Temporal trends and social determinants of sepsis knowledge in Brazil: findings from three national cross-sectional surveys.

BACKGROUND: Public awareness of sepsis is essential for early recognition of warning signs and timely healthcare seeking behavior, but data from resource-limited settings remain scarce. METHODS: We evaluated sepsis knowledge in Brazil using cross-sectional surveys conducted in 2014, 2017, and 2026. Standardized questionnaires were administered through face-to-face interviews using random sampling stratified by age, sex, and geographic region. Adequate basic knowledge was defined as having heard the term sepsis and correctly identifying it as a severe host response to infection. In 2026, we additionally assessed knowledge of sepsis time-dependent nature and long-term disability after sepsis. Multivariable logistic regression identified factors associated with knowledge. RESULTS: A total of 6,312 participants were interviewed (2014: n = 2,126; 2017: n = 2,100; 2026: n = 2,086). Adequate basic knowledge increased from 2.6% in 2014 to 5.8% in 2017 (OR 2.25, 95% CI 1.63-3.16; p < 0.001) and 10.3% in 2026 (OR 3.45, 95% CI 2.54-4.75; p < 0.001). In 2026, 70.0% of participants acknowledged that earlier diagnosis and treatment improve survival. Awareness of long-term disabilities was lower (24.4%). Higher educational attainment was the strongest determinant of knowledge across all domains. Younger age, male sex, residence outside state capitals, and lower household income were independently associated with lower knowledge. CONCLUSION: Public awareness of sepsis in Brazil has improved substantially over the past decade, suggesting a positive impact of national and international awareness initiatives. Nevertheless, important knowledge gaps persist, and awareness continues to be strongly influenced by socioeconomic factors, highlighting the need for continued efforts to improve sepsis awareness and promote equitable access to health information.