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European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
84
Assessment of the knowledge, attitude & practice of worm
infestation among the school going children in Hapania, Agartala,
West Tripu
1.Dr Kaushik Tripura , Associate Professor, Department of Community
Medicine, TMC & Dr
BRAM Teaching hospital
2. Dr Joy Philip Reang, Assistant Professor, Department of Pathology , TMC
& Dr BRAM
Teaching hospital
3. Dr Tamal Chakraborty, Assistant Professor, Department of Community
Medicine, TMC & Dr
BRAM Teaching hospital
4. Dr Arindam Datta, Professor, Department of General Medicine, TMC &
Dr BRAM Teaching
hospital
5. Dr Argha Majumder, Internship trainee, TMC & Dr BRAM Teaching
hospital
Corresponding author- Dr Joy Philip Reang, Assistant Professor, Department of
Pathology , TMC & Dr BRAM Teaching hospital, 799014, Hapania, West Tripura.
Authors email address- tripurakaushik@gmail.com joyphilipreang@gmail.com
Tamalchakraborty598@gmail.com drarindamdatta@gmail.com
argha.majumder619@gmail.com
Introduction
Worm infestation is one of the major causes of childhood malnutrition, anemia, stunted
physical and mental growth, psycho-social problems and this along with repeated
gastrointestinal and upper respiratory tract infection contributes to high morbidity in children
and remains a major cause of high infant and child mortality in our country. The infection is
usually transmitted via ingestion of eggs from contaminated foodstuffs, an infection may
occasionally occur via inhalation of eggs and swallowing of infected secretions.[1]
The overall prevalence of helminth infection in school-age children in India is about
50% in Urban and 68% in the rural area. Soil-transmitted helminths commonly known as
worms form part of the Neglected tropical diseases which are associated with substantial
acute and chronic morbidity, particularly among children [2].
Worm infestation as a public health problem needs immediate attention from
policymakers in India. Most helminths infections, if left untreated, result in multi-year,
chronic inflammatory disorders that cause both concurrent and delayed-onset pathology to
the afflicted human host, it is now appreciated that chronic helminth infections are also linked
to more insidious persistent health [3].
Infection occurs at all ages but is most common in children of preschool or early
school age. Both sexes are equally affected. Though more common in children, intestinal
obstruction due to AscariasisLumbricoides in adults, especially young adults are also well
known.[4]
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
85
The World Health Organization (WHO) recommends that baseline data collection has
to be collected before the control strategy is selected in areas where schistosomiasis and soil-
transmitted helminthiasis (STHs) control programs are to be initiated, as this would allow
monitoring and evaluation of control strategies [5].
There were very few studies conducted on worm infestation in Tripura, therefore, this study
conducted to assess the knowledge, attitude and practice among school going children in
Hapania, Tripura.
Materials & Method
A cross-sectional study was conducted at Dukli higher secondary School, Hapania, Agartala,
West Tripura, which is under peri-urban field practice area for the Department of Community
Medicine, Tripura Medical College &Dr. BRAM Teaching Hospital, for a period of two
months August to September 2018. The school is situated just nearby the urban health
training center under Department of Community Medicine of Tripura Medical College &Dr.
BRAM Teaching Hospital. It is a Govt. School consists of Morning section (1st standard to
5th standard) and afternoon section (6th standard to 12th standard). This study was conducted
under ICMR STS project and targeted only the afternoon students for feasibility. Ethical
permission was obtained from the Institutional ethical committee of Tripura Medical College
and Dr BRAM Teaching Hospital.
Sample size calculation:
The total number of the students study at Dukli higher secondary School Hapania from 6th
standard to 12th standard was 542. The sample size was calculated to 91 using the formula n=
(z1−𝛼/2)2*𝑝*𝑞/𝑒2, where (z1−𝛼/2) =1.96, p =50%, q = (1-p), e (absolute error) =10%. It’s
rounded off to 100.
Sampling procedure:
Two-stage sampling was done for the proper representation of students from each standard.
The students were stratified according to their standard. From 6th to 11th standard 14 students
were selected from each class by simple random sampling considering attendance register as
a sampling frame and 16 students were selected from the 12th standard by following the same
procedure. In case any selected student were happened to absent or refused to include in the
study, in such cases the next roll number were included in the study.
Study tool:
A structured and pre-tested questionnaire was used for data collection.The questionnaire has
2 parts, Part-1 regarding socio-demographic profile like age, gender, parents occupation,
parents education.
Part 2 has three sub parts; related to Knowledge, attitude and practices. The questions related
to knowledge was have they heard about worms, type of worms, symptoms related to worms
infestation. The questions related to attitude were measured by 3 scale Likert. The last part of
the questionnaire was related to practices like regular use of foot wares, use of sanitary
latrines etc.
Data collection procedure:
After getting the ethical permission from the institutional ethical committee the Principal of
the school was approached for permission one week before data collection and with
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
86
consultation with the principle a telephonic permission was sought from the guardians of the
students. Data were collected during class hour. The students were fully explained about the
study. The questionnaire distributed to the participants according to the preference of
language.
Data analysis:
Data collected from the above method was entered in Microsoft Excel spreadsheet and was
expressed in terms of proportions in appropriate tables.
Results
Table no 1: Distribution of the study participants is according to Socio-demographic
profile (n = 100)
Variables
Frequency
Percentage
Gender Female
Male
37
63
37%
63%
Type of family
Nuclear
Joint
Three generation
No Idea
77
18
4
1
77%
18%
4%
1%
Religion Hindu
Muslim
Others
96
3
1
96%
3%
1%
Fathers education
Graduate & above
Higher secondary
Secondary
Primary
Illiterate
2
9
67
12
10
2%
9%
67%
12%
10%
Mothers education
Graduate & above
Higher secondary
Secondary
Primary
Illiterate
-
9
14
73
4
-
9%
14%
73%
4%
Fathers occupation
Govt. job
Private
Business
farmer
No job
52
12
18
12
-
52%
12%
18%
12%
-
Mother occupation
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
87
House wife
Govt. job
Private
Business
Farmer
No job
84
8
8
-
-
-
84%
8%
8%
-
-
-
Socio-demographic:
In the present study out of 100 participants 63% were male and 37% were female. Most the
participants were (77%) were belongs to nuclear family followed by 18% from joint
family,4% from three generation family and 1% of the participants said they have no idea
about their family type. 96% of the participants were from Hindu community. 67% of the
participants said their father studied up to secondary followed by 12% said that their father
studied up to primary standard. 73% of the participants said their mother studied up to
primary followed by 14% said that their father studied up to secondary standard. 52% of the
participants said their fathers engaged with Govt Job. 84% of the participants said their
mothers were house wife.
Table no 2: History of passing worm in stool in last one month (n = 100)
History of passing worm in
stool in last one month
Frequency
Percentage
Yes
No
59
41
59%
41%
Table no 2. Show that the 59% of the study participants have given history of passing worm
in stool in last one month.
Table no 3: Distribution of study participants according to knowledge, attitude &
practice of the study participants
Questions related to Knowledge
Frequency (%)
Percentage
Have you heard about worms? (n =
100) Yes
No
What are the types? (n = 60)
Roundworm
Tapeworm
Threadworm
Multiple responses
No Idea
Clinical manifestation of worm
60
40
10
12
23
5
10
60%
40%
16.7%
20%
38.3%
8.3%
16.7%
-
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
88
infestation (n = 60)
Pain abdomen
Pain abdomen & itching
Vomiting
Worms in stool
Perini itching
Multiple responses
No idea
Sources of the worms (n = 60)
Animal Feces
Human Feces
Meat
Soil
Multiple responses
No idea
10
15
2
11
14
6
2
3
35
4
5
1
12
16.7%
25%
3.3%
18.3%
23.3%
10%
3.3%
5%
58.3%
6.7%
8.3%
1.7%
20%
Question related to attitude (n=100)
Yes
No
idea
No
Yes
No
idea
No
Hand wash should be done before
every meal
Everyone should use footwear
Vegetable & fruits should be washed
93
91
89
4
6
9
3
3
2
93%
91%
89%
4%
6%
9%
3%
3%
2%
Question related to practices (n=100)
Frequency
Percentage
Type of latrine use
Sanitary
Insanitary
Open defecation
No idea
Regular use of footwear
Yes
No
Waste disposal
Municipal collection
Nearby place
no idea
76
11
4
9
98
2
50
27
23
76%
11%
4%
9%
98%
2%
50%
27%
23%
Knowledge of study participants:
Table no 3 shows that in the present study 60% of study participants heard about worms.
Among them, 38.3% were heard about threadworms followed by tapeworms (20%). Majority
of the participants said pain abdomen and itching (25%) as a clinical manifestation of worm
infestation followed by Perini itching (23.3%) followed by worms in the stool (18.3%). Most
of them knew human feces (58.3%) as sources of worms.
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
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The attitude of the study participants:
Table no 3 shows that in the present study 93% of participants had a positive attitude of Hand
wash before every meal. Around 91% of participants had a positive attitude about wearing
footwear. 89% had a positive attitude about Vegetable & fruits washing before consuming.
Practices of the study participants:
Majority of study participants (76%) had the sanitary latrine in their house followed by
insanitary latrine (11%). Most of them use footwear's (98%). Most of the waste disposal is
done by municipality collection (50%)
Discussion
93% of the study participants in this present study have a positive attitude about hand
washing before every meal. Studies done Kancheepuram District, Chennai7 and Ghana8 had
shown 100% of the study participants had a positive attitude towards hand washing before the
meal. A study was done in Ethiopia9 shown lower (54%) positive attitude compare to the
present study. In the present study, 76% of study participants use sanitary latrine which lower
than Bangladesh (98.4%)10. 4% of the study participants of our study go for open defecation
which much lower than the study done in Kolkata (40.9%) 11.
Conclusion
Most of the school going children are aware of worm infestation & their deleterious effects
on health. A good number of study participants have a positive attitude towards hand hygiene
which can be helpful in the prevention of worm infestation. Sanitary latrines are also used by
the majority of the participants which is a good practice. Frequent health awareness sessions
will be helpful to bring the uncovered population under the umbrella of practicing health
hygiene.
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 09, Issue 07, 2022
90
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