INTRODUCTION:

Helminth infection is a global health issue that not only causes acute helminthiasis but long‑term infection may lead to complicated symptoms as well as severe complications.

Health status of the children of a nation is a highly reliable index of the health of its population. School going children contribute around 40% of the population.

School children aged 5 - 12 years suffer the highest infection rate and worm burden that attributes to poor sanitation. Over 267 million preschool-age children and over 568 million school-age children live in areas where these parasites are intensively transmitted, and are in need of treatment and preventive interventions¹.

Parasitic helminth infection remains a crucial global public health problem, especially in tropical and sub- tropical countries in several continents including Africa, South America, and Asia–Pacific². Children have the greatest risk of morbidity due to soil transmitted helminth infections, which have a particularly debilitating effect on their health and cognitive development, causing anemia, malnutrition, stunted growth, and learning delays³. STHs can be transmitted effortlessly by contacting with soil, ingesting contaminated foods, vegetables, and fruits, also drinking water containing the infective stage of the parasite^{4, 5}.

According to the World Health Organization (WHO), 1.5 billion people, i.e., 24% of the world population, have mainly the soil-transmitted helminths (geohelminths) Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), Ancylostoma duodenale, and Necator americanus (hookworms).

More than 836 million children are at risk of parasitic worm infections across the world. According to World Health Organization, 241 million children between the ages of 1 and 14 years are at risk of parasitic intestinal worms in India, also known as Soil-Transmitted Helminths (STH).⁶.

NEED AND SIGNIFICANCE OF THE STUDY:

Parasitic worm infection disproportionately affects school-age children, with this age group showing the highest intensity and highest prevalence compared to any other age group⁷. Soil-transmitted helminthiases as a public health problem in children worm infections problems cause anemia, poor physical growth, poor Intellectual development and impaired cognitive function, the infection reaches maximum intensity in the age range of 5 to 14 years⁸. India alone contributes nearly 25% to the total global cases with 220.6 million children in need of preventive chemotherapy^9,10.

A study was conducted in association between intestinal worm infection and malnutrition among rural children aged 9–11 years old in Guizhou Province, China. Among 2179 children, part of children was infected by intestinal worm (41.85%). Stunting (28%), low memory IQ (87.52%), and low process IQ (62.59%) were highly prevalent in the sample. Socio-demographic factors were associated with thinness, underweight, stunting, low memory IQ. This study demonstrated the association between intestinal worm infections and stunting low IQ. The study highlighted the importance of deworming and improving nutrition.¹¹A careful screening of the identified literature yielded 39 studies that reported the prevalence of soil-transmitted helminth infections from 19 different states of India. Ascaris lumbricoides was the most prevalent parasite. Higher than 50% prevalence was reported from six states.¹² 76.85% of the general population have poor knowledge about worm infestation, a similar study conducted in Punjab found that 40% of the population have below-average knowledge The role of civil society participation is very important to the implementation and success of the programs. A similar study conducted at Gujarat Andhra Pradesh and Punjab showed the same opinion^13,14.

Effectiveness of planned teaching programme regarding worm infestation on knowledge among mothers of under-five children in rural area of Lucknow district, the experimental pre-test-post-test control group design used and probability random sampling technique was adapted to select 92 mothers for both groups. The results revealed that in experimental group post-test mean and SD score i.e. (16±3.56) was significantly higher the pre-test score i.e. (8.26±3.79) and compared the ‘t’ value, calculated ‘t’ value was (3.76) at the level of significance (0.05) and with 45 degrees of freedom i.e. (2.01). So, it showed that the planned teaching programme regarding worm infestation among the mothers of under-five children in rural area was found effective.¹⁵

Non-experimental Comparative study was conducted to assess the knowledge among mothers in urban and rural area at Karaikal. Sample size comprised of 150 mothers of school going children non-randomized convenience sampling. Out of 150mothers 75 from urban and 75 mothers from rural area, by using structured knowledge questionnaire the majority of the mothers 37%²⁸ had adequate knowledge, 40%³⁰ had moderately knowledge and 23%¹⁷ had inadequate knowledge. In rural area the majority of the mothers had 35%²⁶ had inadequate, 36%²⁷ had moderately knowledge and 29%²² had adequate knowledge regarding worm infestation. Mean and standard deviation (SD) of the urban and rural area mothers of school going children respectively 16.8±4.77, 15.01±5.16. The researcher concluded that the need for more research to improve not only the knowledge also attitude and practices among mothers of school age children on worm infestations.¹⁷

National Deworming Day is observed between 1- 19-years children in all states on February 10 every year, with a mop-up day on February 15, in an attempt to make every child in the country worm-free. More than 836 million children are at risk of parasitic worm infections across the world. According to World Health Organization, 241 million children between the ages of 1 and 14 years are at risk of parasitic intestinal worms in India, also known as Soil-Transmitted Helminths (STH) Deworming is been done through schools and Anganwadi Centres, 8.9 crore children were administered the deworming tablet across 11 states, achieving 85 per cent coverage, more than 114 crore doses of albendazole administered to children in order to improve their overall health, nutritional status, access to education and quality of life.¹⁸ The role of school teachers was very important to effective control in worm infestation, the similar advice found in the World health organization report mentioned about the role of school teachers in the implementation of deworming activities¹⁹.

Health education, an effective tool which aims at promoting health should therefore be given at a young age when habits are formed in the childhood and the child is in the process of being educated to lead a civilized life taking responsibilities in the society.

Health and hygiene education among school children reduces the transmission and reinfection by encouraging healthy behaviors. Increasing children’s awareness of the problem can help to combat the disease. With this view in mind, researcher felt the need to conduct the present study to assess the knowledge of students regarding worm infestation and to educate them regarding prevention of worm infestation so as to reduce the morbidity and mortality rates in school children.

PURPOSE OF THE STUDY:

The purpose of the study is to evaluate the effectiveness of the teaching program me regarding prevention and management of Helminthic infections among school children in selected schools of Alappuzha District’’

STATEMENT OF THE PROBLEM:

A study to evaluate the effectiveness of of the teaching program me regarding prevention and management of Helminthic infections among school children in selected schools of Alappuzha District.

OBJECTIVES OF THE STUDY:

· Assess the knowledge regarding prevention and management of Helminthic infections among school children

· Evaluate the effectiveness of structured teaching programme on knowledge regarding prevention and management of Helminthic infections among school children.

· Find the association of knowledge regarding prevention and management of Helminthic infections among school children with selected socio-demographic variables

RESEARCH METHODOLOGY:

A school-based Intervention Study was conducted in the school children in selected schools of Alappuzha District’’Population in this study consists of 75 school children of age 10 to 12 years selected from VVHSS, Thamarakulam, Aleppey District who were selected using non-probability convenient sampling technique.

DESCRIPTION OF THE TOOL:

Part 1: Socio demographic data which includes age, sex, education, religion, type of family, and socioeconomic status, area of residence, occupation of parents, and education of parents.

Part 2: The knowledge questionnaire consists of 30 multiple choice questions regarding prevention and management of Helminthic infections

Part 3: Intervention: Teaching Programme was given using appropriate audio-visual aids like charts, models, power point presentation with detailed description about prevention and management of Helminthic infections.

DATA COLLECTION PROCEDURE:

After getting approval from the concerned authorities for the study, Socio-demographic data was collected. The validated questionnaire was used to assess the pre-test knowledge regarding the prevention, management Helminthic infections and using the audio-visual aids health education was given. Post- test was done after 7 days to evaluate the effectiveness of the teaching programme.

RESULT AND DISCUSSION:

Section A: Description of demographic variables of the sample

Table 1: Shows distribution of the subjects based on demographic variables (n=75)

Sl. No	Variables	Frequency	Percentage (%)
1	Age
	6-9 years	5	6%
	9-12 years	60	81%
	13-15 yea	6	8%
	Above 15 years	4	5%
2	Gender
	Male	45	60%
	Female	30	40%
3	Area of residence
	Urban	18	24%
	Rural	57	76%
4	Type of family
	Nuclear family	55	70%
	Joint family	20	30%
5	Religion
	Hindu	25	33%
	Muslim	35	46%
	Christian	15	21%

Section-B: To assess the pretest and posttest knowledge scores of students regarding the prevention and management of ascariasis.

Table 2: Shows Comparison of Frequency and Percentage according to pre-test and post-test knowledge score (n=75)

Level of knowledge	Range of score	Pre - test		Post – test
Level of knowledge	Range of score	Frequency	%	Frequency	%
Below average	Below 20	30	40%	3	4%
Average	20-30	35	46%	30	40%
Good	30-50	10	14 %	42	56 %

Figure 1: Shows Comparison of Frequency and Percentage according to pre-test and post-test knowledge score (n=75)

Table 3: Mean, Standard deviation, mean difference and ‘t’ value of Pre-test and post- test (n=75)

Parameter

Mean

Difference

‘t’

Level of

Significance

Pre test

10.94

2.70

4.23

10.44

Significant

Post test

15.17

2.25

Section C: Association of pre- test knowledge score with selected demographic variables:

The study shows no significant association between knowledge of subjects with selected demographic variable except practice score and the demographic variable religion with a significance of p<0.05. Thus, sex influences the practice of subjects.

DISCUSSION:

The findings of the present study were compared with the objectives of the study and findings of other studies are reviewed. The major findings of the study were in pre-test out of the 75 subjects 40% had below average knowledge, 46% had average knowledge and 14% had good knowledge. Whereas in post- test after the structured teaching programme out of the 75 subjects 56% had good knowledge, 40 % had average knowledge and 4% of them had below average knowledge.

The statistical analysis of the data revealed the following findings:

Knowledge level: In pre-test out of the 75 subjects 40% had below average knowledge, 46% had average knowledge and 14% had good knowledge. Whereas in post- test after the structured teaching programme out of the 75 subjects 56% had good knowledge, 40 % had average knowledge and 4% of them had below average knowledge regarding prevention and management of ascariasis among school children.

This study finding was supported by a study conducted on the effectiveness of structured teaching programme on prevention of worm infestation among school children. An Pre-experimental research was conducted on students of 6th and 7th class of, Mohali, Punjab, to assess the effect of s teaching programme on prevention of worm infestation a total of 35 students Results indicate the increase in the knowledge scores of school children after implementation of STP as evidenced by About 83% of the children had attained good knowledge in post-test reveals that mean pretest knowledge score of children was 13.88+ 3.62 whereas after the structured teaching programme the score has been increased to 16.71+2.07. The mean difference was +2.83 which was statistically significant at 0.05 level²⁰

Another study conducted in south India at Tamilnadu showed the same impact on the school children the similar study conducted at China found a significant impact on school children^21,22,23. The health education showed positive impact among the school teachers on worm infestation, the similar result found the study in conducted in the corporate schools of Tirupati, Tamilnadu the similar impact showed in a study conducted at another Neighboring country Nepal and in Australia^24-26

Apart from educational programme the community and the teachers should be regularly trained regarding the prevention and management of worm infestation and also about the National deworming programme.

To evaluate the impact of the National Deworming Day programme, the Health Ministry initiated follow-up prevalence surveys led by NCDC and partners done in 14 States. All 14 States have shown reduction in the follow up survey compared to the baseline prevalence survey. For example, the State of Chhattisgarh had the drop in prevalence from 74.6 in 2016 to 13.9, Similarly, Sikkim, has reduction from 80.4 to 50.9; Andhra Pradesh has, limited reduction from 36 to 34.3. Rajasthan State due to low baseline of 21.1 in 2013 has seen significant reduction to less than 1% in 2019 as per the survey.²⁷

An Pre-experimental research was conducted on students of 6th and 7th class of, Mohali, Punjab, to assess the effect of s teaching programme on prevention of worm infestation a total of 35 students were recruited for the study via convenient sampling technique. Results indicate the increase in the knowledge scores of school children after implementation of STP as evidenced by About 83% of the children had attained good knowledge in post-test reveals that mean pretest knowledge score of children was 13.88+ 3.62 whereas after the structured teaching programme the score has been increased to 16.71+2.07. The mean difference was +2.83 which was statistically significant at 0.05 level²⁰

Another study conducted in south India at Tamilnadu showed the same impact on the school children the similar study conducted at China found a significant impact on school children^21,22,23.

The health education showed positive impact among the school teachers on worm infestation, the similar result found the study in conducted in the corporate schools of Tirupati, Tamilnadu the similar impact showed in a study conducted at another Neighboring country Nepal and in Australia^24-26. The government of India has undertaken several accelerated programmes aimed at providing sources of safe water for a large number of villages and small towns. Integrated Child Development Service (ICDS).

CONCLUSION:

Worm infestation is one of an easily preventable disease. Simply educating the children at grass root level can help to develop awareness among school children and subsequently they become more conscious about their health. More and more educational programmes should be carried out and the health workers, nursing students should be involved in these programmes. Apart from teaching programmes focus should also be placed on providing basic services to children so that a healthy nation can be developed.

The findings showed significant differences between the pre-test and post-test knowledge regarding prevention and management of ascariasis among school children. The second objective was to find out the association between the pre-test knowledge with selected demographic variables. The findings showed that there is no significant association between pre-test knowledge except the demographic variable religion.

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19. Tags: #Deworming #National Deworming Day Press Information Bureau Government of India Posted On: 20 OCT 2020 12:36PM by PIB Delhi

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Received on 10.07.2024 Modified on 10.08.2024

Int. J. of Advances in Nur. Management. 2024; 12(3):136-140.

DOI: 10.52711/2454-2652.2024.00031