Cross-sectional study to determine viral hepatitis knowledge in different urban populations in Brazil

Table 1 Participants' sociodemographic characteristics of studies, n (%)

Item	Total, 447	Southeast viral hepatitis ambulatory, 100	South health center, 89	Northeast health center, 114	Southeast low resource areas, 77	Northeast low resource areas, 67	P value
Gender
Female	269 (60.2)	55 (55.0)	33 (37.1)	76 (66.7)	51 (66.2)	54 (80.6)	0.000
Male	178 (39.8)	45 (45.0)	56 (62.9)	38 (33.3)	26 (33.8)	13 (19.4)
Age groups by yr
≤ 40	193 (43.2)	29 (29.0)	28 (31.5)	68 (59.6)	27 (35.1)	41 (61.2)	0.000
> 40	254 (56.8)	71 (71.0)	61 (68.5)	46 (40.4)	50 (64.9)	26 (38.8)
Education
Illiterate	136 (30.4)	28 (28.0)	11 (12.4)	27 (23.7)	38 (49.3)	32 (47.8)	0.000
Primary school	66 (14.8)	16 (16.0)	12 (13.5)	15 (13.2)	13 (16.9)	10 (14.9)
Secondary school	186 (41.6)	42 (42.0)	48 (53.9)	51 (44.7)	25 (32.5)	20 (29.8)
College	59 (13.2)	14 (14.0)	18 (20.2)	21 (18.4)	1 (1.3)	5 (7.5)
Family income
Low	38 (8.5)	3 (3.0)	1 (1.1)	5 (4.4)	7 (9.1)	17 (25.3)	0.000
Intermediate	250 (55.9)	62 (62.0)	25 (28.1)	72 (63.2)	55 (71.4)	41 (61.2)
High	145 (32.5)	35 (35.0)	61 (68.5)	34 (29.8)	11 (14.3)	4 (6.0)
Race
White	211 (47.2)	47 (47.0)	67 (75.3)	33 (28.9)	42 (54.5)	22 (32.8)	< 0.0001
Non-white	225 (50.3)	51 (51.0)	20 (22.4)	74 (64.9)	35 (45.5)	45 (67.2)
Marital status
Married	222 (49.7)	46 (46.0)	44 (49.4)	59 (51.8)	40 (51.9)	33 (49.3)	0.909
Unmarried	224 (50.1)	54 (54.0)	45 (50.6)	55 (48.2)	36 (46.8)	34 (50.7)
People in home
1	39 (8.7)	14 (14.0)	9 (10,1)	8 (7.0)	7 (9.1)	1 (1.5)	0.000
2	97 (21.7)	23 (23.0)	28 (31.5)	16 (14.0)	24 (31.1)	6 (9.0)
3	128 (28.6)	34 (34.0)	23 (25.8)	30 (26.3)	24 (31.2)	17 (25.4)
4	94 (21.0)	14 (14.0)	17 (19.1)	32 (28.1)	8 (10.4)	23 (34.3)
5	88 (19.7)	14 (14.0)	12 (13.5)	28 (24.6)	14 (18.2)	20 (29.8)

Table 2 Correct answers regarding viral hepatitis given by individuals from each group evaluated (n = 447) according to general aspects, clinical manifestations, risk of acquiring hepatitis, complications, transmission and prevention, n (%)

Sentence	Total,n = 447	Southeast viral hepatitis ambulatory,n = 100	South health center,n = 89	Northeast health center,n = 114	Southeast low resource areas,n = 77	Northeast low resource areas,n = 67	P value
General aspects
Can hepatitis be caused by viruses	321 (71.8)	84 (84.0)	69 (77.5)	75 (65.8)	48 (62.3)	45 (67.2)	0.005
Can hepatitis be caused by bacteria	242 (54.1)	50 (50.0)	19 (21.3)	74 (64.9)	56 (72.7)	43 (64.2)	0.000
Can hepatitis be caused by alcohol	172 (38.5)	31 (31.0)	31 (34.8)	38 (33.3)	34 (44.2)	38 (56.7)	0.006
Can hepatitis be caused by medicines	154 (34.5)	45 (45.0)	29 (32.6)	32 (28.1)	24 (31.2)	24 (35.8)	0.110
Does hepatitis A exist	394 (88.1)	98 (98.0)	78 (87.6)	97 (85.1)	68 (88.3)	53 (79.1)	0.004
Does hepatitis B exist	410 (91.7)	99 (99.0)	88 (98.9)	95 (83.3)	73 (94.8)	55 (82.1)	0.000
Does hepatitis C exist	359 (80.3)	99 (99.0)	86 (96.6)	66 (57.9)	61 (79.2)	47 (70.1)	0.000
Does hepatitis D exist	121 (27.1)	56 (56.0)	18 (20.2)	10 (8.8)	18 (23.4)	19 (28.4)	0.000
Does hepatitis E exist	92 (20.6)	40 (40.0)	15 (16.9)	7 (6.1)	14 (18.2)	16 (23.9)	0.000
Does a vaccine for hepatitis exist	376 (84.1)	91 (91.0)	78 (87.6)	97 (85.1)	58 (75.3)	52 (77.6)	0.026
Can you have the same hepatitis more the once	132 (29.5)	37 (37.0)	23 (25.8)	37 (32.5)	13 (16.9)	22 (32.8)	0.040
Clinical manifestations
No clinical manifestations	292 (65.3)	89 (89.0)	75 (84.3)	61 (53.5)	35 (45.5)	32 (47.8)	0.000
After years	311 (69.6)	81 (81.0)	75 (84.3)	61 (53.5)	47 (61.0)	47 (70.1)	0.000
Fever discomfort, nausea	369 (82.6)	76 (76.0)	67 (75.3)	99 (86.8)	64 (83.1)	63 (94.0)	0.008
Jaundice, pale stools and dark urine	410 (91.7)	93 (93.0)	81 (91.0)	103 (90.4)	72 (93.5)	61 (91.0)	0.922
People at risk of acquiring hepatitis
People working in laboratory	235 (52.6)	61 (61.0)	39 (43.8)	67 (58.8)	38 (49.4)	30 (44.8)	0.054
People who work in hospitals	310 (69.4)	72 (72.0)	58 (65.2)	88 (77.2)	56 (72.7)	36 (53.7)	0.014
Not people who work in rural areas	157 (35.1)	36 (36.0)	41 (46.1)	46 (40.4)	18 (23.4)	16 (23.9)	0.006
People who work in the beauty areas	353 (79.0)	91 (91.0)	70 (78.7)	89 (78.1)	57 (74.0)	46 (68.7)	0.007
People who use drugs	393 (87.9)	98 (98.0)	85 (95.5)	96 (84.2)	64 (83.1)	50 (74.6)	0.000
People who receive tattoos or piercings	389 (87.0)	98 (98.0)	79 (88.8)	96 (84.2)	64 (83.1)	52 (77.6)	0.001
People who live indoors	253 (56.6)	46 (46.0)	45 (50.6)	66 (57.9)	57 (74.0)	39 (58.2)	0.004
Not people who work in offices	299 (66.9)	19 (19.0)	68 (76.4)	28 (24.6)	26 (33.8)	31 (46.3)	0.000
Complications
Cirrhosis	361 (80.8)	91 (91.0)	82 (92.1)	79 (69.3)	62 (80.5)	47 (70.1)	0.000
Liver cancer	378 (84.6)	91 (91.0)	78 (87.6)	95 (83.3)	65 (84.4)	49 (73.1)	0.031
There is no loss of body movements	88 (19.7)	32 (32.0)	17 (19.1)	27 (23.7)	6 (7.8)	6 (9.0)	0.233
There is no loss of blood through the mouth	65 (14.5)	17 (17.0)	18 (20.2)	16 (14.0)	8 (10.4)	6 (9.0)	0.000
There is no vision loss	117 (26.2)	30 (30.0)	23 (25.8)	40 (35.1)	13 (16.9)	11 (16.4)	0.016
There is no blood in the stool	49 (11.0)	18 (18.0)	10 (11.2)	9 (7.9)	7 (9.1)	5 (7.5)	0.121
Transmission
By transfusion and transplantation	386 (86.4)	94 (94.0)	85 (95.5)	91 (79.8)	67 (87.0)	49 (73.1)	0.000
By sex	310 (69.4)	96 (96.0)	76 (85.4)	64 (56.1)	42 (54.5)	32 (47.8)	0.000
By water and contaminated vegetables	318 (71.1)	88 (88.0)	49 (55.1)	79 (69.3)	60 (77.9)	42 (62.7)	0.000
By seafood	135 (30.2)	59 (59.0)	17 (19.1)	27 (23.7)	23 (29.9)	9 (13.4)	0.000
By tattoo and piercing	361 (80.8)	96 (96.0)	76 (85.4)	88 (77.2)	57 (74.0)	44 (65.7)	0.000
By cutting instruments	385 (86.1)	99 (99.0)	77 (86.5)	90 (78.9)	66 (85.7)	53 (79.1)	0.005
By hemodialysis	280 (62.6)	74 (74.0)	58 (65.2)	60 (52.6)	53 (68.8)	35 (52.2)	0.010
Cannot be by mosquito bite	221 (49.4)	58 (58.0)	49 (55.1)	60 (52.6)	31 (40.3)	23 (34.3)	0.000
Cannot be by air	268 (60.0)	69 (69.0)	69 (77.5)	68 (59.6)	34 (44.2)	28 (41.8)	0.000
Prevention
Building cesspools	324 (72.5)	78 (78.0)	49 (55.1)	89 (78.1)	63 (81.8)	45 (67.2)	0.000
Channeling water	318 (71.1)	76 (76.0)	53 (59.6)	84 (73.7)	63 (81.8)	42 (62.7)	0.007
Selecting uninfected donors	363 (81.2)	90 (90.0)	71 (79.8)	105 (92.1)	58 (75.3)	39 (58.2)	0.000
Filtering water and treating drinks	372 (83.2)	88 (88.0)	57 (64.0)	101 (88.6)	71 (92.2)	55 (82.1)	0.000
Killing mosquitoes does not prevent hepatitis	189 (42.3)	53 (53.0)	41 (46.1)	41 (36.0)	33 (42.9)	21 (31.3)	0.029
Providing vaccine	405 (90.6)	94 (94.0)	80 (89.9)	107 (93.9)	70 (90.9)	54 (80.6)	0.030
Using masks does not prevent hepatitis	210 (47.0)	69 (69.0)	57 (64.0)	46 (40.4)	26 (33.8)	12 (17.9)	0.000
Using condoms	378 (84.6)	97 (97.0)	82 (92.1)	93 (81.6)	56 (72.7)	50 (74.6)	0.000

Table 3 Sociodemographic characteristics according to knowledge scores for viral hepatitis, n (%)

Item	Mean of knowledge score (± SD)	Knowledge score		Bivariate analysis P value
		Low (0-28), n = 192	Desirable (29-46), n = 255
Gender
Female	28.49 ± 6.16	120 (62.5)	149 (58.4)	0.430
Male	29.04 ± 6.10	72 (37.5)	106 (41.6)
Age in yr
≤ 40	27.6 ± 6.6	91 (47.4)	102 (40.0)	0.120
> 40	27.5 ± 8.5	101 (52.6)	153 (60.0)
Education level
Illiterate	25.4 ± 8.3	74 (38.5)	62 (24.3)	0.002
Primary school	28.1 ± 5.1	32 (16.7)	34 (13.3)
Secondary school	30.9 ± 5.7	66 (34.4)	120 (47.1)
College	30.8 ± 5.4	20 (10.4)	39 (15.3)
Family income
Low	26.1 ± 6.9	21 (10.9)	17 (6.7)	0.200
Indeterminate	29.4 ± 7.0	105 (54.7)	145 (56.9)
High	30.3 ± 5.5	57 (29.7)	88 (34.5)
Race
White	29.8 ± 7.1	79 (41.1)	132 (51.8)	0.030
Non-white	28.2 ± 6.3	107 (55.7)	118 (46.3)
Marital status
Married	28.4 ± 7.1	94 (48.9)	128 (50.2)	0.840
Unmarried	27.3 ± 8.0	97 (50.5)	127 (49.8)
Individuals living in the same home
1	30.5 ± 5.0	11 (5.7)	28 (11.0)	0.014
2	29.5 ± 5.6	41 (21.4)	56 (22.0)
3	28.3 ± 6.3	63 (32.8)	65 (25.5)
4	28.8 ± 6.6	31 (16.1)	63 (24.7)
≥ 5	27.6 ± 6.4	46 (24.0)	42 (16.5)
Population
Southeast viral hepatitis ambulatory	33.1 ± 4.5	13 (6.8)	87 (34.1)	< 0.0001
South health center	29.1 ± 5.3	37 (19.3)	52 (20.4)
Northeast health center	27.5 ± 5.0	58 (30.2)	56 (22.0)
Southeast low resource areas	27.6 ± 4.7	43 (22.4)	34 (13.3)
Northeast low resource areas	25.0 ± 8.5	41 (21.3)	26 (10.2)

Table 4 Final adjusted model of multivariate logistic regression for knowledge scores for viral hepatitis

Variable	Knowledge score
	OR	95%CI		P value
		Lower	Upper
Education level
Illiterate	2.230	1.084	4.586	0.290
Primary school	1.799	0.807	4.009	0.151
Secondary school	1.028	0.528	2.002	0.936
College	1.000	-	-	-
Individuals living in the same home
1	1.000	-	-	-
2	1.611	0.671	3.867	0.286
3	2.328	0.992	5.465	0.052
4	0.818	0.332	2.017	0.663
≥ 5	1.832	0.748	4.486	0.185
Population
Southeast viral hepatitis ambulatory	1.000	-	-	-
South health center	6.154	2.900	13.058	0.000
Northeast health center	8.617	4.177	17.777	0.000
Southeast low resource areas	7.491	3.508	15.994	0.000
Northeast low resource areas	11.262	5.007	25.327	0.000

CI: Confidence interval; OR: Odds ratio.