Health literacy assessment of individuals with and without Chagas disease: a cross-sectional study

Abstract

Background

Chagas disease (CD) is neglected that affects vulnerable individuals, whose majority has low ability to understand health information.

Objectives

To assess health literacy and its association with sociodemographic, clinical, and quality of life (QoL) characteristics.

Design and setting

A cross-sectional study the participants with Chagas disease (ChD) were identified through serological diagnosis during blood donation, while those without the disease were seronegative blood donors.

Methods

Health literacy was assessed using the SALPHA-18 tool and grouped into three categories: adequate, inadequate, or illiterate. Descriptive analysis was performed for categorical and quantitative variables, and ordinal logistic regression models assuming proportional odds were used to evaluate the relationship between sociodemographic, clinical, and QoL variables.

Results

A total of 611 participants were included, with 328 having ChD and 283 without the disease. The proportions of individuals with adequate (n = 323), inadequate (n = 200), and illiterate (n = 88) health literacy among those with ChD were 40.2% (130/323), 65.5% (131/200), and 76.1% (67/88), respectively, while among those without the disease, the proportions were 59.8% (193/323), 34.5% (69/200), and 23.9% (21/88), respectively. Better health literacy was associated with females, OR: 1.91 [1.34–2.71]; residents of São Paulo, OR: 3.15 [2.09–4.75]; age < 56 years, OR: 3.05 [2.12–4.39]; income ≥ R$2,200, OR: 2.93 [2.04–4.21]; white ethnicity, OR: 1.64 [1.10–2.44]; and individuals without ChD, OR: 3.78 [2.65–5.41]. Conclusions: The proportion of individuals with inadequate and illiterate health literacy was high, especially among those with positive serology for ChD.