Knowledge, Attitude and Practice for Prevention and Treatment of Swine Flu in Population of Udaipur City

Background: Swine flu has become a very common seasonal respiratory disease having larger number of morbidities and mortalities. It has created panic situation among general public and health care workers just because of lack of awareness regarding the same. Aims & Objectives: This study was carried out to reach general public of every class for their perception for this pandemic disease. Knowledge regarding measures for prevention and treatments available if it occurs was the objective of this study. Also to find out myths prevalent in them and to create awareness in proper direction was the objective of this study. Material and Method: This study was carried out on 500 people chosen randomly from different places of Udaipur having different class and strata. Study was done by making pre-formed questionnaires. Data was analyzed by using SPSS. Findings: Major part of study population gain information from news papers and TV channels. 76% of study population had heard about swine flu by different resources. Myths are prevalent in 37% of populations regarding causes and mode of occurring of swine flu. Only 23% of study population knows importance of hand-washing as measure for preventing swine flu. Conclusion: Though large campaign carried out by government and media, people needs to be made aware for every aspects of swine flu through ground level awareness programmes.


Introduction
Swine influenza is an acute respiratory disease occurs due to different strains of influenza virus type A which is named globally as H1N1. 1 Initially virus outbreak was prevalent only in pigs but due to regular contacts between pigs and human, some strains had spread from pigs to human.In 21 st century first outbreak of this H1N1 flu occurred in Maxico city in the month of March 2009, after that it spread within a very limited time to all over the world. 1 After that outbreak, World Corresponding Author: Chanchal Shrivastav Mobile no.9079663696 Email: chanchalshrivastav29811@gmail.com health organization (WHO) had declared it as pandemic as it had approached in more than two continents. 2 It was given a name 'swine flu' as during 2009 pandemic, the strain of H1N1 influenza showed very similar genes to the influenza virus affecting North American swine. 3,4nsidering amongst the largest populist country, India is on 3 rd rank according to the number of cases and total number of deaths because of swine flu. 5 Due to increasing numbers of morbidities and mortalities in subsequent years, swine flu is considered as global threat amongst emerging diseases.According to data of Ministry of health and family welfare, government of India, 6,804 cases and 542 deaths from swine flu has been registered up to October 2018. 6Rajasthan reported 191 deaths from swine flu amongst 1912 cases with second most after Maharashtra in the year of 2018. 6

Material & Method
This is a cross-sectional study carried out on general public of Udaipur city.For knowledge, attitude and practice study, sample size should be atleast 200. 7In this study total 500 participants were included so as to achieve larger representation of population.Study was carried out during October-December 2018.
Study was approved by institutional ethical committee.Inclusion criteria for participants were minimum 15 years of age with at least primary education achieved.To make this study more representative of population, participants were selected from different parts of city having different economic status, different educational level and different occupations like some professional persons working as company executives, lawyer, bankers, and also some shopkeepers, street vendors, students, housewife etc. Random sampling was done for selection.Informed consent was taken from participants.None of the participant refused as they were assured for complete anonymous study.
Participants were approached personally for interview.Pre formed questionnaires were used which includes their demographic profile (sex, age, education, occupation), knowledge regarding swine flu (how it occurs, mode of spreading, signs and symptoms), attitude towards disease and practice they follow for prevention and treatment of disease.

Findings
In the present study 346 participants were male and 154 were female.Educational levels of participants were from primary to professional level with different job profile.Myths or misconception regarding swine flu are by eating non-vegetarian food 34 (7.7%), bite of some bugs 26 (5.9%), blood contact of infected patient 43 (9.8%), while majority of participants 316 (72.1%) were aware that swine flu spread by close contact with affected person and by inhalation through respiratory route when patient cough or sneeze.(Table -

Discussion
Knowledge regarding infectious disease among community people is the benchmark of incidence and prevalence of that disease.Right attitude and practice towards the disease make them less vulnerable and ultimately it decides well being of any community.This study is based on knowledge, attitude and practice for prevention and treatment of swine flu (H1N1) amongst urban community of Udaipur city which may help local authorities related to health sectors for planning and implementing programme for awareness regarding swine flu.Some misconceptions must be removed from general public like swine flu is always deadly disease and no any treatment available.
In this study 87.6% participants have heard about swine flu which is lower than study done by Chaudhary V et al 8 and Rathi S et al 9 while it is higher than study done by Singh S et al 10 which may be due to different educational level of participants and awareness programmes by local authorities at different places.Study population represents all aspects of community with wide variety of demographic profiles.Male participants are more in numbers which is similar to study done by Singh S et al 10 while in study of Latiff et al 11 female participants are more.

Knowledge on clinical features of swine flu amongst
participants of this study is found to be similar to study done by Farhat et al 12 with fever is known to be the most common symptoms while another common symptom of running nose is not much known amongst participants.
Prevention is always considered as more important tool than treatment.In this study 73.7% participants consider use of face mask as the best method for prevention but another much important measure of frequent hand washing is known only to 35.8% which is contrast to study done by Rubin et al. 13 This is because lack of interest and lazy attitude towards disease and awareness programmes run by authorities.
Myths also prevalent amongst participants like eating of non vegetarian food specially pork, bite of mosquito or other bugs or by taking contaminated food or water which contradict to study done by Shilpa K et al 14 in Karnataka having very low 2.4% prevalence of myths .This may be due to failure of health workers and authorities in making ground level efforts for spreading awareness regarding actual cause and mode of disease.Telemedia and newspapers are major source of information as better availability of these resources in urban population similar to findings of other studies. 5,12,15ealth education is very important measure for increase well being of community by reducing prevalence of disease.Mass media including social media is considered best in current scenario to approach every individual of society.

Conclusion
If knowledge regarding swine flu is increased, it definitely changes attitude of community towards disease and practice of preventive measures to be taken.These are three pillars of health system as it directly affects health programmes implemented by government.Focal points regarding swine flu like running nose as important symptoms, frequent hand washing as important practice and removing all myths for disease are key areas to be considered and mass media can help during epidemic of swine flu for creating awareness of these key areas instead of creating panics and blaming health authorities.Also role of health workers and concerned authorities is important as early detection and timely notification of disease can help to break chain of spreading of

Table - 1: Knowledge on symptoms of swine flu
Amongst 500 participants, 438 (87.6%) had previously heard about swine flu so further interview was carried out for these 438 participants only.190(43.3%) knew that swine flu is caused by virus.The most common symptoms of swine flu like running nose was known to 85 participants (19.4%), fever to 390 (89.1%) and cough to 375 (85.6%) participants.(Table-1)