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.

9

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SIGNATURE OF

CANDIDATE

1 REMARKS OF GUIDE

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NAME AND

DESIGNATION OF GUIDE

Ms.chetana priyadarshini

Associate professor community

health nursing

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CO-GUIDE

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SIGNATURE

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HEAD OF THE

DEPARTMENT

Ms.chetana priyadarshini

Associate professor

community health nursing

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SIGNATURE

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REMARKS OF PERSONEL

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