Insect bites and stings are very common in children ...



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA,

PROFORMA FOR REGISTRATION OF

SUBJECTS FOR DISSERTATION

SANDEEP K RAJU

1ST YEAR M.SC NURSING

CHILD HEALTH NURSING

YEAR 2010-2012

CAUVERY COLLEGE OF NURSING

THERESIAN COLLEGE CIRCLE

SIDDARTHA LAYOUT

MYSORE

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE

|11 |NAME OF THE CANDIDATE AND ADDRESS |SANDEEP K RAJU |

| | |1ST YEAR M.SC NURSING, |

| | |CAUVERY COLLEGE OF NURSING, |

| | |# 42 / 2B, 2C, THERECIAN COLLEGE |

| | |SIDDARTHA LAYOUT |

| | |MYSORE |

|22. |NAME OF THE INSTITUTION |CAUVERY COLLEGE OF NURSING, MYSORE |

|33. |COURSE OF STUDY AND SUBJECT |MASTER OF SCIENCE IN NURSING –CHILD HEALTH NURSING |

|44. |DATE OF ADMISSION TO THE |01-06-2010 |

| |COURSE | |

|55. |TITLE OF THE TOPIC: | Effectiveness Of Structured Teaching Programme On Knowledge Regarding |

| | |Prevention And First Aid Management Of Insects Bite In Children Among The |

| | |Primary School Teachers In Selected Primary Schools At Mysore, Karnataka. |

|5.1. |STATEMENT OF THE PROBLEM | A Study To Assess The Effectiveness Of Structured Teaching Programme On |

| | |Knowledge Regarding Prevention And First Aid Management Of Insects Bite In |

| | |Children Among The Primary School Teachers In Selected Primary Schools At Mysore,|

| | |Karnataka. |

ANNEXURE-II

6. BRIEF RESUME OF THE WORK INTENDED STUDY

6.1 INTRODUCTION

“An ounce of prevention is worth a pound of cure.”

Henry de Bracton

Children are the blessings for today and promises for the days to come! The body of children is the most super sensitive, delicate and susceptible form which can be easily be harmed if not taken care of. Well being of your kid comprises of physical, mental and social well-being. Children can become seriously ill and any sort of infection may be dangerous, so don't take chances because illness at this age requires immediate attention.1

In many parts of the world, widespread introduction of simple, inexpensive interventions have successfully targeted the major killers of infants and children. Highly effective and often “low-tech” solutions, as well as improvements in health delivery systems, have enabled rapid declines in child mortality to occur, even in developing countries.2

Since children playing outdoors are often bitten or stung by Insects, when children are outside and no matter what they are doing, it is important for them to be protected. Knowing how to prevent and treat common Insects bites and stings, and knowing when to not overreact, can help keep your kids safe and healthy.3

The symptoms that can be caused by Insects bites depend on the type of Insects and how sensitive you are to it. Symptoms can vary from mild swelling, pain, itchiness and redness to large blisters or life threatening anaphylactic reactions.3

More serious signs and symptoms of anaphylaxis, a type of life threatening reaction, can include trouble swallowing, throat and chest tightness, low blood pressure (hypotension), diaphoresis (sweating), dizziness, weakness, itching, hives, wheezing and difficulty breathing. These symptoms usually develop fairly quickly and usually within 30 minutes of being stung. we should seek immediate medical attention or activate our local emergency services if your child has these symptoms following an Insects bite or sting. 3

Mosquito bites commonly cause itchy red bumps, which can vary in size from being very small to 1/2 inch. They usually also have a central raised area. Fire ants are notorious for causing severe local reactions, including pustules or pimples and red, swollen, and extremely itchy areas, which may turn into blisters. They often bite multiple times, most commonly on the feet and legs. A large number of bites, more than 10-20, in a young infant can lead to serious reactions and may require medical attention. 3

Bees, wasps, yellow jackets, and hornets usually cause painful red bumps. Honey bees have a barbed stinger and usually leave it behind at the site of the sting. The stinger will usually appear as a black dot inside the bite if it has been left behind. More serious local reactions can cause swelling of an entire limb. Unlike other bites, tick bites are painless and usually don't itch. Bedbugs also usually cause painless bites, which then become itchy. Since bedbugs usually only come out to feed at night, and they feed infrequently (often just weekly), they can be hard to detect. Chiggers or harvest mites also commonly bite children, especially in the southern United States, Chigger bites usually occur on the legs and along the belt line and can appear as small red bumps and are extremely itchy. Flea bites also commonly affect children, causing multiple, grouped red bumps with a central area of crusting. 3

Spider bites cause a lot of fear in parents, but rarely cause serious reactions in children. These spiders can be readily identified by their characteristic markings, including the red or orange hour glass shape on the abdomen of the black widow spider and the violin shaped markings on the back of the brown recluse. These bites are usually painless or cause mild irritation. More serious reactions usually occur quickly and within 3-12 hours and can include muscle pain, diaphoresis , nausea, vomiting, headache and high blood pressure. 3

To prevent the child from getting bitten or stung by Insects, we can:

• Make sure to keep as much of their skin covered with clothing as possible, including a long sleeve shirt, long pants, socks, and a hat.

• Wear light colored clothing, so as not to attract bugs.

• Avoid using any scented soaps or other products , since the fragrances can also attract Insects.

• Use an insects repellent regularly. Commonly used Insects repellents that can usually be safely used in children include those with less than 10% DEET, or others with citronella or soybean oil.

• Apply Insects repellents to clothing instead of to skin so that it won't be absorbed.

• Wash off Insects repellents as soon as possible.

• Follow the instructions, including age restrictions on any Insects repellent you are considering using.

• Do daily tick checks of our child's body when he has a possible exposure, especially when camping or hiking, so as to prevent tick borne diseases, such as Lyme disease.

• Remember that Insects repellents do not protect against most stinging Insects, including wasps, bees and fire ants.

• Use window and door screens to prevent Insects from getting inside your house. 3

First aid is the provision of initial care for an illness or injury. It is usually performed by a non-expert person to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care past the first aid intervention. It generally consists of a series of simple and in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment.4

Some of the first aid measures for Insects bite are

1. Stay Safe! Follow universal precautions and wear personal protective equipment if you have it. If a stinger is present, follow the directions for treating bee stings.

2. Apply an ice pack to the site of the sting. Alternate on and off to prevent tissue damage - usually 20 minutes on and 20 minutes off.

3. If the victim exhibits any of the following, consider the possibility of anaphylaxis:

o itching

o swelling (other than the site of the sting)

o shortness of breath

o heart palpitations

o chest pain

o hives or redness

4. Try to identify the bug. If the bug is dead, scoop it up and take it with you to the emergency department. Be careful, even dead bugs have venom.

5. For pain relief, try sting swabs (compare prices). Acetaminophen and ibuprofen are also good for pain. 5

Keeping the same as the reference, the present study was planned to assess the knowledge level of the school teachers regarding prevention and first aid management of Insects bite in children.

6.2 NEED FOR THE STUDY

Insect’s bites and stings are very common in children, especially during the spring and summer months. Among the arthropods that often bite and sting are spiders, ticks, mites, mosquitoes, flies, fleas, ants, bees, and wasps. While most Insects bites only result in mild local reactions, they can cause more serious conditions, such as anaphylactic reactions and Lyme disease. Knowing how to prevent and treat common Insects bites and stings, and knowing when to not overreact, can help keep the kids safe and healthy.6

In the United States, the American Association of Poison Control Centers reported 42,620 cases of exposures to Insects in 2007. Just more than 200 of these were listed as resulting in moderate or major reactions. A moderate reaction is defined as signs or symptoms that were more pronounced or systemic, whereas a major reaction is life-threatening or lead to significant residual disability. Fatalities among these exposures are rarely reported to poison centers and usually result from allergic reactions to Hymenoptera stings. Because of underreporting, these numbers are only a glimpse as to what is actually occurring.7

A study in tropical Zimbabwe, where biting Insects are common, found that 1.5% of hospital admissions were related to Insects exposure, including both bites and stings. A vast majority of these were arachnid or Hymenoptera related. 7

Estimates of mortality from Insects-provoked anaphylaxis in the United States range from 50-150 persons annually. In Arizona, for example, death from reduviid-associated anaphylaxis has been reported as a leading cause of death from Insects exposure. Worldwide, the greatest morbidity and mortality associated with Insects bites are due to Anopheles species mosquito bites resulting in infection with malaria. Incidence and prevalence of sting 9.3 million people yearly. Other Hymenoptera account for more than 1 million stings annually. Estimates of mortality from Insects-provoked anaphylaxis in the US range from 50 to 150 individuals annually (Fernandez). Mortality from spider bites occur mostly in very young children and the elderly, and deaths has been attributed to presumed brown recluse envenomation. Many potentially dangerous scorpions inhabit the underdeveloped or developing world. Consequently, numerous envenomations go unreported, and the true incidence is unknown. The highest reported mortality data for scorpion envenomation is from Mexico, with estimates as high as 1,000 deaths in 1 year.8

A study of 750 definite spider bites in Australia indicated that 6% of spider bites cause significant effects, the vast majority of these being red back spider bites causing significant pain lasting more than 24 hours.9

The jumping spider is probably the most common biting spider in the United States, the main species being Phidippus audax. Bites from a jumping spider are usually painful, itchy and cause redness and significant swelling. The spiders of most concern in the United States, however, are brown recluse spiders and black widow spiders. Most recluse spider bites are minor with little or no necrosis. However, a small number of bites produce severe dermon ecrotic lesions, and, sometimes, severe systemic symptoms, including organ damage. Rarely the bite may also produce the systemic condition with occasional fatalities.9

Allergic reactions to bee and Insects stings are potentially fatal. Bee, wasp, and Insects stings cause more deaths in the United States than any other kind of envenomation. Wasps and bees cause 30 to 120 deaths each year in the U.S. Most deaths occur in people 35-45 years of age. Fifty percent of deaths occur within 30 minutes of the sting. Stinging Insects are most active during the summer and early fall. Yellow jackets cause over 95% of the

allergic insects stings in this country.10

A study was conducted on “Acute immune thrombocytopenic purpura triggered by Insects bite.” The report shows that acute thrombocytopenic purpura is most commonly seen in young children, with a sudden onset, following a Insects bite and viral illness. The report is a rare case of ITP, which was triggered by a honey-bee bite and caused continuous intermittent bleeding from the gingival sulcular region of the maxillary left permanent first molar, and ecchymotic spots on the forehead, scalp, and lower limbs. A complete hemogram revealed severe thrombocytopenia with platelet count as low as 15,000/mm3. The patient was immediately hospitalized and administered platelet replacement and medication. With this report, the authors, as dentists, emphasize the significance of recognition, early diagnosis, and referral of such patients with bleeding disorders to specialized centers, for prompt treatment.11

A retrospective analysis was conducted in Belgaum, Karnataka, India. Among the cases of all childhood poisonings in District Hospital, over 5 years in the 1 to 15 years age group were studied with respect to age, sex, type of poison and outcome. A total of 116 cases were studied. The study showed male predominance. Amongst 116 cases of poisoning, 40 cases were due Insects bites. Maximum number of cases observed was in the age group 4 and 12 years. The study showed male predominance than females. Maximum number of Insects bites occurred in rainy and summer season. All the cases were accidental in nature. The investigator recommends that access prevention and massive health education campaign should be instituted to reduce the incidence of accidental poisoning in children.12

The investigator felt the need to conduct a study on Prevention and first aid management of Insects bite in children as it is assumed that school teachers spend most of their time with children in schools next to parents. Teaching preventive and first aid measures on Insects bite helps to prevent and save children from harmful effects of Insects bite such as anaphylaxis reaction or preventing a deadly disease such as malaria. Therefore, the study aims at improving the level of knowledge about preventive and first aid measures of Insects bite in children, which also helps the school teachers in communicating this information to others with whom they come in contact.

6.3. STATEMENT OF THE PROBLEM

A Study To Assess The Effectiveness Of Structured Teaching Programme On Knowledge Regarding Prevention And First Aid Management Of Insects Bite In Children Among The Primary School Teachers In Selected Primary Schools At Mysore, Karnataka.

6.4. OBJECTIVES

1. To assess the knowledge of Primary school teachers regarding the Prevention and first aid management of Insects bite in children before the administration of STP.

2. To develop and administer STP regarding Prevention and first aid management of Insects bite in children.

3. To assess the knowledge of Primary school teachers regarding the Prevention and first aid management of Insects bites in children after the administration of STP.

4. To evaluate the effectiveness of STP by comparing pre and post test knowledge scores regarding Prevention and first aid management of Insects bites in children among the Primary school teachers

5. To find out the association between the pre-test knowledge scores and the selected socio demographic variables.

6.5. HYPOTHESIS

H1:- There will be a significant difference between the pre and post test knowledge scores of Primary school teachers regarding Prevention and first aid management of Insects bite in children.

H2:- There will be a significant association between pre test knowledge scores of Primary school teachers and selected demographic variables.

6.6. ASSUMPTION

1. The Primary school teachers may have some knowledge regarding Prevention and first aid management of Insects bite in children prior to the administration of STP.

2. Administration of STP may promote the knowledge of Primary school teachers regarding Prevention and first aid management of Insects bite in children.

6.7. OPERATIONAL DEFINITIONS

• Assess

It refers to an activity to estimate the knowledge of Primary school teachers regarding Prevention and first aid management of Insects bite in children before and after the STP as revealed by suitable knowledge questionnaire.

• Effectiveness

It refers to significant increase in the level of knowledge of Primary school teachers regarding Prevention and first aid management of Insects bite in children which is measured from the response of pre-test, STP and post test.

• Structured teaching programme (S.T.P)

It refers to systematically organized instruction on Prevention and first aid management of Insects bite in children for the Primary school teachers of selected primary schools at Mysore.

• Knowledge

It refers to the understanding and awareness of Primary school teachers regarding Prevention and first aid management of Insects bite in children as expressed to the response of knowledge questionnaire

• Prevention

In this study the term prevention is refers to those interventions that are carried out to save the children from Insects bite.

• First aid management

In this study the term First aid management is refers to the provision of initial care of children for an Insects bite. It is usually performed by primary school teachers to a sick or injured child until definitive medical treatment can be accessed.

• Insects bite

In this study it refers to when an Insects is agitated and seeks to defend itself through its natural defense mechanisms, or when an Insects seeks to feed off the bitten person. The selected Insects in this study are fire ants, bees, wasps, hornets mosquitoes, fleas, and mites.

• Primary school teachers

In this study they refer to persons who provide schooling for pupils and students (1st -4th standard) in selected primary schools of Mysore.

6.8. DELIMITATION OF THE STUDY

1. The study is limited to the Primary school teachers who are working at selected Primary schools at Mysore.

2. Study period is limited to 4-6 weeks of duration.

3. Sample size is limited to 60 Primary school teachers

4. The study design is limited to Pre-experimental (Single group pre-test post- test) design.

6.9. CONCEPTUAL FRAME WORK

Conceptual frame work is based on the General System Theory {Ludwig Von Bertanlanffy system theory-1968}

6.10. REVIEW OF LITERATURE

A study was conducted to validate the gSG6-P1 peptide as an epidemiological tool evaluating exposure to An. funestus bites, the second main malaria vector in sub-Saharan Africa.A multi-disciplinary survey was performed in a Senegalese village where An. funestus represents the principal anopheline species. The IgG antibody level specific to gSG6-P1 was evaluated and compared in the same children before, at the peak and after the rainy season. The result of the study reveals that Two-thirds of the children developed a specific IgG response to gSG6-P1 during the study period and--more interestingly--before the rainy season, when An. funestus was the only anopheline species reported. The specific IgG response increased during the An. funestus exposure season, and a positive association between the IgG level and the level of exposure to An. funestus bites was observed. The study concluded that the evaluation of the IgG response specific to gSG6-P1 in children could also represent a biomarker of exposure to An. funestus bites. 13

A study was conducted on Risk factors for anthroponotic cutaneous Leishmaniasis at the household level in Kabul, Afghanistan. Using data from a standardized survey of 872 households in 4 wards of Kabul, Afghanistan, univariate and multivariate logistic regression analyses the investigator tested associations between presence of active ACL and ACL scars with 15 household-level variables. The result of the study showed that active ACL was positively associated with household member's that is in children, age, ACL prevalence, and brick wall type, but negatively associated with household number of rooms, bed net use, and proportion of windows with screens. The study concluded that Household-level characteristics were shown to be risk factors for ACL. Monitoring a selected number of household characteristics could assist in rapid assessments of household-level variation in risk of ACL. ACL prevention and control programs should consider improving house construction, including smoothing of walls and screening of windows.14

A study was conducted on “Analysis of Anopheles arabiensis blood feeding behavior in southern Zambia during the two years after introduction of Insectsicide-treated bed nets”. Anopheles arabiensis mosquitoes are the primary vector responsible for Plasmodium falciparum transmission in Macha, Zambia. Because Insectsicide-treated bed nets (ITNs) have the potential to alter host feeding behavior, the extent of the zoophilic and exophagic tendencies of the vector was evaluated during the two rainy seasons after ITN introduction. Centers for Disease Control light traps, paired indoor/outdoor human landing catches, and outdoor cattle-baited collections were used to assess potential changes in host preference. Results support the hypothesis that An. arabiensis mosquitoes in Macha remain highly anthropophilic despite high ITN use. Anopheles arabiensis mosquitoes in Macha appear to be relatively exophagic and have been caught biting outdoors immediately after sunset and before sunrise, potentially circumventing some of the protective effects of ITNs.15

A study was conducted on “To bite or not to bite! A questionnaire-based survey assessing why some people are bitten more than others by midges”. In this study researcher used a questionnaire-based survey to assess the association between people's perception of how badly they get bitten by midges and their demographic, lifestyle and health related characteristics. The result of the study reveals that most people (85.8%) reported being bitten sometimes, often or always with only 14.2% reporting never being bitten by midges when in Scotland. There was no association between level of bites received and age, smoking, diet, exercise, medication, eating strongly flavored foods or alcohol consumption. However, there was a strong association between the probability of being bitten and increasing height (in men) and BMI (in women). A large proportion of participants (33.8%) reported experiencing a bad/severe reaction to midge bites while 53.1% reported a minor reaction and 13.1% no reaction at all. Also, women tend to react more than men to midge bites. This study suggests that midges prefer to bite men that are tall and women that have a large BMI, and that the tendency for a child to be bitten or not could be inherited from their parent. Although the results are relevant only to the Scottish biting midge, the approach used here could be useful for investigating human-Insects interactions for other Insects, particularly those which transmit pathogens that cause disease.16

A study was conducted to investigate Wash-resistance and field efficacy of Olyset net, a permethrin-incorporated long-lasting Insecticidal netting, against Anopheles minimus-transmitted malaria in Assam, Northeastern India.. The investigator report the research findings of Olyset net as an intervention against Anopheles minimus-transmitted malaria in foothill area of Assam for the first year of observations beginning July 2005 till June 2006.The result of the study reveals that there was a consistent decline in the malarial incidence in Olyset net intervention villages, and the overall impact on the malarial transmission was significant compared to untreated net and no-net control villages for the corresponding study period. The study concluded that the Olyset nets were safe to use, wash resistant, and assessed to be operationally feasible, community-based intervention for sustainable management of disease vectors against malaria.17[pic][pic]

A study was conducted on “School-based health promotion for mosquito-borne disease prevention in children”. The investigator enrolled 345 fourth-grade students in a classroom-randomized, controlled trial to evaluate a school-based West Nile virus health education program's impact on knowledge, attitudes, and personal protective behavior use. The result of the study revealed that Immediate and sustained improvements in West Nile virus knowledge and greater frequencies of reported personal protective behaviors resulted from the educational intervention.18

A study was conducted on “Epidemiology of Insects-venom anaphylaxis”. The latest data from population-based studies of anaphylactic reactions due to Hymenoptera stings, as well as those extrapolated from studies of epidemiology of anaphylaxis due to any cause are reviewed. The topic of biphasic anaphylactic reactions due to Insects stings is also examined. Although no parameter has been identified that can predict which sensitized individuals will have a future anaphylactic reaction, several factors associated with the severity of a systemic resting reaction are known and emphasized here. The result of the study shows that as half of individuals with fatal sting reactions had no documented history of previous systemic reaction. Moreover, and no less important, the epidemiological studies on sting anaphylaxis conducted in the 2000s continue to reveal the poor management of allergic patients and the startling lack of awareness of the efficacy of venom immunotherapy. These findings indicate the urgent need to educate the general population and doctors on the management of venom-allergic patients. 19[pic][pic]

A study was conducted to determine the knowledge and attitudes of a sample of Turkish teachers regarding the administration of first aid. 312 teachers took part in this study to evaluate knowledge and attitudes of teachers in primary schools about first aid. Data were obtained using a questionnaire. It included 30 questions that help identify the teachers and determine their knowledge and attitudes about first aid. Data were analyzed by chi-square test. In this study, it was determined that most of the teachers do not have correct knowledge and attitudes about first aid. For example, 65.1% of teachers gave incorrect answers regarding epistaxis, 63.5% for bee stings, and 88.5% for abrasion. It was found out that as the age of the teacher’s increases, appropriate first-aid practice becomes more and more unlikely. This study concluded that those teachers did not have enough knowledge about first aid.20

A study was conducted on Quantifying mosquito biting patterns on humans by DNA fingerprinting of blood meals. A major debate in infectious disease epidemiology concerns the relative importance of exposure and host factors, such as sex and acquired immunity, in determining observed age patterns of parasitic infection in endemic communities. Resolution of these questions for human parasitic diseases has been frustrated by the lack of a quantitative tool for quantifying the exposure rate of people in communities. Analysis of parallel human and mosquito samples from the same households in an urban endemic focus for bancroftian filariasis in South India demonstrates that a 9-locus radioactive short-tandem repeat system is able to identify the source of human DNA within the blood meals of nearly 80% of mosquitoes. The results show that a person's exposure rate, and hence the age and sex patterns of exposure to bites in an endemic community, can be successfully quantified by this method.21

A study was conducted to assess the frequency of bites by the Blandford fly. Questionnaires were sent to a random sample of 1,500 people, selected from the lists of the two general practices in Blandford Forum, and satisfactory replies were obtained from 1203 (80%). Altogether, 194 (16%) of subjects reported one or more Insects bites, during the 2-month season, that had led to skin swelling more than 2.5 cm across. Of these, more than a quarter had suffered associated systemic symptoms, in the form of fever or joint pain. 149 had used medications for bites, 20 had consulted a doctor, and 7 had taken time off work or school.22[pic][pic]

The authors attempted to determine whether a targeted educational intervention in an area with endemic Lyme disease could increase knowledge, positive attitudes related to tick bite prevention and consequently decrease tick bites, as measured by a biomarker of tick bites. 317 subjects, were randomized to receive either tick-related or general health-related educational materials bimonthly through the mail. At each of three clinic visits, participants completed questionnaire and provided a serum sample. Linear and logistic regression analyses were used to determine whether the educational intervention was associated with a change in knowledge, attitudes, related to examining the body for ticks and Insects repellent use. The result of the study showed that the behavioral intervention was associated with an increase in the KAB measures.23 [pic][pic]

[pic][pic]

7. MATERIALS AND METHODS OF STUDY

7.1. SIGNIFICANCE OF THE STUDY

The study signifies the importance of structured teaching programme on Prevention and first aid management of Insects bite in children for Primary school teachers. Knowledge of first aid, which constitutes life-saving treatments for injuries or unexpected illnesses, is important for every individual at every age. First aid and basic life support are so important that teaching basic first aid for school teachers should be compulsory in all schools. This helps the Primary school teachers to make improved knowledge and skills in first aid for Insects bite in children. This study also helps the Primary school teachers in knowing Preventive measures for Insects bite.

7.2. SOURCES OF DATA COLLECTION

Data will be collected from the Primary school teachers of selected Primary schools at Mysore.

7.3. RESERCH DESIGN

The research design used for the present study is pre-experimental; one group pre-test post-test design. It includes manipulation, no randomization and no control group.

|Group of 60 Primary school teachers |Pre-Test |Intervention |Post-test |

| | | | |

|S |01 |X |O2 |

Key words:

S- Study group.

01- Assessment of pre-test knowledge regarding Prevention and first aid management of Insects bite in children.

X - STP on Prevention and first aid management of Insects bite in children. 02- Assessment of post-test knowledge regarding Prevention and first aid management of Insects bite in children

7.4. METHOD OF COLLECTING DATA

Data collection is planned through the structured questionnaire on knowledge regarding Prevention and first aid management of Insects bite in children and based on the following aspects.

PART -A: Demographic variables include Age, Gender, Experience, Additional qualification, Leisure time activities, Previous knowledge regarding First aid management of Insects bite, Source of knowledge related to health, attended any training programme regarding First aid,

PART –B: Structured questionnaire on knowledge regarding Prevention and first aid management of Insects bite in children.

7.5. SAMPLING PROCEDURE

7.5.1 Criteria for selection of sample

Inclusion criteria:

1. Primary school teachers who are working in selected Primary schools at Mysore.

2. Primary school teachers, who know to read, write and speak Kannada and English.

Exclusion criteria:

1. Primary school teachers who are not present at the time of data collection.

2. Primary school teachers who are not willing to participate in the study.

2. Population

Primary school teachers of selected Primary schools at Mysore.

3. Sample

Primary school teachers, those who fulfill the inclusion criteria.

4. Sample size

Total sample size is 60 Primary school teachers

5. Sampling technique

Convenient sampling technique {Non-Probable Sampling} will be used.

7.5.6 Setting

The settings selected for the study is Selected Primary schools of Mysore.

7.5.7 Pilot study

10% of the population size is planned for the pilot study during the month of June 2011.

7.6. VARIABLES

Independent variable

STP on Prevention and first aid management of Insects bite in children.

Dependent variable

Knowledge of Primary school teachers regarding Prevention and first aid management of Insects bite in children.

7.7 PLAN FOR DATA ANALYSIS

It includes descriptive and inferential statistics.

Descriptive statistics

The Descriptive statistics includes Frequency, percentage, mean and standard deviation.

Inferential statistics

Paired “t” test to be used to find out the difference between Pre-test and Post test. Chi-square test will be used to test the association between the knowledge of Primary school teachers and the demographic variables.

7.8. ETHICAL CLEARANCE

1. Has informed consent will be obtained from the chosen samples?

…...Yes.

2. Has ethical clearance being obtained from the School Authority?

..…Yes.

3. Does the study require any interventions to be conducted on Primary school teachers?

…. Yes.

8. LIST OF REFERENCE (VANCOUVER STYLE)

1. Kid's Health [Online]. Available from: URL:

2.The Importance of Child Health [Online]. Available from: URL:

3. Vincent I. Insect Bites and Stings. July 05, 2010. Health's Disease and Condition content is reviewed by the Medical Review Board. Available from: URL:

4. First aid [Online]. Available from: URL:

5. Rod Brouhard. How To Treat Common Bug Bites. January 30, 2009. Health's Disease and Condition content is reviewed by our Medical Review Board. Available from: URL:

6. Vincent I. Don't Let the Bugs Bite . July 05, 2010.2010. Health's Disease and Condition content is reviewed by the Medical Review Board. Available from: URL:

7. Burns BO, Kavon C, Azadi MD. Oct 13, 2009. Available from: URL: Insect Bites

8. Insect or Spider Bites and Stings. Available from: URL:

9.Spider bite 25 November 2010. Available from: URL:

10. Bee and insect stings. Pediatric Dental Health. August 17, 2002. Available from: URL:

11. Namdev R, Dutta SR, Singh H. Acute immune thrombocytopenic purpura triggered byinsectbite. 2009 Volume: 27 Available from: URL:



12. Honnungar, Ravindra S, Kumar, Lavlesh, Shetty, Ashok K et al. A study of paediatric poisoning cases at District Hospital Belgaum, Karnataka. . Available from: URL

13..Fornadel CM, Dev V, Raghavendra K, Barman PA, Samb B, Doucoure S et al. First attempt to validate the gSG6-P1 salivary peptide as an immuno-epidemiological tool for evaluating human exposure to Anopheles funestus bites. Trop Med Int Health. 2010 Oct; 15(10):1198-203. doi: 10.1111/j.1365-3156.2010.02611.x. Epub 2010 Aug 17. Available from: URL:

14. Reithinger R, Mohsen M, Leslie T. Risk factors for anthroponotic cutaneous Leishmaniasis at the household level in Kabul, Afghanistan. PLoS Negl Trop Dis. 2010 Mar 23;4(3):e639. Available from: URL:

15. Glass GE, Norris DE. Analysis of Anopheles arabiensis blood feeding behavior in southern Zambia during the two years after introduction of Insectsicide-treated bed nets. Am J Trop Med Hyg. 2010 Oct;83(4):848-53.

16. Logan JG, Cook JI, Stanczyk NM, Weeks EN, Welham SJ, Mordue AJ. To bite or not to bite! A questionnaire-based survey assessing why some people are bitten more than others by midges. BMC Public Health. 2010 May 25;10:275. Available from: URL:

17.Phookan S, Dash AP. Wash-resistance and field efficacy of Olyset net, a permethrin-incorporated long-lasting Insecticidal netting, against Anopheles minimus-transmitted malaria in Assam, Northeastern India. Vector Borne Zoonotic Dis. 2010 May;10(4):403-10.

18.LaBeaud AD, Glinka A, Kippes C, King CH. School-based health promotion for mosquito-borne disease prevention in children. J Pediatr. 2009 Oct;155(4):590-2.Available from: URL:

19. Bilò BM, Bonifazi F. Epidemiology of Insects-venom anaphylaxis. Curr Opin Allergy Clin Immunol. 2008 Aug;8(4):330-7.

20. Başer M, Coban S, Taşci S, Sungur G, Bayat M. Evaluating first-aid knowledge and attitudes of a sample of Turkish primary school teachers. J Emerg Nurs. 2007 Oct;33(5):428-32. Epub 2007 Aug 8. Available from: URL:

21. Michael E, Ramaiah KD, Hoti SL, Barker G, Paul MR Quantifying mosquito biting patterns on humans by DNA fingerprinting of blood meals. Am J Trop Med Hyg. 2007 Dec;65(6):722-8.

22. Inskip H, Campbell L, Godfrey K, Coggon D. A survey of the prevalence of biting by the Blandford fly. Br J Dermatol. 2007Apr;134(4):696-9. Available from: URL:

23. Rebecca M, Peter W, Elli L. Longitudinal Evaluation of an Educational Intervention for Preventing Tick Bites in an Area with Endemic Lyme Disease in Baltimore County, Maryland. Am J Epidemiol. 2006 Jun 1;157(11):1039-51. Available from: URL:



24 Donnel Wong. Wong’s essential for pediatric Nursing. 6th ed. Harcourt pvt Ltd.

25 Park K. Preventive and social Medicine 20th ed. M/S Banarsidas Bhanot. 2009.

26 Nelson. Essentials of pediatrics. 4th ed. Elsevier a division of reed Elsevier India Pvt Ltd. 2004.

27 Denise F, Polit, cherly tatano Beck. Nursing research. 7th ed. New Delhi: JP Publishers Pvt Ltd.; 2003. P. 105.

| | | |

|9. |SIGNATURE OF THE CANDIDATE | |

| | | |

|10. |REMARKS OF THE GUIDE | |

| | | |

|11. |NAME AND DESIGNATION OF THE GUIDE (IN BLOCK LETTERS) | |

| | | |

|11.1. |GUIDE | |

| | | |

|11.2. |SIGNATURE | |

| | | |

|11.3. |CO-GUIDE (IF ANY) | |

| | | |

|11.4. |SIGNATURE | |

| | | |

|11.5. |HEAD OF THE DEPARTMENT | |

| | | |

|11.6. |SIGNATURE | |

| | | |

|12. |REMARKS OF THE CHAIRMAN AND PRINCIPAL | |

| | | |

|12.1. |SIGNATURE | |

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