ميزان شيوع شپش سر در دانش‌آموزان دبستاني شهر سمنان و ارزيابي اثر آموزش خانواده در پيشگيري از آن

Prevalence of head lice in the Iranian primary school children and the effectiveness of family training to its prevention

ﺷﭙﺶ ﺳﺮ ﯾﮏ ﺑﯿﻤﺎري اﻧﮕﻠﯽ ﺷﺎﯾﻊ در ﻧﻘﺎط ﻣﺨﺘﻠﻒ ﺟﻬﺎن اﺳﺖ. آﻟﻮدﮔﯽ ﺑﻪ آن در ﮐﻮدﮐﺎن ﺷﺎﯾﻊﺗﺮ از ﺑﺎﻟﻐﯿﻦ اﺳﺖ و ﻣﯽﺗﻮاﻧﺪ ﻣﻮﺟﺐ ﻏﯿﺒﺖ از ﻣﺪرﺳﻪ ﺷﻮد. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺿﻤﻦ ارزﯾﺎﺑﯽ ﺷﯿﻮع ﺷﭙﺶ ﺳﺮ در داﻧﺶآﻣﻮزان دﺑﺴﺘﺎﻧﯽ ﺷﻬﺮ ﺳﻤﻨﺎن، اﺛﺮ آﻣﻮزش ﺑﺮ ﭘﯿﺸﮕﯿﺮي از آن ارزﯾﺎﺑﯽ ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ از اﺳﻔﻨﺪ 96 ﺗﺎ ﺧﺮداد 97 در دو ﻣﺮﺣﻠﻪ اﻧﺠﺎم ﺷﺪ. در ﻣﺮﺣﻠﻪ اول ﺷﻬﺮ ﺳﻤﻨﺎن ﺑﻪ 4 ﻣﻨﻄﻘﻪ ﺗﻘﺴﯿﻢ ﺷﺪ و از ﻫﺮ ﻣﻨﻄﻘﻪ ﯾﮏ ﻣﺪرﺳﻪ دﺧﺘﺮاﻧﻪ و ﯾﮏ ﻣﺪرﺳﻪ ﭘﺴﺮاﻧﻪ ﺑﻪ ﺗﺼﺎدف اﻧﺘﺨﺎب ﺷﺪﻧﺪ )ﻣﺪارس ﻣﺪاﺧﻠﻪ(. در ﻣﺠﺎورت ﻫﺮ ﻣﺪرﺳﻪ ﯾﮏ ﻣﺪرﺳﻪ ﺑﻪ ﻋﻨﻮان ﻣﺪارس ﮐﻨﺘﺮل اﻧﺘﺨﺎب ﺷﺪﻧﺪ. در ﻣﺪارس ﻣﻨﺘﺨﺐ، از ﻫﺮ ﭘﺎﯾﻪ ﺗﺤﺼﯿﻠﯽ ﺣﺪاﻗﻞ 5 ﻧﻔﺮ ﺑﻪ روش ﺳﯿﺴﺘﻤﺎﺗﯿﮏ اﻧﺘﺨﺎب )ﺟﻤﻌﺎً 767 ﻧﻔﺮ( و ﺿﻤﻦ ﺛﺒﺖ ﻣﺸﺨﺼﺎت ﻓﺮدي، از ﻧﻈﺮ آﻟﻮدﮔﯽ ﺑﻪ ﺷﭙﺶ ﺳﺮ ﻣﻌﺎﯾﻨﻪ ﺷﺪﻧﺪ. در ﻣﺮﺣﻠﻪ دوم ﺑﻪ ﮐﻠﯿﻪ داﻧﺶآﻣﻮزان و واﻟﺪﯾﻦ ﻣﺪارس ﻣﺪاﺧﻠﻪ از ﻃﺮﯾﻖ ﺳﺨﻨﺮاﻧﯽ و ﭘﺨﺶ ﭘﻤﻔﻠﺖ آﻣﻮزش داده ﺷﺪ. ﺳﭙﺲ ﺣﺪود 2 ﻣﺎه ﭘﺲ از آﻣﻮزش ﺑﻪ ﮐﻠﯿﻪ ﻣﺪارس آﻣﻮزشدﯾﺪه و ﮐﻨﺘﺮل ﻣﺮاﺟﻌﻪ و ﻣﺠﺪداً ﺑﻪ ﻫﻤﺎن ﺷﯿﻮه 767 داﻧﺶآﻣﻮز اﻧﺘﺨﺎب ﺷﺪﻧﺪ. اﻓﺮاد از ﻧﻈﺮ آﻟﻮدﮔﯽ ﺑﻪ ﺷﭙﺶ ﺳﺮ ﻣﻌﺎﯾﻨﻪ ﺷﺪﻧﺪ و ﻣﺸﺨﺼﺎت ﻓﺮدي در ﭼﮏﻟﯿﺴﺖ ﺛﺒﺖ ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ، ﺑﻪ ﻃﻮر ﮐﻠﯽ 5/2% )ﺑﺎ ﻓﺎﺻﻠﻪ اﻃﻤﯿﻨﺎن 6/8 :%95%- 3/6%( داﻧﺶآﻣﻮزان آﻟﻮدﮔﯽ ﺑﻪ ﺷﭙﺶ ﺳﺮ داﺷﺘﻨﺪ. ﺟﻨﺲ )0/006=OR=2/71 ،95% CI: 1/32 –5/54 ،p( و ﻧﯿﺰ ﺳﻄﺢ ﺳﻮاد ﭘﺪر )0/001

Head lice contamination has a global outbreak. Head lice infestation is more common among children than adults and can cause absence from the school. In this study, the severity of the problem in primary schoolchildren in Semnan city (Iran) was evaluated. Then health education has given to the students/parents and the effects of education on its prevention was evaluated. Materials and Methods: This study was conducted from March 2018 to May 2018 in two stages. In the first stage, the city of Semnan, Iran was divided into 4 regions and from each district, a girl school and a boy school were randomly selected. In this account, in the vicinity of each school, one school was selected as a control. In selected schools, at least five students were selected systematically from each grade (767 people) and the condition of head lice infection was evaluated. In the second stage, all students and their parents of 50% schools were taught through lecture and pamphlet. Then, about 2 months after the training, 767 students in the trained and control schools were selected again by the mentioned sampling method. Children were examined for head lice and the personal details were recorded in checklist. Results: Before the intervention, in 5.2% (95% CI: 3.6-6.8%) of the children were seen head lice infection. Gender (OR=2.71, 95% CI: 1.32-5.54, p=0.006) and fatherchr('39')s level of education (p<0.001) were significantly correlated with head lice infection. The chance of head lice in girls was 2.71 times higher than boys. In addition, the chance of infection to head lice in students with illiterate fathers or elementary literacy, were 9.15 times of students with college-educated fathers. The prevalence of head lice in trained schools decreased by 2.7% after intervention but did not change in control schools. The difference was statistically significant (p<0.05). Conclusion: In general, the prevalence of head lice infection in primary school children in Semnan is relatively high. Particular attention is needed to girlschr('39') schools, also families with low literacy levels. The effectiveness of education emphasizes that the corporation between the University of Medical Sciences & health services and primary schools authorities to raising the awareness of students and their parents, helps to decrease this problem