Dengue fever is a severe by Qv86ji

VIEWS: 2 PAGES: 24

									   RAJIV GANDHI UNIVERSITY OF HEALTH SCEINCES,

             BANGALORE, KARNATAKA.




“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME REGARDING EARLY DETECTION

    AND PREVENTIONAL ASPECTS OF DENGUE FEVER

     AMONG MOTHERS OF CHILDREN (1-12 YEARS)

            IN A SELECTED COMMUNITY

                 AREA AT KOLAR”.




      PROFORMA FOR REGISTRATION OF SUBJECT

                FOR DISSERTATION




           Mr. MOHAMMED FARUK KHILZI



         AECS PAVAN COLLEGE OF NURSING

              BANGLORE, KARNATAKA.
    RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
              BANGALORE, KARNATAKA

     PROFORMA FOR REGISTRATION OF SUBJECT FOR
                    DISSERTATION
                      MR. MOHAMMED FARUK KHILZI
                      S/O MOHAMMED SATTAR KHILZI
    NAME OF THE
1                     1st YEAR, M.Sc. NURSING
    CANDIDATE
                      AECS PAVAN COLLEGE OF NURSING,
                      KOLAR

    NAME OF THE       AECS PAVAN COLLEGE OF NURSING,
2
    INSTITUTION       KOLAR

    COURSE OF         DEGREE OF MASTER OF SCIENCE IN
3   STUDY AND THE     NURSING.
    SUBJECT           PAEDIATRIC NURSING

    DATE OF
4   ADMISSION TO      19 MARCH, 2012
    COURSE
                      A STUDY TO ASSESS THE
5   TITLE OF THE      EFFECTIVENESS OF STRUCTURED
    TOPIC             TEACHING PROGRAMME REGARDING
                      EARLY DETECTION AND
                      PREVENTIONAL ASPECTS OF DENGUE
                      FEVER AMONG MOTHERS OF
                      CHILDREN (1-12 YEARS) IN A
                      SELECTED COMMUNITY AREAS AT
                      KOLAR.
6. BRIEF RESUME OF THE INTENDED WORK

6.1. INTRODUCTION

“Health implies a sound mind, in a sound body, in a sound family, in a sound

environment”.

                                              An-ancient view J.E. Park.



Every child must be ensured the best start in life – their future and indeed the future of

their communities, nations and the whole world depends on it.1 A child is a unique

individual; he or she is not a miniature adult, not a little man or woman. Child’s health is

greatly depends upon parents’ health, parents’ physical and social environment which

includes the life styles, culture, custom, tradition and habits, child bearing and rearing

practices.2



Dengue is a mosquito-borne infection found in tropical and sub-tropical regions around

the world. In recent years, transmission has increased predominantly in urban and semi-

urban areas and has become a major international public health concern.3



The origin of the word dengue are not clear, but one theory is that it is derived from the

Swahili phrase ‘‘Ka-dinga pepo’’, meaning ‘‘cramp-like seizure caused by an evil

spirit’’. The Swahili word ‘‘dinga’’ may possibly have its origin in the Spanish word

‘‘dengue’’ meaning fastidious or careful, which would describe the gait of a person

suffering the bone pain of dengue fever. Alternatively, the use of the Spanish word may

derive from the similar-sounding Swahili. Slaves in the West Indies who contracted

dengue were said to have the posture and gait of a dandy, and the disease was known as

‘‘Dandy fever’’.4


                                             1
Dengue fever is a severe, flu-like illness that affects infants, young children and adults,

but seldom causes death. Dengue should be suspected when a high fever (40°C/ 104°F)

is accompanied by two of the following symptoms: severe headache, pain behind the

eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms

usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an

infected mosquito.5



The incidence of dengue has grown dramatically around the world in recent decades.

Over 2.5 billion people – over 40% of the world's population – are now at risk from

dengue. WHO currently estimates there may be 50–100 million dengue infections

worldwide every year.6



Severe dengue is a potentially deadly complication due to plasma leaking, fluid

accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs

occur 3–7 days after the first symptoms in conjunction with a decrease in temperature

(below 38°C/ 100°F) and include: severe abdominal pain, persistent vomiting, rapid

breathing, bleeding gums, fatigue, restlessness, blood in vomit. The next 24–48 hours of

the critical stage can be lethal; proper medical care is needed to avoid complications and

risk of death.7



“I’d conservatively estimate that there are 37 million dengue infections occurring every

year in India, and maybe 227,500 hospitalizations,” said Dr. Scott Halstead, a tropical

disease expert focused on dengue research. The global dengue problem is far worse than

most people know getting worse,” said Dr. Raman Velayudhan, the WHO’S lead dengue

coordinator. Officials say that 35,000 people in India had been sickened with dengue


                                            2
fever through November, 2012- a sharp increase from 18,860 cases and 169 deaths in

2011.Over 28,292dengue cases and 110 deaths were reported in 2010.But the real

number of Indians who get dengue fever annually is in millions, several experts said.

Record-based study conducted in a costal district of Karnataka. Required data from the

entire laboratory confirmed cases from 2002to 2008 were collected from Medical

Records Department (MRD) and analyzed using SPSS 13.5 version. Study included 466

patients. Majorities were males, 301(64.6%) and in the age groups of 15-44 years,

267(57.5%). Maximum number of cases were seen in 2007, 219(47%) and in the month

of September, 89(19.1%). The most common presentation was fever 462(99.1%),

followed by myalgia 301(64.6%), vomiting 222(47.6%), headache 222(47.6%) and

abdominal pain 175(37.6%). The most common hemorrhagic manifestation was

petechiae 84(67.2%).391(83.9%) cases presented with dengue shock syndrome. Out of

66(14.1%) patients who developed clinical complications, 22(33.3%) had ARDS and

20(30.3%) had pleural effusion. Deaths reported were 11(2.4%). Community awareness,

early diagnosis and management and vector control measures need to be strengthened,

during peri-mansoon period, in order to curb the increasing number of dengue cases.8



The dengue fever is now endemic in more than 100 countries in Africa, the Americas,

the Eastern Mediterranean, South-east Asia and the Western Pacific. South-east Asia and

the Western Pacific regions are the most seriously affected. According to WHO over 2.5

billion people are now at risk of dengue and there are about 50-100 million dengue

infections worldwide every year.9




                                           3
6.2. NEED FOR THE STUDY

“The trouble with always trying to preserve the health of the body is that it is so

difficult to do without destroying the health of mind”.

                                                                        - G. K. Chesterton

Dengue is the most important mosquito-borne, human viral disease in many tropical and

sub-tropical areas. In India the disease has been essentially described in the form of case

series. We reviewed the epidemiology of dengue in India to improve understanding of its

evolution in the last 50 years and support the development of effective local prevention

and control measures. Early outbreak reports showed a classic epidemic pattern of

transmission with sporadic outbreaks, with low to moderate numbers of cases, usually

localized to urban centers and neighbouring regions, but occasionally spreading and

causing larger epidemics. Trends in recent decades include: larger and more frequent

outbreaks; geographic expansion of endemic transmission; spread of the disease from

urban to peri-urban and rural areas; an increasing proportion of severe cases and deaths;

and progression to hyperendemicity, particularly in large urban areas. The global picture

of dengue in India is currently that of a largely endemic country. Understanding

demographic differences in infection rates and severity of dengue has important

implications for the planning and implementation of effective public health prevention

and control measures and targeting of future vaccination campaigns.10



The dengue fever is now endemic in more than 100 countries in Africa, the Americas,

the Eastern Mediterranean, South-east Asia and the Western Pacific. South-east Asia and

the Western Pacific regions are the most seriously affected. According to WHO over 2.5

billion people are now at risk of dengue and there are about 50-100 million dengue

infections worldwide every year.11


                                            4
India has recorded 37,070 dengue cases in 2012. The number of deaths in the country

this year till November15, 2012 due to dengue has touched 227. The state of Tamil Nadu

crossed the 9249 dengue cases topping the list with the death of 60 people. It is followed

by Maharashtra crossed the 1731 dengue cases with 59 lives lost and the state of

Karnataka registered 3640 dengue cases with 21 deaths reported. In the Kolar district of

Karnataka 45 people died was dengue fever in 2012(according to district health officer).

The Kerala has 3760 cases of dengue fever with 15 death reports (data based on reports

of Ministry Of Health And Family Welfare Of India).12



In New Delhi, 65 new cases of dengue fever were reported on October 19, 2012,

bringing the total number of infected this season to 4,679 till now 1980 cases positive of

dengue fever with 4 lives lost. There are approximately 70 new cases every day. An

outbreak of dengue fever has been reported in Madeira, Portugal. As of October 2012, a

total of 18 confirmed cases and 191 cases have been reported. The Ministry of Health

Jalisco (SSJ) reported that there have been 288 cases of dengue reported so far this year,

of which 255 are the classical type and 33 are hemorrhagic. The Director of Public

Health of the SSJ, Barocio Bernardo Carrillo, said that 39 new cases were reported, of

which 33 are conventional type and 6 are hemorrhagic.13



A record-based descriptive study was undertaken to determine the clinical profile and

outcome of all patients admitted to a tertiary care teaching hospital at Manipal,

Karnataka (Kasturba Hospital) with a diagnosis of dengue, DHF and DSS according to

WHO protocol, from January 2002 to December 2008. All standardized dengue enzyme

linked immunosorbent assay (ELISA) IgM antibody positive (Pan Bio Kit - Australia)

cases were included in the study. Data were collected using a pre-designed questionnaire


                                            5
and analyzed using Statistical Package for Social Sciences. Of the total 466 cases,

admitted to the hospital between 2002 and 2008, 391 (83.9%) had dengue fever, 41

(8.8%) had dengue hemorrhagic fever, and 34 (7.3%) had dengue shock syndrome. The

year 2007 had the highest number of reported cases, 219 (47%). Most of dengue cases

occurred during the month of September, the districts from where the cases were

reported predominantly, Davangere 192 (41.2%), Shimoga 107 (23%), and Udupi 35

(7.5%). Majority of the cases, 301 (64.6%) were males and 165 (35.4%) were females.

Maximum number of cases was in the age group of 15–44 years, 267 (57.3%), while

number of cases reported among the under-five children was 35 (7.5%). Average

duration of stay in hospital was 6–10 days, 256 (54.9%). As seen, fever was present in

almost all cases 462 (99.1%) followed by myalgia 301 (64.6%), vomiting 222 (47.6%),

headache 222 (47.6%), abdominal pain 175 (37.5%), breathlessness 83 (17.8%), diarrhea

65 (13.9%), skin rash 101 (21.7%), and altered sensorium 48 (10.3%). Hemorrhagic

manifestations included petechiae 84 (67.2%), ecchymosis 29 (6.2%), gum bleeding 24

(5.2%), hematuria 23 (4.9%), malena 22 (4.7%), hematemesis 15 (3%), and epistaxis 12

(2.6%). In the study, 66 patients had complications of which, 22 (33.3%) patients had

adult respiratory distress syndrome (ARDS), 20 (30.3%) had pleural effusion, 9 (13.6%)

had multiple organ failure, 7 (10.6%) had encephalopathy, 4 (6.1%) had pneumonia, and

1(1.5%) had renal failure. The year-wise distribution of the deaths reported among 11

cases (2.4%). Of the 11 deaths, 7 (63.6%) were males, 4 (36.4%) were females and 7

(63.6%) were children.14



An estimated 500 000 people with severe dengue require hospitalization each year, a

large proportion of whom are children. About 2.5% of those affected die. Severe dengue

is a potentially deadly complication due to plasma leaking, fluid accumulation,


                                          6
respiratory distress, severe bleeding, or organ impairment. Warning signs occur 3–7 days

after the first symptoms in conjunction with a decrease in temperature (below 38°C/

100°F) and include: severe abdominal pain, persistent vomiting, rapid breathing,

bleeding gums, fatigue, restlessness, blood in vomit. The next 24–48 hours of the critical

stage can be lethal; proper medical care is needed to avoid complications and risk of

death.15



The purpose of the study is to assess the knowledge and practice of mothers regarding

early detection and prevention of dengue fever in children. It may help to reduce the

prevalence of dengue fever by improving the knowledge of mothers.



According to investigator experience and review of literature that the mothers with more

knowledge to prevent their children from dengue infection by provide clean and healthy

environment and consistently observing their children’s activities. Therefore, we have

understood that if we could provide more awareness about dengue fever through media

and people in this hour then there will be drastic improvement in mother’s attitude

towards their children for prevention of dengue fever. This will lead to eradication of

such disease in the near future. So the investigator felt that mothers of children should

have awareness regarding early detection and prevention of dengue fever through

structured teaching programme.




                                            7
6.3 REVIEW OF LITERATURE

Review of literature is key step in research process and refers to extensive, exhaustive

and systematic examination of publication relevant to research project. The task of

reviewing literature involves identification, section, critical analysis and reporting

existing information on the topic of interest.



A study was conducted on ‘‘Knowledge, attitude and practice on dengue, the vector and

control in an urban community of the Northeast Region”, in Brazil, 2011. The study was

observational and used a semi-structured survey composed of questions about the disease

and vector control measures, which was answered by residents of selected households

(IC 95%) of the community of Santa Rosa, in the city of Cabo de Santo Agostinho,

Pernambuco State. The variables of the KAP were classified into appropriate, regular and

insufficient. There is adequate knowledge about the characteristics of the vector and

regular regarding the disease and the activities of control. The population does not know

that the insecticide used in water is chemical and uses this water for domestic

consumption and drinking. Regarding government activity the knowledge was

insufficient. It also demonstrates a non appropriate attitude regarding the prevention of

dengue and insufficient practice in the prevention of the vector in the household. The

practice of water care was adequate for 41% of residents. The local risk situations raised

are related to the intermittency in water and also behavioral.16



A study was conducted on ‘‘Role of primary care providers in dengue prevention and

control in the community”, in Malaysia, 2010.It is believed that many seek treatment at

the primary care clinics and are not admitted. This study aims at establishing the fact that

primary care practitioners, as the first point of patient contacts, play a crucial role in


                                                 8
advising patients suspected of having dengue to take early preventive measures to break

the chain of dengue transmission. A total of 236 patients admitted to two government

hospitals for suspected dengue fever were interviewed using a structured questionnaire

over a one week period in December 2008. It was found that 83.9% of the patients had

sought treatment at a Primary Care (PC) facility before admission to the hospital, with

68.7% of them seeking treatment on two or more occasions. The mean time period for

seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared

to almost five (4.9) days for admission. The majority of patients (96-98%) reported that

primary care practitioners had not given them any advice on preventive measures to be

taken even though 51.9% of the patients had been told they could be having dengue

fever. This study showed the need for primary care providers to be more involved in the

control and prevention of dengue in the community, as these patients were seen very

early in their illness compared to when they were admitted.17



A study was conducted on ‘‘Family leader empowerment program using participatory

learning process for dengue vector control”, in Thailand, 2010. This quasi-experimental

research utilized the two-group pretest-posttest design. The sample group consisted of

120 family leaders from two communities in Mueang Municipality, Chachoengsao

Province. The research was conducted during an 8-week period between April and June

2010. The data were collected and analyzed based on frequency, percentage, mean,

paired t-test, and independent t-test. The result was evaluated by comparing the

difference between the mean prevalence index of mosquito larvae before and after the

process implementation in terms of the container index (CI) and the house index (HI).18




                                            9
The study was conducted on ‘‘The efficacy of play-based education in preventing dengue

in primary-school Children”, in Bucaramanga between July and November 2009. A

group of leading primary-school children received play-based education about Dengue

and leadership after they had been surveyed regarding their knowledge about dengue

control practices. Then they signed commitments to implement action with family and

neighbours; they were followed-up for four months and home visits were made to assess

commitment and repeat the survey. Data was compared before and after, by Chi2 test,

considering p<0.05 to be significant. Follow-up was completed for 89 of the 99 children

(90 %). There were significant increases in knowledge about dengue as a disease (from

73 % to 95.5%), as being very severe (82 % to 96.6 %), being transmitted by mosquitoes

(82 % to 100 %), being caused by virus (1.1 % to 19.1 %), in recognising larvae (54 %to

95.5 %) and breeding sites (43 % to 88 %), recognising symptoms of fever (67.4% to

97.8 %), pain in the bones (21.3 % to 62.9 %), headache (37.1 % to 64 %) and bleeding

(16.8 % to 42.7 %), in the need for opportune consultation (77.5 % to 98.9 %), spraying

(22.5 % to 47.2 %) and washing out water tanks (67.5 % to 89.7 %). The children

fulfilled their commitment and creatively and inventively engaged in more activities.19



A study was conducted on ‘‘Proactive Vector control strategies and improved monitoring

and evaluation practices for dengue prevention”,in USA,2009. Despite tremendous

efforts by public health organizations in dengue-endemic countries, it has proven

difficult to achieve effective and sustainable control of the primary dengue virus vector

Aedes aegypti (L.) and to effectively disrupt dengue outbreaks. This problem has

multiple root causes, including uncontrolled urbanization, increased global spread of

dengue viruses, and vector and dengue control programs not being provided adequate

resources. In this forum article, we give an overview of the basic elements of a vector


                                           10
and dengue control program and describe a continuous improvement cyclical model to

systematically and incrementally improve control program performance by regular

efforts to identify ineffective methods and inferior technology, and then replacing them

with better performing alternatives. The first step includes assessments of the overall

resource allocation among vector/dengue control program activities, the efficacy of

currently used vector control methods, and the appropriateness of technology used to

support the program. We expect this will reveal that 1) some currently used vector

control methods are not effective, 2) resource allocations often are skewed toward

reactive vector control measures, and 3) proactive approaches commonly are

underfunded and therefore poorly executed. Next steps are to conceptualize desired

changes to vector control methods or technologies used and then to operationally

determine in pilot studies whether these changes are likely to improve control program

performance. This should be followed by a shift in resource allocation to replace

ineffective methods and inferior technology with more effective and operationally tested

alternatives. The cyclical and self-improving nature of the continuous improvement

model will produce locally appropriate management strategies that continually are

adapted to counter changes in vector population or dengue virus transmission dynamics.

We discuss promising proactive vector control approaches and the continued need for the

vector and dengue control community to incorporate emerging technologies and to

partner with academia, business and the community-at-large to identify new solutions

that reduce dengue.20



A study was conducted on ‘‘Dengue fever: clinical features” in France, 2009.Dengue

fever is usually transmitted by Aedes aegypti. It is due to an arbovirus-flavivirus of

which four different serotypes are known: Den 1 to 4. Each serotype is responsible for


                                          11
specific prolonged immunity but no cross-reactivity exists between serotypes. Clinically,

the onset is abrupt with frontal headache, retro-orbital pain, myalgia, joint pain,

prostration and, in many cases, a macular rash usually sparing the face and extremities.

Haemorrhagic signs may occur, such as petechiae, purpura, epistaxis or bleeding

gingivae. Two severe forms of dengue fever, particularly among children below 3 years

of age, include dengue haemorrhagic fever (DHF) and DHF with shock (dengue shock

syndrome). If a case is suspected in metropolitan France, the diagnosis should be

systematically confirmed by positive specific IgM, RT-PCR or viral isolation. 21



A study was conducted on ‘‘Dengue and dengue haemorrhagic fever” in India, 2008. The

relationship of this country with dengue has been long and intense. The first recorded

epidemic of clinically dengue-like illness occurred at Madras in 1780 and the dengue

virus was isolated for the first time almost simultaneously in Japan and Calcutta in 1943-

1944. After the first virologically proved epidemic of dengue fever along the East Coast

of India in 1963-1964, it spread to all over the country. The first full-blown epidemic of

the severe form of the illness, the dengue haemorrhagic fever/dengue shock syndrome

occurred in North India in 1996. Aedes aegypti is the vector for transmission of the

disease. Vaccines or antiviral drugs are not available for dengue viruses; the only

effective way to prevent epidemic dengue fever/dengue haemorrhagic fever (DF/DHF) is

to control the mosquito vector, Aedes aegypti and prevent its bite. This country has few

virus laboratories and some of them have done excellent work in the area of molecular

epidemiology, immunopathology and vaccine development. Selected work done in this

country on the problems of dengue is presented here.22




                                           12
A study was conducted on ‘‘Is dengue emerging as a major public health problem”?,

Vellore, India. Diagnosis of dengue infection is easily and best accomplished by

demonstration of specific IgM antibodies in blood. We analyzed retrospectively the

dengue IgM seropositivity available for samples obtained over a period of five year

(1999-2003) from patients with suspected dengue fever (DF)-like illness to investigate

whether there was an overall increase in the dengue IgM prevalence over this period.

Serum samples from a total of 1426 individuals (suspected dengue cases) obtained over

five year was tested for dengue specific IgM antibodies. Of the 1426 patients, 693 were

adults (>15yr) and 694 children (<15 yr) (excluding 39 individuals whose age was not

known). There were 807 males and 610 females (excluding 9 individuals whose status on

sex was unknown). A total of 423 (29.7%) samples were positive for dengue IgM over

the five year period. Overall, there was a significant increase in the percentage of dengue

IgM positive individuals over this period (P<0.001). When the individuals were grouped

into children (<15yr) and adults (>15 yr), a significant increase in the number of dengue

IgM positive individuals was noticed only in children (P<0.001) and not in adults. When

the individuals were grouped into males and females, a significant increase in the

number of dengue IgM positive individuals was noticed in both the sexes (P<0.03).

Month-wise analysis of the dengue IgM positivity rates indicated the year-wide

occurrence of dengue. A total of 158 (41%) of the dengue IgM positive individuals

showed positivity for dengue IgG also suggestive of a secondary heterotypic infection.23


A study was conducted on ‘‘Temperature related storage evaluation of an RT-PCR test

kit for the detection of dengue infection in mosquitoes”, Kuala Lumpur, Malaysia, 2005.

The rapid detection of dengue infection in mosquito vectors is important for early

warning to forestall an outbreak. Reverse Transcriptase-Polymerase Chain Reaction (RT-

PCR) provides a rapid method for dengue detection in man and mosquitoes. An RT-PCR

                                            13
kit developed by the Medical Entomology Unit, Institute for Medical Research to detect

dengue infection in mosquitoes, was tested for its shelf life at 3 storage temperatures:

room temperature, refrigerator and freezer. Test kits were tested once every 3 days for

kits stored at room temperature, and once every week for those stored at refrigerator and

freezer temperatures. The results showed that the test kit could only be stored above its

recommended storage temperature of -20 degrees C for not more than 3 days.DNA 100

bp markers in the kits appeared to be stable at the tested temperatures and were usable up

to the 20th day when stored at 2 degrees C and below.24


A study was conducted on ‘‘Serological and entomological investigations of an outbreak

of dengue fever” in certain rural areas of Kanyakumari district, Tamil Nadu. During the

first week of July 2003, suspected cases of dengue fever were reported from three

villages in Kanyakumari district in Tamil Nadu. Since the fever outbreak occurred for the

first time in these villages, serological, virological and entomological investigations were

carried out to confirm the aetiology of outbreak. A total of 76 plasma samples were

collected from suspected cases of dengue fever and screened for the presence of IgM

antibodies by Pan Bio ELISA kit. Toxo-IFA system was used for the isolation of dengue

virus from the plasma samples. Vector survey employing ovitraps and adult landing

collection were carried out in the study villages.Pooled samples of Aedes mosquito were

screened for dengue virus antigen by an in-house antigen capture ELISA test employing

dengue virus specific monoclonal antibodies. Of the 76 samples tested, 15 (20%) were

found positive for dengue virus specific IgM antibodies. Dengue virus serotype-3 was

detected from a plasma sample by Toxo-IFA test using virus specific monoclonal

antibodies. Entomological survey revealed the abundance of Aedes albopictus (Skuse)

mosquitoes in the study area. One pool consisting of 12 Ae. albopictus males were found

positive for dengue virus infection.25

                                            14
6.4. STATEMENT OF PROBLEM

A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAMME REGARDING EARLY DETECTION AND PREVENTION

ASPECTS OF DENGUE FEVER AMONG THE MOTHERS OF CHILDREN

(1-12 YEARS) IN A SELECTED COMMUNITY AREAS AT KOLAR DISTRICT.


6.5. OBJECTIVES OF THE STUDY

1.   To assess the existing level of knowledge regarding early detection and

     preventional aspects of dengue fever among mothers of children (1-12 years).

2.   To determine the effectiveness of structured teaching programme regarding early

     detection and preventional aspects of dengue fever among mothers of children

     (1-12 years).

3.   To compare the level of knowledge regarding early detection and preventional

     aspects of dengue fever among mothers of children (1-12 years) before and after

     structured teaching programme.

4.   To find association between post test knowledge level regarding early detection

     and preventional aspects of dengue fever among mothers of children (1-12 years)

     with selected socio-demographic variables.


6.6. OPERATIONAL DEFINITIONS

1.   ASSESS: Measurement Of Knowledge Score On Early Detection And

     Preventional Aspects Of Dengue Fever Among Mothers Of Children (1-12

     Years) Of Based On Structured Interview Schedule.

2.   EFFECTIVENESS: It refers to the extent of structured teaching programme to

     enhance the desired effect on early detection and prevention aspect of dengue

     fever in children


                                        15
3.     STRUCTURED TEACHING PROGRAMME: It refers to the structured

       teaching programme on the early detection and prevention aspect of dengue fever

       in children for the mothers of the children to enhance the knowledge on the

       meaning, types, techniques, and the early detection and prevention of the

       diseases.

4.     DENGUE FEVER: Is also known as break bone fever, is an                     infectious

       tropical disease caused by the dengue virus. Symptoms Include fever, headache,

       muscle and joint pains, and a characteristic skin rash that is similar to Measles.

5.     CHILDREN: Children who belongs the age group 1 to 12 years.

6.     MOTHERS: refers to the mothers of children (1-12 years) from the selected

       Community.



6.7. HYPOTHESIS:

H01 There will be no significant difference in the level of knowledge of mothers in

selected communities regarding the early detection and prevention aspect of dengue

fever in children.

H02 There will be significant association between pretest and post test knowledge of

mothers in selected communities regarding the early detection and prevention aspect of

dengue fever in children.



6.8. ASSUMPTION OF THE STUDY:

1.      Mothers have basic knowledge regarding the early detection and prevention

       aspect of dengue fever in children.

2.      Structured teaching programme will enhance the knowledge of mothers

       regarding the early detection and prevention aspect of dengue fever in children.


                                             16
6.9. DELIMITATION

1.       The study is delimited to mothers of the children (1-12 years) from the selected

         communities.

2.       Mothers of the children (1-12 years) who are willing to participate in the study.

3.       The study is delimited to a period of 4- 6 weeks.



7. MATERIALS AND METHODS:

7.1. SOURCE OF DATA

        Mothers of children (1-12 years) at selected community areas at kolar.



7.2.1. INCLUSION CRITERIA

1.       Mothers of the children (1-12 years) in selected community areas.

2.       Mothers who are willing to participate in the study.

3.       Mothers who speak and read English and kannada.



EXCLUSION CRITERIA

        The mothers who do not read English and kannada.



7.2.2. RESEARCH DESIGN

        Quasi experimental design one group pre-test and post-test.



7.2.3. SETTING OF THE STUDY

        The study will be conducted in selected community areas at kolar



7.2.4. SAMPLING TECHNIQUES

        Probability random sampling techniques.



                                             17
7.2.5. SAMPLE SIZE

        The sample size of the present study will be 80 mothers.



7.2.6. TOOL OF RESEARCH

Self Administered knowledge Questionnaire will be developed and used for data

collection.



7.2.7. COLLECTIONOF DATA

The investigator will administer the knowledge Questionnaire to collect data from the

subjects.



7.2.8. METHODS OF DATA ANALYSIS AND PRESENTATION

The plan of the data analysis will be as follows:

Organise the data in master sheet.

1.       Frequencies and percentage of the demographic data.

2.       Mean standard deviation paired T-test to determine the significance.

3.       Chi-square to measure the association.



7.3.     DOES     THE      STUDY       REQUIRE        ANY      INVESTIGATION     OR

INTERVENTION TO BE CONDUCTED ON THE PATIENT OR OTHER

HUMAN OR ANIMALS? IF SO PLEASE DESCRIBE BRIEFLY.

Yes, the study will be conducted in selected community areas in kolar.



7.4.     HAS    ETHICAL      CLEARANCE            BEEN   OBTAINED        FROM   YOUR

INSTITUTION IN CASE OF 7.3.?

Yes, the ethical clearance has been obtained from the institution.



                                            18
8. LIST OF REFERENCES:

1.    Eric H. Ericsons, Childhood and Society, Stanford University, 2006.

2.    Parul Dutta, Pediatrics Nursing, New Delhi, Jaypee Brothers

3.    Lund S, Jackson J, Leggett J, et.al.Reality of glove use and washing in a

      community hospital.AMJ infect Control.1994 Dec: 226(6):352-7.

4.    Zafer A B, Goudas LA,Furlong WB.Effectiveness of infection control

      programme in control programme in controlling nosocomial clostridium

      difficile.AM J infect control 1998 Dec:26(6):588-93

5.    Bennett G, Monsell I. Universal precautions:a survey of community nurses

      experience and practice. J Clinc Nurs.2004 may:13(4):41 3-21.

6.    Zimakoff J, Stormark M, Laesen S O. Use of gloves and hand washing behaviour

      among health care workers workers in intensive care units. A multicenter

      investigation in four hospitals in Denmark and Norway.J Hosp Infect.1993 may

      :24(1):63-7

7.    Goldmann DA. The role of barrier precautions in infection control. J Hosp infect

      1991 Jun:18 Suppl A: 515-23

8.    Larson E. Guidelines for use of antimicrobial agents . A M J Infect Control.1998

      Dec:16(6):253-66.

9.    Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation

      of the most important agents for scrubs and rubs . Clin microbial Rev.2004

      oct:17(4):863-93.

10.   Beggs CB.Shepherd SJ,Kenr KG. How does health care worker hand hygiene

      behaviour impact upon the transmission of MRSA between patients? An analysis

      using a monte carlo model> B M C infect Dis.2009 MAY 15 : 9:64.




                                         19
11.   Temime L,Opalowski L,Pannet Y, Peripathetic health care workers as potential

      superspreaders.Proc Natl Acael Sci USA.2009 . Oct 27:106(43):18420-5.E Pub

      2009. Oct 19.

12.   Allorich WC, Harburths. Health care workers. Source, vector or victims of

      MRSA. Lancet infect Dis.2008 May :8(5):289-30.

13.   dos Santos SL, Cabral AC, Augusto LG, Knowledge, attitude and practice on

      dengue, the vector and control in an urban community of the Northeast Region,

      Brazil, Cien Saude Colet. 2011;16 Suppl 1:1319-30.

14.   Ang KT, Rohani I, Look CH, Role of primary care providers in dengue

      prevention and control in the community, Med J Malaysia. 2010 Mar; 65(1) :

      58-62.

15.   Pengvanich V, Family leader empowerment program using participatory learning

      process for dengue vector control, J Med Assoc Thai. 2011 Feb;94(2):235-41.

16.   Vesga-Gomez c, Caceres-Manrique Fde M,The efficacy of play-based education

      in preventing dengue in primary-school children, Rev Salud Public (Bogota).

      2010 Aug; 12 (4) :558-69.

17.   Eisen L, Beaty BJ, Morrison AC, Scott TW, ProactiveVector control strategies

      and improved monitoring and evaluation practices for dengue prevention, J Med

      Entomol. 2009 Nov; 46(6):1245-55.

18.   Dellamonica P, Dengue fever: clinical features, Arch Pediatr. 2009 Oct;16 Suppl

      2:S80-4.

19.   Chaturvedi UC, Nagar R, Dengue and dengue haemorrhagic fever: Indian

      perspective, J Biosci. 2008 Nov;33(4):429-41.




                                         20
20.   Vijayakumar TS, Chandy S, Sathish N, Abraham M, Abraham P, Sridharan G, Is

      dengue emerging as a major public health problem?, Indian J Med Res. 2005

      Feb;121(2):100-7.

21.   Ooi CP, Rohani A, Zamree I, Lee HL, Temperature related storage evaluation of

      an RT-PCR test kit for the detection of dengue infection in mosquitoes, Trop

      Biomed. 2005 Jun;22(1):73-6.

22.   Paramasivan R, Thenmozhi V, Hiriyan J, Dhananjeyan K, Tyagi B, Dash AP,

      Serological and entomological investigations of an outbreak of dengue fever in

      certain rural areas of Kanyakumari district, Tamil Nadu, Indian J Med Res. 2006

      May;123(5):697-701.




                                        21
9.    SIGNATURE OF THE CANDIDATE



10.   REMARKS OF THE GUIDE



11.   NAME AND DESIGNATION OF



      11.1. GUIDE



      11.2. SIGNATURE



      11.3. CO-GUIDE



      11.4. SIGNATURE


      11.5. HEAD OF THE

      DEPARTMENT


      11.6. SIGNATURE


      REMARKS OF CHAIRMAN AND
12.
      PRINCIPAL


      12.1. SIGNATURE




                          22

								
To top