A STUDY TO ASSES THE KNOWLEDGE AND PRACTICE REGARDING
DENGUE FEVER AND ITS PREVENTION AMONG WOMEN WITH
VIEW TO DEVELOP AN INFORMATION BOOKLET
AT SELECTED COMMUNITY, BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
PREM SAGAR THELLA
HOSMAT COLLEGE OF NURSING, BANGALORE
JANUARY - 2013
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / MR.PREM SAGAR THELLAM.SC NURSING 1ST YEAR
COMMUNITY HEALTH NURSING,
HOSMAT COLLEGE OF NURSING ,
BANGALORE
2 / NAME OF THE INSTITUTION / HOSMAT COLLEGE OF NURSING,NO:33, 80FT ROAD, OPP
LAGGARE RING ROAD BRIDGE,
BANGALORE - 560058
3 / COURSE OF THE STUDY AND SUBJECT / M.SC NURSING 1ST YEAR
COMMUNITY HEALTH NURSING
4 / DATE OF ADMISSION OF COURSE / 01/06/2012
5 / TITLE OF THE TOPIC / “A STUDY TO ASSES THE KNOWLEDGE AND PRACTICE REGARDING DENGUE FEVER AND ITS PREVENTION AMONG WOMEN WITH VIEW TO DEVELOP AN INFORMATION BOOKLET AT SELECTED COMMUNITY ,BANGALORE
6. BRIEF RESUME OF THE INTENDED WORK
6.1. INTRODUCTION
Diseases prevail as long as human life exists,
The better life is to secure from them.
Dengue fever is a viral illness caused by infection with 1 of 4 types of the dengue virus. When a person recovers from dengue infection they develop a long term (not always lifetime) immunity to that type, but not the other 3 types. If the person is infected again with a different virus type, they may develop the more severe form of the illness known as dengue hemorrhagic fever (DHF).
It is spread by the bite of an infected dengue mosquito (usually the Aedesaegypti species). There is no spread from human to human.
Dengue fever occurs in tropical and sub-tropical areas of the world, including north Queensland. Although the mosquito capable of spreading dengue is found in Queensland as far south as Roma in the inland and Gladstone on the coast, and as far west as Commonweal, the area at particular risk for acquiring dengue is coastal to sub coastal Queensland north of Bowen
Aedes aegypti mosquitoes have not been established in the Northern Territory (NT) since the 1950s and there has been no dengue fever transmitted in the NT since then. The mosquito is imported periodically into Darwin on overseas vessels such as foreign fishing vessels and cargo ships, but has been detected and eliminated each time. Dengue mosquitoes were imported into Tennant Creek from Queensland in 2004 and eliminated by March 2006 and on Groote Eylandt in 2006 and eliminated by 2008. Surveys continue in the NT to ensure early detection and identification of any importation of the dengue mosquito. A recent detection again in Tennant Creek (2011) has resulted in the current dengue mosquito elimination program there.
For the past 60 years all persons notified with dengue fever in the NT have been interviewed to confirm that the disease was acquired in known dengue endemic areas overseas or in north Queensland. In the 10 years between 2002 and 2011 there have been 276 cases of dengue notified in the NT. These were acquired mostly in Indonesia or East Timor. Mosquito surveys by the Department of Health continue to ensure that knowledge about the presence of any exotic mosquito population remains current.
It usually takes 3 to 14 days (commonly 4-7 days) between getting bitten by a dengue virus infected mosquito and becoming sick.
Dengue fever is more commonly seen in older children and adults. It is characterized by abrupt onset of high fever lasting 3-7 days, severe frontal headache, pain behind the eyes and muscle and joint pains. Other symptoms may include loss of appetite, nausea, vomiting and diarrhea, a blanching rash and sometimes minor bleeding (e.g. from nose and gums). The acute symptoms of dengue fever last up to 10 days. Some people may experience repeated episodes of fever. Full recovery may be slow and associated with weakness and depression. It is rarely fatal.
There is no specific treatment or vaccine. Supportive treatment includes plenty of oral fluids and paracetamol for relief of fever and body aches and pains. Aspirin and non-steroidal anti-inflammatory drugs should not be used as they can affect blood clotting. Anyone with DHF should be hospitalized for fluid replacement and observation.
6.2. NEED FOR STUDY
Dengue fever is an arthropod borne viral fever. It is acquiring epidemic proportion in this part of the world and it has become major public health problem with high mortality. Estimates suggest that 50 million cases of dengue infection and 500,000 cases of dengue hemorrhagic fever occur in Asian countries .Earlier it was prevalent in those areas with humid atmosphere and plenty of rain, but with changing monsoon pattern this disease becoming prevalent in Deccan landscape including Karnataka 1
It is vital to recognize at the earliest- the signs and symptoms , alteration in biochemical parameters and multisystem involvement pattern in dengue to reduce the mortality5
In the WHO South-East Asia Region, over the past 15 years, DF/DHF has become a leading cause of hospitalization and death among children. The annual incidence of DF cases is estimated to be between 20-30 million and of DHF between 200 000 and 400 000 cases with 10 000 deaths. During 1996-1998, an increasing trend in morbidity associated with DF/DHF has been observed in India, Indonesia, Maldives, Myanmar, Sri Lanka and Thailand. There are formal DF/DHF control programmes in most of the countries except India and Maldives. The DF/DHF control strategy relies mainly on two 6
As per a study in Karnataka where among the 417 fever cases 15 blood samples of chikungunya and 45 samples of dengue were sent to viral diagnostic laboratory at Shimoga for testing. Of the blood samples sent, seven chikungunya cases, including three from Jalavalli in Honnavar taluk and four from Banavasi in Sirsi taluk have been confirmed. In case of dengue fever, foru from Hegdekatta in Sirsi taluk, one each from Kasarkod and Jalavalli, five from Nagarbastikeri and two cases from Nandolli have been reported. Last year, the district had witnessed 162 chikungunya cases and 49 dengue fever cases, the release stated.7
Dengue virus infection is a escalating health problem throughout the world because of increasing mortality and morbidity and is currently endemic in over 100 countries.The rapid geographic expansion of both the virus and the mosquito, regularity of epidemics, and the increasing occurrence of Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) are all causes for great concern;3 particularly for India where an increased frequency of the infection has been observed in recent years.
Dengue virus is a flavivirus that affects 50-100 million people annually while DHF cases range from 20,000 to 500,000 per year. The case fatality rate of DHF and DSS is around 5 to 7%.
This is probably because of lack of baseline data on knowledge, a and practices of the population regarding dengue fever. Literature search revealed that despite the increasing incidence of dengue fever in India in recent years, only one KAP on dengue fever has been conducted to date..so a study was therefore undertaken to evaluate the knowledge, attitude and practices among different strata of the society regarding Dengue fever.
There are approximately 2.5 billion population at risk or 24.2% of the total world population. An estimated 1.3 billion people or 52% of the population residing in the SEA Region are at risk of DF/DHF or approximately 87% of SEAR population are at risk. Seven of the ten countries in the Region regularly report disease incidence, i.e. Bangladesh, India, Indonesia, Maldives,Myanmar, Sri Lanka and Thailand. No report of DF/DHF has been made so far from the Himalayan Kingdoms of Nepal and Bhutan and from the Democratic People’s Republic of Korea.
Dengue fever has been reported from India over a long time, but dengue haemorrhagic fever was first reported in 1963 from Calcutta city. Although several outbreaks of dengue fever have been reported from India since then, a major epidemic of dengue haemorrhagic fever occurred in Delhi during 1996 when 10 252 cases and 423 deaths were reported. Cases were also reported from the neighbouring states of Haryana, Punjab, Rajasthan, Utter Pradesh and two southern and western states. DEN-2 was isolated during this epidemic and the proportion of DHF to DF was very high. The number of DF/DHF cases and deaths reported since the epidemic have been low with 1 177/36 cases being reported in 1997, 707/18 cases in 1998, 944/17 cases in Aedes aegypti was reported from all the affected areas with house indices exceeding 20%. Surveillance activities are carried out on a limited scale by the National Institute of Virology, Pune and few other institutions in the country. Since 1996, dengue control activities are coordinated and carried out by the National Anti-Malaria Programme. A proposal to set up a National Dengue/Dengue Haemorrhagic Fever Control Programme is under consideration by the Government.9
There is no vaccine against dengue, an emerging tropicaldiseaseregularly also hitting tourists, sothe onlyway of controlling it is by suppressing the mosquitoes transmitting thedisease.Since the sixties the yearlynumberof new cases of dengue – also known as break bone fever – has grown thirtyfold. Forty per cent of the world population is at risk of infection by the dengue virus. Every year fifty million people become infected. Light cases are similar to influenza, including heavy fever, headache, excruciating muscle pains. In severe cases the numberof platelets in the blood crashes, which leads to a half million cases of bleeding and 25 000 deaths per year. There is no vaccine, and no medicine. Luckily, most people recover spontaneously. In severe case, physicians can support the recovery with symptomatic measures, like administering fluids or a blood transfusion, but only if they react fast enough and follow up the patient and his fluidbalanceclosely.10
During the past two decades the epidemics of dengue fever have been causing concern in several South East Asia countries, including India. A study was conducted in a tertiary care hospital situated in Southern India to determine the trends & out comes of dengue cases.
So the best way to lay a control on such aspects is to find the knowledge and find the strategies that could enhance the successful implementation of planned activities. There is a high level a difference between the rural and urban life, do the difference stays with knowledge regarding dengue fever too? If so the materials used to improve awareness could not be same. So the researcher after observing the high breeding of mosquitoes in both rural and urban area decided to assess the knowledge and Practice of women regarding dengue fever and its prevention .
6.3. REVIEW OF LITERATURE
A Review of Literature is a key step in research process. Review of Literature refers to an extensive, exhaustive and systematic examination of publications relevant to the research project.
A study was carried out in Bangalore with the objective of determining the current state of knowledge and practices of the people among women regarding dengue fever prevention .The purposive and random sampling was used for the study and 60 households were recruited in the survey woman of each household was interviewed using a structured questionnaire. The mean age of the Participants was 35years with a standard deviation. The researcher concluded that the knowledge and practice of the women has to be improved by the health care professionals.
A cross sectional study was conducted on awareness regarding safe and hygienic practices among women in rural area of Wardha district, Maharashtra. The findings shows that majority of the women received the information regarding dengue fever from their neighbors 41%, followed by media 24% ,friends 19% . The women who develop fevers not went under any good treatment. The study concluded that it is important to educate the women with scientific knowledge & dispelling their myths, misconceptions and encouraging safe and hygienic.
A study was conducted to assess the knowledge and practices related to dengue fever among women in Chirala of Prakasam dist of Andhra Pradesh. The study results revealed that common sources of information about dengue fever the prevailing of fever in the community is among children’s most probably. The level of hygienic practices regarding surroundings was found to be unsatisfactory. 98% of the women believed that there should be no some regulation regarding preventive measures. The source of information for others was T.V. 3%, mothers 5%, magazines 5%, movies 10% and relatives 6.5%. The researcher concluded that it is important to educate women about issues related to dengue fever, so that they can safeguard themselves and hold implications for professionals involved in improvement sanitary and preventive measures.
A comparative study was conducted to assess the knowledge and attitudes about dengue and practice of prevention followed by the residents of a rural area and an urban resettlement colony of East Delhi, in Jan2007 to Feb 2007. A pre-structured and pre-tested format containing the relevant questions was administered to the subjects. A total of 687 subjects (334 rural and 353 urban) were interviewed. Nearly four fifth (82.3%) of these were aware of Dengue. Audiovisual media was the most common source of information in both the areas. Knowledge about the disease was fair to good. Fever was the commonest symptom of the disease known to 92% urban and 83% rural respondents followed by symptoms of bleeding and headache. Mosquito was known to spread the disease to 71% rural and 89% urban respondents. More than two third respondents in urban and two fifth in rural areas had used some method of mosquito control or personal protection during the epidemic.11