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Background: This study aimed to investigate the level of awareness of and factors associated with major infectious diseases in rural China and to provide the most recent baseline data for the prevention and control of these diseases. Methods: This cross-sectional study was carried out in Zhejiang province between December 2010 and April 2011. Participants were recruited from 36 villages and interviewed by doctors from the community health service using a structured questionnaire. Results: The study sample consisted of 36,377 subjects aged 15 to 80 years old. Study results showed that knowledge of HIV was adequate in 44.21% of rural residents; knowledge of TB was adequate in 52.66% of respondents; and knowledge of HBV was adequate in 60.18% of respondents. People in older age groups and with lower education levels were more likely to have low levels of awareness of these three infectious diseases. Participants in the farming industry had poorer awareness of HIV and HBV, while students and factory workers knew little of TB. The proportions of people reporting being fully satisfied with the control policies for HIV, TB and HBV were 37.70%, 34.25% and 36.12%, respectively. Conclusions: The level of awareness of HIV, TB and HBV is still low among rural residents. Further national disease control plans for major infectious diseases should emphasise effective and comprehensive health education campaigns to increase public awareness of these diseases in rural areas of China. [ABSTRACT FROM AUTHOR]