RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE
AND ADDRESS
Ms.AMBATI SUREKHA
1st YEAR M. Sc. NURSING,
K.N.N. COLLEGE OF NURSING,
YELAHANKA, BANGALORE,
KARNATAKA.
2.NAME OF THE
INSTITUTION
K.N.N. COLLEGE OF NURSING,
CA 23/B,A SE CTOR,SATALITE
TOWN,
YELAHNKA, BANGALORE.
3.COURSE OF STUDY AND
SUBJECT
MASTER IN COMMUNITY
HEALTH
NURSING.
4.
DATE OF
ADMISSION TO
THE COURSE
28. 06.2012
5. TITLE OF THE
STUDY
A STUDY TO ASSESS THE
EFFECTIVENESS OF COMPUTER
ASSISTED TEACHING ON
KNOWLEDGE REGARDING
DENGUE FEVER AND ITS
PREVENTION AMONG
SCHOOLTEACHERS IN SELECTED
SCHOOLS, BANGALORE.
6.0 INTRODUCTION:
A man is a poor physician who has not two or three remedies ready for use in every case of
illness.
We are in new era in which hundreds and millions of people are safe from some most of
the diseases. On other hand world health reports 1996 shows that the world also stands on the brink of
global crisis, in infectious diseases. No country is safe from them and no country can effort to ignore
to their threat any longer. Infectious diseases are not only a health issue. They became a social
problem with tremendous consequences for the wellbeing of the individual and the world we live in.1
Emerging infectious diseases are those whose incidence in humans has increased during last
two decades which threaten to increase in the near future. The factors responsible for emergence and
re emergence of infectious disease are unplanned and under planned urbanization, over crowding and
rapid population growth, poor sanitation, inadequate public health infrastructure, resistance to anti-
biotics, increased exposure of humans to disease vectors and reservoirs of infection in nature and
rapid intense international travel.
Infectious diseases involves all the major modes of transmission .They are spread either from
person to person or insects or animals or through contaminated water or food.
Vector borne diseases are caused by infectious microbe that is transmitted to people by blood sucking
arthropods.1
Of all the arthropod born viral diseases, dengue fever is the most common. Dengue fever is
one of the most important emerging disease of the tropical &sub tropical regions, affecting urban
&periurban areas. The geographical distribution of the disease has greatly expanded and the number
of cases has increased dramatically in the past 30 years..2
Classical dengue or break bone fever has been known in India for a very long time.
It is an acute viral infection caused by arboviruses of at least 4 serotypes. Dengue fever can occur
epidemically or endemically. Epidemics may be explosive and often start during the rainy season
when the breeding of the vector mosquitoes is generally abundant, temperature also plays an
important role in the transmission of dengue virus on mosquitoes. Dengue hemorrhagic fever is a
severe form of dengue fever, caused by infection with more than one dengue virus. The severe illness
is thought to be due to double infection with dengue viruses. The first infection probably sensitizes
the patient, while the second appears to produce an immunological catastrophe.
Dengue is transmitted primarily by the “Aedes aegypti mosquito” which
preferentially breeds in artificial water containers in close proximity to human habitation. Dengue
transmission risk increases with rapid unplanned and unregulated urban development, poor water
storage, unsatisfactory sanitary conditions. As no effective dengue vaccine and treatment is
symptomatic and supportive, vector control is the significant way to prevent dengue transmission.4
The reservoir of infection is both man and mosquito. The transmission cycle is man-
mosquito- man. All ages and both sexes are susceptible to dengue fever. The illness is characterized
by an incubation period of 3 to 10 days. The onset is sudden with chills and high fever, intense
headache, muscle and joint pains which prevents all movements. With in 24hrs retro orbital pain,
particularly on eye movements and photophobia develops. Other common symptoms include extreme
weakness, anorexia, constipation altered taste sensation, ,sore throat ,and general depression. Fever is
usually between 39 degree Celsius &40 degree Celsius.
6.2 NEED FOR THE STUDY
Diseases can rarely be eliminated through early diagnosis or good treatment,
but prevention can eliminate disease.
The goals of medicine are to promote health, to preserve health, to restore
health when it is impaired, and to minimize suffering and distress. These goals are
embodied in the word prevention. The secret of national health lies in the homes of
the people. But infectious disease will last as long as humanity i tself.
Communicable disease in endemic (or) epidemic form have been taking a very heavy
of human lives throughout history. 4
Dengue is a tropical disease affecting 110 countries throughout the world and
placing over 3 billion people at risk of infection. According the World Health Organization 70 to 500
million persons are infected every year including 2 million who develop hemorrhagic form and
20,000 who die. Children are at highest risk for death.
The most of the countries of SEAR have experienced large out break of the disease. Currently
dengue fever and dengue haemorrhagic fever is endemic in Bangladesh, India. Indonesia, Maldives,
Myanmar, Srilanka, and Thailand, and approximately 1.3 billion people are living in the endemic
areas. Dengue and dengue haemorrhagic fever is widely prevalent in India. 2.5 to 3 billion people live
in areas where dengue viruses can be transmitted. An pandemic in 1998 in which 1.2 million of cases
of dengue fever and dengue haemorrhagic fever were reported from 56 countries. According to WHO
reports it is estimated that each year 50 millions infections occur, with 5,00,000 cases of dengue
haemorrhagic fever and atleast 12,000 deaths mainly among children, although fatalities could be
twice.
Over the fast 10, 15 years next diarrohoeal disease and acute respiratory infections, dengue
has become a leading cause of hospitalization and deaths, among children and South East Asia
Region.
The vector of DF and DHF breed in and around houses. The environmental measures
are detection and elimination of mosquito breeding places, proper covering of stored water. The
personnel prophylactic measures are wearing of full sleeve shirts and full pants, use of mosquito
repellent creams, liquids, coils, mats etc; use of bed nets for sleeping infants and young children
during day time to prevent mosquito bite .6
Dengue surveillance unit shows current statistical report of dengue fever
reported around 14 states in India. There are more incidences in New Delhi nearly
more than 2000 positive cases, 1,500 cases including 8 deaths in Karnataka state .
Thus the researcher felt that there is an emerging need to educate the school teachers on
dengue fever and its prevention, especially the incidence rate is high in Karnataka mainly among
school children. Since teachers are those who stay with large group of children where the
communicable diseases can spread easily. School being one of the important part of children’s and
teacher’s life sanitation in and around the school is prime importance in controlling mosquitoes.
Hence with this vision researcher thinks its very reasonable to educate school teachers who educate
thousands of children to improve the quality of life.
6.3 REVIEW OF LITERATURE
Review of l iterature is organized as follows.
6.3.1 Literature Related to various aspects of dengue fever.
6.3.2 Literature Related to incidence and prevalence of dengue fever in children.
6.3.3 Literature related to prevention of dengue fever.
6.3.4 Literature related to effectiveness of computer assisted teaching on dengue and
its prevention.
6.3.1 Review of Literature Related to various aspects of dengue fever.
A cognitive anthropological study was conducted with an objective Understanding
cultural dimensions concerning Mexican and Colombian healthcare workers suffering from dengue to
produce information and elements for healthcare and prevention. . Purposive sampling was used to
select 197 healthcare workers. Results suggests that Participants cultural conceptions regarding
dengue in Mexico. Overall, a holistic vision was shown which included a medical vision and related
social aspects. 8
A study was conducted on understanding dengue pathogenesis in England.
The study revealed that in this century dengue spread throughout the tropics,
threatening the health of a third of the world’s population. Dengue viruses’ cause
50-100 million cases of acute febrile disease every year, including more than
500,000 reported cases of the severe forms of the disease-dengue haemorrhagic
fever and dengue shock syndrome. The study emphasized on an urgent need to
provide a solution to the escalating global public health problems caused by dengue
infections. 9
Effects of seasonal fluctuations of dengue fever vector were assed and found that Aedes
aegypti population was more prevalent in all the localities in Delhi, India. Water
coolers and tires were found to be preferred breeding habitats of Aedes mosquitoes
in the city. Out of 103,778 houses surveyed, 20,513 houses and 3,547 containers
were reported positive for Aedes aegypti. The house containers were very high
during the post monsoon season. 1 0
A prospective study was conducted on Eco-epidemiological analysis
of dengue infection in India. This study was designed to find out a relationship of
dengue infection with climatic factors such as rainfall, temperature and relative
humidity during the dengue fever epidemic in the year 2003. Blood samples were
collected from 1550 patients experiencing a febrile il lness clinically consistent with
dengue infection. Out of 1550 suspected cases, 893 cases (57.36%) were confirmed
as serological positive. A study highlighted rain, temperature and relative humidity
as the major and important climatic factors, of which could alone (or) collectively
be responsible for an outbreak. 1 1
A study on outbreak of dengue fever in a Rural background
colony in Kanyakumari district, TamilNadu were assessed by collecting a total of 76
plasma samples from suspected cases of dengue fever and screened for the presence
of IgM antibodies by Pan Bio Elisa kit, and the study was enumerated through
vector survey. The study revealed that 15 (20%) were found positive for dengue
virus specific IgM antibodies. 1 2
6.3.2 Review of Literature Related to incidence and prevalence of dengue
fever in children.
A study was conducted in Thailand with an objective is to determine the impact of
impregnated school uniforms on dengue incidence among school children. A randomized controlled
trial used conducted in eastern Thailand in a group of schools with approximately 2,000 students aged
7-18 years. Pre-fabricated school uniforms will be commercially treated to ensure consistent, high-
quality insecticide impregnation with permethrin. A double-blind, randomized, crossover trial at the
school level will cover two dengue transmission seasons. 1 3
A study conducted and revealed, community-based active dengue fever surveillance among
the 0-to-19-year age group in rural villages and urban areas during 2006-2008. Active surveillance for
febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital
thermometers combined with weekly home visits to identify persons with fever. An investigation
team visited families with febrile persons to obtain informed consent for participation in the follow-
up study, which included collection of personal data and blood specimens. Dengue-related febrile
illness was defined using molecular and serological testing of paired acute and convalescent blood
samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736
laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4-57.8/1,000 person-
seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-
seasons) and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons). The distribution
of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-
211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were
affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, p<0.001).14
A study was conducted in Thailand in 2010 with an objective to assess the burden of dengue
in and to analyze the complications in patients aged less than 18 years old. Result shows the overall
mortality of dengue in all age groups and in patients aged under 18 years were 0.3 and 0.6/ 100,000,
respectively. The mortality rate was highest among children aged 6-12 years (0.8/100,000). Among
the 8 children with dengue fever that died, the 2 most common complications were fluid electrolyte
and acid-base imbalance and disseminated intravascular coagulation (DIC). The common
complications among the 91 cases with dengue hemorrhagic fever that died included fluid electrolyte
and acid-base imbalance, hepatic failure, respiratory failure, bacterial infection, DIC and renal
failure.15
6.3.3 Review of Literature related to prevention of dengue fever.
A study was conducted to analyze education actions and their strategies for preventing and
controlling dengue fever, highlighting constraints and difficulties. Conducted through a qualitative
approach at the Primary Care Unit and 8 properties in Brazil, its 17 subjects are divided into groups: I
(8 PCU users), II (4 Endemic Disease Control Agents), and III (5 healthcare practitioners). The data
was collected through semi-structured interviews, participative observation and documentary
analyses, using a hermeneutic dialectic analysis method. The findings indicate that health education
actions are divergent, while transforming actions are ineffective in terms of impacts on the disease.
Difficulties include: weak location-specific actions, educational messages whose contents are not
tailored to their contexts, authoritarian and coercive strategies; absence of public policies, gaps
between PCU and local population, stress on public health campaigns; practitioners who do not listen
to the population and vice-versa; with technical expertise still prevailing over users. The evidence
underscores the need for actions strengthening the possibilities of empowering the subjects, helping
them become responsible for their own lives and citizenship construction processes.16
A study conducted from May 2002 to May 2004, revealed that, an intervention was
implemented to advance social action against dengue in three districts of the municipality of Playa,
Cuba. A learning group and community working groups (CWG) were organized in each location.
Diagnostic tools were developed for communities, preventative actions, communication, surveillance,
and evaluation. Changes in participation were identified by applying the content analysis technique to
the documents and through interviews with key informants. The community work advanced at a pace
relative to the abilities and interests of each community with different areas of focus: healthy
community, environmental risk, and entomological risk. Positive changes in the concept of
participation were obtained, according to the five areas evaluated: leadership needs assessment,
organization, management, and mobilization of resources. At the end of two years of intervention, the
rate of Aedes aegypti larvae and pupae deposits found per 100 households had declined 79% and
cases of dengue were not detected in any of the districts.17
A study was conducted revealed; the first three months of 2002 witnessed a dengue
epidemic in the State of Janeiro. At that time, health authorities encouraged community participation
in the elimination of vector breeding sites. For this campaign, a great quantity of information about
the disease was extensively publicized in order to guide the population's preventive action. This paper
analyzed the three pamphlets most widely distributed at that time in Rio de Janeiro city considering
that this information contributed to the construction of disease representation and its prevention. It
was observed that even though this information was provided repeatedly it must be revised.
A study was conducted at establishing the fact that primary care practitioners, as the first point
of patient contacts, play a crucial role in advising patients suspected of having dengue to take early
preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to
two government hospitals for suspected dengue fever were interviewed using a structured
questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had
sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them
seeking treatment on two or more occasions. The mean time period for seeking treatment at primary
care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission.
The majority of patients (96-98%) reported that primary care practitioners had not given them any
advice on preventive measures to be taken even though 51.9% of the patients had been told they
could be having dengue fever. This study showed the need for primary care providers to be more
involved in the control and prevention of dengue in the community, as these patients were seen very
early in their illness compared to when they were admitted.19
A study was conducted on Dengue prevention in Singapore. After 15
years period of low incidence, dengue has reemerged in Singapore in the past
decade. The potential combination of lowered herd immunity, virus transmission
outside the house, an increase in the age of infection, and the adoption of a case
reactive approach to vector control contribute to the increased dengue incidence.
Singapore’s experience with dengue indicates that prevention efforts may not be
sustainable. For renewed success, Singapore needs to return to a vector control
program that is based on carefully collected entomologic and epidemiologic. 20
6.3.4. Literature related to effectiveness of computer assisted teaching on
dengue fever and its prevention.
A mass communication campaign was conducted at 20 randomly selected female high schools
and 2 school supervision centers in Jeddah to improve knowledge, attitudes and practices of students,
teachers and supervisors about dengue fever. A total of 5977 pre- and post-intervention
questionnaires were completed and the intervention was conducted using lectures and audiovisual
aids. A marked improvement in all areas of knowledge, attitudes and practices was observed after the
programme in all groups. Students obtained the highest improvement in mean knowledge scores after
the programme compared to the other 2 groups. There is a need to expand such programmes to all
schools. 21
A study was conducted in Thailand in 2001 with an objective and to compare prevention
measures of people with and without knowledge of dengue. 1650 persons has chosen as samples.
Knowledge of dengue and the use of prevention measures were measured by means of a structured
questionnaire. Result shows 67% had knowledge of dengue. Fever (81%) and rash (77%) were the
most frequently mentioned symptoms. Persons with knowledge of dengue reported a significantly
higher use of prevention measures than persons without knowledge of dengue. In multivariate
analyses, knowledge of dengue significantly differed by age, sex, occupation and site (P < 0.05).
Younger people knew more about dengue than older persons: adjusted odds ratio (aOR) of 6.75 [95%
confidence interval (CI): 4.32-10.6] for the 15-29 age group compared with people aged 60 and older.
The study shows Persons with knowledge of the disease more frequently reported the use of
preventive measures, indicating the value of education programmes as a tool in dengue prevention. . 21
6.4. STATEMENT OF THE PROBLEM
A study to assess the effectiveness of computer assisted teaching on
knowledge regarding dengue fever and its prevention among
schoolteachers in selected schools, Bangalore.
6.5. OBJECTIVES OF THE SUTUDY:1. To assess the pre test knowledge level of schoolteachers regarding dengue fever and its
prevention.
2. To evaluate the effectiveness of computer assisted teaching
regarding dengue fever and its prevention among school teachers.
3. To associate the knowledge of school teachers regarding dengue fever and its prevention with their
selected demographic variables.
6.6. OPERATIONAL DEFINITIONS1. EFFECTIVENESS:- It refers to the outcome of computer assisted teaching identified with
structured knowledge questionnaire to the school teachers on dengue fever and its prevention.
2. COMPUTER ASSISTED TEACHING:-It refers to the systematically organized method of
teaching with the use of computer for school teachers to provide information regarding dengue fever
and its prevention.
3. KNOWLEDGE:-
It refers to the information regarding dengue fever and its prevention among pre and post test series.
4. DENGUE FEVER: In this study, it refers to classical dengue fever and dengue haemorrhagic
fever caused by an arbo virus transmitted by mosquito.
5. PREVENTION:-In this study, it refers to Refers to the measures taken to control and prevent the
incidence of dengue fever.
6. SCHOOL TEACHERS:- School teachers refers to the teachers who are working in selected primary schools
in Bangalore.
6.7. ASSUMPTIONS:-
School teachers may have some knowledge regarding dengue fever and its
prevention.
Teaching method like computer assisted teaching may help school teachers
improve the knowledge regarding dengue fever and its prevention.
Adequate knowledge regarding dengue fever and its prevention among school
teachers may help to prevent dengue fever.
6.8. HYPOTHESIS:
H1: There will a be significant difference between pretest and post test knowledge scores
regarding dengue and its prevention after computer assisted teaching among school teachers.
H2: There will be a significant association between pretest level of knowledge and selected
demographic variables of school teachers on dengue and its prevention.
6.8 DELIMITATION
The study is delimited to
. School teachers who are working in selected schools at Bangalore.
. . 4 weeks period of data collection only.
. 60 school teachers.
7. MATERIAL AND METHODS
7.1 SOURCE OF DATA
Data will be collected from school teachers who are working in selected schools at Bangalore.
7.2 METHOD OF DATA COLLECTION
7.2.1TYPE OF STUDY/ RESEARCH APPROACH
Evaluative /Quantative approach.
7.2.2 RESEARCH DESIGN
Pre experimental, One group pretest - post test design.
7.2.3 VARIABLES OF THE STUDY:
Independent variable:
Computer assisted teaching on dengue and its prevention of Dengue fever.
Dependent variable:
Knowledge of school teachers regarding dengue fever and its prevention.
7.2.4 SAMPLING TECHNIQUE
Convenient sampling technique.
7.2.5 SAMPLE SIZE
60 school teachers from selected schools.
7.2.6 SAMPLING CRITERIA
Inclusion criteria
Teachers from selected schools at Bangalore.
Teachers who are available during the period of data collection.
Teachers who are willing to participate in the study.
Exclusion criteria
Teachers who are not available during the period of data collection.
Teachers who already attended to the mass media educational programmes on dengue fever and its
prevention.
7.2.7 DURATION OF THE STUDY:
One month of data collection.
7.2.8 TOOL INSTRUMENTS:
Self structured knowledge questionnaire on dengue fever and its prevention.
SECTION: A: - Socio-demographic Profile.
SECTION: B:- Structured Knowledge questionnaire regarding dengue and its prevention.
7.2.9 DATA COLLECTION PROCEDURE A formal permission from respective school authorities will be taken.
Consent will be obtained from study participants after explaining the objectives of
study. Samples will be selected by convenient sampling technique.Pre test will be
conducted by using structured knowledge questionnaire to assess the knowledge of
school teachers regarding dengue and fever and its prevention.On the same day
teaching on dengue fever and its prevention using computer will be done. On 7 t h day
post test will be conducted by using the same structured knowledge questionnaire.
7.2.10. PLAN FOR STATISTICAL DATA ANALYSIS
The data obtained will be tabulated and analyzed in terms of objectives
of the study by using descriptive and inferential statistics.
Descriptive statistics
Demographic data will be analyzed using Frequency and percentage distribution will
be used to analyze socio demographic data.
Mean, mean percentage and standard deviation will be used to analyze pre-test and
post-test knowledge scores of school teachers on dengue fever and its prevention.
Inferential statistics
Effectiveness of computer assisted teaching will be analyzed by using paired- t test.
Chi-square test will be used to find association of pre test level knowledge with
selected demographic variables of school teachers.
7.3.Does the study require any investigation or intervention on patient or
human/ animal? If so describe briefly.
Yes, computer assisted teaching will be provided and structure knowledge questionnaire will be
administered to assess the knowledge regarding dengue and its prevention to the school teachers.
7.4. Has ethical clearance been obtained?
Yes, ethical clearance will be obtained from the ethical committee of selected schools. Written consent will
be obtained from subjects, confidentiality and anonymity of subjects will be maintained.
8. LIST OF REFERENCES
1. K. Park. Text book of preventive and social medicine. 19 t h edition. Jaypee
publisher. New delhi.
2. Whitehorn J, Farrar J. Dengue. Br Med Bull. 2010; 95:161-73. Epub 2010 Jul 8.
3.Sharma SN, Riana VK, Kumar A. Dengue/DHF: an emerging disease in India. J Commun Dis.
2000 Sep; 32(3):175-9.
4. K. Park. Text book of preventive and social medicine. 19 t h edit ion. Banarsidas bhanot
Publishers.Jabalpur-(206-208,296-297)
5. Teyssou R. Dengue fever: from disease to vaccination. Med Trop (Mars). 2009 Aug; 69(4):333
6. K. Park Textbook of preventive and social medicine 21st edition. Banarsidas bhanot
Publishers.Jabalpur-2011,(231).
7. TIMES OF INDIA(8/OCT/2012) WWW.TIMES OF INDIA .COM
8.Torres-Lopez TM,Sotter R,Cultural dimentions concerning health care workers in Mexico and
Colombia having dengue. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/2325016.
9.Stephenson JR Dengue pathogenesis world health organization. 2005
April;83(4):308-14.
10.Sharma RS, Kaul Sm, Sokhay J. Seasonal fuctuations of dengue fever vector.
Southest Asian journal of Trop medical public health 2005 January;36(1):186-90.
11.Chakracvarti A, Kumaria R. Eco-epidemiological analysis of dengue 2005
April;14:2:32.
12.Paramasivan R, et al. entomological investigation of an outbreak at dengue fever.
Indian journal of medical research 2006.May;123(5):697-701.
13.Wilder-smith A, Tazan Y, Byass P, The impact of insecticide-treated school uniforms on dengue
infections in school aged children. Available from
http://www.ncbi.nlm.nih.gov/pubmed/23153360.
14. Hati AK. Dengue serosurveillance in Kolkata, facing an epidemic in West Bengal, India. J Vector
Borne Dis. 2009 Sep; 46(3):197-204.
15. Lumbiganon P,kosalaraksa P,Sutra S.Dengue mortality in patients under 18 years old:
an analysis from health situation analysis of thai population in 2010 project. Available
from
http://www.ncbi.nlm.nih.gov/pubmed/23130442.
16. 35. Sales FM. Health education actions for the prevention and control of dengue fever: a study at
Icaraí, Caucaia, Ceará State, Brazil. Cien Saude Colet. 2008 Jan-Feb; 13(1):175-84.
17. .Sánchez L, Pérez D, Alfonso L, Castro M, Sánchez LM, Van der Stuyft P, Kourí G. A
community education strategy to promote participation in dengue prevention in Cuba. Rev Panam
Salud Publica. 2008 Jul; 24(1):61-9.
18. 26. Lenzi Mde F, Coura LC. Dengue prevention: focus on information. Rev Soc Bras Med Trop.
2004 Jul-Aug; 37(4):343-50. Epub 2004 Aug 20.
19. Ang KT, Rohani I, Look CH. Role of primary care providers in dengue prevention and control in
the community. Med J Malaysia. 2010 Mar; 65(1):58-62.
20. Ooi EE, Goh KT, Gubler Dj. Dengue prevention. Emergency infections disease
2006 January; 12 (6):87-93.
21.Ibrahim NK,Abalkhail B, Rady M, Aibar H. An educational programme on dengue fever and
prevention and control for females in Jeddah high school. Available
From http://www.ncbi.nlm.nih.gov/pubmed/20214118.
22. Van Benthem BH, Khantikul N, Panart k, Kessels pj, Oskam L. Knowledge and use of prevention
measures related to dengue in northern Thailand. J Trop Med Hyg 1991 dec,94(6):377-87.
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SIGNATURE OF
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Ms.chetana priyadarshini
Associate professor community
health nursing
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Ms.chetana priyadarshini
Associate professor
community health nursing
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