**5. Discussion**

This study was done to evaluate the KAP toward hepatitis B and C among different community populations**.** Firstly, in this study, there is no age grouping for study participants, only people with age less than 16 years are not included in this study. Above 16 year of age participants are included in current study. Second prospect of this study was to evaluate knowledge, different attitudes, and practices of literate and illiterate community toward hepatitis B and C. In this study, we also look for the socioeconomic status of study participants. To evaluate how much of the community was non-affording. A scoring system was developed and scores of participants for each domain were analyzed and co-related with various demographic factors, also for each domain participants have been categorized according to their scores. Results of this study revealed that demographic factor gender showed no significant difference in knowledge and attitude of male and female candidates, but the practice of these two categories showed significant value of chi-square (p = 0.004). According to marital status, the single people had more knowledge than the married participants in this study. The results of chi-square test showed a significant difference between the knowledge of these two groups (p = 0.017), but there was no significant difference between the attitude and practice of the married and single participants in this study. Another significant finding of the study was that although there was no significant difference between KAP of undergraduates and postgraduates, there was statistically significant difference between knowledge of participants belonging to different educational categories (primary, secondary, and illiterate), as compared to undergraduates. Current study shows that participants belonging to undergraduate level showed high mean score on knowledge and practices section than participants belonging to postgraduate level. The study has attempted to shed light on KAP by engaging study participants from different levels of education (primary, secondary, undergraduates, postgraduates, and illiterate). As the p values of knowledge, attitude, and practice were 0.014, 0.00, and 0.021, respectively. These results clearly showed a significant difference between the knowledge, attitude, and practice of the participants belonging to different levels of education. One of the important findings of study was the evaluation of knowledge attitude and practice among the participants according to

#### *Awareness and Prevalence of Hepatitis B and C in Rural Areas of Lahore, Pakistan DOI: http://dx.doi.org/10.5772/intechopen.109192*

screening test results. Chi-square results indicate significant difference (p = 0.004) in the attitude of people having B+, C+, and both +ve and -ve. The most positive attitude was seen among the participants having positive hepatitis B and C. But there was no significant difference between knowledge and practice among these groups. The poorest knowledge, attitude, and practice were seen among the participants having both hepatitis B and C negative. Another significant value was seen among the participants associated with different levels of occupation. A significant difference was observed in the practice (p = 0.021) of these groups (unemployed, government servants, private jobs, and housewives). There was no significant difference in knowledge and attitude; however, the mean score value showed that government servants had better knowledge and attitude; whereas, according to the mean scores, the knowledge, attitude, and practice of housewives were poorest among all. According to health belief model, the perception of disease and probability of adoption of positive practices and attitude of an individual depends on four important variables, that is, perceived seriousness of a disease, susceptibility of a disease, perceived benefits of positive attitude and practice, and lastly, perceived barriers that might restrain an individual to make positive changes [25]. A common negative attitude that was observed among study participants was low perceived seriousness of hepatitis B and C, financial barriers, and lack of time and knowledge about disease treatment and vaccination. Due to these barriers and somehow due to superstitious thoughts of people about hepatitis, people did not agree to get treatment. According to a previous study of WHO in 2015, only 3–5% of infected individual receive treatment annually, worldwide. About 75% of infected individuals are not aware of their HCV positive status and remain undiagnosed. This cause a huge economic impact cost for government, society, and also for patient. As with the progression of ailment, cost also increases [26].
