الفهرس 
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Abstract
Intestinal parasitic infection is a serious public health sproblem throughout the world particularly in developing countries. It is a well-known fact that parasitic infections are more common in pediatric age group as children area more vulnerable population. The consequences of these parasitic infections results in malnutrition, anemia, cognitive impairment and increased susceptibility to other infections (El-Sayed & Ramadan, 2017).
World health organization (WHO) has suggested that the control of parasitic invasion should be effectively incorporated into a multi-disease control approach together with T.B, Malaria and HIV. Various risk factors are responsible for this prevalent disease, which include low socioeconomic status, poor hygienic conditions, impure drinking water, low literacy rate of parents, large size of the family and poor health status of the child (WHO, 2017).
Aim of the study:
This study aimed to assess health care practices of children suffering from parasitic infection.
Researcher questions:
1. What are the knowledge level of children and their mothers about parasitic infection?
2. What are the health care practices of children and their mothers regarding parasitic infection?
Subjects and Methods
Research Design
A descriptive design was used to conduct this study.
Research setting
This study was conducted at outpatient clinics at children’s hospital affiliated to Ain Shams University hospitals. The outpatient clinic consist of 3 clinics (surgery clinic, family medicine clinic and medicine clinic) in the ground floor, the researcher selected subject from medicine clinic and family medicine clinic. The medicine clinic is opening 6 days/week (from Saturday to Thursday) and the family medicine clinic is opening 2 days /week (Sunday & Wednesday) only. The two clinics equipped with two beds, two offices, two chairs, stethoscope, sphygmomanometer, thermometer, weighing scale, tape measurement and prescribtion paper for medications, there are 3 doctors available in each clinic for childrens’ interview & examination.
Sample size and characteristics
- A purposive sample of 80 children were included in the study. Their accompanying mothers (80) were also involved when necessary to confirm the gathered data from their children. Only 36 of the children were able to answer the study tools. Children were suffering from intestinal parasitic infection and attended the previously mentioned setting over a 6 months period regardless their educational level and residence and satisfying the following inclusion criteria;
- Diagnosed with intestinal parasitic infection.
- Children aged 6-12 years.
- from both genders.
- Free from any chronic or mental disease.
Tools of data collection
Data were collected through using of the following tools:
1) Pre-designed interviewing questionnaire form [Appendix II (A)]:
It was designed by the researcher after reviewing the scientific related literatures and written in a simple Arabic language to assess data about the following:
Part I: It concerned with characteristics of study subjects
a- It was used to assess characteristics of the studied children which included age, gender, level of education and rank of the child in the family.
b- It was used to assess characteristics of the mothers which included: age, level of education, residence and occupation.
Part II: Family and home characteristics
1- Family characteristics namely, type of family, number of family members and number of children in the family.
2- Home characteristics related to number of rooms, source of the safe water supply, lighting, kitchen, bathroom, drainage system and methods of trash disposal.
3- Home characteristics (presence of birds or animals, raising birds/animals at home and presence of insects at home).
Part III: It concerned with children and their mothers’ knowledge regarding intestinal parasitic infection as definition, causes, types of parasitic infection, mode of transmission, clinical manifestations, prevention, food & drink precautions, hygienic precautions during treatment, drug precautions during treatment, complication of parasitic infection, treatment of parasitic infection and source of knowledge regarding parasitic infection. It consisted of 11 questions.
Scoring System:
The scoring system was ranging from zero for incorrect or un known answer and two for correct answer for each question , that made total score of 22 marks. Then the scores were summed and divided by the number and accordingly the studied subjects total knowledge were either:
• Unsatisfictory total knowledge < 60% (< 13 grades)
• Satisfictory total knowledge ≥ 60% (13 grades or more)
2) Observation checklists [Appendix II (B)]:
The checklists were adopted from Perry et al., (2013), Jacob et al., (2015) and Lynn, (2015), and used to assess the reported practices of children and their accompanying mothers regarding hand washing, food safety, oral drug administration and change of bed linens.
Scoring system:
The scoring system was ranging from zero for not done or done incorrectly and two for done correctly for each item, that made total score of 60 grades and accordingly the studied subjects total practices were either:
• Inadequate practices < 60% (< 36 grades)
• Adequate practices ≥ 60% (≥36 grades or more)
3) Child medical record [Appendix II (C)]:
A. Physiological assessment (vital signs) such as temperature, pulse and respiration (assessed by the reseracher).
B. Physical assessment for each child was carried out by the researcher in the previously mentioned setting included:
1- Growth assessment of height and weight by growth charts adopted from Dalta,(2014).
2- Genearal observations included skin, colour, nails, eyes, hair, teeth and saliva discharge during sleeping adopted from Dalta,(2014).
C. Complications related to parasitic infection for the children such as (respiratory, gastrointestinal, circulatory, urinary, neurological and growth & development, comitted to school attendance and school a chievement).
D. History of Parasitic Infection including:
1- Previous history of parasitic diseases included family members affected with parasitic diseases and duration of the present infection.
2- Laboratory analysis of parasitic infection included type of analysis for diagnosis, number of analysis for follow up, duration between repeated analysis/week, type of parasite, repeated analysis after treatment course, occurance and cause of relapse.
3- Treatment from parasitic infection included take medication for previous parasitic infection, type of the current treatment and complence with treatment plan.
Field work
Data were collected over a period of six months from February 2019 to July 2019. The researcher first met the children and their mothers, explained the purpose of the study after introducing herself. Then, individual interviewing was done after obtaining subjects’ oral consent to participate in the study. The researcher was visiting the study setting 2 days weekly at morning shift to collect data of the study. The researcher was reading each question and its answer and waiting until mother and children choose suitable answer, also the researcher performed physiological (vital signs, such as temperature, pulse and respiration) and physical assessment (height in centimetres, weight in (kg) and general observation from head to toes, children asked to open mouth to observe gum and teeth and females were asked to remove scarfe to observe hair. Time needed to fill in the questionnaire was about 30-45 minutes and time needed to fill in the assessment was about 15 -20 minutes. The researcher was waiting the result of stool analysis until the mother presented it from lab of Ain Shams University Hospital in the ground floor, but some cases (about 20 mothers) the result of stool analysis presented from private laboratories before coming to outpatient clinic after that doctor wrote the medication according to the result’s of analysis.
The present study revealed the following main results:
• 55% of the studied children were not committed to school attendance, while 23.8% of them were excellent in academic achievement.
• 41.2% of the participants had birds/ animals at home and 72.5% suffering presence of insects at home.
• The studied children were having normal skin, color, nails, eyes, healthy hair and normal teeth found in 80%, 20%, 66.2%, 56.2%, 55%, 18.8% of them respectively.
• 46.2% of the studied children had previous history of pinworm with 78.8% positive family history with parasitic infection.
• All of the studied children did stool analysis for confirmation of the diagnosis and 70% of them did the analysis once.
• 43.8% were suffering pinworm and 78.8% were suffering relapse (re- infection).
• 70% of the studied children were suffering anemia.
• 71.2% of the studied mothers and 83.3% of the studied children had unsatisfactory total knowledge regarding parasitic infection.
• 48.8% of the studied mothers and 66.7% of the studied children had inadequate total reported practices regarding parasitic infection.
• 78.8% of the studied mothers and 58.3% of the studied children get their knowledge regarding parasitic infection from the physician.
Recommendation:
In the light of the study findings the following recommendations are suggested:
• Encourage healthy practices in the different aspects of children’s daily living at home, school and community.
• Monitoring maternal and children’s practices for prevention and management of parasitic infection.
• Raising awarness of mothers and their school age children and the community as well regarding parasitic infection and healthy practices through different media and methods.
• Conduction of educational programs for mothers and their children for prevention regardig intestinal parasitic infection and promotion childrens’ health care practices.
• Continuous health education based upon actual needs assessment of children and their mothers to improve their knowledge and practices regarding intestinal parasitic infection.
• Conducting further studies about intestinal parasitic infection among children in different age’s categories and different geographic areas in Egypt.
Conclusion
The current study concluded that majority of children and their mother’s knowledge regarding parasitic infection was unsatisfactory and their total reported practices were inadequate.