title: Health literacy and infectious diseases: why does it matter?
abstract: OBJECTIVE
  Multifactorial interventions are crucial to arrest the threat posed by infectious diseases. Public involvement requires adequate information, but determinants such as health literacy can impact on the effective use of such knowledge. The influence of health literacy on infectious diseases is examined in this paper.
  
  
  METHODS
  Databases were searched from January 1999 through July 2015 seeking studies reporting on health literacy and infections such tuberculosis, malaria, and influenza, and infection-related behaviours such as vaccination and hand hygiene. HIV was excluded, as comprehensive reviews have already been published.
  
  
  RESULTS
  Studies were found on antibiotic knowledge and use, the adoption of influenza and MMR immunizations, and screening for sexually transmitted and viral hepatitis infections. There was a lack of investigations on areas such as tuberculosis, malaria, hand hygiene, and diarrhoeal diseases.
  
  
  CONCLUSIONS
  Limited or insufficient health literacy was associated with reduced adoption of protective behaviours such as immunization, and an inadequate understanding of antibiotics, although the relationship was not consistent. Large gaps remain in relation to infectious diseases with a high clinical and societal impact, such as tuberculosis and malaria.
authors.affiliation: NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK. Electronic address: e.castro-sanchez@imperial.ac.uk.
authors.forename: Enrique
authors.initials: E
authors.lastname: Castro-Sánchez
authors.affiliation: National Taipei Hospital, Ministry of Health and Welfare, Taiwan, Taipei Medical University, Taipei, Taiwan.
authors.forename: Peter W S
authors.initials: PWS
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Alzira, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Vila-Candel
authors.affiliation: Academic Paediatric Hospital "Pedro Borrás", Havana City, Cuba.
authors.forename: Angel A
authors.initials: AA
authors.lastname: Escobedo
authors.affiliation: NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK.
authors.forename: Alison H
authors.initials: AH
authors.lastname: Holmes
mesh_terms: D003141:Communicable Diseases; D058015:Health Communication; D057220:Health Literacy; D006801:Humans; D020377:Self Efficacy
keywords: Health communication; Health literacy; Infectious diseases; Self-efficacy