Discussion
Public health literacy is an essential concept in modern society that
determines the health behavior of individual’s and community. It affects
the level of health services utilization and improves the intended
outcome of health care services (14). The complex nature of chronic
disease needs better health literacy from the public and individual
patient. With better health literacy, it is possible to reduce the
incidence of chronic disease and improve management of their
complication efficiently. Knowledge toward the disease is of great
importance in health literacy (15-16). This study is the first in
Ethiopia to assess public knowledge of chronic disease. CKD is a
significant health concern in Ethiopia even though the inadequacy in
data of national figure hospital-based assessment revealed a higher
magnitude of CKD (17). For combating this health problem, improving the
health literacy of the society would be of great benefit. Therefore
understanding the knowledge gap and determining the appropriate
intervention is a prior issue.
Consequently, findings generated from this study would be a significant
input for policymaker and program manager to look into appropriate
intervention. In our study, we explored the public knowledge towards CKD
using the tool adopted from previous 154 study (5). The tool was
pretested and discussed with experts on its strength to capture the
necessary details.
The computed mean (S.D.) knowledge score was found to be 11.2 (± 4.21),
which is a substantial level of knowledge. It is comparable with the
findings reported from Australia and Tanzania, which was 10.34 (± 5.0)
and 3.85 (± 4.66), respectively (5, 13). This high score of knowledge is
mainly associated with participant characteristics. We recruited the
participant from the capital city of the country, unlike the previous
study (13) and more than half of them had a college diploma and above.
It was found from the current study established that educational level
had a significant effect on knowledge of CKD with P-value of
0.015. Therefore the higher score of the knowledge would be associated
with a large number of educated participant and the study site we
selected. This finding would not be representative of the country; hence
the literacy rate of the Ethiopian population is below 50 per cent, and
only 20.4 per cent of the population is the urban population (18). The
study included a significant number of rural household participants
claimed lower knowledge score in comparison to our study (13).
Regarding general knowledge of study participants on chronic kidney
disease, 83.7 % of the study participants knew that a person could lead
a healthy life with one healthy kidney; this was slightly lower in
comparison to Hong Cong study, in that study most (84.7%) of the
participant were aware of the kidney’s function (11). However, the
finding of the current study is also promising since organ shortage is a
global crisis and the public knowledge and awareness is a crucial
element for promoting the living organ donation practice (19). As a
developing country, the level of awareness claimed in this study is
substantial. A lower number of a study respondent (22.6 %) believes
that herbal supplements can be useful in treating CKD however 2/3rd of
the participant from Tanzania study claimed that they were likely to use
traditional medicines for the treatment of kidney disease and also
around 14 % 177 of use self-treatment with home remedies(13). A study
from Nigeria revealed that 47.8 % of respondents have faith in local
herbal concoctions and spiritual means to cure CKD (10), this may be
associated with the belief in herbal medicine in the urban area.
In the present study, almost half (57.5 %) of the study participants
knew that certain medications could help to slow down the worsening of
CKD, which was lower in comparison to Hong Cong study (80 %). In
previously, mentioned study half of the study group had a risk factor
for CKD such as diabetes and hypertension (11) that may increase their
awareness towards risk factor for CKD. With current evidence expanding
health education to prevent CKD is indispensable. Since there are
several treatment options which able to render the progression of CKD by
preventing the advance in risk factor (20), most participants knew that
the kidney makes urine and kidney clean blood, but around 21 and 34 per
cent of the participants identified that the kidney helps to maintain
blood pressure and keep bones healthy respectively. Likewise, in Hong
Cong study, nearly half of the study participants did not know the role
of the kidney in maintaining blood pressure (11). Therefore health
education focusing on chronic disease prevention and management is
critical. There is an increase in the prevalence of the chronic disease
in Ethiopia, particularly in urban setups; therefore, due focus from
policymaker and health care strategist is expected (21).
The majority of the study respondents knew that hypertension (51.8 %)
and Diabetes (57.8 %) are the risk factors for the development of CKD.
This finding is similar to several studies elsewhere (10-12). This
finding is promising since the public has a good awareness of the risk
factor of the disease; the possibility of prevention would be higher.
About signs and symptoms of an advanced stage of CKD, 68.8 % of
recognized water retention is one of the advanced stage symptoms, nausea
and vomiting (39.5 %), loss of appetite (56.6 %) and increased fatigue
(75.7%). This finding depicted participants had good knowledge of
alarming signs and symptoms of CKD in comparison to previously reported
results (5, 10). This would help implement prevention strategies and
management of a communicable disease.
Similar to other studies, public knowledge CKD significantly associated
with the level of education. Several other studies depicted that the
level of education is significantly associated with knowledge related to
CKD (5, 10-11). Since health literacy is highly associated with personal
determinants like knowledge and competence, this variation is the
expected (14). In addition to health literacy, the general literacy of
society is essential for improving the overall wellbeing of society.
This study assessed the public knowledge of CKD for the first time in
Ethiopian, and it produced useful findings which serve as an input for
health education programs at the community level, in health facilities
and media sector. Furthermore, the findings serve as an input for
in-service and pre-service training of health professionals in Ethiopia.
As a limitation, we recruited participants only from the capital city of
the country and further studies focusing on the rural base of the
country will be needed.