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

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.