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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRESS / Mr. NAGALINGAPPA KARADI2. / NAME OF THE INSTITUTION / Vivekananda college of nursing
3. / COURSE OF THE STUDY AND SUBJECT / M.Sc. NURSING
CHILD HEALTH NURSING.
4. / DATE OF ADMISSION TO THE COURSE
5. / TITLE OF THE TOPIC /
A Study to assess the impact of health education on prevention of faeco oral infections among school age children in selected urban slums of Chitradurga
6. / BREIF RESUME OF THE INTENDED WORK6.1
6.2 / INTRODUCTION:
More than a third of the world's children are infected with intestinal nematodes. Current control approaches emphasis treatment of school age children, and there is a lack of information on the effects of deworming school children.1 Feacooral infection is common in early childhood specially those between 6 month and 2 years, incidence is highest in the age group 1 to 2 years, the introduction of contaminated food and direct contact with human and animal feces , lack of personal and domestic hygiene.
Intestinal parasitic infections are among the most prevalent infections in humans in developing countries and are responsible for considerable morbidity and mortality. Most of them are transmitted by the faeco-oral route. In general, situations involving unhygienic conditions promote transmission. These infections are globally endemic and have been described as constituting the greatest single worldwide cause of illness and disease. They are associated with poor hygiene and lack of access to safe water. Food handlers play an important role in their transmission. Ignorance is also a contributing factor to transmission especially among people living in rural areas where level of awareness is relatively low. Like the majority of the parasitic diseases, these infections are influenced by human behavior especially their hygienic practices, and failure to take advantage of available screening services or comply with treatment.
The faeco-oral diseases are main types commonly found in Ethiopia, their general symptoms and signs, how to treat mild cases and when to refer patients with severe conditions for specialized treatment, or laboratory tests to confirm the diagnosis. You will also learn about the importance of giving effective health education to your community on ways to prevent and control faeco-oral diseases.
As the name suggests, faecal-oral diseases are diseases that occur when the causative organisms which are excreted in the stools of infected persons (or less commonly animals) gain entry into the human host via the mouth. Therefore, the organisms have to pass through the environment from the faces of an infected person to the digestive system of a susceptible person. This is known as the faecal-oral transmission route. Faecal-oral transmission of organisms causing disease occurs mostly through faecal contamination of food, water, and hands which is not at all apparent. Very small amounts of feces can carry enough organisms to establish infection. Seemingly sparkling clear water may be dangerously polluted. Contaminated food may smell, look and taste normal and yet harbor infective organisms. Clean-looking hands may carry and transmit enough micro-organisms to spread disease. The diagram below summarizes the faecal-oral transmission rout
Immunization against all the vaccine-preventable diseases also promotes the general health of children and helps to protect them from faeco-oral diseases. A child who is suffering from a condition such as measles or pneumonia is also more vulnerable to develop a faeco-oral disease, because their immune system is overloaded by infection. Giving vitamin A supplements with the measles vaccine at the age of nine months, and every six months thereafter until the age of five years, also helps to promote health and increase resistance to infection. So, ensuring that parents and other caregivers know about and follow all these good practices can help to reduce the risks to children from faeco-oral diseases. A vaccine to protect children against rotavirus infection – the main cause of viral diarrheal disease – is expected to be added to the routine Expanded Programme on Immunization (EPI) in the near future.
Without sufficient clean and functioning toilets children will defecate in and around the school compound. In such situations the school and its surroundings are likely to become infested with parasitic helminthes. Many of the faeco -oral infections listed above can also spread via contaminated drinking-water. Children dipping their unwashed hands into a shared drinking-water supply are a typical route of contamination. But problems can also arise from water which is not used for drinking. If rainwater or floodwater is allowed to stand in puddles, the breeding of mosquito’s and other insects may be encouraged, leading to transmission of diseases such as malaria, dengue fever and schistosomiasis. (Similar problems can arise from accumulated waste, which, additionally, may attract flies, rodents and dogs. The availability of convenient hand washing facilities is as important as safe disposal of urine and feces. Hepatitis A, diarrhea caused by Escherichia coli, amoebic and bacillary dysentery, cholera and typhoid are among the infectious diseases which can be spread via the faecal-oral route. Staff and pupils must be able to wash their hands after defecation as well as before eating food.
NEED FOR THE STUDY:
The study of the feaco-oral infection to epidemiology, clinical manifestations, diagnosis, treatment and how to prevent each one of them. As we go through this information, then we will realize that the concepts learnt in the first information of the diseases need to be the study.
The study conducted by S.A.Wani and Ahamad shows that, the frequency of intestinal helminthes parasites in children of Kupwara, Kashmir, India. Three hundred and twelve children in the age group of 4-15 years were examined for different intestinal helminthes in three schools located in rural areas. Two hundred and twenty two of 312 (71.15%) tested positive for various intestinal helminthes. The various helminth parasites included Ascaris lumbricoides , Trichuris trichiura , Enterobius vermicularis and Taenia saginata . By far, the highest frequency of 69.23% (216/312) was noted for Ascaris lumbricoides followed by Trichuris trichiura 30.76% (96/312), Enterobius vermicularis 7.69% (24/312) and Taenia saginata 7.69% (24/312). Single infection was found in 33.65% (105/312) and mixed infection was seen in 37.5% (117/312) children. This study emphasizes the need for improved environmental conditions, i.e., clean water supplies, enhanced sanitation and chemotherapy of school-age children in rural areas.
To study the transformation of diseases for food plays a central role in transmitting diseases because it can be directly or indirectly contaminated via polluted water, dirty hands, contaminated soil, flies, animals and animal products. Water can be polluted directly by feces or faecal material may be washed into it from the polluted soil along river banks.
To provide the awareness to mother about the house fly is very likely to carry faecal material because of its habit of starting a meal on faeces and finishing it off on human food. The fly can transfer organisms from faeces to food by carrying them on its body, by vomiting on solid food in order to liquefy the food and by defecating on food. The faeces and vomits of the fly may contain viable infective organisms from human faeces.
To provide health workers with the competencies they need to provide promotive , preventive and curative health services to children. Its content includes: How to take a sick child’s history, perform physical examination, all the necessary precautions that should be observed and the concept of IMCI to ensure proper management of a sick child. Child growth and development; Health Education; Promotion and counseling; Nutrition; Immunization; faeco-oral disease; Diarrhea; Anemia; Internal Helminthes; diseases;
A study conducted by Vyas Dhara and Shah Parul.D, suggest that, proper education on the hygiene habits and sanitation should be provided. Regular de-worming exercise especially at the primary school level coupled with legislation against indiscriminate disposal of faeces and its endorsement should be done.
REVIEW OF LITERATURE:
The quality of drinking water directly affects the well-being of individuals with cumulative effects at every social level. The World Health Organization attributed 4.0% of all deaths and 5.7% of the global disease burden to water-related illnesses, which stemmed from poor water quality, hygiene and sanitation (Pruss et al. 2002). These diseases disproportionately affect the developing world and young children. As opposed to the developed world, which has nearly complete coverage, less than half of sub-Saharan Africa has access to safe drinking water (United Nations 2005). As the combination of unsafe drinking water, absence of acquired immunity and lack of hygienic facilities increase the risk of infection, young children in developing regions are especially
According to Andualem Anteneh, Abera Kumie. the use of sanitation facilities is known to interrupt the transmission of faecooral related disease. The construction of traditional pit latrine is relatively a simple technology that is available to control the spread of diarrhea that is prevalent in developing nations. However, 2.4 billion people, 40% of the total world population, lack improved sanitation and 80% of these people live in rural areas of the developing world. In the WHO African Region, a total of 631 million people, (40%), had no access to any kind of improved sanitation facilities in 2000. This figure is about the same (36%) in 2002 for Sub-Saharan African nations. A very recent publication of WHO/UNICEF indicated Africa is lagging much to attain MDG goals in sanitation, that aims to achieve improving a coverage of 38% (in 2006) to a level of 66% (in 2015).2 Person-to-person passage of this infection, oral±oral and faecal±oral, are the most likely modes of transmission.Faecal±oral spread of H. pylori infection could occur directly from the infected person or with crowded orsuboptimal sanitary conditions, as in institutionalizedsubjects, or indirectly from contaminated water or food.Supporting evidence includes detection of H. pylori fromhuman faeces by culture and PCR.21 High concordancerates of H. pylori infection and hepatitis A further support a faecal±oral transmission route.3
The fecal–oral route, or alternatively, the oral–fecal route or orofecal route is a route of transmission of diseases, in which they are passed when pathogens in fecal particles from one host are introduced into the oral cavity of another potential host.
There are usually intermediate steps, sometimes many of them. Among the more common causes are:
· water that has come in contact with feces and is then inadequately treated before drinking;
· food that has been handled with feces present;
· poor sewage treatment along with disease vectors like houseflies;
· poor or absent cleaning after handling feces or anything that has been in contact with it;
· sexual practices that may involve feces, such as analingus.
sexual fetishes that involve feces, known collectively as coprophilia (its eating is known as coprophagia)
6.3 / STATEMENT OF THE PROBLEM:
A study to assess the impact of health education on prevention of early childhood faeco oral infection for mother in selected urban slums at chitradurga.
6.4 / OBJECTIVE OF THE STUDY:
1) To pretest the level of knowledge regarding prevention of early childhood faecooral infection of mother.
2) To determine the impact of health education of prevention early childhood faecooral infection of mother.
3) To correlate the degree of relationship between the knowledge of prevention of faecooral infection and socio demographic variables
6.5 / OPERATIONAL DEFINITIONS:
1. EFFECTIVENESS:-
Producing an intended result. In this study, it refers to determine the extent to which the structured teaching program has brought about the results in pre and post test which is measured by using statistical measurement.
2. PLANNED TEACHING PROGRAMME:-
“It is a planned, orderly framed content to educate an individual
or group purposefully “. In this study, it is a systematically developed
Instruction and teaching designed to provide information on prevention of water borne diseases regarding definition, causes, common types and preventive measures for 45 minutes by using DVD with Television.
3. KNOWLEDGE:-
Information gained through experience or education. In this study, it refers to the knowledge in terms of written response of the children about prevention of selected water borne diseases which is measured by self-administered knowledge questionnaire and its scores.
4. PRACTICE:-
It means way of doing something. In this study it refers to the
Knowledge on practice in terms of written response of the school children about prevention of selected water borne diseases which is measured by self-administered practice dichotomous questionnaires and its scores.
5. PREVENTION :-
It is stopping something from happening. In this study, it refers to the action taken to remove the possibility of water borne diseases occurring in school children by creating awareness to the school children regarding prevention of water borne diseases.
6. SELECTED WATER BORNE DISEASES :-
Many diseases that can be spread through contaminated water, which are called as water borne diseases. In this study, it refers to typhoid, cholera, hepatitis-A, amoebic and bacillary dysentery are chosen to inculcate knowledge and practice among school children.
7. SCHOOL CHILDREN:-
Children who are going to an institution for basic education. In this study, it refers to children who are studying between 1st to 5th standard between the age group of 6-10 years.
6.6 / HYPOTHESIS:
H1: There is no significant difference in Scores of pre and post test scores on knowledge of mother regarding early childhood faecooral infection.
H2: There is no significant relationship between knowledge of mother and their socio demographic variables.
6.7 / ASSUMPTIONS:
1. The primary school children may have inadequate knowledge regarding malaria.
2. Planned teaching program may enhance their knowledge regarding malaria.
6.8 / DELIMITATIONS:
1. The study is delimited to primary school children.
2. The study is delimited to selected Government schools in Chitradurga.
3. The study is delimited to knowledge aspect only
7. / MATERIALS AND METHODS
7.1 / SOURCE OF DATA / Primary school children studying in class 1 to 5, in the age group 6 to 10 years.
7.2 / METHODS OF DATA COLLECTION
7.2.1 / SAMPLING CRITERIA
INCLUSION CRITERIA / 1) Who are having early childhood mother.
2) Presently residing in selected area.
3) Who are willing to participate in the study.