الفهرس 
Introduction & Aim of the WorkOnly 14 pages are availabe for public view
Abstract
Viral Hepatitis is a major public health concern it is a source of significant morbidity and mortality around the world and exerts a substantial cost on society. Viral Hepatitis is the most common cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma. Five viruses types causing hepatitis have been identified to date. Distinct they are hepatitis types A,B,C,D and E (Rayan and Ray .2004).
Egypt is one of the highest prevalence rate of the virus C in the world. Eight to ten million people are carrying hepatitis C but 5 million of those are actively infected. The annual infection rate is more than 70,000-140,000 new cases each year, at least 35,000 of them would have chronic hepatitis C. About one out ten persons has the virus (Saleh, 2008).
The high incidence rate has resulted from the use of non-disposable syringes. A history of anti schistosomal injection treatment before 1986. Schistosomiasis used to be a common parasitic disease in Egypt acquired through swimming in stagnant water. Thus, farmers and rural populations were at greatest risk, and this is supported by the higher prevalence rate of HCV in the Nile Delta and rural areas. Schistosomiasis can lead to urinary tract or liver damage over many years (Rayan and Ray, 2004).
Aim of the study
The aim of the study is to assess family preventive measures taken toward the infected member with hepatitis C virus in rural community through:1- Assessing patients and family knowledge about hepatitis C virus.
2- Identifying family practices of preventive measures against HCV infection.
3- Assessing the sanitary condition of home environment.
Research Questions:
Do family and patient with HCV have knowledge about hepatitis C virus?
What measures are the family following to be protected from infected patient?
What is the relationship between patient and family knowledge about the disease and their socio demographic characteristics?
Is there a relationship between patient and family members practices and their socio-demographic characteristics.
Is there a relationship between home crowding index and family practices of preventive measures?
Research design:
Descriptive analytic study was utilized Technical Design:
Setting:-
The study was conducted in the outpatient clinic of Medical Department for liver diseases and in Theodor Bilharz Research Institute and at patients’ homes in Elmanashie, Portoass, Ossim and Eloratein villages Guiza governorate.
Sampling:
The sample of the study was purposive. It included 60 HCV patients and their family members (138) during two scheduled days (Sunday & Tuesday) weekly and for a period of fourteen months from the beginning of February, 2010 till the end of April 2011. The investigator was visiting the outpatient clinic during the first six months to select patients until the defined number was reached. As regards home visits, they were conducted every Friday in order to reach most of the family members taking into consideration the following criteria.
1) Patients ages are between 15-60 years while their family members not less than 18 years and who can read and write .
2) Patients diagnosed with hepatitis C virus since at least six months
Tools for data collection:
First tool: An interview questionnaire was developed by the investigator and experts opinions to assess three parts: 1 -The Socio-demographic characteristics of the patients and their family members as regards, age, gender, education, occupation, numbers of members and monthly income per capita (Appendix 1).
2- The knowledge of patients and their family members about hepatitis C virus as regards definition, incubation period, infectivity period, mode of transmission, clinical manifestations and protective measures. For family members the questionnaires were self-administered. (Appendix 2).
3- Past and present history as regards health problems, habits, behavior and practices in relation to tattooing, shaving, sharing equipment, and circumcision (Appendix 3,4).
Scoring system:
Knowledge of patients and their family members. included 17 items: Score (2) for correct answer, score (1) for incomplete answer and sore (zero) for false answer. The total scores were 3, from 1 to 10 scores was considered “ Poor “, from 10 to 20 was considered “Average” and more than 20 was considered “Good” level of knowledge (Appendix 2)
Second tool: An observation checklist for assessing the house sanitation condition and patients practices against hepatitis C virus as crowding index, housing sharing, type of building and floor, water supply and storage, sewage disposal, presence of toilet, garbage refuse, refrigerator, washing machine ventilation (11 items) handling and disinfecting body secretions (9 items for patient and 16 items for family members). This tool was adopted from Edith and Patricia, (2005) (Appendix 5, 6)
For preventive practices of patients and their family members .The total items were 9 for patients and 16 for family members. Score (2) for always done, score (1) for sometimes done and (zero) for not done . So the total score was 18 for patients and 32 for family members. Categorization of levels of practices was as follows: scores from 1 to 4 were considered Poor, from 5 to 6 were considered Average and more than 6 scores were considered Good. Crowding index was measured as number of family members over number of rooms. As regards ventilation it was measured as: room space in square meters × 1/16. Less than one meter was considered bad ventilation.
II-Operational Design:
Preparatory phase:
A review was done for the current and past available literature covering the various aspects of the problem using textbooks, articles, magazines and internet search. This was necessary for us to be acquainted with, and oriented about aspects of the research problem, as well as to assist in the development of data collection tools.
*Pilot study:
A pilot study was carried out on six HCV patients and their family members, in order to test content validity, practicability, clarity and consistency of the tools. Based on obtained results, items were then omitted or added as needed. The final forms of the tools were then obtained and the time needed for completing them was also determined. The interviewing questionnaire tool took about 40 minutes and the observation checklist took about one hour. Patients who shared in the pilot study were excluded from the study sample.
Results:
The results of this study have shown the following:
- 53.3% of the study sample males and 46.7% females, 51.66% of them their ages ranged between35<50 years.
- 78.33% of the study sample were married, 41.66% illiterate, 45% farmers and 36.66% their income monthly per capita less than100 Pounds Egyptian
-As regards family members, 54.34% males and 45.66% females, 44.2%, their ages ranged between 35<50 years, 56.52% were single and55.07% were son or daughter.
- 54.34% of the family members read and write followed by 33.33% had secondary level of education and56.525 were unemployed.
- In relation to patients past and present health history 63.33% have discovered HCV since 12-36 months, 60% have Diabetes Mellitus, 42 patients out of 60 have previous shistosomiasis, 30% have liver cirrhosis, 16.66% had fibrosis and 53.33% the source of infection were surgical intervention .Patients habits and unhealthy behavior revealed 84.37% males smokers, 81.66% circumcisions done beyond the medical supervision, 64.29% deliveries conducted by traditional birth attendant, 86.66% and 55% respectively used individual tooth brush and articles as well as tattooing were done for 73.33% of the patients .
- Knowledge of the patients were 52% average scores, 35% poor scores and 13% good scores while for the family members 47% average scores, 28% poor scores and 25% good scores.
- In relation to sanitary home environment 76.6% of homes were shared, 35% paved buildings, 80% water supply inside home, 61.66% pit-latrines, 76.6% trench sewage disposal and 70% weekly garbage refuse.
- Regarding patients practices 55.00% poor scores, 41.66% average scores and 3.34% good scores while for family members practices 60.87% poor scores, 36.23% average scores and 2.89% good scores
- There were statistically significant relations between patients knowledge\ practices & their socio demographic characteristics regarding age 35< 50 years, education (university level), occupation (employee), gender (male) and low crowding index.