iali y
Responden s we e in e iewed based on in o med consen and hei olun a y decision o answe he su ey ques ions.
Da a con iden iali y o each pa icipan was s ic ly main ained h oughou he da a collec ion and analysis phases.
4. Resul s
We p esen he esul s ob ained om ou in es iga ion.
4.1. Sociodemog aphic Cha ac e is ics o Responden s
The sociodemog aphic cha ac e is ics o he su eyed e e ina ians a e p esen ed in Table 1 below:
Table 1 Sociodemog aphic Cha ac e is ics o Su eyed Ve e ina ians
Va iables
Numbe (n=79)
F equencies (%)
Gende
Male
Female
67
12
85
15
Age g oup (yea )
Unde 30
] 30 - 40]
] 40 - 50]
O e 50
18
30
20
10
23
38
25
14
P o ince o esidence
Hau -Ka anga
Hau -Uélé
I u i
Kasaï-O ien al
Kinshasa
Kongo-Cen al
Kwango
Kwilu
Lualaba
No d-Ki u
Sud-Ki u
Sanku u
Tanganyika
Tshopo
37
1
2
1
19
4
1
1
1
4
4
1
1
2
48
1
2.5
1
25
5
1
1
1
5
5
1
1
2.5
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Yea s o expe ience as a clinical e e ina ian
Less han 5 yea
] 5 – 10 ans]
] 10 – 15 ans]
Mo e han 15 yea
18
26
16
19
23
33
20
24
Wo k a ea
U ban
Ru al
U ban- u al (pe i-u ban)
51
11
17
64.5
14
21.5
F om his able, i appea s ha he majo i y o he clinical e e ina ians in e iewed we e male. Mos we e o e 30
yea s old. They came om 14 di e en p o inces o he Democ a ic Republic o he Congo, wi h a p edominance o
clinical e e ina ians om Hau -Ka anga P o ince (48%). The majo i y had a leas 5 yea s o p o essional expe ience
and wo ked ei he in u ban a eas (64.5%), u al a eas (14%), o pe i-u ban zones (21.5%).
4.2. Knowledge Abou Monkeypox
Table 2a P opo ion o Responden s Who Repo ed Knowledge o Monkeypox Symp oms and Modes o T ansmission
Va iables
Numbe (n=79)
F equencies %
Knowledge o monkeypox symp oms
Yes
No
74
5
93.7
6.3
Symp oms lis ed
Numbe o imes men ioned
%
Fe e
Skin lesions
Fa igue
Loss o appe i e
o he s
No eponse
74
73
38
37
7
5
93.6
92.4
48.1
58.2
8.8
6.3
Knowledge o monkeypox ansmission modes
Numbe (n=79)
%
Yes
No
77
2
97.5
2.5
Modes o ansmission lis ed
Numbe o imes men ioned
%
Di ec con ac wi h in ec ed sec e ions
Bi es/sc a ches
Consump ion o in ec ed mea
Con ac wi h con amina ed su aces
Ae osol ansmission
O he s
No eponse
77
30
53
55
19
4
2
97.5
50.6
68.8
71.4
24.6
5.2
2.6
I appea s om Table 2a ha 93.7% o esponden s epo ed being awa e o he symp oms o monkeypox. The mos
equen ly lis ed symp oms we e e e , skin lesions, a igue, and loss o appe i e. Among hose esponden s, 97.5%
indica ed ha hey we e awa e o he modes o ansmission o he disease.
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Table 2b Disease De ini ion, A ec ed Animal Species, and Diagnos ic P ocedu es
Monkeypox known as a zoono ic disease
Numbe (n=79)
%
Yes
No
78
1
98.7
1.3
Animal species a ec ed by monkeypox
Numbe o imes men ioned
%
P ima es
Roden s
Domes ics animals
O he s (p ai ie dog)
77
52
15
3
97.4
65.8
18.9
3.8
Awa e o monkeypox diagnos ic me hods
Numbe (n=79)
%
Yes
No
No esponse
59
19
1
75
24
1
Known diagnos ic me hods
Numbe o imes men ioned
%
Clinical signs e alua ion
Pa aclinical analyses
Se ology (ELISA)
Molecula analysis (PCR)
GeneXpe
Monkeypox An igen es casse e
28
19
9
32
1
1
47.4
32.2
6.7
54.2
1.6
1.6
On déjà ai é les cas de a iole du singe
Numbe (n=79)
%
Yes
7
9
No
72
91
Ha e al eady ea ed monkeypox cases
Numbe (n=79)
%
Yes
29
36,7
No
50
63,3
Table 2b e eals ha 98.7% o esponden s iden i ied monkeypox as a zoono ic disease, wi h he mos equen ly ci ed
animal sou ces being monkeys, oden s, and domes ic animals. Among hese esponden s, 75% epo ed knowing
diagnos ic me hods o he disease, wi h molecula analyses and clinical signs e alua ion being he mos commonly
men ioned echniques. A mino i y (36.7%) indica ed ha ing ecei ed speci ic aining on monkeypox, and 9% epo ed
ha ing p o ided he apeu ic ca e o monkeypox cases.
4.3. P ac ices o Responden s Rega ding Monkeypox
Table 3 p esen s he p ac ices o clinical e e ina ians conce ning animals ca ying monkeypox.
Table 3 P ac ices o Clinical Ve e ina ians Rega ding Animals In ec ed wi h Monkeypox
P ac ices owa d sick animals
Numbe o imes
men ioned
F equencies %
Isola ion
Sampling
Symp oma ic ea men
No i ica ion o heal h au ho ies
O he s
74
49
42
65
2
93.7
62
53
82
2.5
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No eponse
1
1
Use o diagnos ic ools in clinics/o ices
Numbe (n=79)
%
Yes
No
No eponse
3
74
2
3.8
93.7
2.5
Knowledge o p e en i e measu es agains monkeypox
Numbe (n=79)
%
Yes
No
59
20
74.7
25.3
P e en i e measu es men ioned
numbe o men ions
%
Isola ion o sick animals
Wea ing pe sonal p o ec i e equipmen (PPE)
Main aining hygiene and disin ec ion Respec ing ba ie
measu es
Following biosecu i y and biosa e y measu es
A oiding di ec con ac
Vaccina ion
T aining o heal hca e s a
In o ming au ho i ies
24
26
30
6
6
18
8
1
1
40.6
44
50.8
10
10
30.5
13.5
1.6
1.6
F equency o PPE use when handling a suspec ed monkeypox
case
Numbe (n=79)
%
Always
Some imes
Ne e
No eponse
34
18
17
10
43
22.8
21.5
12.7
Accessibili y o accines agains Mpox in animals
Numbe (n=79)
%
Yes
No
2
77
2.5
97.4
F om Table 3, we no e ha isola ion o animals suspec ed o ha ing monkeypox and no i ica ion o sick animal cases o
au ho i ies a e he mos equen ly epo ed p ac ices among esponden s. A small pe cen age (3.8%) o esponden s
decla ed ha ing he necessa y equipmen o manage monkeypox cases in hei wo kplaces. The majo i y o esponden s
epo ed knowing p e en i e measu es agains he disease. Among hese p e en i e measu es, hygiene and su ace
disin ec ion, use o pe sonal p o ec i e equipmen (PPE), isola ion o sick animals, and a oidance o con ac wi h
in ec ed animals we e he mos commonly ci ed.
4.4. Pe cep ions o Responden s on he Epidemiological Risk o Monkeypox and Challenges Encoun e ed
Table 4 Pe cep ion o he Epidemiological Risk o Monkeypox
Epidemiological isk o Mpox o animals is:
Numbe o imes men ioned
F equencies %
Low
Mode a e
High
Ve y high
No eponse
31
16
28
3
1
39.2
20.3
35.4
3.8
1
Risk o zoono ic ansmission o Mpox
Numbe (n=79)
%
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Low
Mode a e
High
Ve y high
No eponse
10
37
24
6
2
12.6
46.8
30.4
7.6
2.5
Challenges encoun e ed in managing monkeypox cases
Numbe o imes men ioned
%
Lack o eliable in o ma ion
Lack o diagnos ic ools
Lack o medicines
Cos o ca e
Lack o collabo a ion wi h heal h au ho i ies
O he s
54
61
40
29
54
1
68.3
77.2
50.6
36.7
68.3
1
F om Table 4, i appea s ha opinions among su eyed e e ina ians a e di ided ega ding he epidemiological and
zoono ic isk o monkeypox. This isk is pe cei ed as low by some, mode a e by o he s, and high o e y high by o he s
s ill. The majo challenges iden i ied in managing monkeypox include, in o de , he lack o diagnos ic ools, absence o
eliable in o ma ion and collabo a ion wi h heal h au ho i ies, sho age o medicines, and he cos o ca e.
4.5. Epidemiological Su eillance o Monkeypox
Table 5 P ac ices Rega ding Epidemiological Su eillance o Monkeypox
Is he e an epidemiological su eillance p og am o monkeypox?
Numbe
(n=79)
F equencies
%
Yes
No
26
53
33
67
Ha e pa icipa ed in monkeypox epidemiological su eillance p og ams?
Yes
No
18
61
23
77
Tasks assumed by pa icipan s in su eillance p og ams
Numbe (n=18)
%
Case epo ing
Collec ion o epidemiological da a
Moni o ing o in ec ed animals
O he s
15
18
11
1
83
100
13.2
5.5
A endance a wo kshops o semina s on zoonoses managemen , including
monkeypox
Numbe (n=78)
%
Yes
No
42
36
53.8
46.2
Table 5 shows ha 33% o esponden s epo ed he exis ence o an epidemiological su eillance p og am o
monkeypox, and 23% o hem ha e al eady pa icipa ed in his p og am. The asks hey unde ake du ing su eillance
include case epo ing, collec ion o epidemiological da a, and moni o ing o in ec ed animals. Mo e han hal , 53.8%,
pa icipa e in wo kshops add essing zoonoses managemen , including monkeypox.
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Table 6 Sugges ions and Recommenda ions o he Managemen o Monkeypox Use ul ools o imp o e e e ina ians’
knowledge and p ac ices on MPOX, wha is needed o be e igh monkeypox in e e ina y p ac ice:
Use ul ools o imp o e e e ina ians’ knowledge and p ac ices on MPOX
Tools
Numbe o imes men ioned
%
Addi ional aining
Access o diagnos ic ki s
Access o pe sonal p o ec i e equipmen (PPE)
Technical assis ance om e e ina y au ho i ies
O he s
74
64
56
56
2
93.6
81
70.8
70.8
2.5
Wha is needed o be e igh monkeypox in e e ina y p ac ice:
E ec i e communica ion among clinical e e ina ians
Moni o ing wildli e mo emen s
Mul idisciplina y app oach in case managemen
Vaccina ion
Funding
T aining
De elop a clea p o ocol o MPOX managemen
Equip e e ina ians wi h diagnos ic ools
Implemen a ion o su eillance p og ams
Pe sonal p o ec i e equipmen (PPE)
Expe imen al esea ch
Awa eness aising and popula iza ion
Moni o ing hun e s, comba ing poaching
P omo ion o wildli e conse a ion
Good hygiene p ac ices
Collabo a ion be ween human heal h and e e ina y au ho i ies
4
2
3
5
2
21
1
8
3
2
1
8
3
1
6
5
5
2.5
3.8
6.3
2.5
26.5
1
10.1
3.8
2.5
1
10.1
3.8
1
7.5
6.3
Table 6 shows ha esponden s emphasize he need o aining sessions on monkeypox managemen o be e igh
he disease. Se e al o he sugges ions we e made, anging om imp o ed communica ion o enhanced collabo a ion
be ween human heal h and e e ina y au ho i ies.
5. Discussion
The Democ a ic Republic o Congo (DRC) has expe ienced spo adic cases o monkeypox, and wi h he esu gence o
zoonoses, i was impe a i e o his s udy o assess he p epa edness and capaci y o e e ina ians o espond o his
disease. This opic allows o an explo a ion o he impac o e e ina y knowledge on epidemiological su eillance and
case managemen , which is i al o public heal h. The in e connec ion be ween human and animal heal h, highligh ed
by he "One Heal h" concep , unde sco es he impo ance o an in eg a ed app oach o zoonosis con ol. By assessing
e e ina ians’ knowledge, his esea ch will acili a e collabo a ion be ween e e ina ians and human heal h
p o essionals, he eby p omo ing a holis ic app oach o managing monkeypox- ela ed isks.
A e he i s case o monkeypox was documen ed in Saudi A abia, a c oss-sec ional s udy assessing he knowledge and
a i udes o medical s uden s ega ding monkeypox was conduc ed in a medical school in he coun y in 2022.
Subsequen ly, wo o he s udies [18]; [19]) ca ied ou in Sy ia and Jo dan e ealed a low le el o Mpox knowledge
among heal hca e wo ke s in Jo dan, which was associa ed wi h lowe con idence in case managemen and diagnosis
among physicians and nu ses [20]). Howe e , no s udies on his opic ha e been epo ed in he DRC ega ding clinical
e e ina ians, who play an essen ial ole in zoonosis managemen . Gi en his esea ch gap, ou s udy aimed o e alua e
he knowledge and skills o clinical e e ina ians ega ding monkeypox in he DRC.
