Rajiv Gandhi University of Health Sciences, Karnataka
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION
NAME OF THE CANDIDATE / Ms. AUGUSTINE ELLEN ANGELINEI YEAR M.Sc. NURSING
RATHNA COLLEGE OF NURSING,
B.M.Road, HASSAN,
KARNATAKA
NAME OF THE INSTITUTION / RATHNA COLLEGE OF NURSING,
B.M.Road,
HASSAN,
KARNATAKA
COURSE OF STUDY AND SUBJECT / MASTERS OF SCIENCE IN NURSING
CHILD HEALTH NURSING
DATE OF ADMISSION TO COURSE / 15/07.2013
TITLE OF THE TOPIC / ‘‘KNOWLEDGE REGARDING WORM INFESTATION AMONG MOTHERS OF SCHOOL AGE CHILDREN IN SELECTED HOSPITAL, AT HASSAN.’’
STATEMENT OF THE PROBLEM / ‘‘A STUDY TO ASSESS THE KNOWLEDGE REGARDING WORM INFESTATION AMONG MOTHERS OF SCHOOL AGE CHILDREN IN SELECTED HOSPITAL, AT HASSAN.’’
6.BRIEF RESUME OF THE INTENDED STUDY
6.1 INTRODUCTION:
Worm infestation in school age children is a common and major health problem in India and other parts of the world.1
Helminthes infection is a common infection of the human gastro – intestinal tract It has a worldwide distribution. It is a major health problem in the whole China South East and West Asia and Laten America especially Maxico globally it is estimated that in 1999, 45 million people carried E-histolytica in their intestinal tract. It is probable helminthes is accounted about 70,000 deaths in the world. Prevalence rates vary as low as 2 percent to 60percent or more in areas devoid of sanitation. In areas of high prevalence amoebiasis occurs in incidence forms as a result of high levels of transmission and constant re-infection endemicwater borne infections can occur if there is heavy contamination of drinking water supply.1
In India it is generally agreed that amoebiasis effects about 15 percent of the India throughout India the prevalence rate is about 15% ranging from 3.6 to 47.4 percent in different areas. The reported variations in prevalence are attributed to variations in clinical diagnostic criteria.2
The mode of transmission of helminthes is faecal oral route, this may realy take place through intake of contaminated water or food, if there is heavy contamination of drinking water supply vegetables especially those eaten raw from fields irrigated with sewage polluted water can readily convey infection. Viable cysts have been found on the hands and under finger nails. This may lead to hand to mouth transmission. Vectors such as cockroaches and rodents are capable of carrying cysts and contaminating food and water holes worms enter the body specially feet by penetrating the skin when in contact with contaminated soil with cysts.2
One third of the world’s population is infected with one or more species of intestinal helminthes and public health specialists are concerned that these infections impair children’s growth and development. Studies have shown associations between helminthes infection and under nutrition, iron deficiency, anaemia stunted growth poor school attendance and poor performance in cognition tests. Better sanitation reduces transmission but another approach is to treat children or whole population routinely to reduce infection rates. Whether sustainable solution is not clear as rapid re infection occurs. Reportsof successful combined programs spaning several decades have come from Japan. The world banks claims that worm infections impair learning and the helmenthesis control is one of the most cost effective strategies to improve health in developing countries. Both the world banks and WHO promotes helminthes control programmes in developing countries as a cost effective intervention programmes aim to target mass treatment of children giving all children in communities where worms are endemic antihelmenthic drugs every three to six months. Treatment regimens depend on local prevalence rate.3
Worm infestation remains one of the main problem of child development. This is especially as greater health hazard in developing countries. Of 246 children aged 6-12 years attending school in rural Hassan 91% carried safari lumbricoides and 82% carried trichurias trichuria. In Madagascar, a study revealed prevalence of 93% ascaris lumbreciodes 55% for trichurias trichuria and 27% for hooks worm. The same authors in a earlier study have reported prevalence of 98% for ascaris lumbrecioides 38% for trichurias, trichuria, 16% for hook worm and 0.4% for schist soma Mansone in children in the ranomafana rain forest Madagascar.4
Impure water, low socio economic state, poor sanitation couplet with low literacy rates of parents particularly mothers are the main causes of this worm infestation is one of the major causes of childhood malnutrition, anaemia stunted physical and mental growth, psycho social problems and this along with repeated gastro intestinal and upper respiratory tract infection contributes to high morbidity in children. And remains major causes high infant and child mortality in our country So it is very important to reduce the incidence of worm infestation in our country through creating awareness of the causes of worm infestations and their preventive measures among the school age children and parents specially those whose socio –economic and educational status is low.5
NEEDS FOR STUDY
Worm infestation is the most common and major health problem in India and other parts of the world. Globally it is estimated that in 1997, 45 million people carried E-hystolytica in there intestinal tract.It is probable that amoebasis is accounted for 70,000 deaths in the world. Prevalence rates vary from as low as 2 percent to 60 percent or more in areas of devoid sanitation.In India it is generally agreed that amoebasis affects about 15% of the Indian Population.6
It is estimated that during 1997 the global prevalence of hook worm infection was about 151 millions cases. The annual number of deaths were approximately 65,000 as a result of hook worm anaemia.7
Hook worm infection is widely prevalent in India especially north and south India. The heavily infected areas are found in Assam, west Bengal, Bihar, Orissa Andrapradesh , Tamilnadu , Kerala, Maharashtra and Karnataka.8
More than 200 million people are estimated to be infected in India. It is believedthat 60-80 % of population of certain areas of west Bengal, UP, Bihar, Orrissa, Punjab and eastern coast of Tamilnadu and Andhrapradhesh are infectedwith hookworms. The study carried out in Kanpur on hook worms among children depicted a prevalence of 20% boys and 16% in girls present study also showed the prevalence of worm infestation around 55.68% the similar trend has been observed in different studies that showed 41% prevalence of hook worms and 56% although prevalence of worm infestation conformed either by history of prevalence of protozoa in comparison to 35% in the present study, passing worms or by examination of stool, present study covered history of passing worms and pica with or without abdominal pain as criteria for worm infestation.9
Amoebasis is a potentially lethal disease it carries substantial morbidity and mortality.1
Worm infestation is a major health problem in children from developing countries due to bad hygiene conditions it produces in children especially when hooks worm infestation is present.10
One of the common health problems among children is of worm infestation there are numerous numbers of worms living in the size while others can be seen quite easily. These common organisms can be everywhere in our environment commonly in food and water we drinks.11
The worms which commonly affect human are round norms and tapeworms. The worms inside in the intestine stealing nutrients from the body causing symptoms of severe worm infestation which are hunger pains, diarrhea, loss of appetite weight loss and respiratory symptoms like rough and breathing difficulty worms can invade body through food content or through the nose and skin. Once established in the body they will eat the same foods you eat of they will eat you.12
Worm infestation can be prevented by practicing good personal hygiene washing hands before eating and after going to the bathroom or handling pets, fingernails should be kept short and clean.Fruits and vegetables should be washed before consuming. The wax substance on fruit or vegetables should be scraped off with a knife before washing. Eating grapes with open splits should be avoided meals and fish should be cooked properly. Raw or uncooked meat should be avoided. Check for worms especially on fish.Children should be instructed to drink pure water parasites are associated with many water borne outbreaks and are highly resistant to conventional methods of disinfection.Living environment should be kept clean. Children should be advised not to walk on barefoot on warm most soil or play with the soil. Parasites are abundant in soil and can penetrate through skin cells. Dogs and Cats are host to many parasites that human can contract. Animals can spread 240 diseases to human because of parasites. A little garlic added to their food will help control some parasites.13
Many number of studies have reported high prevalence of worm infestation among children in the different parts of the country. These study for worm infestation is essential to promote and prevent school children from worm infestation through creating awareness and providing knowledge among school children and parents especially with low socio-economic and educational status.14
6.2 REVIEW OF LITERATURE
This study is divided into three leadings.
6.2.1Literature related to worm infestation
6.2.2Literature related to mothers of school age children
6.2.3Literature related to prevention of worm infestation
6.2.1Literature related to worm infestation
BatiaeV P (2007): Related that India has shown remarkable progress and no of nutrition intervention programmes have been implemented but malnutrition remains highly prevalent in poor states of the country. The overall prevalence of PEM was observed as 62.62%. Which has higher among boys (65.87%) as compared to girls (58.90%). The peak prevalence was found in the age group of 6-12 months. A significant association between acute ailments (diarrhea, ARI and fever with rash) and PEM was observed (P < 0.001) prevalence of worm infestation on the bases of history was recorded as 35.67 % over half (5834%) of the children are affected.
Henrich J (2005):Conducted that worm infestations may play a role in preventing allergies. There is a lack of epidemiological information from western countries on the association between worm infestation and eczema in a proper temporal Sequence and under consideration of allergic sensitive worm infestation is associated with a reducedfrequency of subsequent eczema. The data support the concept that a lacks of immune stimulation by parasitic infections contributes to the development of allergies.
Phathammovog (2007):Stated the approximately one third of school children in Vientiane capital study were infested by intestinalparasites. The persistent parasite infestationseemed to be associated with growth rate pattern among those children school based parasite controlled programme and health promotion are needed to eliminate there major health problems.
P S Mlay (2007):Conducted a study which was carried out to establish normal blood levels of hemoglobin and total plasma proteins and the impact of worm infestation one these parameters in fresh water fish under natural and artificial rearing systems in Morogoro, Tanzania. The standard cyanomethemoglobin and burette methods were used to determine hemoglobin concentration (HB) and plasma total protein (TP) respectively, mean HB concentration were 9.7 gldl for claries gariepinus 7.5 g/dl for Oreochromics karomos and 9.2 g/dl for Oreochromics nilotous.
Babarmallik (2005):Concluded that worm infestation remains one of the main problem of children. A very high percentage (81%) of children from suburbs of abbottabad have intestinal worm infestation and majority of the (48%) of positive cases have ascaris lumbricoides children were not very severely anaemic because of virtually any hook worm causes.
Monika Sharma (2007): Reported a case of an 18 month old child who present with severe eosinophilic pneumonia requiring ventilation as a result of round worm infestation. This child presented with symptoms alike acute severe asthma and had high absolute eosinophil count of 9,234/ cm. A course of steroids, albendazole and diethylcarbazine were followed by rapid recovering and a decrease in eosinophil counts to 616/cm within one month of treatement.
Chalsma T (2000):Conducted a study among children of baiga abuihmadia and bharia tribes of Madhya Pradhesh to assess the prevalence of anemia and intenstinal parasitic infestation among themselves. A total 776 school going children were included inter study of whole blood samples of all and stool samples of 409 were collected. Their haemoglobin was measured and stool samples were examined under microscope for ova and cyst. The result revealed that 30.3% of the children has several anemia (hb < 7gm/dl) and 50% children had intestinal parasite. The most common parasite were hook worm (16.3%) and lumbricoides (18.5%) the continued presence of worms in marginally nourished children could contribute significantly to blood loss in the intestine with resultant anaemia.
6.2.2 Literature related to mother of school age children.
Adenike A E Olaogun:Stated the public health research is shifting focus to the role of socio economic factors play in improving health and health seeking behavior is important for public health policy. This is because the share of resources devoted to different policy options should depend on the relative effectiveness. This poses a lot of challenges to policy makers in the developing nations where women’s education and earning capacity is low. There is therefore a need to increase the number of women benefiting from microcredit. This will ensure that more women are engaged in a form of occupations that is profitable and can sustain the health needs of the family.
Amuyunzu Nyamongo:Quoted that prompt and appropriate health seeking is critical in the management of childhood illness. This examines the health seeking behavior in under five child morbidity. It explores in detail actions taken by 28 months when their children become seeks 62 in depth interviews with mothers were conducted from four study communities. The mothers were identified form a demographic surveillance system. The interviews were recorded, transcribed and the thematically analyzed. The study shows that mothers classify childhood illnesses into four main categories (1) not serious – coughs, cold and diarrhea (2) series but not life threatening – malaria (3) sudden and series – pneumonia (4) chronic and therefore not requiring immediate action –malnutrition, tuberculosis and chronic coughs. The classification is referred to the action taken and time it takes to act. Shopes are used as the first sources of health care and when care moves out of the home private health facilities are is more compare to public health facilities while even fewer mothers consult traditional healers it was conducted that there is need to train mothers to encourage potentially life threatening conditions and to seek appropriate treatment promptly. Drug vendors should be involved in intervention programmes because they reach many mothers at the critical time of health seeking.
Thaplyal, Priyanka:Concluded that malnutrition is one of the most wide spread nutritional problems among school age children in India. Almost 50% of the children are moderately or severely malnourished making this an issue of national importance. The supplementary feeding programme under ICDS is a major intervention taken by government of India with the objective of improving the nutritional status of children from 6-12 years. A part from that the programme has not be able to capture a vast majority of the poor population. There is wide variety in the nature of supplement provided. It was often to be unacceptable to the beneficiaries on account of poor quality, taste and quantity. The impact on the nutritional status have been limited. The programme is grossly underfunded, which is one of the major causes of above problems. The top -down approach of the programme we implementation and lakh of adequate funds and objective evaluations are responsible for the limited impact of the programme. Sustained political commitment and a decentralized approach to the programme may improve effectiveness.
6.2.3. Literature related to prevention of worm infestation among children
Chiranjay Mukhopadhya (2008):Concluded that heavy infection of geo helminths in children should be corrected by appropriate medication and maintaining strict personal hygiene, health education, clean water, good sewage management and congenial environment should be ensured to minimize infection.
Vijay D Upadhyaya:Concluded that partial as well as complete round worm intestinal obstruction (without signs of peritonitis) can effectively be managed conservatively by using naso – gastric piperazine salt and glycerin plus liquid paraffin enemas. This modality of treatment is quite safe, required less hospital stay and is cost effective. Only in exceptional case surgical intervention is required.
Dongre A R:Concluded that the need base; focused life skills based child to child hygienic education was effective for behavior change. An integrated approach of drug treatment and focused participatory hygienic education is required to control parasitic load among rural Indian children.
Shally Aswathi:Stated that there is limited evidence of routine treatment of children in areas where helminthes are common and effects on weight gain but this is not consistent between trials. There is insufficient evidence as to whether this intervention improves cognitive performance.