الفهرس 
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Abstract
Trachoma is an infectious disease responsible for about 3% of blindness globally. About 8 million people worldwide are irreversibly affected by blindness from trachoma. Most cases of trachoma occur in poor areas of Africa, where 85% of the population suffers from the disease. In areas where the disease is common, infection rates among children under five can be as high as 60% or more. It is caused by recurrent infection with bacteria known as Chlamydia trachomatis, which spreads through contact with an infected person and through hands, clothing, or bedding that have been in contact with an infected person. Initially, symptoms of trachoma are mild itching and irritation of the eyes and eyelids. Then you may notice swollen eyelids and pus discharge from the eyes. Early treatment can help prevent complications of trachoma (Stewart et al.,2019)
Research hypotheses :
H 0: The application of health educational program will not improve mothers’ knowledge and practices regarding care of children with trachoma.
H1: The application of health educational program will improve mothers’ knowledge and practices regarding care of children with trachoma.
Study Design:
A quasi-experimental design (pretest-posttest) was utilized for the purpose of the current study.
Research setting
The study was conducted at outpatient ophthalmological clinics at Minia University Hospital and Ophthalmology hospital at Minia City.
Sample of the study
A Purposive sample of 60 mothers meeting the inclusion criteria was selected according to the flow rate reported from (The registration office of Minia university hospital and ophthalmology hospital, 2018).
Data Collection Tools:
Two tools were included in this study as follow:
•First tool Socio-demographic characteristics Questionnaire: It was designed by the investigator which included three parts :
Part 1: Socio-demographic characteristics of mothers: it consists of twenty-two items as follow:
•Personal data: included (6 items) age, marital status, residences, educational level, occupation, and monthly income,
•Family data: included (6 items) No of family members, No. of children in the family, a ranking of the child, and type of family, the definition of trachoma, and their source of information about trachoma
•Environmental data included (10 items) type of house, paved house, room number, crowding index, source of water, presence of wash basin, face wash basin no, presence of sewage, presence of bathroom, bathrooms no.
Part two: Medical history of child and family, which include :
Child’s Previous disease history
It consists of nine (9) questions which were used to assess the previous disease history of the child, such as (suffering from chronic illness, type of chronic illness, presence of eye inflammation, previous presence of eyelid granules, uses of antibiotics, the previous occurrence of trachoma, presence of any family members who were suffering from trachoma, previous hospitalization of the child and had received enough treatment.
Child’s Present disease history:
It consists of five (5) questions used to assess the child’s present ophthalmological disease history, such as duration of illness, diagnosis of trachoma, .current inflammation, suffering from eyelid granules, and current hospitalization.
Part three: Mothers’ knowledge regarding trachoma Questionnaire:
This tool was developed to assess the mothers’ knowledge regarding trachoma, and it included ten (10) Multichoice questions(MCQ) questions regarding (trachoma is infectious, causative organism, mode of transmission, manifestations, action toward symptoms, diagnosis, prevention, complication, the influence of recurrence, and therapeutic management of trachoma.
Second tool: Mothers’ self-reported practices regarding trachoma (10 practices):
The mothers’ self-reported practices regarding the trachoma structured interviewing sheet were developed by the investigator after revising relevant literature and included (10 practices); it was used to assess mothers’ practices regarding trachoma prevention as following preventive measures: (daily hand washing, daily face care, hand washing after entering the bathroom, Hand washing before eyewash, individual towel for every member in the family, Washing face towel of the child, wash the child face if it is dirty or presence of nose or eye secretions, consultation a doctor if there is inflammation, redness, and secretions in child’s eye, daily washing of face basin, and eye care daily house cleaning of flies .
Data Collection Procedure:
•The program lasted for six months: the study started at the beginning of December 2019 and was completed by June 2020. the program was implemented to the mothers in sessions using various teaching methods. The total session was four sessions. These sessions include three sessions for knowledge and one session for practice. The total number of mothers was divided into small groups. Each group had (10 mothers) attend the session. The program took about (14) weeks .post-test was immediately and one month after completing the program.
The present study revealed the following main results:
•More than one third (36.7%) of mothers aged between 30 - < 39 years with mean age 31.0 ± 11.9 years, most (78.4%) of them were married, more than half (53.3%) of them lives in the rural area and more than one quarter (40%) of them were illiterate, more than half (53.3%) of them were housewives mothers and less than half (40%) of them their monthly income ranged between 1000- 2000 L.E.
•one-quarter of the studied children had a chronic disease, near to two-third of them had pain, inflammation, burning in their eye, more than half of them usually used antibiotics and eye drops, less than half of them previously had trachoma, and more than one-quarter of them previously admitted to hospital
•More than half (61. 7%) of them didn’t have any previous knowledge about trachoma, regard to their source of information, more than third of them (34.8% ) listed more than one method, and no one had attended any previous educational program with highly statistically significant differences.
•One quarter (25%) of studied children had a chronic illness, More than half (65% )of them had suffered from pain, inflammation, and burning in their eye, More than half (56.7% )of them usually used antibiotics, and eye drops, less than half (41.7 %) of children had the previous occurrence of trachoma, less than half (48.3% )of them their family member had trachoma, less than half( 46.7%), of their children, had trachoma and (53.6% )hospitalized due to trachoma.
•The minority of the studied mothers (5%) had a high level of knowledge pre-educational program compared to most of them (91.7%) immediately after the end of an educational program and slightly decreased to the majority of them (80.0%) after one month of an educational program with highly statistically significant differences.
•More than one-third of (41.7%)of the studied mothers had high self-reported practices level pre-educational program increased to most of them (91.7%) immediately after the end of an educational program and slightly decreased to the majority of them (88.3% ) after one month of an educational program with statistically significant differences which p-value was .0001,0.05 respectively.
• Scores of mothers’ knowledge and self-reported practices increased immediately after the educational program than pre-educational program then slightly decreased post one month of an educational program than immediate at the end of the educational program with highly statistically significant differences with P-value < .0001 respectively.
•There was a statistically significant relationship between the total knowledge scores of the studied mothers and their residence and educational level pre-educational program and occupation post one month of an educational program.
•There was a statistically significant relationship between the total self-reported practices scores of the studied mothers and their education level and occupation pre the educational program, and with age, residence, academic level, and monthly income of them post one month of an educational program.
•There was a strong positive association between mother knowledge and their practices regarding the trachoma pre-educational program.
•Additionally, there was positive effects of health education program on mothers knowledge and self-reported practices regarding trachoma after health educational program compared to pre-test scores
Conclusion
Teaching program is effective in improving the knowledge and practices of mothers. It found that level of knowledge and practices posttest was significantly higher after teaching program as compared to their values at pretest.
Recommendations:
•Providing training for mothers with a child with trachoma at Minia city and continuous supervision of maternal and neonatal care by the ministry of health and population.
• Health education programs should be planned and implemented through the school health curriculum to control communicable eye diseases.
•Health education focused on the SAFE strategy should be provided at the community level, during mass drug administration, and at health facilities, while people are waiting to receive treatment to increase good knowledge and changing cultural perceptions that contribute to behavioral changing and increase good practices towards trachoma prevention and control
•Design and disseminate related booklets and brochures to raise mothers and public knowledge regarding the child with trachoma.
•Activate the school nurse’s role through health education about hygienic care, assessment, early detection, and management of trachoma disease.