Rajiv Gandhi University of Health Sciences, Karnataka

SYNOPSIS

FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name of the candidate Ms. K. JAYANTHI

2. Name of the institute Diana college of nursing ,no-68,

Chokkanahalli, jakkur post,

bangalore-560064.

3. Course of the study Master science of nursing

Community Health Nursing

4. Date of admission to course 28.06.2008

5. Title of the topic

Assess the knowledge on prevention

of tuberculosis among adults

residing at selected rural

community, Tamil nadu.

6. Brief Resume of Intended Work

INTRODUCTION

Tuberculosis is an infectious disease spread by person to person at all age and sex

group. Tuberculosis (TB) is regarded as one of the highest burden among communicable

diseases. One Third of the world’s population is already infected with the Tuberculosis

bacterium. By 2020 an estimated 200 million of these would contract Tuberculosis would

be about 35 million deaths amount them unless the infection rate is halted. This situation is

especially challenging in Asia, the Middle East and Africa where there is a relatively high

incidence of Tuberculosis (J.Al-Abri).

Tuberculosis is a major public health problem in India, coupled with rising member

of cases of Acquired immuno deficiency syndrome (AIDS) in whom the most common

opportunistic infection is tuberculosis, it has gained even greater importance. The revised

national tuberculosis control programme (RNTCP) depends on the passive to the health

institutions. Therefore, it is important that the basic knowledge about the disease, the

availability of treatment and prevention of Tuberculosis is clear among the individuals in

the community. Equally important is to assess the impact of various strategies adopted for

improving knowledge and compliance (R. Mahotra ).

One essential step for adequate containment of Tuberculosis is to ascertain the

understanding in society of its risk factors, mode of transmission and diagnosis. It is

becoming increasingly clear that many problems which were previously thought of as

primarily biomedical are infect more appropriately detangled by changing individual and

social attitudes and behavior. Tuberculosis related knowledge, attitudes, beliefs and

practices have been examined in different part of the world and suggest the presence of a

pervasive misunderstanding about the disease. Tuberculosis thought to be due to “idleness

and generative tendency” and in some communities the word for Tuberculosis is often

associated with an insult. Tuberculosis has been thought to be hereditary, triggered by

smoking, alcohol, even hard work as well as exposure to cold. Sufferers may hide their

condition for fear of desertion, rejection or being blamed for spreading Tuberculosis (S.Al-

Adawi ).

Tuberculosis is a specific infections disease caused by mycobacterium tuberculosis. The

disease primarily affects lungs and causes pulmonary tuberculosis. It can also affect

intestine, meanings, bones and joints, lymph glands, skin and other tissues of the body. The

global incidence rate of tuberculosis is growing at approximately 1.1 percent per year and

the number of cases at 2.4% per year. M. Tuberculosis infects an estimated on third of the

world’s population and remains the leading cause of death of infections disease in the

world (K.Park).

The global tuberculosis programme has promoted the revision of national tuberculosis

programme by short-course (DOTS). National Tuberculosis Control Programme (NTCP)

which was established in 1962. In 1992, a revised national tuberculosis control programme

(RNTCP) was envisaged with a view to achieve a cure rate of at least 85% amongst newly

detected sputum positive cases under Direct Observation Treatment (K.Park).

6.1. Need for Study In India, Every year, approximately 1.8 million persons develop Tuberculosis, of

which about 0.8 million are new smear positive highly infectious cases. Annual risk of

becoming infected with Tuberculosis is 1.5%, two of every five Indians are infected with

Tuberculosis bacillus. Everyday about 5000 people develop the disease. Patients with

infectious Pulmonary Tuberculosis disease can infect 10 – 15 people in a year. 2 persons

die of Tuberculosis every 3 minutes, more than 1000 people die every day almost 0.5

million die every year (K.Park ).

A few anecdotal observations, attitudes towards Tuberculosis have been little

reported in the Arab world and to our knowledge, there has been no study on psychosocial

issues associated with Tuberculosis from Oman. Increasing affluence in the country has

resulted in Omans traveling to high-burden Tuberculosis countries. Oman also attracts a

large labour force from parts of the world known to have epidemics of infectious diseases

including Tuberculosis (A.S.S.Dorvlo).

We also postulated according to the “Contact Hypothesis” that previous exposure

To Tuberculosis would enhance a person’s understanding and form a basis for heightening

essential knowledge towards Tuberculosis. In a paternalistic society such as Oman,

woman have traditionally played a domestic role and it is not clear how such division of

roles would influence, Tuberculosis awareness. Studies carried out in different cultures

suggest that there are gender differences in attitudes towards Tuberculosis, and thus

another aim of present study was to examine whether knowledge differs between men and

women in oman. ( A.S.S.Dorvlo )

6.2. Review of Literature 1. Literature related to tuberculosis.

2. Literature related to knowledge on prevention of tuberculosis.

3. Literature related to revised national tuberculosis control programme (RNTCP).

1.Literature related to Tuberculosis

Nina M. Larsen (1994) conducted a study on “Risk of Tuberculin skin test conversion

among health care workers : occupational versus community exposure and infection”.

Result showed a total of 69 (1.2%) of 5773 susceptible employees had a documented

tuberculin skin test (TST) conversion (overall RATE 0.33 per 100 person – years worked).

TST conversion rates were low and risk of conversion among HCWs was associated most

strongly with non-occupational factors.

Brig. L. Pichu(2004) conducted a study on “Effects of drug administration strategy and

health education on knowledge and pulmonary tuberculosis patient admitted to a

tuberculosis hospital”. It is concluded as there was significant improvement in post test

knowledge in both groups but health education booklet had no significant role in improving

the knowledge of tuberculosis among patients undertaking Direct observation Treatnent

strategy (DOTS).

Diwan,A Thorson (2004) conducted study of “Diagnosis and treatment of pulmonary

tuberculosis at basic health care facilities in rural Vietnam, a survey of knowledge and

reported practices among health staff”. Shows that Staff members who attended tuberculosis

training courses had inadequate tuberculosis knowledge, particularly in the area of

tuberculosis control.

Kehkashan Mufti et al (2002) conducted a study on “Awareness about Direct

observation Treatnent strategy (DOTS) amongst medical teachers of private and public

sector medical colleges of Karachi.” - Out of 120 teachers, 50 teachers (42%) had good

knowledge regarding epidemiology, complications and diagnostic tests of tuberculosis, 42

(35%) had average knowledge and 28 (23%) had poor knowledge.

T. wondimu, K.W. Michael (2005) conducted a study on “Delay in initiating

Tuberculosis treatment and factors associated among pulmonary tuberculosis patients in

East Wollega, western Ethiopia”. The study revealed that Patients from urban areas were

46% more likely to present to health and care providers than patients from rural areas.

Patient from urban areas were 54% more likely to be diagnosed and start treatment earlier

than patients from rural areas. Female patients were more delayed to present to health

providers than male.

Kamaran Khan, Peter Muennig (2002) conducted a study on “Global drug – resistance

patterns and the management of Latent tuberculosis infection in immigrants to the united

states.’It showed a strategy of detecting and treating latent Tuberculosis infection was cost

saving among immigrant from Mexico, Haiti, sub-saharan, South Asia, East Asia &

Pacific. Rifamin plus Pyrazinamide was preferred strategy for treating latent infection.

2.Literature review related to knowledge on prevention of tuberculosis

Ching – Yun Liang (1993) conducted a study on “Behaviour, attitude and knowledge of

Tuberculosis between the patients with self management and administration nurse during

treatment of tuberculosis in Taiwan”. This study showed that self evaluated scores of 3

different aspects provided by patient himself/herself were higher than evaluated scores

from public-health nurse, especially in knowledge part about tuberculosis.

A.A. Al-Jabri et al (2006) conducted a study on “ Knowledge of tuberculosis among

medical professionals and university students in Omen”. Results shows that Medical

students who have better health education were likely to have fewer misconceptions about

the mode of transmission and other clinical aspects of Tuberculosis than non-medical

students.

Anjana Roy et al(2008) conducted a study on “Evaluating knowledge gain from

Tuberculosis leaflets for prison and homeless sector staff : the national knowledge service

Tuberculosis pilot”. Concluded that Staff knowledge on symptoms of Tuberculosis

increased significantly after reading the targeted information resources. Knowledge gain

for symptoms ranged from 17% for weight loss, to 45% for persistent fever. Knowledge

about general guidelines that are available to this target groups also improved, as did

knowledge about potential role of staff in supporting directly observed treatment [ by

68%] and the usual length of Tuberculosis treatment [32%]. pre-existing knowledge about

the infectiousness of Tuberculosis, risks for transmission and the likely period of

hospitalization of patients with Tuberculosis was high.

Adeline Nyamathi ; Barbara Leake (2004) conducted a study “To investigate

tuberculosis knowledge, perceived risk, and risk behaviors in a sample of homeless persons

with latent Tuberculosis in the skid row district of Los Angels”. The result of this study

shows that Tuberculosis knowledge deficits mainly centered on ignorance, and risk factors

for Tuberculosis infection. Latinos and injection drug users were most likely to like

Tuberculosis knowledge.

Javaid Adhed Knah; Irfan Muhammad (2006) conducted a study on “ Knowledge,

attitude and misconceptions regarding Tuberculosis in Pakistani patients”. Stated that

11(7%) patients thought Tuberculosis was not an infectious disease and 18 (10.6%) did not

consider it a preventable disease. Contaminated food was considered the source of

infection by 81 (47.6%) and 96 (57%) considered emotional trauma\ stress the causative

agent of Tuberculosis. No counseling about preventing spread was received by 81(50%)

patients and 97(57%) considered separating dishes as an important meas of preventing

spread. 31(18%) patients would have discontinued their medications following relief of

symptoms. 39(23%) of the respondents thought that Tuberculosis could lead to infertility

and 66(38.8%) believed that there were reduced chances of getting married following

infection.

Rita L.Ailinger R.N.Rachel Armstrong (2004) conducted a study on “Tuberculosis (TB)

knowledge in Latino immigrants receiving latent Tuberculosis infection therapy (LTBI).

The results concluded that ,the mean Tuberculosis knowledge score was 66% more than

80% of study participants correctly answered questions about the importance of keeping

monthly appointments and how Isoniazid works to eradicate TB germs in human body.

Questions that pertained to the contagiousness of active Tuberculosis and how the disease

spreads received the most incorrect responses.

R. Mahotra; D.K. Taneja (2002 to 2006) conducted a study of “Awareness regarding

Tuberculosis in a rural population of Delhi”.showed Cough with sputum (73.75) was the

most common symptom known, 95.3% were aware that TB could spread to others with

65% being aware of air as a route, 48.4% knew an infectious agent is the cause of

Tuberculosis. Females and those without schooling were significantly less aware of

various aspects of Tuberculosis.

Megha Chandra singh. M, Bano Tanveer(2002) conducted a study on “Knowledge and

attitudes towards Tuberculosis in a slum community of Delhi”.showed 83.5% heard of

Tuberculosis mainly from neighbours and friends. Only 2.3% knew that Tuberculosis was

caused by a germ. Literates were more aware than illiterates regarding some signs and

symptoms of Tuberculosis. 12.6% knew about the duration of treatment for 6-8 months

and 1.7% knew about preventive role of BCG. Tendency to discriminate Tuberculosis

patients was evident from the findings eg :- 71% respondents agreed about isolating

Tuberculosis patients from the family, 74.1% on avoiding the patient in food sharing, on

quitting job by the patient (33%) prohibiting marriage of the patient 27.6%., shunning him

from attending social functions 18%.

Golditz GA, Brewer TF (1994) conducted a study on “ efficacy of BCG vaccine in the

prevention of tuberculosis”, this study described as to quantify the efficacy of BCG vaccine

against tuberculosis on average, BCG vaccine significantly reduces the risk of Tuberculosis

by 50%. Protection is observed across many populations, study designs, and forms of

Tuberculosis. Age at vaccination did not enhance predictiveness of BCG efficacy.

Protection against tuberculosis death , meningitis, and disseminated disease is higher than

total Tuberculosis cases .

Audrey L.French, MD; Sharon F (1998) conducted a study on “Use of DNA

fingerprinting to assess tuberculosis infection control”. Results of this study is

Mycobacterium tuberculosis isolates from the study period underwent DNA fingerprinting.

Fingerprinting revealed that five isolates represented false positive cultures and that

91(54%) of the remaining 168 isolates were in 15 DNA fingerprinting clusters , which

ranged in size from 2 to 29 isolates.

Lilia p.manangan, Charles L. (1992 to 1996) conducted a study on “Nosocomial

Tuberculosis prevention measures among two groups of US hospitals”. The results in

1992 , 63% of PCP hospitals had rooms meeting centers for disease control and

prevention(CDC) criteria for acid-fast bacilli isolation; in 1996 , almost 100% had such

isolation rooms. Similarly, in 1992, nonfitted surgical masks were used by Health Care

Workers at other US hospitals, while N95 respirators were used at 90% of PCP hospitals

and 83% of other UShospitals in 1996.

Roberts, M .Lobato (2002) conducted a study on “Tuberculosis prevention and control

in large jails a challenge to tuberculosis elimination”. It results 20% of jail system(4\20)

had conducted an assessment of risk for Tuberculosis transmission in the facilities,

55%(11/20) monitored tuberculin skin test conversions of inmates and staff. 65% (13/20)

of jails had an aggregate record- keeping system for tracking Tuberculosis status and

treatment , which was usually paper based. 45% of jails (9\20) had polices to offer HIV

counselling and skin testing to tuberculin skin test-positive patients, and 75% (15\20)

screen HIV-infected inmates chest radiographs. Three quarters of jails (15\20) had policies

to always isolate patients with suspected or confirmed pulmonary Tuberculosis in an

airborne infection isolation room.

J.F. Broekmans, et al(2000) conducted a study on “European framework for Tuberculosis

control and elimination in countries with a low incidence”. This study concluded

thatGovernment and private sector commitment towards elimination, effective case

detection among symptomatic individuals together with active case finding in special

groups, standard treatment of disease and infection, access to Tuberculosis diagnostic and

treatment services, prevention (e.g. through screening and bacilli calmette-gueria

immunization in specified groups), surveillance and treatment outcome monitoring are

prerequisites to implementing the policy package recommended in this new framework

document.

3. Review of literature related to Revised national tuberculosis control programme

According to WHO, (2008) report states that “India has highest tuberculosis

prevalence”.in thatNew Delhi, March 24 India is home to over 3.4 million tuberculosis

patients - about one-fifth of the global figure - making it the most Tuberculosis prevalent

country, says the World Health Organisation (WHO) report released Monday. “India is the

number one country in terms of Tuberculosis prevalence and an alarming 17 percent of

patients who have availed themselves of treatment earlier have developed multi-drug

resistance (MDR),” the report said. It revealed that 325,172 people in India had died of the

disease in 2005 alone

WHO report (2008 ) ) report states that “Global tuberculosis control - surveillance,

planning, financing.This report showed that the African region has the highest incidence

rate per capita(363 per 100 000 population ).There were an estimated 14.4 million

prevalent cases of tuberculosis in 2006. There were an estimated 0.5 million cases of

multidrug-resistant tuberculosis in 2006.

Kishnamurthy (1991) conducted a study on “Incidence of tuberculosis infection in a

South Indian village with a single sputum positive case:an epidemiological case study”.

This case study investigates the background of the observed high infectivity. The

investigation reveals that at least 21 persons, found newly infected at II survey, had varying

levels of contact with the index case. The remaining infected persons could not be linked,

either directly or indirectly, to any other known bacteriological case including the index

case in the village. All the persons identified as infected at II survey were distributed

throughout the village, beyond the likely zone of infection of the index case.

K.Pawar et al (2008)conducted a study on “India's Revised National Tuberculosis Control

Programme: looking beyond detection and cure”.Resuls showed that Patients who

consulted a private provider participating in the public-private mix (PPM) were more likely

to be suspected (OR 2.63, 90% CI 1.04-6.64) and referred (OR 6.8, 95%CI 2.08-22.21) to

the revised national tuberculosis control programme (RNTCP). Once the patients entered

the revised national tuberculosis control programme (RNTCP), the response of the system

was rapid, with diagnosis offered and treatment initiated within on average 7 days.

Verma s. K et al (2005) conducted a study on “A Five-Year Follow-up Study of Revised

National Tuberculosis Control Programme of India at Lucknow “. The study revealed the

outcome of 208 registered patients during the study period at the end of completion of their

treatment was: treatment success (cured+treatment completed)-187 (89.9%), default-11

(5.3%), death-9 (4.3%) and treatment failture-1 (0.4%). On follow-up at five years, only 80

(42.8%) patients were traced, while 68 (36.4%) patients had migrated to other places and

for 39 (20.8%) patients addresses could not be traced.

Arora VK (2000) stated that “Revised National Tuberculosis

Controlpogramme:IndianPerspective”Revised National Tuberculosis Control Programme

and its recent progress in Direct observation Treatnent strategy (DOTS) expansion has

been encouraging.In the year 2004 alone more than 1100,000 cases were placed on

treatment, and in the 2005, more than 1290,000 cases were placed on treatment largest

cohort of cases, more than any other country in the world . By June 2008, about 8.77

million patients have been initiated on treatment, saving more than 1.58 million additional

lives.

Statement of problem

Assess the knowledge on prevention of tuberculosis among adults residing at selected rural

community, Tamil nadu.

6.3. Objectives

1. To assess the knowledge on prevention of tuberculosis among adults residing at

selected rural area.

2. To find the association between knowledge on prevention among adults and their

selected demographic variables.

Operational definitions

Assess: Refers to statistical measurement of knowledge on prevention of tuberculosis

among adults of selected rural community.

Knowledge: Refers to correct verbal responses of adult to the items asked in structured

interview schedule regarding prevention of tuberculosis. For the purpose of study it is

divided into adequate, moderate adequate and inadequate knowledge.

Adult: It refers to men between the ages of 20 to 44 years residing at selected rural

community, Tamil nadu.

Prevention of tuberculosis: It refers to the measures taken by the adults at primary,

secondary and tertiary level to prevent tuberculosis.

Rural community: It refers to a village where group of people living in selected

geographical area.

Assumptions

1. Adults may have some knowledge on prevention of tuberculosis.

2. There may be association between knowledge of adults at selected rural community

and their demographic variables.

Hypothesis

H1 - There will be association between knowledge on prevention of tuberculosis

among adults and their demographic variables.

7. Materials and methods

Source of data The source of data will be adults between

20 to 44 years of age at selected rural

community.

Method of data collection

Research design

Non experimental descriptive design will

be used for the study.

Setting The setting will be selected rural

community, Tamilnadu.

Population The population will be adults.

Sample Men between 20 to 44 years of age at

selected rural community will be the

sample of study.

Sample size The sample size will be 90 adults from

selected rural community.

Sampling technique Purposive sampling technique will be

used to select the adults from selected

rural community, Tamilnadu.

Inclusion criteria Adults from selected rural community

who,

1. Will be between 20 to 44

years of age.

2. Willing to participate in the study.

3. Will be available at the time of

data collection.

4. Will understand Tamil.

Exclusion criteria Adults from selected rural community who,

1.Will be suffering from Tuberculosis.

2. will Belongs to health profession.

Tool The structured interview schedule will be

used to assess the knowledge on

prevention of tuberculosis among adults.

Data collection Permission will be obtained from

concerned panchayat leader to collect the

data. Further, consent will be taken from

every subject and confidentiality will be

maintained. The data will be collected by

the investigator herself.

Dataanalysis, resentation and

interpretation

The collected data will be analyzed by

using descriptive and inferential

statistical. Chi square test will used to

find the association between knowledge

and selected demographic variables. The

findings will be presented in the form of

table, diagram and graphs.

7.3 Does the study require any investigation or intervention to be conducted on

patients or other humans or animals? If so, describe briefly.

Yes the study will be conducted on adults at selected rural community, Tamilnadu.

7.4 Has ethical clearance been obtained from your institution in case of 7.3?

Yes, informed consent will be obtained from concerned subjects and authority of

selected rural community, Tamilnadu.

Ethical Committee

Tital of the Topic

. Assess the knowledge on prevention

of tuberculosis among adults residing

at selected rural community,Tamil

nadu

Name of the Candidate : K.Jayanthi

Course and the subject : Master of Science in Nursing

Community Health Nursing.

Name of the Guide : Prof. Veda Vivek

Principal and HOD

Department of Community Health Nursing.

Diana College of Nursing,

Bangalore – 64

Ethical Committee : Approved

MEMBERS OF ETHICAL COMMITTEE

1. Prof. Veda Vivek

Principal and HOD

Department of Community Health Nursing.

Diana College of Nursing,

Bangalore – 64

2. Prof. Elizabeth Dora

Head of the Department

Department of Child Health Nursing

Diana College of Nursing,

Bangalore – 64

3. Prof. Kalaivani

Department of Obstetrics & Gynecological Nursing

Diana College of Nursing,

Bangalore – 64

4. Prof. Vasantha Chitra

Head of the Department

Department of Medical Surgical Nursing

Diana College of Nursing,

Bangalore – 64

5. Prof. Surendra

Biostatistician

G.K.U.K.Jakkur post

Bangalore .

8.LIST OF REFERENCES

BOOKS :

1. Brunner & Suddarth’s “Text books of medical surgical nursing; Lippincott Williams

& wilkins publication’ 10th Edition’ Page No. 534 – 538.

2. Clement “Basic Concepts of Community Health Nursing’ IC Publications’ 1st

Edition’ Page No. 319 – 320.

3. Kasturi Sundar Rao “An introduction to community health Nursing” BI Publications

Pvt. Ltd.,’ 4th Edition’ Page No.146-149.

4. Karen Saucier Lundy & Sharyn Janes “Essentials of Community – Based Nursing”

Jone & Barlett Publishers’ Page No. 167 – 169.

5. K.Park “Text Book of Preventive & Social Medine” M/S Banarsiday Bhanot

Publishers’ 18th Edition’ Page No.146 – 160.

6. Lippincott “Mannual of Nursing Practice” Jaypee Publciations, 8th Edition’ Page

No.295 – 300.

7. Kamalam S. “Essential in Community Health Nursing Practice” Jaypee

Publciations, Page No.202– 210

8. Marica Stanhope’ Jeanethe Lancaster’ Coomunity & Public Health Nursing”

Masby Publciations, 6th Edition’ Page No.515 – 526.

9. Sunitha Patney “Text Book of Community Health Nursing” Modern Publishers, 1st

Edition Page No. 301-305

JOURNALS :

1. Verma.S, Kant Surya, “A Five year – floow up Study of RNTCP of India at

Lucknow”. 2008, Vol-50, Page No.195 – 197.

2. Rita L.Ailinger’ Rachel Armstorng” Latino immigrants Knowledge of

Tuberculosis” Public Health Nursing’ 2004, Vol;21, Issue-6, Page No.519 – 523.

3. Nina M.Larsen, Cara L.Biddle “risk of tuberculin Skin Test Conversion among

health care workers; occupational versus community exposure and infection”.

Journal of clinical infectious disease’ 2002, Vol. 37, Page No.796 – 801.

4. Brig L.Pichu, “Effects of drug administration strategy and health education on

knowledge of pulmonary tuberculosis patients admitted to a tuberculosis hospital”

Indian Journal of Community Medicine, 2004, Vol. 20, No-1.

5. WHO: DOTS – TB Cure for all, New Delhi, World Health Organisation, 2001 : 2 –

5

6. Malhotra R, Taneja DK, Dhingra VK, “Awareness Regarding tuberculosis in a rural

population of Delhi”. Indian Journal Community Medicine Apr. Jun 2002, vol. 27,

No-2, P.No. 62-68.

7. N. Hoa, V Diwan, A Thorson “Diagnosis and treatment of pulmonary tuberculosis

at basis health care facilities in rural Vietnam, a survey of knowledge and reported

practices among health staff” health policy ,2004, Vol. 72, Issue-1, P. No. 1- 8.

8. Kelkar – Khambete’ Pawar: porter “India’s Revised National Tuberculosis control

programme looking beyond detection and cure”. The international Journal of

Tuberculosis and Lung disease’ Vol. 12, No.1, Jan 2008, PP 87-92.

9. A.A. Al. Jabri, A.S.S. Dorvlo, “Knowledge of tuberculosis among medical

professional and university students in Oman” Sep. 2006, Vol. 12, No.5.

10. Kamaran Khan, Peter Muenning “Global Drug resistance patterns and the

management of latent tuberculosis infection in immigrants to the united status”.

Dec. 2002, Vol. 347, No.23.

11. Javaid Ahmed Khan, Irfan Mohmmed,” Knowledge, attitude & Misconceptions

regarding tuberculosis in Pakistani Patients”. Journal of Pakistan Medical

Association’ 2006, Vol.5, No.5 PP 211 – 214.

12. Anjana Joy, Ibrahim Abubakar, Sujan Yaties, “Evaluating knowledge gain from TB

leaflet’s for prison and homless sector staff: the national knowledge service TB

Pilot”. The European Journal of Public Health, Oct 2008.

13. Lilia P. Manangan, Charles “Nosocomial Tuberculosis prevention measures among

two groups of US hospitals” Journal of Chest Medicine, 2000, Vol. 117, P. No. 380

– 384.

9. Signature of Candidate

10. Remarks of the guide The research topic selected for the

candidate is suitable as it is related to

the knowledge on prevention of

tuberculosis. There is a need to assess

the knowledge of adults.

11. Name & Designation of Guide

Signature

Prof. Veda Vivek

Principal and HOD, Department of

Community Health Nursing. Diana

College of Nursing, Bangalore – 64

HOD

Signature

12. Remarks of the chairman

&principal

The topic selected for the candidate is

researchable and feasible and

forwarded for needful action.

Signature