Assessing Portuguese Public Health Literacy on Legionella Infections: Risk Perception, Prevention, and Public Health Impact

Abstract

Legionella is an environmental bacterium capable of causing severe respiratory infections, with outbreaks posing significant public health challenges in developed countries. Understanding public awareness of Legionella transmission, risk perception, and preventive behaviors is crucial for reducing exposure and guiding health education strategies. This study aimed to evaluate the Portuguese population’s knowledge of Legionella infections and their readiness to adopt preventive measures. A structured questionnaire was developed and administered to 239 participants aged 18–76 years across Portugal, collecting socio-demographic data and assessing literacy through statements organized into domains related to Legionella risk, control measures, and public health impact. The results indicate that participants possess moderate to high awareness of Legionella severity, transmission routes, and preventive strategies, yet gaps remain in understanding key risk factors, optimal water system maintenance, and the influence of temperature on bacterial growth. Age, educational attainment, and occupational status were associated with differences in self-assessed literacy levels. Artificial neural network models were applied to classify literacy levels, achieving a near 90% accuracy and demonstrating higher confidence in low and moderate categories. These findings provide insights for designing tailored educational programs, improving public health communication, and enhancing preventive behaviors to reduce Legionella infection risks.