|Year : 2007 | Volume
| Issue : 3 | Page : 192-194
Health awareness of high school students
Sonu Goel, Amarjeet Singh
Department of Community Medicine, PGIMER, Chandigarh, India
|Date of Submission||28-Jul-2005|
|Date of Acceptance||16-Aug-2007|
Department of Community Medicine, PGIMER, Chandigarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Goel S, Singh A. Health awareness of high school students. Indian J Community Med 2007;32:192-4
| Introduction|| |
Students knowledge about management of commonly occurring injuries and illnesses, particularly in rural areas has been documented to be fragmented, disintegrated and non-sequential.  Various wrong practices and myths associated with illnesses and injuries have also been reported among students.  Students are usually found to be enthusiastic for any training program organized for them in first aid and basic life support system.  In view of this, the present study was conducted to ascertain the awareness of high school students about management of common illnesses and injuries; estimate the prevalent wrong practices and beliefs about illness and injuries; and to assess their knowledge about basic reproductive and child health.
| Materials and Methods|| |
The study was conducted during November and December 2004 in a purposefully selected Boys Senior Secondary School of field practice area of Department of Community Medicine, rural health training center, Naraingarh, Haryana. All the science section students of 9 th and 10 th class were included in the study. The principal investigator contacted and briefed the principal, teachers and students of both the classes about the nature and purpose of the study. Their consent was also taken.
A self-administered structured questionnaire was designed as per the syllabus of high school and was then translated into local language to assess the knowledge of students about various illnesses, their prevention and management, viz., malaria, tuberculosis, leprosy, pneumonia, diarrhea and life style diseases like diabetes and hypertension. It also sought information on immunization, reproductive and child health, registration of birth and death, management of injuries, dog bite, snakebite, burns, high fever, worm infestation, epilepsy, dental caries, drowning and poisoning, etc. For each question, a mixed set of 4-6 correct options was provided. The number of possible correct options for each question varied from 1-5. The students were asked to tick (Ö) all possible correct options. A scoring system was devised to quantify the knowledge and practices of the students. A score of 'one' was given for each correct option marked by the students. In case wrong options were chosen, 'one- fourth' mark was deducted. The level of knowledge of the students was categorized as good (60% and above), average (33-60%) and poor (less than 33%) on the basis of score obtained by them for different questions.
In addition, group scoring was also done. For this, "total possible score" for a particular question was obtained by multiplying total possible correct options of that question by the total number of students (i.e., 76). "Group score" was obtained by adding all the correctly marked options by the students for that particular question. No negative marking for group scoring was done.
| Results|| |
The questionnaire was administered to 76 students of science section of 9 th and 10 th class. Eighty percent of students scored more than 50% marks (range 34.5%-82.8%).
There were 68.5% correct responses (263 out of 380) regarding malaria, 41.5% had some knowledge about signs and duration of treatment of leprosy, 18.8% and 46.4% knew about the correct treatment of leprosy and tuberculosis respectively, 33.2% could correctly enumerate food- and water-borne diseases, 74.5% knew about their methods of control [Table - 1]. Knowledge about hypertension and diabetes was present in 65.3% and 58.3% of the students respectively.
Only 23.7% students knew about the correct number of antenatal checkups recommended to a pregnant woman. However, majority knew about medications advised during pregnancy (85.5%) and hygiene during delivery (81.9%). Only 34.2% students could correctly tell about the right time of birth and death registration. There was sufficient knowledge about newborn care (85.5%), methods of oral rehydration solution (ORS) preparation (78.9%) and etiology of dental caries (85.5%), but knowledge about worm infestation (52.4%), immunization (54.6%), pneumonia (40%) was lacking in majority of the students.
Majority had adequate knowledge about management of injuries (80.9%), skin infections (93.4%) and drowning (78.9%). Only 42.8% and 27% students identified appropriate management of snakebite and dog bite respectively [Table - 2].
Many wrong practices and beliefs were prevalent among students regarding various aspects of injuries and illnesses. Almost 90% students felt that penicillin was the treatment of choice for malaria; that tetanus injection is given during infancy; and that tourniquet should be tightened as firmly as one could in a case of snakebite. Majority (78.9%) of students felt that oral rehydration solution could be prepared by mixing one teaspoonful of ORS powder in one glass of water; that spice/ chilly should be applied for dog bite management (68.4%) and that shoe sniffing should be used for epileptic attack (65.8%). Around half of the students felt that DPT injection prevented tuberculosis and that mustard oil should be applied to treat head lice.
| Discussion|| |
The concept of teaching basic disease management skills to the students is not new. In Andhra Pradesh, students (8-14 years old) were trained under Chinnari doctors, or little doctors, scheme, to handle minor health-related emergencies in their villages. They were given first aid kits and trained to handle emergencies like burns, accidents and fevers and to even prescribe basic medicines. Provision of knowledge about correct management of injuries and illnesses to students is a sound and logical investment. First, it will improve their health knowledge, which in turn will help them to lead a healthy life. Second, such empowered students could be effectively used as a change agent in the family and community.
In our study, majority of students possessed reasonably adequate knowledge about mosquito control and treatment of malaria. However, many named penicillin as the drug of choice instead of chloroquine. Other authors have also reported overall malaria knowledge score to be 77% among students; but simultaneously, existence of inappropriate knowledge was also documented - viz., prevention of malaria by taking multivitamins and chloroquine, causing abortions.  Cultural and traditional beliefs were cited as the most common reasons for major misconceptions about malaria.  It has been observed in our study that knowledge about mode of transmission and signs of tuberculosis was adequate among majority of the students. However, only few students knew about its correct treatment. Tanimowo et al. also reported that majority of Zambian senior secondary school students knew about spread and transmission (through air droplets and overcrowding) of tuberculosis. The study also reported that the knowledge of major symptoms (i.e., persistent fever, cough and loss of weight) and curability of tuberculosis was also present in over three-fourths of the students. Around half of the students wrongly mentioned that diarrhea and constipation are the major signs of tuberculosis. The study also reported of the belief that tuberculosis could be cured by making sacrifices.  It seems that the knowledge about malaria and tuberculosis was reasonably adequate among the students as they routinely encountered these illnesses in their day-to-day lives. On the other hand, leprosy is uncommon in this part of India; therefore, students don't possess much knowledge about its symptoms/ signs and treatment. Few respondents could enumerate life style diseases or the diseases associated with obesity. Majority knew about management of diabetes, which is in conformity with other studies.
Level of knowledge regarding pregnancy and vital registration system was poor among the respondents. This may be due to the fact that children were not concerned about these topics, which are considered a topic fit for adults and married people. Awareness of newborn care was adequate among students, but only half of them knew about causes of infant deaths. Knowledge about signs of pneumonia and diarrhea was present, but very few were aware of home management of childhood pneumonia. Majority of the students could not tell the correct method of preparation of homemade oral rehydration solution (ORS). Nath et al.  in a study in Bangladesh reported that three-fourths of students had correct knowledge of management of diarrhea, which was slightly higher than in our study. Though majority of students could enumerate various vaccines administered at birth, only few knew about diseases prevented by them. Various studies have reported that only few students knew about correct immunization schedule and about the benefits of immunization. Most of our respondents knew about correct age of marriage, but only one-third knew about registration of vital events.
Many wrong practices were prevalent among the respondents - for example, spice/ chilly application for dog bite, etc. Other studies  have also reported that various items like kerosene oil, mobile oil, mustard oil and urine were used for injury management.
Our respondents seemed to possess elementary knowledge regarding various communicable and noncommunicable diseases. However, when disease-wise knowledge was assessed, they lacked knowledge about leprosy (signs and treatment) and tuberculosis (treatment). Very few could correctly enlist all the food- and water-borne diseases, life style diseases and diseases associated with obesity. Regarding newborn and childhood care, their knowledge about causes of infant death, management of pneumonia, immunization and worm infestation was not adequate. Their awareness regarding antenatal care was grossly deficient, and more than half of the students scored poor individual score. Very few knew about the time of birth and death registration. Thus, there is a definite need of strengthening the knowledge of the students regarding these issues. "Good score" items need to be strengthened while "poor score" items need to be corrected.
| References|| |
|1.||School Health Programme. Report of National Workshop. CHEB, DGHS: New Delhi; Nov. 26- Dec 1, 1978. |
|2.|| Kyawt-Kyawt-Swe, Pearson A. Knowledge, attitudes and practices with regard to malaria control in an endemic rural area of Myanmar. Southeast Asian J Trop Med Public Health 2004;35:53-62. |
|3.||Tanimowo MO. Knowledge, attitudes and practices regarding tuberculosis among senior secondary school students. East Afr Med J 1999;76:47-50. [PUBMED] |
|4.||Nath SR, Mohsin M, Chowdhury AM. Health knowledge of children in Bangladesh: An exploratory study. Public Health 1997;111:311-5. [PUBMED] |
|5.||Singh AJ, Kaur A. Minor injuries in ninth class school children of Chandigarh and rural Haryana. Indian Pediatr 1996;33:25-30 [PUBMED] |
[Table - 1], [Table - 2]