Download In this study a viral hepatitis serosurvey done on 381 nursing

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION.
1
NAME OF THE CANDIDATE Mr. SHINEDEV.T
AND ADDRESS
Ist YEAR MSc. NURSING STUDENT,
N.D.R.K. COLLEGE OF NURSING
B.M. ROAD HASSAN, KARNATAKA.
2
NAME OF THE INSTITUTION
N.D.R.K. COLLEGE OF NURSING, B.M. ROAD, HASSAN,
KARNATAKA.
3
COURSE OF STUDY AND
SUBJECT
4
DATE
OF
MASTER OF SCIENCE IN NURSING
(CHILD HEALTH NURSING)
ADMISSION
TO 15.06.2010
THE COURSE
5
TITLE OF THE TOPIC
“EFFECTIVENESS OF STRUCTURED TEACHING
PROGRAMME
ON
KNOWLEDGE
REGARDING
PREVENTION OF VIRAL HEPATITIS AMONG P.U
STUDENTS IN SELECTED P.U COLLEGE AT HASSAN.”
5.1
STATEMENT OF THE
“A STUDY TO EVALUATE THE EFFECTIVENESS OF
PROBLEM
STRUCTURED TEACHING PROGRAM ON KNOWLEDGE
REGARDING
PREVENTION
OF
VIRAL
HEPATITIS
AMONG P.U STUDENTS IN SELECTED P.U COLLEGE AT
HASSAN.”
1
6. BRIEF RESUME OF THE INTENDED WORK
6.1. INTRODUCTION
“An ounce of prevention is worth than a pound of cure”
Benjamin Franklin
Viral hepatitis is known as “inflammation of the liver” due to viral infection. It is a
worldwide problem emerging from western as well as eastern part of the world including India.
It occurs due to unhygienic practices, unsafe, poor environmental sanitation, etc. Viral hepatitis
is most common in adolescents. The causative agents are the heterotrophic viruses (A, B, C&E).
While hepatitis A&C transmitted through enteral route, hepatitis B&C transmitted through
parentral route. It is necessary that everyone should be aware of the disease. The major challenge
faced by the health care workers today is to provide awareness about hepatitis. So as to promote
healthy behavior and thus be able to prevent disease.1
Hepatitis A is an acute infectious disease caused by hepatitis A virus. According WHO
about 10- 50 person per 100,000 are affected annually. India, Bangladesh, Bhutan and Nepal
demonstrated that 85-95% of children have been infected and are immune to hepatitis A virus
infection by 10 years of age. Hepatitis A virus is very common, due to poor sanitation and
environmental hygiene. Outbreaks of hepatitis A virus infection in urban settings are associated
with drinking water and food. Hepatitis B infection is 66% of the entire world’s population living
in areas where there high levels of infection. More than 2 billion people worldwide have
evidence of past or current hepatitis B virus infection and 350 million are chronic carriers of
virus. The carrier rate hepatitis B is high in general population (5-7%). In India alone there is an
estimated 45 million. It is also estimated that 3% of world population is infected with hepatitis C
virus and around 170 are chronic carriers in many countries particular population subgroups such
as voluntary blood donors have very high prevalence of hepatitis C virus infection.1
Viral hepatitis A accounts for about 150,000 of the 500,000-600,000 new cases of viral
hepatitis that occur each year in the United States. The hepatitis caused by hepatitis A virus is
acute illness (acute viral hepatitis) that never becomes chronic. At one time, hepatitis A was
referred to as “infectious hepatitis” because it could be spread from person to person like other
viral infections.1
2
Nearly 200,000-300,000 new cases of viral hepatitis B infection each year in United
States. Type B hepatitis at one time referred as “serum hepatitis” because it was thought that the
only way hepatitis B virus spread was through blood and serum (liquid portion of the blood)
containing the virus.1
Around 150,000 new cases of hepatitis C was reported each year. Type C hepatitis
previously referred to as “ non-A, non-B hepatitis,” because the causative virus had not been
identified, but it was known to be neither hepatitis A nor hepatitis B. the hepatitis C virus usually
is spread by shared needles among drug users, blood transfusion, hemodialysis and needle sticks.
Approximately 90% of transfusion associated hepatitis caused by hepatitis C.1
Hepatitis E virus is the etiological agent of non-hepatitis A virus enterically transmitted
hepatitis. It is the major cause of sporadic as well as epidemic hepatitis, which is no longer
confined to Asia and developing countries but has also become a concern of the developed
nations. In the Indian subcontinent, it accounts for 30-60% of sporadic hepatitis.1
A study was conducted on “significant increase in hepatitis B virus, hepatitis C virus,
human immunodeficiency virus and syphilis infections among blood donors in West Bengal,
eastern India” to evaluate the prevalence of markers of hepatitis B virus, hepatitis C virus, human
immune virus. Seroprevelance of hepatitis B surface antigen, anti- hepatitis C virus and anti-,
human immune virus was studied among 113051 and 106695 voluntary blood donors screened in
2004 and 2005, respectively and a pilot study on 1027 HBsAg negative donors was carried out
for evaluating the presence of hepatitis B virus (1448 vs 1768, P<0.001), human immune virus
(262 vs 374 P < 0.001), hepatitis C virus (314 vs 372 P < 0.003) and syphilis ( 772 vs 853,
P=0.001) infections was noted among blood donors of Kolkata West Bengal in 2005 as
compared to 2004. Study reveals the significantly increasing endemicity of hepatitis viruses,
syphilis and human immune virus among the voluntary blood donors.2
6.2. NEED FOR THE STUDY
Viral hepatitis is a major public health problem all over the world. Approximately
152,000 cases of hepatitis A occur annually in United States and 10 million worldwide.
Worldwide nearly 300 million peoples are infected with hepatitis B virus. 80,000 new cases of
hepatitis B are estimated annually in United States. Worldwide approximately 170 million
people are infected with hepatitis C virus. In the United States it is estimated that 4 million
3
individuals have been exposed, with 3 million of them chronically infected. Of these nearly 50%
are not aware of their infection. Currently an estimated 25,000 new cases are diagnosed
annually.3
A cross sectional sero-survey is done in four Pacific Island nations to determine the
proportion of people previously infected with hepatitis A virus by measuring antibodies to
hepatitis A virus (anti- hepatitis A virus). In American Samoa, 0.0% of 4-6 year olds (95% CI
0.0-3.7) were anti- hepatitis A virus positive. In Chunk, FSM, 8.6% of 2-6year olds (95% CI 5.711.5) were anti- hepatitis A virus positive compared with 98.3% of individual>/=16year old
(95% CI 96.6-100). In Pohnpei, FSM 0.8% of 2-9 year olds (95% CI 0.0-1.6) were anti-HAV
positive compared with 95.1% of >/=16 year olds (95% CI 92.2-98.0). In RMI, 85.7% (95% CI
81.9-89.5) of 4- 9 year olds were anti hepatitis A virus positive (95% CI 0.0-1.8). The low
hepatitis A virus seroprevelance among children in American Samoa, FSM and Palau may
indicate a vulnerability to hepatitis A morbidity among these populations. These data shows the
need for hepatitis A surveillance and vaccination programs.4
Government of India reported that in India at least 100,000 people die every year due to
illness related to HBV infection. Realizing the dangers of hepatitis B, the government expanded
the Universal Immunization Program to include hepatitis B vaccine in the year 2002. This was
done in 33 districts and 15 large cities with support of Global Alliance for Vaccines and
Immunization, as a pilot project. According to pilot project report, 1.2 million children were
vaccinated, with 3 dose of Hepatitis B. the Government plan to make reach of the vaccine
nationwide by 2009.5
Indian current affairs (2010) reported regarding death due to water pollution in India
from the period 2007 to 2009. It shows that acute diarrhrial disease is the primary cause of death
and viral hepatitis is the secondary cause of death. According to this report, 30 deaths occurred at
Karnataka due to viral hepatitis in the year 2009.6
A study was conducted on “epidemiological investigation of an outbreak of infectious
hepatitis in Dakor town, Gujarat.” Epidemiological data collected from hospital records, active
surveillance and the survey sample. The overall incidence rate of hepatitis E was found to be
18.76 per 1000 population. Similar finding was observed during the investigation of hepatitis
4
outbreak in Ahmadabad city during 1975-1976(the incidence rate of hepatitis E was 14 per 1000
population). Study shows that hepatitis E virus causes a major public health issue in India.7
According to Bangalore water supply department, 14,980 cases of viral hepatitis reported
in the State in 2008, due to drinking contaminated water.
A study was conducted on, “Uncertain knowledge: a national survey of high school
students' knowledge and beliefs about hepatitis C” (2007) in Australia. In this study sample of
students in Years 10 and 12 in government secondary schools (n = 3,550). Students' knowledge
about HCV was found to be extremely poor. Of the seven questions on hepatitis, only one was
answered correctly by more than half of the students. Few could differentiate between hepatitis
A, hepatitis B and hepatitis C. Only a small number (12%) perceived themselves to be at risk of
hepatitis and fewer than half (41%) had sought advice about hepatitis. The study concluded that
there is a need of more hepatitis C virus education and health promotion for secondary school
students.8
During the time of adolescence, after Pre University course people may go away from
home for further studies. They will stay in risky circumstances like hostels, lodges, etc. Water
and food supply on such condition may not be safe and this will cause hepatitis A and other
communicable diseases. After Pre University course some of them go for medical and other
allied courses. In hospital they are more prone to get needle stick injuries and other nosocomial
infections. During adolescents some of them are willing to donate blood. This is also risk factor
for hepatitis B and C. Sex attitude of adolescents are more than one sexual partner and
homosexual activities may lead to hepatitis B, C and other sexually transmitted diseases. When
adolescent people away from family members there is a chance to start alcoholism due to peer
group influence. Alcoholism is one of the risk factor for hepatitis.
So the investigator felt that providing knowledge to P.U students regarding prevention of
viral hepatitis, will improve their knowledge and they will practice it in future life. Thus the
threat of viral hepatitis can be reduced to large extend.
5
6.3. STATEMENT OF THE PROBLEM
“A study to evaluate the effectiveness of Structured Teaching Program on Knowledge
regarding Prevention of Viral Hepatitis among P.U students in selected P.U College at
Hassan.”
6.4. OBJECTIVES OF THE STUDY
1. To assess the knowledge of P.U students regarding prevention of viral hepatitis before and
after the administration of structured teaching program.
2. To Develop and administer structured teaching program regarding prevention of viral hepatitis
among the P.U students.
3. To evaluate the effectiveness of structured teaching program by comparing pre-test and posttest knowledge scores regarding the prevention of viral hepatitis.
4. To associate the pretest and post test knowledge score of P.U students with selected socio –
demographic variable.
6.5 HYPOTHESIS
NULL HYPOTHESIS
H0: There will not be any a significant difference between pre test and post test knowledge
scores of who have received the structured teaching program on prevention of viral hepatitis.
RESEARCH HYPOTHESIS
H1: There will be a significant difference between pre test and post test knowledge scores of who
have received the structured teaching program on prevention of viral hepatitis.
H2: There will be significant association between selected socio demographic variables and
knowledge of P U students.
6
6.6 ASSUMPTIONS
1. The P U students will be having less knowledge regarding viral hepatitis.
2. The P U students will be expressing willingness to learn and understand about viral hepatitis.
6.7 OPERATIONAL DEFINITIONS
1. EVALUATE
It is the process of judging the value or quality of study regarding prevention of viral hepatitis
before and after implementation of Structured Teaching Program.
2. EFFECTIVNESS
It refers the significant gain in difference between pre test and post test knowledge and practice
scores.
3. HEPATITIS
Hepatitis is the inflammation of liver cells caused by hepatitis virus.
4. KNOWLEDGE
It refers to the understanding of or information regarding viral hepatitis among P.U students of
selected P.U College, Hassan.
5. STRUCTURED TEACHING PROGRAM
It refers to systematically organized instruction (power point presentation) on knowledge
regarding viral hepatitis.
6. SELECTED P. U COLLEGE
It refers The Krishna P.U College at Hassan
7. P.U STUDENTS
P.U students are those who studying P.U College with age between 15-17 years.
7
6.8. CRITERIA FOR SAMPLE SELECTION
Inclusion criteria
1. P.U students who are studying in selected P.U College at Hassan.
2. P.U students who are present at the time of study
Exclusion criteria
1. P.U students who are not present during research study.
2. Students who are studying in high school.
6.9 LIMITATIONS OF THE STUDY
Study is limited to:
1. 60 P.U students in a selected P.U College at Hassan.
2. A period of 4 -6 weeks
6.10. SIGNIFICANCE OF THE STUDY
This study will increase the knowledge of P.U students regarding viral hepatitis. And it
also paves the way for P. U students to gain knowledge regarding preventive measures of viral
hepatitis.
6.11 CONCEPTUAL FRAME WORK
Theoretical framework based on, “Ludwig Von Bertalanffy’s General System Theory”
(1968)
6.12. REVIEW OF LITERATURE
Review of literature is a key step in research process. Review of literature refers to an
extensive, exhaustive and systematic examination of publications relevant to the research project.
Before any research can be started whether it is a single study or an extended project, literature
review s of previous studies and experiences related to proposed investigations should be done.
8
One of the most satisfying aspects of the literature review is the contribution it makes to the new
knowledge, insight and general scholarship of the researcher.
Review of literature divided into three according to global, national and regional studies
GLOBAL:
A study was conducted was conducted in Bangui, Central African Republic, Dried blood
Spots from 801 adolescent high school and young adult university students were prepared by
spotting a drop of whole blood (4 spots) from the same finger prick onto Whatman filter paper.
The overall prevalence was 42.3% for antibody to hepatitis B core antigen, 15.5% for HBsAg of
which 1.3% of HBsAg alone. HBV familial antecedents, sexual activity and socioeconomic
conditions were the main risk factors of HBV infection encountered in the adolescents and young
adults.9
A study was conducted for. “The analysis on HBV epidemical trend of people age <20
from rural areas of Zhaodong”. In this study serum samples were collected in 1986 and 2005
respectively. HBsAg, anti-HBs and anti-HBc of the sera with SPRIA were tested. HBsAg
average positive rate of the people age <20 decreased from 8.5% in 1986 to 4.4% in 2005 (chi2 =
10.88, P < 0.01). The anti-HBs average positive rate increased to 43.1% in 2005 from 18.3% in
1986 (chi2 = 130.47, P < 0.01). The anti-HBc average positive rate decreased from 39.9% to
15.1% (chi2 = 122.18, P < 0.01). The HBV infectious background of the rural population in
Zhaodong city is high and the HBV infection rate decreased obviously after Hepatitis B
inoculation since 1986, but it is still higher than the state average rate. It indicated that the HBV
prevention in this district needs to be enforced and improved.10
A study was conducted to find the prevalence and risk factors of hepatitis B and C virus
infections in an impoverished urban community in Dhaka, Bangladesh. In this study from June
2005-November 2006, 1997 participants were screened for HBsAg, anti-HBc and anti-HCV, 738
(37%) were males with mean (SD) age of 24 (14) years. HBV-seropositivity was documented in
582 (29%) participants, 14 (0.7%) were positive for HBsAg, 452 (22.6%) for anti-HBc and 116
(5.8%) for both HBsAg and anti-HBc. Four (0.2%) participants were positive for anti-HCV and
another five (0.3%) for both anti-HBc and anti-HCV. 96/246 (39%) family members residing at
same households with HBsAg positive participants were also HBV-seropositive.11
9
A study was conducted on, “Hepatitis antibody profile of Royal Thai Army nursing
students.” In this study a viral hepatitis serosurvey done on 381 nursing students in Bangkok;
360 (94%) were female. The mean age was 20 (+/-3.6) years, 143, 92, 86 and 59 students came
from Thailand's Central, North, Northeast and South provinces, respectively. The overall
prevalence of hepatitis A, B, C and E antibody in the students was 8.9%, 10.8%, 0.5% and
11.5%, respectively. The highest seroprevalence to hepatitis A was observed in cadets from the
southern region of Thailand.12
A study was conducted to find, “the seroprevalence of hepatitis A among children of
different socioeconomic status in Cairo”. This study was carried out during the 6 months of
period October 2003 to March 2004 on 426 children aged 3-18 years from low socio economic
areas and 142 from high socio economic areas. Seroprevelance was significantly higher with age.
Seropositivity to anti hepatitis A virus antibodies was significantly higher among children with
low and very low socioeconomic status, 90%, compared to children of high socioeconomic
status. Among the children who participated from the health insurance clinic, seroprevelance of
anti- hepatitis A virus antibodies was 86.2% overall, 85.3% among male and 86.9% females with
no statically significant difference (P>0.05). In the high socioeconomic status group, overall
prevalence of anti-HAV antibodies was 50.2%, also with no significant difference between males
and females. A significantly higher prevalence of anti-hepatitis A virus in relation to age was
observed in the low socio economic status children,64.3% among those < 6 years, 85.3% among
those aged 6-10 years, and 90% among older children (≥11years) (p <0.05).13
A study was conducted on “Prevalence of hepatitis virus A, B and C markers according
to geographical origin of medical students.” Antibodies against viral hepatitis A, B and C were
evaluated in 221 students of medical school of Padua University born in countries different from
Italy. Data compared with those measured in 362 students born in Veneto region and 87 students
born in Centre-Southern Italy. The result showed a high, significant prevalence of positive
antibodies against hepatitis A in students from Africa (94.7%), Asia (60.9%), centre southern
America (60.9%) and East Europe (52.7%); in Italy the prevalence was significant in students
from Central Southern Italy (19.5%). A high prevalence of hepatitis B antibody was observed in
33.3% of Africa students, in 22.6% of students from East Europe and in 12.5% of Asian and
Central Southern American students. Finally infection with hepatitis C is sporadic and without a
significant geographic distribution.14
10
A sero-epidemiological study was undertaken in 2003–2004 in general populations of
Flanders, Belgium with purpose of obtain a clear picture of the prevalence of hepatitis A, B and
C. In this study 4,058 blood samples were drawn and collected in 10 hospitals in Flanders. . The
study group was representative for the Flemish population. For hepatitis A seroprevalence of
55.1% was found. In the non-Belgian residents, the HAV prevalence was significantly higher
than in Belgians (62% versus 52%; χ2 = 8.05; p = 0.005). For hepatitis B, 9.9% of the study
group showed serological evidence of hepatitis B markers: 6.9% of the participants was positive
for anti-HBs/anti-HBc, 0.7% appeared to be HBsAg positive and 3.5% was solely anti-HBs
positive. The prevalence of HBV markers in Belgians was 6.9%, significantly lower compared to
the 13.4% among non-Belgians (χ2 = 14.05; p = 0.00018). 4055 serum samples were analyzed
for hepatitis C serology by second generation anti-HCV tests. Anti-HCV was detected in 0.87%
of the serum samples. No statistically significant difference was found in HCV prevalence
between Belgians and non-Belgians. Results of this study should help policy makers in their
decisions on the most appropriate hepatitis A and B vaccination strategy and on the most
effective prevention strategy for hepatitis C.15
A study was conducted on, “knowledge and practice and attitude of Swedish travelers on
prevention of travel related infectious disease.” Self administered anonymous questionnaires
were distributed to Swedish travelers (n=957). A majority of travelers sought general
information, 74% and travel health advice, 59% prior to departure. Most perceived vaccination
as safe and effective, but only 40% and 3% of travelers reported adequate vaccine coverage
against hepatitis A or hepatitis B, respectively the study states the need for further health
education among travelers.16
A study was conducted on 2002 to find age specific seroprevalence on hepatitis A among
school children in Central Tunisia. They assessed seroprevalence of HAV in Sousse in Central
Tunisia. A total of 2,400 school children 5–20 years of age (mean ± SD age = 11.7 ± 3.5 years)
were selected by two-stage cluster sampling and tested serologically for IgG antibody to HAV by
using an enzyme-linked immunosorbent assay. The overall seroprevalence among this population
was 60% (44%, in children < 10 years old, 58% in those 10–15 years of age, and 83% in those >
15 years of age.17
11
A study was conducted to find out, “Prevalence of Hepatitis A in Children and
Adolescents in Adana, Turkey” on 1998. The study was carried out in 711 children and
adolescents (355 male, 356 female) aged 2.1 to 16.5 years (mean age 8.3 years).The overall
prevalence of anti-HAV was 44.4% (316/711). The prevalence increased with advancing age i.e.
28.8% (2.1-6 yr), 49.8% (6.1-12 yr), and 68% (12.1-16.5 yr) (P < 0.0001). Seroprevalence was
significantly lower in children less than 6 years and belonging to higher socioeconomic status.18
NATIONAL:
A study was conducted to find out outbreak of acute viral hepatitis due to hepatitis E
virus in Hyderabad from March through August 2005. In this study five hundred and forty-six
clinically and biochemically documented cases were screened for the hepatotropic viral markers,
hepatitis A, B, C, and E by the ELISA method. In this study hepatitis E as the major cause of the
outbreak (78.57%). Occasionally, mixed infection of HEV-HAV (5.31%) or HEV-HBV (0.91%)
was detected in the present series of acute viral hepatitis. Seroanalysis of 546 serum samples
from the outbreak revealed the presence of at least one seromarker of hepatitis in 534 (98 %)
cases. Among the 546 patients studied, males outnumbered females with a ratio of 2.3:1. The
most affected age-group was that between 15 and 25 years, with an incidence of 73% in males.
We found a relative sparing of children below 10 years of age. Of the 13 pregnant women with
AVH, 3 (23%) women who were in the third trimester had a fatal outcome. No untoward effects
were observed in the remaining 10 HEV infected pregnant women during their follow-up.19
According to Wikipedia there is hepatitis B outbreak in early 2009 at Gujarat. The
hepatitis B epidemic was spread in Midasa, northern Gujarat, India. Over 125 people were
infected and up to 49 people were killed in the epidemic.20
REGIONAL:
A study was conducted at a large multi-specialty military hospital located at Bangalore,
India over a period of one and half years from 01 Jul 2003 to 31 Dec 2004. A total of 252 cases
of acute hepatitis were seen during the period of study. Twenty eight cases were excluded due to
various reasons. 224 cases of acute viral hepatitis were included in the study. There were 175
males and 49 females in the mean age group of 22.5 years. Hepatitis E was the commonest cause
seen in 102 (45.5%), followed by hepatitis A in 74 (33%) and hepatitis B in 28 (12.5%) cases.
There were only two cases of acute hepatitis C. Mixed infection was seen in 18 cases (A+E 16
12
cases, B+E and B+A in one case each respectively). Hepatitis A constituted 41.2% of all cases
in the age group 11-20 years, followed by hepatitis E (35.3%). In the older age group, 21-30
years, hepatitis E was the commonest (52%) infection followed by hepatitis A (31.3%).21
A hospital based study was conducted on hepatitis E virus in St. John’s Medical College
stated that a total of 569 serum samples were screened for hepatitis E virus between April 1997
and March 2000, by commercially available hepatitis E Immunoglobulin G capture enzyme
linked immune sorbent assay. The diagnosis was invariably acute hepatitis for differential
diagnosis of jaundice. The percentage of seropositivity was found to be 18.8% in confirmed
hepatitis E cases.22
7. MATERIAL AND METHODS OF STUDY
7.1. SOURCES OF DATA
The data will be collected from selected P.U students studying a in a selected P.U College at
Hassan, Karnataka.
7.2. METHOD OF DATA COLLECTION
Data will be collected by self administered questionnaire.
1. Research design
Quasi experimental design with single group pre-test post-test research.
Schematic plan of the study:Group
Pretest
Intervention
Posttest
A
group
of
60
P.U
O1
X
O2
students studying at selected P. U
college at Hassan.(Single group)
13
Key:O1= Pretest knowledge of P.U students regarding prevention of viral hepatitis.
X = Structured teaching program on prevention of viral hepatitis.
O2 = Post test knowledge of P.U students regarding prevention of viral hepatitis.
2. Research setting: - Selected P.U College at Hassan, Karnataka
3. Population: - students studying in a selected P.U College at Hassan
4. Sample: - students who full fill the inclusion criteria.
5. Sample size: - 60 P.U students.
6. Sampling technique: - Probability sampling method by stratified random technique will be
used for the study.
7. Collection of data-Data will be collected by using self administered questionnaires.
8. VARIABLES
Independent variable
Structured teaching program for P.U students regarding prevention of viral hepatitis.
Dependent variable
Knowledge of P.U students regarding prevention of viral hepatitis.
Extraneous variable
Age, sex, class of study, religion, type of family, place of residence, education of father,
education of mother, mass media exposure, socioeconomic status
14
9. PLAN FOR DATA ANALYSIS
Descriptive statistics
Descriptive statistics include percentage, frequency, mean and standard deviation
Inferential statistics
It include paired‘t-test’ with chi- square test for the assessment of knowledge and to associate the
socio demographic variable is planned .
10. PILOT STUDY
10% of sample size is planned for the pilot study.
11. ETHICAL CONSIDERATION
1. Does the study require any intervention to be conducted on P.U students?
Yes
2. Has ethical clearance will be obtained from your institution?
Yes
3. Has the consent been taken from selected P.U College?
Yes
15
12. LIST OF REFERENCES (VANCOUVER STYLE)
1. Park K, “Text book of preventive and social medicine” 19th edition, Banarasidas Bhanot,
Jabalpur 2007 Pp 173-178
2. B. Ataei etal, “Hepatitis E virus in Isfahan Province: apopulation based study” Int J Infect
Dis, Jul, 2008
3. S.M Lewis, M M Heitkemper and S.H Dirkson’s “Text book of medical surgical nursing” 5th
Edition, Mosby publishers, Philadelphia, 2005, Pp 1105-15
4. Fisher GE etal, “The epidemiology of hepatitis A virus infections in four Pacific Island
Nations, 1995-2008”, Trans R Soc Trop Med Hyg. 2009 Jun 9
5. W.A Achvan etal, “Epidemology of hepatitis B, C and E viruses and Human immune
Deficiency viruse infection in Tahuna, Sangihe-Talaud Archipelago, Indonesia” Intervirology,
2007, 50(6): Pp 408-11
6. Indian Current Affairs 2010
7. A bhagyalexmi, M Gadhavi and B S Bhavasar, “Epidemolgical investigation of an outbreak
of infectious hepatitis in Dakor town” Indian Journal of Community Medicine, 2007;32(4)
Pp 277-279
8. Lindsay J etal, “Uncertain knowledge: a national survey of high school students' knowledge
and beliefs about hepatitis C” Aust N Z J Public Health. 2009 Apr; 23(2), Pp 135-9.
9. Komas NP etal, “The prevalence of hepatitis B virus markers in a cohort of students in
Bangui, Central African Republic”, BMC Infect Dis. 2010 Jul 29; 10, Pp 226-228.
10. Wang F etal, “Analysis on HBV epidemical trend of people age <20 from rural areas of
Zhaodong”, Zhongguo Ji Hua Mian Yi. 2010 Jun; 16(3), Pp211-3
16
11. Ashraf H etal “Prevalence and risk factors of hepatitis B and C virus infections in an
Impoverished urban community in Dhaka, Bangladesh”, BMC Infect Dis. 2010 Jul 15; 10,
Pp208-209.
12. Pilakasiri C etal, “Hepatitis antibody profile of Royal Thai Army nursing students”
Trop Med Int Health. 2009 Jun; 14(6), Epub 2009 Mar 2, Pp 609-611.
13. Salama etal, “Seroprevalence of hepatitis A among children of different socioeconomic status
in Cairo”, Eastern Mediterranean Health Journal, Volume 13 No. 6 November – December
2007.
14. M. Beggio etal, “Prevalence of hepatitis virus A, B and C markers according to geographical
origin of medical students”. G Ital Med Lav Ergen, 2007, 29(3)Pp 745-7.
15. M. Beutels etal, “Prevalence of hepatitis A, B and C in the Flemish population”,
European Journal of Epidemiology, 2006, Volume 13, Number 3, Pp 275-280.
16. A L Dahlgren, L DeRoo and R Steffen and R Steffin, “Prevention of travel related infectious
Diseases; knowledge, practices and attitude of Swedish traveler” Scand J Infect Dis 2006;
38(11-12): Pp1074-80.
17. Amal Latieff etal, “Age specific seroprevalance of hepatitis A among school children in
Central Tunisha” Am.J.Trop. Med.Hyg 2005 73(1) Pp 40-43.
18. Hacer Yapicioglu etal, “Prevalence of hepatitis a in children and adolescents in Adana,
Turkey”, Indian Pediatrics 2002; 39, Pp 936-941.
19. P Sarguna etal, “Outbreak of acute viral hepatitis due to hepatitis E virus in Hyderabad”
Year: 2007, Volume: 25, Issue: 4, Pp 378-382.
20. www.wikepedia.com
17
21. Nandi etal, “Spectrum of Acute Viral Hepatitis in Southern India”MJAF 2009 vol 65 No.1
Pp 7-9
22. B Mishra etal, “A hospital based study of hepatitis E by serology” Indian J Med Microbio.
2003, Apr-Jun; 21(2): Pp 115-117.
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