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DISSERTATION
MS WANGKHEIRAKAM RINA
NAME
OF
CANDIDATE
ADDRESS
2.
NAME OF THE
INSTITUTE
3.
4.
DATE OF ADMISSION
5.
THE
AND
MS.WANGKHEIRAKPAM RINA
M. SC. NURSING 1ST YEAR
PADMASHREE COLLEGE OF
NURSING,
GURUKRUPA LAY OUT
NAGARBHABI,
BENGALURU 560072
1.
6.1 INTRODUCTION
It's a global pandemic. It's quite clear that the disease...has
evolved.
Of all the arthropod borne viral diseases, dengue fever is the most
common. Dengue fever is one of the most important emerging disease of the
tropical and sub tropical and subtropical regions affecting urban and periurban
areas. The geographical distribution of the disease has greatly expanded and the
number of cases has increased dramatically in the past 30years. Some of 2.5
billion people live in the areas where dengue viruses can be transmitted 1.
Dengue fever is an acute, infectious tropical disease caused by an
arbovirus transmitted by the bite of infected female Aedes aegypti mosquitoes.
Dengue fever can be caused by any one of four types: DEN-1, DEN-2, DEN-3,
and DEN-4. Infection with one virus does not protect a person against infection
with another. A person can be infected by at least two, if not all four types of the
dengue virus at different times during a life span, but only once by the same
type.2
The incidence of dengue has grown dramatically around the world in
recent decades. Some 2.5 billion people two fifths of the world's population
are now at risk from dengue. WHO currently estimates there may be 50 million
dengue infections worldwide every year In2007 alone, there were more than
890 000 reported cases of dengue in the Americas, of which 26 000 cases were
Dengue Hemorrhagic Fever. The disease is now endemic in more than 100
countries in Africa, the Americas, the Eastern Mediterranean, South-east Asia
3
and the Western Pacific. South-east Asia and the Western Pacific are the most
seriously affected. Before 1970 only nine countries had experienced Dengue
haemorrhagic fever epidemics, a number that had increased more than four-fold
b19953.
It is of sudden onset that usually follows a benign course with symptoms
such as headache, fever, exhaustion, severe muscle and joint pain, swollen
glands and rash he presence of fever, rash, and headache (and other pains) is
particularly characteristic of dengue. Other signs of dengue fever include
bleeding gums, severe pain behind the eyes, and red palms and soles. Dengue
strikes people with low levels of immunity. Because it is caused by one of four
serotypes of virus, it is possible to get dengue fever multiple times. However, an
attack of dengue produces immunity for a lifetime to that particular serotype to
which the patient was exposed. Dengue goes by other names, including "break
bone" or "dandy fever Dengue often have contortions due to the intense joint
and muscle pain, hence the Name break bone fever.4
A study was conducted on changing clinical manifestation of dengue
infection in North India,2008. Data were collected using structured performa.
During the period of the study, a total of 139 children suspected dengue patients
were admitted to the hospital, of which 124 could be tested for dengue IgM ,
and 102 were positive. Of these102 patients, 80 could be followed up and
documented. Seizures were observed in 45% cases, altered sensorium in 53.7%,
vomiting in 41.2%, haemorrhage in 38.8%, skin rash in 37.5%, abdominal pain
in 25%, headache in 18.8% and jaundice in 2% cases. Gastrointestinal tract was
the commonest site of bleeding. On examination ,edema was present in 47.5%
cases, hepatomegaly in 62.5%, splenomegaly in 60.0% and hypotension in
10.0% cases. The investigations revealed a low platelet count of less than 100
000/mm3 in 60.3%cases. Mean liver enzyme levels were mildly raised. Mean
total duration of fever in survivors was 14.97.3 days. The overall fatality rate
in hospital was 5.0%.5
dengue cases in the region is between 20- 30 million and dengue hemorrhagic
fever cases about 2,00,000.
The Incidence of this fever is variable and depends on the geographical
region and the density of mosquito-borne diseases in a region. Several hundred
thousand cases of dengue hemorrhagic fever per year. Dengue Hemorrhagic
Fever is more serious and the fatality rate is about 5%. Children younger than
15 years comprise 90% of Dengue Hemorragic Fever subjects in the world.
Dengue Hemorrhagic Fever can affect both adults and children. Poor
surveillance system in India makes it difficult to know the exact incidence of
the epidemic in the country.8
Dengue fever, is spreading in Asia. "Officials at the WHO say Asia, home
to 70 percent of the at-risk population, has seen a rise in dengue mainly because
of higher temperatures due to climate change, rising populations and greater
international travel., the highest number of reported cases in Asia this year to
August are in Indonesia (80,065) followed by Thailand (57,948) and Sri Lanka
(27,142).It was found in the Himalayan countries of Bhutan and Nepal for the
first time in 2004, and is endemic in most of Southeast and South Asia as well
as Indonesia and East Timor. In India, government hospitals in New Delhi are
overflowing with dengue victims as the city hosts 7,000 foreign athletes and
officials for the Commonwealth Games. Cases in India were at a 20-year high
with 50 people dead and 12,000 reported infections. The number of actual
infections is likely to be far higher. Surveys conducted by the health ministry
indicate that the dengue prevalence rate was 3.4 percent in 2006, rising to 5.25
percent in 2007, and by 2009 to 9.1 percent9
The number of patients with dengue fever has increased in the last two
months in the Bangalore City. Registered Medical Officer of the Hospital says
that there have been 23 cases tested positive with Dengue fever in his hospital.
Nearly 8-10 suspected cases visit Browing every day with symptoms of Dengue
fever. It is not just adults but even children are being affected by this viral
6
Structured
6. High school children: It refers to students who are studying from 8 th to 10th
standard in selected schools at Bengaluru.
6.7 ASSUMPTIONS
1. School children have some knowledge regarding prevention of dengue
fever.
2. Structured teaching programme may improve the knowledge of high
school children on prevention of dengue fever
3. The high school children will be expressing willingness to learn and
understand about prevention of dengue fever.
6.8 HYPOTHESIS
H1: There will be significant difference between pre test and post test
knowledge scores on prevention of dengue fever among high school children
H2 : There will be significant association between pre test knowledge and
selected demographic variables
16
Comparing age,
Section B:
Review of literature to studies on knowledge, attitudes and practice of
prevention of dengue fever
A cross-sectional approach was conducted to assess knowledge, attitudes
and practice of high school female students, teachers and supervisors towards
Dengue fever, and to determine scoring predictors of high school students
knowledge and practice scores, Jeddah. A multistage, stratified, random sample
method was applied. A total of 2693 students, 356 teachers and 115 supervisors
completed confidential self-administered questionnaires.. the result was
Students obtained the lowest mean knowledge score compared to the other two
groups (F = 51.5, P < 0.001). A positive family history of Dengue fever (a OR
= 2.05; 95% CI = 1.153.64), having literate mothers (secondary education),
and students age 17 were the predictors of high students knowledge score.
The only predictor of high practice score was obtaining high knowledge score
(a OR = 2.06; 95% CI = 1.732.44).18
12
14
16
Research design
The research design for this study is pre-experimental one group pre test post
test design
II.
Research variable
V. Sample size
The high school children who are fulfilling the inclusion criteria will be the
sample. The sample size will be 60 high school children
VI. Criteria for sample selection
Inclusion criteria
The study include high school children
17
19
Yes , with prior consent from the sample the study will be conducted in selected
urban school at Bengaluru . The study will require intervention in the form of
structured teaching programme only. No other intervention which cause any
harm will be done to the subject.
7.4
Yes , the permission will be obtained from concerned authority and the study
subject.
Privacy , confidentiality and anonymity will be guarded
Scientific objectivity of the study will be maintained with honest and
impartiality.
Ethical clearance certificate has been enclosed for the verification
8. LIST OF REFERENCES
1.
2.
Dengue
Fever.
Cause,
risks, complications.
symptoms,
Available
treatment,
from:
www.mamashealth.com/infect/dengue
3.
4.
prevention .
23
Nov
2010 .Available
from
Dengue
fever
www.essortment.com
prevention.
Available
from:
management
in
children.Available
from:
www.commedtvm.org/phus/phu01_session%202.html
8.
16
2010.Availablefrom:
www.businessweek.com/magazine/.../b4196013896421.ht
Service.
Available
from:
www.deccanherald.com/.../cases-dengue-fever-increasingcity.html
21
in
denguevectorcontrol.2009.Availablefromwww.bmj.com/content/338/bmj.b1959.full
24. Smith A, Horstick O. Effectiveness of peridomestic space spraying with insecticide on
dengue transmission; systematic review. Journal of topical Medicine and Internal
Health. 2010 May:619-31.
25. Erlanger T.E,KejserJ, and Utzinger J. Effect of dengue vector control interventions on
entomological parameters in developing countries. Journal of Medical and Veterinary
26.
23
11.2 Signature
11.4 Signature
11.6 Signature
24
11.8 Signature
25