Factors Predicting the Intention to Engage in Self-Protective Behavior against Monkeypox Infection among Thai People

Authors

Awirut Singkun, Sirindhorn College of Public Health, Yala, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, 95000 ThailandFollow
Wichan Phibarn, Sirindhorn College of Public Health, Yala, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, 95000 Thailand
Wichaporn Intharachuti, Sirindhorn College of Public Health, Yala, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, 95000 Thailand
Arunothai Derramon, Sirindhorn College of Public Health, Yala, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, 95000 Thailand
Thitika Kimise, Sirindhorn College of Public Health, Yala, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, 95000 Thailand

Abstract

Background: An emerging monkeypox outbreak in many countries caused the WHO to declare the disease an international public health problem. This study aimed to explore knowledge of monkeypox and its transmission, intention to engage in self-protection, and factors predicting the intention to engage in self-protective behavior among Thai people.

Methods: A cross-sectional design was conducted between September and October 2022 with a self-administered questionnaire through an online survey. A total of 581 respondents were included in the data analysis. Descriptive statistics, and a binary logistic regression were used.

Results: Most respondents had good knowledge of monkeypox and its transmission (82.4%). More than half had poor intentions of engaging in self-protective behavior. Factors associated with the intention of having self-protective behavior against monkeypox included being single (aOR = 3.973, 95%CI = 1.559–10.126), working for the government (aOR = 2.768, 95%CI = 1.317–5.816), having a smallpox vaccination (aOR = 0.366, 95%CI = 0.183–0.733), never having had a smallpox vaccination (aOR = 0.347, 95%CI = 0.201–0.598), having no intention to get a smallpox vaccination (aOR = 2.725, 95%CI = 1.083–6.858), being undecided about getting a smallpox vaccination (aOR = 5.721, 95%CI = 2.354–13.905), and having good knowledge of monkeypox and its transmission (aOR = 1.807, 95%CI = 1.052–3.103).

Conclusion: Self-protection is needed and health education should be promoted to support accurate perceptions of all aspects of the transmission of monkeypox. Furthermore, public health preparedness measures should be taken to deal with this public health issue.

Keywords: Intention, Monkeypox, Self-protective behavior, Smallpox, Outbreak

Recommended Citation

Singkun A, Phibarn W, Intharachuti W, Derramon A, Kimise T. Factors Predicting the Intention to Engage in Self-Protective Behavior against Monkeypox Infection among Thai People. J Health Res. 2024; 38(4):-. DOI: https://doi.org/10.56808/2586-940X.1083

References

[1] Adebayo O, Owoeye D. Monkeypox. Ann Ibd. Pg. Med. 2017; 15(2): 145.

[2] Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D. Monkeypox: a comprehensive review of transmission, pathogenesis, and manifestation. Cureus. 2022; 14(7). https://doi.org/10.7759/cureus.26531.

[3] Yodjan N. The emerging human monkeypox in Thailand: a mini-review. Access Microbiol. 2022; 1: 000489. https://doi.org/10.1099/acmi.0.000489.v1.

[4] Adler H, Gould S, Hine P, Snell LB, Wong W, Houlihan CF, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK. Lancet Infect. Dis. 2022; 22(8): 1153-62. https://doi.org/10.1016/S1473-3099(22)00228-6.

[5] Adalja A, Inglesby T. A novel international monkeypox outbreak. Ann Intern Med. 2022; 175: 1175–6. doi:10.7326/M22-1581.

[6] Harapan H, Ophinni Y, Megawati D, Frediansyah A, Mamada SS, Salampe M, et al. Monkeypox: a comprehensive review. Viruses. 2022; 14(10): 2155.

https://doi.org/10.3390/v14102155.

[7] Heskin J, Belfield A, Milne C, Brown N, Walters Y, Scott C, et al. Transmission of monkeypox virus through sexual contact–A novel route of infection. J. Infect. 2022; 85(3): 334-63. https://doi.org/10.1016/j.jinf.2022.06.008.

[8] Huang Y, Mu L, Wang W. Monkeypox: epidemiology, pathogenesis, treatment and prevention. Signal Transduction Targeted Ther. 2022; 7(1): 1-22. https://doi.org/10.1038/s41392-022-01215-4.

[9] Zambrano PG, Acosta-España JD, Moyano FM, Jara JBA. Sexually or intimately transmitted infections: A look at the current outbreak of monkeypox in 2022. Travel Med. Infect. Dis. 2022; 49: 102383. https://doi.org/10.1016/j.tmaid.2022.102383.

[10] Saxena SK, Ansari S, Maurya VK, Kumar S, Jain A, Paweska JT, et al. Re‐emerging human monkeypox: a major public‐health debacle. J. Med. Virol. 2023; 95(1): e27902. https://doi.org/10.1002/jmv.27902.

[11] Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox virus infection in humans across 16 countries—April–June 2022. N. Engl. J. Med. 2022; 387(8): 679-91. https://doi.org/10.1056/NEJMoa2207323.

[12] Vaughan A, Aarons E, Astbury J, Brooks T, Chand M, Flegg P, et al. Human-to-human transmission of monkeypox virus, United Kingdom, October 2018. Emerg. Infect. Dis. 2020; 26(4): 782. https://doi.org/10.3201/eid2604.191164.

[13] Antunes F, Cordeiro R, Virgolino A. Monkeypox: From A Neglected Tropical Disease to a Public Health Threat. Infect. Dis. Rep. 2022; 14(5): 772-83.

https://doi.org/10.3390/idr14050079.

[14] Breman JG, Steniowski M, Zanotto E, Gromyko A, Arita I. Human monkeypox, 1970-79. Bull. World Health Organ. 1980; 58(2): 165.

[15] Titanji BK, Tegomoh B, Nematollahi S, Konomos M, Kulkarni PA. Monkeypox: A Contemporary Review for Healthcare Professionals. Open Forum Infect. Dis. 2022; 9(7). https://doi.org/10.1093/ofid/ofac310.

[16] World Health Organization. Smallpox Eradication in Thailand. WHO/SE/78.113. [cited 2022 Nov 16] Available from https://apps.who.int/iris/bitstream/handle/10665/68243/WHO_SE_78.113.pdf?sequence=1&isAllowed=y.

[17] Trishnananda M. Mass campaign aginst smallpox in Thailand. Int. J. Dermatol. 1971; 10: 31.

[18] Saengthong Chancherd. 100 years of the department of disease control. The Ministry of Public Health, Thailand [in Thai]. [cited 2022 Nov 15] Available from https://ddc.moph.go.thuploadspublish967920200107100426.pdf.

[19] Viputsiri PLO-A. Lohsuntorn P, Viputsiri O. Stop for smallpox vaccination [in Thai]. Chula. Med. J. 1979; 23(4): 356.

[20] van Nispen C, Reffett T, Long B, Gottlieb M, Frawley TC. Diagnosis and Management of Monkeypox: A Review for the Emergency Clinician. Ann. Emerg. Med. 2022.

https://doi.org/10.1016/j.annemergmed.2022.07.014.

[21] Kim J-W, Lee M, Shin H, Choi C-H, Choi M-M, Kim JW, et al. Isolation and identification of monkeypox virus MPXV-ROK-P1-2022 from the first case in the Republic of Korea. Osong Public Health Res Perspect. 2022; 13(4): 308-11.

https://doi.org/10.24171/j.phrp.2022.0232.

[22] Altare C, Castelgrande V, Tosha M, Malembaka EB, Spiegel P. From insecurity to health service delivery: pathways and system response strategies in the Eastern Democratic Republic of the Congo. Glob. health, Sci. Pract. 2021; 9(4): 915-27.

https://doi.org/10.9745/GHSP-D-21-00107.

[23] Nuzzo JB, Borio LL, Gostin LO. The WHO declaration of monkeypox as a global public health emergency. Jama. 2022; 328(7): 615-7.

[24] Chakraborty C, Bhattacharya M, Pandya P, Dhama K. Monkeypox in South-East Asia: Is an alarming bell for this region?–Correspondence. Int. J. Surg. (London, England). 2022; 106: 106917. https://doi.org/10.1016/j.ijsu.2022.106917.

[25] Farahat RA, Rackimuthu S, Umar TP, Siddiqui JA, Shrestha AB, Essar MY. Preparedness of South East Asia countries in view of monkeypox emergence: A call for action. Lancet Regional Health-Southeast Asia. 2022; 6.

https://doi.org/10.1016/j.lansea.2022.100074.

[26] Yong SEF, Ng OT, Ho ZJM, Mak TM, Marimuthu K, Vasoo S, et al. Imported Monkeypox, Singapore. Emerg. Infect. Dis. 2020; 26(8): 1826.

https://doi.org/10.3201/eid2608.191387.

[27] Vivancos R, Anderson C, Blomquist P, Balasegaram S, Bell A, Bishop L, et al. Community transmission of monkeypox in the United Kingdom, April to May 2022. Euro Surveill. 2022; 27(22): 2200422. https://doi.org/10.2807/1560-7917.ES.2022.27.22.2200422.

[28] Samaranayake L, Anil S. The monkeypox outbreak and implications for dental practice. Int. Dent. J. 2022. https://doi.org/10.1016/j.identj.2022.07.006.

[29] Rao AK, Schulte J, Chen T-H, Hughes CM, Davidson W, Neff JM, et al. Monkeypox in a traveler returning from Nigeria—Dallas, Texas, July 2021. MMWR Morb. Mortal. Wkly. Rep. 2022; 71(14): 509.

[30] Lin GSS, Tan WW, Chan DZK, Ooi KS, Hashim H. Monkeypox awareness, knowledge, and attitude among undergraduate preclinical and clinical students at a Malaysian dental school: An emerging outbreak during the COVID-19 era. Asian Pac. J. Trop. Med. 2022; 15(10): 461.

[30] Tajudeen YA, Oladipo HJ, Muili AO, Ikebuaso JG. Monkeypox: A review of a zoonotic disease of global public health concern. Health Promot. Perspec. 2023; 13(1): 2.

https://doi.org/10.34172/hpp.2023.01.

[31] Shanmugaraj B, Khorattanakulchai N, Phoolcharoen W. Emergence of monkeypox: Another concern amidst COVID-19 crisis. Asian Pac. J. Trop. Med. 2022; 15(5): 193. https://doi.org/10.4103/1995-7645.346081.

[32] Sklenovská N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front. Public Health. 2018; 6: 241.

https://doi.org/10.3389/fpubh.2018.00241.

[33] Maddux JE, Rogers RW. Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. J. Exp. Soc. Psychol. 1983;19(5):469-79.

[34] Oo MZ, Panza A, Pongpanich S. Factors Related to Intention to Quit Smoking among Industrial Workers in Myanmar: A Cross-Sectional Study. Basic Education. 2019; 6: 0.009.

[35] Sawant R, Goyal R, Rajan S, Patel H, Essien E, Sansgiry S. Factors associated with intention to engage in self-protective behavior: The case of over-the-counter acetaminophen products. Res. Social Adm. Pharm. 2016; 12(2): 327-35.

https://doi.org/10.1016/j.sapharm.2015.06.005.

[36] Litwin H, Levinsky M. Network-exposure severity and self-protective behaviors: The case of COVID-19. Innov. Aging. 2021; 5(2): igab015. https://doi.org/10.1093/geroni/igab015.

[37] Hailey Shin H, Jeong M, Zapata-Cuervo N, Montes Guerra MI, Cho M-H, Kim Y. Effects of customers’ perceived risks of sharing economy on self-protective behavior toward COVID-19. Int. J. Contemp. Hosp. Manag. 2022. https://doi.org/10.1108/IJCHM-12-2021-1547.

[38] Ghobadi K, Rakhshanderou S, Hosseini F, Ghaffari M. COVID-19 Protective Behaviors of Iranian Healthcare Workers: A Psychological Theoretical Design Analysis. Health Scope. 2022; 11(4). https://doi.org/10.5812/jhealthscope-121318.

[39] Fang F, Chen S, Geng X, Kiprop E. Survey on public awareness, attitudes and self-protective behavior adoption in different periods of COVID-19. 2022.

https://doi.org/10.21203/rs.3.rs-1786965/v1.

[40] Al-Rasheed M. Protective behavior against COVID-19 among the public in Kuwait: An examination of the protection motivation theory, trust in government, and sociodemographic factors. Soc. Work Public Health. 2020; 35(7): 546-56.

https://doi.org/10.1080/19371918.2020.1806171.

[41] Cochran WG. Sampling techniques: John Wiley & Sons; 2007.

[42] Seameang H. Factors Related to Dietary Behavior of Diabetic Patients Unable to Control Blood Sugar Levels, Yala Hospital. [in Thai]. J. Educ. Res. Public Health. 2023; 1(2): 104-121. https://so12.tci-thaijo.org/index.php/JERPH_Yala/article/view/509/400.

[43] Tancharoen P. Factors Associated with Satisfaction on Accessibility of Denture Services among the Elderlyin Sai Thong Sub-district, Bang Saphan Noi District, Prachuap Khiri Khan Province. [in Thai]. J. Educ. Res. Public Health. 2023;1(1): 15-30. https://so12.tci-thaijo.org/index.php/JERPH_Yala/article/view/440/249.

[44] Aung PL, Pumpaibool T, Soe TN, Kyaw MP. Knowledge, attitude and practice levels regarding malaria among people living in the malaria endemic area of Myanmar. J. Health Res. 2019. https://doi.org/10.1108/JHR-01-2019-0012.

[45] Bendel RB, Afifi AA. Comparison of stopping rules in forward “stepwise” regression. J. Am. Stat. Assoc. 1977; 72(357): 46-53.

[46] Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am. J. Epidemiol. 1989; 129(1): 125-37.

[47] Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol. Med. 2008; 3(1): 1-8. https://doi.org/10.1186/1751-0473-3-17.

[48] Hammerschlag Y, MacLeod G, Papadakis G, Sanchez AA, Druce J, Taiaroa G, et al. Monkeypox infection presenting as genital rash, Australia, May 2022. Euro Surveill. 2022; 27(22): 2200411. https://doi.org/10.2807/1560-7917.ES.2022.27.22.2200411.

[49] Rizk JG, Lippi G, Henry BM, Forthal DN, Rizk Y. Prevention and treatment of monkeypox. Drugs. 2022; 82(9): 957-63. https://doi.org/10.1007/s40265-022-01742-y.

[50] Sah R, Abdelaal A, Reda A, Katamesh BE, Manirambona E, Abdelmonem H, et al. Monkeypox and its possible sexual transmission: where are we now with its evidence? Pathogens. 2022; 11(8): 924. https://doi.org/10.3390/pathogens11080924.

[51] Tamang ST, Dorji T. Bhutan's preparedness for monkeypox outbreak. Lancet Regional Health-Southeast Asia. 2022; 7. https://doi.org/10.1016/j.lansea.2022.100092.

[52] Chansawang J and Yoseng S. Monkeypox Situation : Health Threat from a Viral Infection. [in Thai]. J. Educ. Res. Public Health. 2023;1(1): 48-55. https://so12.tci-thaijo.org/index.php/JERPH_Yala/article/view/481/346.

[53] Xu T, Wu X. Risk Perception, Media, and Ordinary People's Intention to Engage in Self-Protective Behaviors in the Early Stage of COVID-19 Pandemic in China. Risk Manag. Healthc. Policy. 2022; 1459-71. https://doi.org/10.2147/RMHP.S374889.

[54] Kessy SJ, Gon G, Alimi Y, Bakare WA, Gallagher K, Hornsey E, et al. Training a Continent: A Process Evaluation of Virtual Training on Infection Prevention and Control in Africa During COVID-19. Glob. Health, Sci. Pract. 2023. https://doi.org/10.9745/GHSP-D-22-00051.