“A STUDY TO ASSESS THE EFFECTIVENESS OF PUPPET SHOW ON KNOWLEDGE REGARDING SELECTED MOSQUITO

BORNE DISEASE AMONG PRIMARY SCHOOL

CHILDREN IN SELECTED GOVERNMENT

PRIMARY SCHOOL OF RAICHUR”

PROFROMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

SRINIVAS

NAVODAYA COLLEGE OF NURSING

RAICHUR, DECEMBER-2009

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES BANGALORE,KARNATAKA

PROFORMA FOR REGISTRATION OFSUBJECTS FOR DISSERTATION.

1. / Name of the Candidate / : / Mr. Srinivas
M.Sc. Nursing 1st Year
Community Health Nursing
NavodayaCollege of
Nursing, Raichur
2. / Name of the Institute / : / Navodaya College of Nursing, Raichur
3. / Course of Study and Subject / : / M.Sc. Nursing 1st Year Community Health Nursing
4. / Date of Admission / : / 11-06-2009
5. / Title of the Topic / :

"A STUDY TO ASSESS THE EFFECTIVENESS OF PUPPET SHOW ON KNOWLEDGE REGARDING SELECTED MOSQUITO

BORNE DISEASE AMONG PRIMARY SCHOOL

CHILDREN IN SELECTED GOVERNMENT

PRIMARY SCHOOL OF RAICHUR"

6.0 BRIEF RESUME OF THE STUDY

6.1 NEED FOR STUDY

Mosquito are the most important vectors of human infectious disease like malaria, Dengue, Filarias and Chikungunya. This mosquito came more human suffering than any other organism. Over one million people die from mosquito-borne disease every year.1

In recent years mosquito-borne diseases have emerged as a serious public health problem in countries of the South-East Asia region, including India. Many of these particularly Dengue Fever, Japanese Encephalitis (JE) and Malaria now occur in epidemic form almost on an annual basis causing considerable morbidity and mortality. Dengue is spreading rapidly to newer areas, with outbreaks occurring more frequently and explosively. Chikungunya has reemerged in India after a gap of more than three decades affecting many states. Outbreaks have also been reported from Sri Lanka, Mauritius, the Reunion Island and Maldives. The risk factors which play a key role in the spread and transmission of dengue and chikungunya, include globalization unplanned and uncontrolled urbanization, developmental activities, poor environmental sanitation, human behavior relating to water collection, life styles, wide spread travel and human migration, both within the country and across borders. These are causes for much consent and highlight the need to comprehensively address the challenges faced in combating vector born disease in the country. The recent outbreaks of dengue and chikungunya have been widely reported by and discussed both in the electronic and print media. Japanese encephalitis is currently endemic in 135 Districts, 15 States and union territories of India. The out break in Uttar Pradesh last year took many lives mostly of children presently, nearly 330 millions people are considered to be at risk.2

The Karnataka state in India is endemic for Malaria, Dengue, Lymphatic Filariasis, Japanese Encephalitis and Chikungunya all mosquito-borne disease. Different districts have variable disease rates. During 2000, the state reported a total of 1,09,118 Malaria cases of which 28,065 were of P.Falciparum, of these, Bangalore district accounted for 278 cases of which 143 were of P. Falciparum.The annual parasite incidence (API-cases per thousand populations during the year) was 0.14. Kolar district reported 4,114 Malaria cases and 1,372 P. Falciparum cases. The API was 1.48. There were 189 Dengue cases reported in the Karnataka state 2000, of which 8 were from Bangalore district and 106 from Kolar district. Japanese Encephalitis accounted for 125 cases in the state in 2000 of which 2 were from Bangalore district and 28 from Kolar district.3

Despite centuries of control efforts,mosquito-borne diseases are flourishing world wide, with a disproportionate effect on children and adolescents.These conditions are responsible for substantial global morbidity and mortality. Malaria kills more than 1 million children annually.Dengue virus has expanded its range over the past several decades. Chikungunya virus has emerged in the Indian Ocean base in to affect millions.Effects to limit the effect of mosquito-born-diseases in endemic areas face the challenges of controlling mosquito population delivering effective public health interventions. Children require special advice on mosquito avoidance.4

Even a small number of infected people who remain active can move a virus such a dengue between different part of the community, where it will be picked up by mosquitoes of after an incubation period be passed on to another.5

Children are the world’s most valuable natural resources and it is the first and foremost duly of every nation to preserve it. Children are real assets of Family, Society and Nation. School children constitutes 20% of the total population and are vulnerable for infections. Hence there should be a motto to guide everyone to maintain a good environmental sanitation. As there is more prevalence of ignorance and illiteracy among the public, there is a great need to educate them, especially the children about maintenance of good environmental sanitation to central and prevent mosquito-borne diseases.

Majority of the school children’s in the areas of Raichur are found that this mosquito-borne disease is new to them and knowledge pertained by them are very less regarding this diseases. Researchers found that open drainages system available beside many of the schools of Raichur, so it makes the favorable places to lay eggs by mosquitoes which are taking a major role in spreading this type of diseases. It is found that the environmental condition in these areas are more prone to get this type of diseases. Many of the school going children’s are unaware about the outbreak of mosquito-borne diseases and not have a knowledge in management, control and prevention of these diseases. Hence researchers felt to conduct a puppet show, which is a strategy of health education for school children’s regarding imparting the knowledge about mosquito-borne diseases.

6.2 REVIEW OF LITERATURE

A review of literature on the research topic makes the researcher familiar with the existing studies and provides information which helps to focus on a particular problem, lays a foundation upon which to base new knowledge. It creates accurate picture of the information found on the subujects.6

A study was conducted on a community based health education programme for bio-environmental control of malaria through Folk theatre (Kalajatha) in rural India. In this study Kalajatha events were performed in the evening hours for two weeks in a malaria affected district in Karnataka. The study includes 30 local artists including ten governmental and non-governmental organizations actively participated. The exposed respondents had significant increase in knowledge and change in attitude about malaria and its control strategies, especially on bio-environmental measures (p<0.001). The study concludes that Kalajatha conveyed the important messages on malaria control and prevention to the rural community. 7

A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at Caregivers, in the treatment of Febrile children using chloroquine. The intervention strategy consisted of training a core group of mothers (“Mother Trainers”), disseminated the educational messages about malaria and use of guideline to their communities. The study results shown that knowledge of cause, prevention and treatment of malaria increased with the one-year intervention. There was a significant increase in the correct use of chloroquine from 2.6% at baseline to 52.3% after intervention among those who treated children at home in the intervention arm compared with 4.2% to 12.7% in the control arm. The study concludes that use of guideline with adequate training significantly improved correctness of malaria treatment with chloroquine at home. 8

A study was conducted in Oudomxay province and Lao PDR on school-based malaria education has been shown to be effective for improving the knowledge, attitudes and practices of school children toward malaria control. Participants were 130 school children in grades 3-5 at two primary schools, 103 guardians of these children, and 130 married women who did not have children in the target grades. The intervention included presentation of a flipchart at home and a 1-day campaign conducted by the school children and aimed at the community. The study results shown that in married women without children in the target grades particularly those who were presented with the flipchart and participated in the campaign, the scores of the mean knowledge, attitudes and practices were significantly increased 1 month after the intervention. 9

A study to assess the value of a game known as Jugando en Salud : as a teaching/learning tool leading to the incorporation of school children enrolled in secondary school in the control of aedes aegypti and dengue prevention activities in the Municipality of Venezuela. They carried out in 9 schools that were choosed by systematic random sampling among 29 public schools. The study results shown that knowledge about dengue and the skills that were measured prior to following the prescribed program were lower (6.5 and 18.11 points) than those displayed in the final test (8.255 & 22.9 points). The study concluded that game was highly accepted among students enrolled in secondary school. It helped them acquire greater knowledge about dengue and to develop skills and abilities leading to their incorporation in dengue prevention activities in their respective communities. 10

A study was conducted to evaluate effectiveness of structured teaching programme on chikungunya fever. The sample is selected by using purposive non random sampling method and data were collected by interview method. The study results shown that the pre-test mean score is 42.8% and the post-test mean is 85.48 the ‘t’ test signifies the comparison of the pre-test level of knowledge and post-test level of knowledge which shows significance in all the knowledge variables. It is evident from the calculated ‘t’ value which is 9.61 for overall at p<0.001 level of significance. The study concludes that the structured teaching programme is proved to be effective in improving knowledge regarding chikungunya.11

A study was conducted to evaluate the effectiveness of a special course on environmental health and dengue, given to primary school students and intended to promote behavioral changes in the mothers of those students. The study includes four public schools in the city of Comayaguela, Honduras. Two of the schools formed the intervention group, and the two others made up the comparison or control group. The study results shown that there was a significant increase in the student’s knowledge (p<0.0001) and there were also significant increase in the knowledge of mothers in the intervention group (p=0.02). The study concludes that the application of educational interventions directed to school children, as a part of a comprehensive plan for controlling Aedes aegypti, is an effective way to raise the awareness of teachers and parents with respect to the problem of dengue. 12

A cross-sectional study was conducted by the Department of Community Medicine with the objectives to review the progress of the single dose of di-ethyl carbamazine (DEC) administration in the elimination of lymphatic filariasis and to understand the functioning of the programme to recommend mid-term amendments in Gwalior, India. The study was conducted in three endemic areas in Madhya Pradesh and data were collected by desk review, in depth reviews, on site observations and from the community. The results reported that evaluated coverage with di-ethyl carbamazine tablets intake was much lower and compliance rate was in the range of 60-70%. The study concluded that multi drug administration is restricted to tablet distribution and implementation should be strengthened immediately in the MDA programme in India to achieve the goal of lymphatic filariasis elimination by 2015.13

6.3 STATEMENT OF THE PROBLEM

“A STUDY TO ASSESS THE EFFECTIVENESS OF PUPPET SHOW ON KNOWLEDGE REGARDING SELECTED MOSQUITO-BORNE DISEASE AMONG PRIMARY SCHOOL CHILDREN IN SELECTED GOVERNMENT PRIMARY SCHOOL OF RAICHUR”.

6.4 OBJECTIVES OF THE STUDY

  • To assess the knowledge of primary school children regarding selected mosquito-borne diseases.
  • To evaluate the effectiveness of "Puppet Show" on selected mosquito-borne disease among primary school children
  • To determine the relationship between the post-test knowledge of the primary school children regarding selected mosquito-borne disease with selected variables.

6.5 OPERATIONAL DEFINITIONS

a)Effectiveness : It is the extent to which the puppet show improves the knowledge of primary school children regarding selected mosquito-borne diseases.

b)Knowledge : Refers to the level of understanding of primary school children with regard to mosquito-borne disease as measure by their correct response to knowledge items of the interview schedule.

c)Puppet Show : A small figure of a person or animal having a cloth body and hollow head designed to be fitted over and manipulated by the hand.

d)Primary School Children : Children who are studying in V-standard in selected government primary school.

e)Mosquito-borne Disease :is the diseases transmitted by mosquito to human beings. Malaria, Dengue, Filariasis and Chikungunya, are selected for the present study.

6.6 HYPOTHESIS

On the basis of the objectives of the study the following hypothesis have been formulated.

H1There will be a significant difference between the pre-test and post-test knowledge regarding mosquito-borne disease among primary school children.

H2There will be significant relationship between the post-test knowledge of primary school children with selected variables (Socio-Demographic are age, sex, religion, economic status and type of family).

7. MATERIALS AND METHODS

7.1 SOURCE OF DATA

DESIGN : One group pre-test and post-test pre-experimental design is adopted for this study.

(O1 X O2)

  • O1 Pre-test
  • X  Intervention
  • O2Post-test

SETTING OF THE STUDY :

Study will be conducted in government primary school at Raichur. Raichur is situated in Northern Karnataka, having an area of 60 sq.km., consisting of 5 towns and 300 villages. The Raichur district has 1465 primary schools of which 919 are lower primary schools having classes I to V and 524 are higher primary schools having classes I to VII. The Raichur taluk has 167 LPS (classes I to V) and 125 HPS (classes I to VII).The government primary school have been selected for the present study. The government primary school is located in Indira nagar, Raichur.

POPULATION : The population of the study includes the students studying primary school in selected government primary school , Raichur.

SAMPLE SIZE : Sample for the present study is 30, who are studying in 5th standard in selected government primary school at Raichur.

SAMPLING TECHNIQUE : The purposive sampling technique is used to select the government primary school and simple random sampling will be used to select the sample.

INCLUSION CRITERIA :

The study includes primary school children who are;

  • studying in 5th standard at selected government primary school, Raichur.
  • willing to participate in the study.
  • available at the time of data collection.
  • studying in kannada medium.

EXCLUSION CRITERIA :

The study excludes who are not;

  • studying in 1-4th standard (5-9 years) at selected government primary school, Raichur
  • willing to participate in the study.
  • available at the time of data collection.

SELECTED VARIABLES : Variables included in the present study are

1) Dependent Variable : Knowledge of primary school children

regarding selected mosquito-borne diseases.

2) Independent Variable : Puppet show regarding mosquito-borne disease.

3) Extraneous Variable :

Age :

a.10 years

b.11 years

Religion :

  1. Hindu
  2. Muslim
  3. Christian

Residence :

  1. Urban
  2. Rural

Family Monthly Income :

  1. less than Rs. 1000/-
  2. Rs. 1001/- to Rs. 2000/-
  3. Rs. 2001/- to Rs. 3000/-
  4. Rs. 3001 and above

Types of Family :

  1. Nuclear family
  2. Joint family

Educational Background of Parents :

Sl. No. / Educational Status / Mother / Father
a. / Illiterate
b. / Primary Education
c. / Secondary Education
d. / Graduation
e. / Post-Graduation

Sources of Information :

  1. Mass media
  2. Relatives
  3. Neighbors
  4. Friends
  5. Teachers
  6. Health professionals

7.2 METHODS OF DATA COLLECTION

Data Collection Instrument :

Data collection will be done through structured interview schedule, consists of two parts, namely part-I deals with socio-demographic information and part-II represents items related to the knowledge on mosquito-borne disease.

Data Collection Method :

After obtaining prior permission and consent from significant authorities and from subject, the investigator will assess the knowledge of primary school children regarding selected mosquito-borne disease by using structure interview.

Data collection will be carried out in 3 phases.

Phase-I / Pre-test will be given to assess initial knowledge of primary school children related to the selected mosquito-borne diseases in selected government primary school at Raichur.
Phase-II / An Puppet Show on mosquito-borne disease will be conducted to primary school children of selected government primary school at Raichur
Phase-III / Post-test will be conducted to primary school children after a gap of 7 days, after implementation of puppet show

Plan for Data Analysis :

Numerical data obtained from sample will be organized and summarized from the sample with the help of descriptive statistics, like percentage and frequency. Mean standard deviation and paired 't' test will be used to assess the effectiveness of puppet show.

Testing the level of significant of hypothesis will be done with the help of inferential statistics like 'Chi-Square' test.

7.3 PROJECTED OUTCOMES

The results of the study will through a light on effectiveness of puppet show among primary school children. There by help of the future researchers to adopt modified strategies to enhance the knowledge of high school children.

7.4 DOES THE STUDY REQUIRES ANY INVESTIGATION TO

BE CONDUCTED ON PATIENTS OR THE HUMANS/ANIMALS? IF SO, PLEASE DESCRIBE BRIEFLY :

Yes, the study requires interventions like enactment of puppet show and active involvement of primary school children during session.

7.5 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM THE INSTITUTION IN CASE OF 7.4?

Permission will be obtained from the institution ethical committee, Navodaya College of Nursing, Raichur.

Permission will be obtained from the Head Master of Primary School, Raichur.

Consent will be obtained from all the participants.

8. LIST OF REFERENCES

  1. Dr. Shiv Lal, et.al, Mosquito-borne disease in India by WHO,
  1. K. Ravi Kumar and G. Gururaj, Community Perception Regarding Mosquito-borne Diseases in Karntaka State, India,
  1. Denise. F. Pilot, Nursing Research Principles and Methods, Philadelphia, Lippincott, 7th edition, 2004.
  1. S.K. Ghosh, et.al, A Community-based health education programme for bio-environmental control of Malaria through folk theatre (Kalajatha) in rural India, Malaria Journal 2006 December 15th, Vol. 5, pp.no. 123.
  1. I. O. Ajayi, et.al, Assessment of a treatment guideline to improve home management of malaria in children in rural south-west Nigeria, Malaria Journal 2008 January 29th, Vol. 7, pp.no. 24.
  1. D. Nonaka, et.al, Malaria education from school to community in Oudomxay provincem Lao PDR, Parasitol Int. 2008 March, Vol. 57(1), pp.no. 76-82.
  1. E. Vivas, et.al, A game as an educational strategy for the control of Aedes aegypti in Venezuelan school children, Rev Panam Salud Publica. 2003 December, Vol. 14(6), pp.no. 394-401.
  1. S. Dharshan, et.al, Effectiveness of structured teaching programme on knowledge regarding chikungunya fever among the community of Kaiwara, Chinthamani Taluk, Kolar District. In relation to the epidemic outbreak in May 2006, Nightingale Nursing Times, Vol. 2, pp.no. 60-62.
  1. G. A. Avila Montes, et.al, Evaluation of an educational module on dengue and Aedes aegypti for school children in Honduras, Rev Panam Salud Publica 2004 August, Vol. 16(2), pp. no. 84-94.
  1. Lahariya C, Mishra A, Strengthening of mass drug administration implementation is required to eliminate lymphatic filariasis from India: an evaluation study. J Vector Borne Dis. 2008 Dec;45(4):313-20.