الفهرس 
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Abstract
Parasitic infection (PI) is a major health problem in developing countries. Globally, two billion individuals are infected with intestinal parasites; out of these, the majority of them are children. An increasing trend in intestinal PIs has been recorded in developing countries because of low socioeconomic status, low literacy rate, poor awareness among the parents regarding PI and their mode of transmission, poor quality of drinking water, inappropriate hygiene and sanitation and hot and humid tropical climate (Fakhri et al., 2021).
Parasitic infection has been linked with an increased risk for nutritional anemia, protein-energy malnutrition and growth deficits in children, loss of weight in pregnancy and intrauterine growth retardation followed by low birth weight. Intestinal parasitic worms are generally contracted via many routes; direct via ingesting parasite eggs or larva (e.g. Ascariasis and oxyuris) or indirect ingestion via contaminated articles, fomites and clothes and direct penetration while walking barefooted on contaminated soil e.g. Ancylostoma duodenal (Kaur & Randhawa, 2021).
This study aimed to assess the mother’s Awareness regarding prevention of parasitic infection among their children under five years through: Assessing mother’s knowledge regarding prevention of parasitic infection among their children under five years. Assessing mother’s mother’s reported practices regarding prevention of parasitic infection among their children under five years. Assessing home environmental sanitation from mothers regarding prevention of parasitic infection among their children under five years.
To fulfill the aim of the study, the following research questions were formulated as follows:
1- What are the mother’s knowledge regarding avoiding parasitic infection among their children under five years?
2- What are the mother’s mother’s reported practices regarding avoiding parasitic infection among their children under five years?
3- Is there correlation between socio economic status of mothers and mother’s knowledge regarding avoiding parasitic infection among their children under five years?
4- Is there correlation between socio economic status of mothers and mother’s reported practices regarding avoiding parasitic infection among their children under five years?
A. Research design:
A descriptive analytical design was used in this study.
B. Setting:
The sample was collected from MCH in East Shubra Al-Khaimah in Bahtim area.
In East Shubra Al-Khaimah in Bahtim area two centers were chosen, which are called (1, 2) Shubra El Khaimah is the fourth-largest city in Egypt. It locates in the Qalyubia governorate along the northern edge of the Cairo governorate. It forms part of the Greater Cairo agglomeration, also it is considered one of the suburban areas. They are either part of a city or an urban area (Population data taken from the City Population website Archived, 2018).
Sample type:
A convenience sample was obtained and included Mothers with children under five years old both sex at MCH from East Shubra Al-Khaimah in Bahtim area governorate.
Sample size:
The study subjects included a representative of the children’s mothers under five years in attending to MCH attendance rate (N=2600) at Bahtim health center 1 & 2, in the east of Shubra Al-Khaimah; were center during the period 2020. Based on the sample size equation, 200 mothers participated in the study. The sample size was calculated by adjusting the power of the test to 80% and the confidence interval to 95 % with margin of error accepted adjusted to 5% and known total population of 200 mothers. The sample was (200) to avoid withdrawal and achieve a response rate.
Tools for data collection:
One tool used in this study:
Tool I: Structured interviewing questionnaire sheet: It was designed by the investigator based on reviewing related literature. It was divided into four parts:
Part 1: Demographic data: Demographic characteristics of children under five years (child’s age, sex, birth, nursery attendance) and their mothers (mothers’ age, educational level, marital status, occupation, monthly income, and number of children residence.
Part 2: Home environment of, the studied children (water supply, toilet, and municipal sewage disposal. It was adapted from (Birkhäuser Advances in Infectious Diseases (2020) & modified by the investigator. includes the environment of the studied children which consists of 10 items in form of closed-ended questions (Safe drinking water, type of water, room’s number, ventilation of the house, kitchen at home, bathroom at home type of sanitation type of floor, birds, and animal in the house, ways of waste disposal.
Scoring system: Each item was scored as (0) = No or (1) = Yes
• ≤ 75 % Good environment condition level (8–10 degrees).
• 60%- < 75 % Average environment condition level (6 -7 degrees).
• < 60% Poor environment condition level (0 - 5 degrees).
Part 3: Past medical health history of children under five years old: It was modified (Gizaw et al., 2020) from the mother’s information health habits such as, diet and exercise include ( previous disease include (2 items), type of disease include (2 items): infectious disease, chronic disease, type of infection include (7 items): Entamoeba Hostolytica, Giardiasis, Ascaris, schistosomiasis worms, Hook worms, Hymenolepiasis, Don’t know, child, take necessary treatment include (2 items), result treatment include (7 items): Healing, Complications, Relapse, repeating infections, Family members been infected with the infected child include (2 items) and health habits include (4 items) closed-ended questions(child eats three meals per day, child’s eat breakfast at home, child practice a certain type of sport regularly includes a type of sports (running, football, powerful games, swimming).
Scoring system: Each item scored as (0) = No or (1) = Yes
Part 4: Mother’s knowledge regarding avoiding parasitic infection among children under five-year-old: It was adapted from (Masaku J, et al) 2020) & Modified by the investigator it includes (80 items): meaning (4items), Causes (8items), symptoms (11 items), methods of transmission (3items), ways to avoid the parasitic infection (10 items), general preventive measures& precautions (8 items), complications (7items), The precautions used to take care of eating and drinking for the child (4 items) , mother have a role in preventing and avoiding infection (4) Parasitic infections with intestinal worms that affect preschool-age children (6 items), Precautions to be followed while treating a child with parasitic infection (7 items), Precautions followed while treating a child with parasitic infection for medications (4 items), Precautions followed while treating for family members surrounding a child with parasitic Infection(4 items).
Scoring system of Knowledge:
Each correct answer was given one degree while the incorrect answer was given zero. The total score of knowledge was 80 degrees, it was considered that:
• ≤ 50 % was the satisfactory level of knowledge (40 – 80 degrees).
• < 50 % was an unsatisfactory level of knowledge (0 - 39 degrees).
Part 5: Mother’s reported practices regarding avoiding parasitic infection questionnaire:
It was adapted from Kassaw et al (2020) & Modified by the investigator, it contains (4 items) closed-ended questions (mothers’ personal hygiene, food and drink hygiene, diet practice, home environment, practice child includes (3 items) and personal hygiene, food and drink hygiene and child’s play environment. The first part was the mothers’ part which includes assessment of personal hygiene (7 degrees), Food and drink hygiene (6 degrees), Diet (11 steps), The cleanliness of the home and the environment surrounding the child (5 degrees), the second part was the children’s part which includes: Personal hygiene (6 degrees), Food and drink hygiene (3 degrees) and Play environment for your child (5 degrees).
Scoring system of practice:
Each correct step was given one degree, while the step which was not done was given zero, the total score was 43 degrees, distributed as the following:
The total score of mother’s reported practices was 43 degrees, it was considered that:
• ≤50 % was satisfactory level of the mother’s reported practices (22- 43 degrees).
• < 50 % was unsatisfactory level of the mother’s reported practices (0 - 21 degrees).
The results of the study revealed that:
Less than half (48.0%) of children aged from2 to<4 years with the mean of children age 3.08±1.11, also more than half (53.0%) of them were males, and less than half (47.0 %) of them were females, while the family members ranged between 4-5 members (58.5%) of them. Regarding the ranking of children, one-third (30.5%) of them was the second child and about three quarters (74.0%) of the children go to nursery. More than two-fifths (41.5%) 0f mothers aged between 25-29 years old with mean age was 29.95±4.398. Regarding the educational level, one quarter (25.5%) of the mothers had Intermediate education, more than two-thirds 65.0% of them were house wife, while most (94.5%) & (82.0%) of them were married and their family income was enough respectively, also two-thirds (60.0%) of them had extended family, and most (96.0%) of them lived in suburban areas.
Most (96.5%) of the studied sample had safe water supply while type of water and running water, while less than half (45.5%) of them were living in house with 3 rooms and more. According to the ventilation, most (81.0%, 84.0%, 83.5% & 98.0%) of these houses were good, with separated kitchen and separated bathroom, type of sanitation is government sewage network and these houses with tiles floor respectively. Also, more than two-thirds (65.0 %) & (68.0 %)of them had birds or animals in the house and their disposable waste collected by clean worker respectively.
More than half (52.0%) of the studied children had previous disease and most (89.4%) of them had infectious disease, more than half (52.0%) of the present parasitic infection, as regard to the type of infection, more than one-third (39.4%) of the studied children were suffering from Entamoeba hostolytica. Additionally, most (94.2%) of them were taking their necessary treatment, while less than half (44.2%) of them had healed with the treatment and more than three quarters (77.9%) of them had family members who been infected with the infection.
The most (81.0% & 83.0%) of the studied children had eaten three meals a day and their meals contain all nutrients respectively. Also, more than two-thirds (64.0% & 64.5%) of them eats breakfast at home and practice a certain type of sport regularly respectively and more than half (54.9%) of them played football.
More than two-fifths (42.0%) of the sample report microorganisms that infect the digestive system about definition of parasitic infection, more than one quarter (30.5%) of mothers mentioned the parasitic infection happened because they didn’t wash hands before and after eating answer. Furthermore, more the half (57.0%) of them had severe abdominal pain as a parasitic symptom.
Most (94.0% &83.5%) of the studied mothers had unsatisfactory level of knowledge regarding the complications of parasitic infection and symptoms of a child with parasitic respectively, while most (97.0%) of them had satisfactory level of knowledge regarding their role in preventing and avoiding the parasitic infection and more than two-thirds (68.5 %) of them have satisfactory level of knowledge regarding Precautions to be followed during treatment for family members surrounding a child.
More than two-thirds (61.0%) of the studied mothers had unsatisfactory knowledge level, while more than one third 39.0% of them had satisfactory knowledge level regarding parasitic infection.
The main source of knowledge regarding parasitic infection among the studied mothers was from the doctors (85.0%), while the lowest source of knowledge was from the nurses (2.5%).
Most (80.0%) of studied mothers don’t bathe their children three and more/week, more than half (54.5%) of them wash the underwear of the infected child separately from the rest of the family. While about all (99.0% &98.5%) of the studied mothers wash their hand with running water and soap before and after entering the bathroom and wash hands with soap and water before and after preparing food respectively.
Most (82.5%) of the studied mothers had adequate total mother’s reported practices practice, while less than one-fifth (17.5%) of them had inadequate total mother’s reported practices practice of avoiding parasitic infection.
More than half 57.0% of studied children had adequate practices level and more than two fifths 43.0% of them had inadequate mother’s reported practices practices regarding avoiding parasitic infection.
There is a highly statistically significant positive relation between the total studied mothers’ knowledge and total practice of avoiding parasitic infection p=<.001.
In conclusion, there was a highly statistically significant positive relation between the total studied mothers’ knowledge and total practice of avoiding parasitic infection. More than two-thirds of the studied mothers had unsatisfactory knowledge level, while more than one third of them had satisfactory knowledge level regarding parasitic infection. More than half of studied children had adequate practices level regarding avoiding parasitic infection and more than two fifths of them had inadequate mother’s reported practices practices regarding avoiding parasitic infection.
In the light of the study finding, it is recommended that:
• Provide health education about food, personal, and environmental hygiene for both children and their mothers.
• Improve sanitation of environment to reduce contamination of water and soil.
• Counseling mothers of children with parasitic worms about parasitic worm’s management and healthy home precautions for their children.
• Disseminating health education brochure to increase mothers’ awareness about parasitic worms and healthy home precautions at MCH and outpatient clinics.
Further studies:
• Necessary to currying out the study on large sample and in other setting for generalization