The task of reviewing the literature involves the identification, selection, critical analysis and reporting of existing information on topic of interest. Hence the investigator intended to review the literature available on self care practices using both research and non-research materials.

Singh C; et al (2010) conducted a study to identify the factors associated with intestinal parasitosis in rural and urban school children from 5-14 years of age in Kashmir. Personal hygiene was assessed by length of nails, hair, and frequency of bathing. Out of 274 stool samples from rural and 240 samples from urban 214 (46.7%) students had parasitosis. There was higher prevalence of parasitosis among rural orphanage children compared to urban orphanage students (76% Vs 48% p< or =0.05).highest prevalence of 70% was seen in the age group of 8-11 years 202 students were found to have poor personal hygiene and parasitosis was higher in them compared to students with good personal hygiene(p<0.05).

Mpyel C; et al (2010) conducted a study to determine the personal risk factor associated with trachoma in pre-school children in Nigeria. Out of 639 children from 27 villages were examined. The prevalence of active trachoma was 35.7%. The presence of flies on the face is independent risk factor for trachoma. Education on personal hygiene needed to be emphasized with facial cleanliness.

Dambhare DG ; et al (2010) conducted a cross sectional study to determine prevalence of intestinal parasitic infections and its epidemiological correlates among rural Indian school going children and to find out the effect of hygiene education on personal hygiene of school children at Maharashtra, central India. Out of 172 students prevalence of intestinal parasite infection was 7.76%. Prevalence was high among those having poor hand washing practice (CI-1.30) dirty or untrimmed nails (CI0.56). One month after hygiene education, there was significant change in the key personal hygiene behavior (p<0.05).The proportion of children having practice of hand washing with soap after defecation significantly improved. Health education on personal hygiene to the school children was effective for behavior change.

Biran A (2009) conducted a study to investigate the effectiveness of hygiene promotion intervention in rural India based on germ awareness in increasing hand washing with soap on key occasions. Hand washing was assessed through structured observation on a randomized sample of 30 household per village. The intervention proved scalable and effective in raising hygiene awareness.

SECTION-B: REVIEWS RELATED TO HAIR WASH.

Sims; et al., (2011) conducted a study to investigate socio economic and personal factors influencing head louse infestation from 17 primary school, in Korea. The rate of head louse infestation was significantly lower in children who lived together with mother or in a family. Head louse infestation was higher in children who washed their head less often .Improvement of socio economic factors and personal hygiene will be helpful for reducing head louse infestation.

Al-Maktari MT (2008) conducted a study to assess the prevalence and human risk factors associated with head lice infestation among school children in Yemen. Out of 860 children between 6-14 years of age 114 children (13.3%) were infested with head lice. Highest infestation was recorded in rural areas (20.5%) results indicated that rural residence, sex, long hair, age group 6-8 years, sharing of beds combs, uneducated family, overcrowding were risk factors for the head lice infestation.

Aselik oz (2006) conducted a study to investigate prevalence of pediculosis in the country side of Turkey. The presence of pediculosis species was investigated in 178 students with an age range of 6-14 years. Head lice seen in 17 positive cases were in the first grade. Since personal hygiene is not well developed in this age group.

SECTION-C : REVIEWS RELATED TO BRUSHING

Kilpatrick NM (2012) conducted a longitudinal study of Australian children to explore association between oral health and four indicators of social disadvantages : socio economic position(SEP), residential remoteness, indigenous status, non-English speaking background. Results revealed that lower SEP and indigenous status were associated with higher odds of poor oral health, less accessible location associated with increased caries experiences and non use of dental services.

Martgnon; et al (2012) conducted a study to assess oral hygiene knowledge, attitude and practices of school children using video recorded session and questionnaire at school in Columbia. Out of 146 children median total tooth brushing time was 115 sec. Most children brushed their maxillary (97%), mandibular (95%) ,anterior (96%) and posterior (81%).72% rinsed their teeth.92% were confident that tooth brushing sessions were effective. Questionnaire revealed only 34% is supervised by an adult and only 30% brushed twice a day.

Molina ; et al (2012) conducted a cross sectional study of 111 children attending elementary school in Mexico to assess prevalence of flourosis and dental caries using methods recommended by WHO. Results revealed flurosis prevalence 52.73% ,caries prevalence 53.2%. Dental caries was associated with frequency of brushing, brushing before sleeping and application of fluoride.

Yekaninejad MS (2012) conducted a study to determine the effect of a school based oral health education program on Iranian children.392 school children in 6 schools participated. Schools were randomly allocated into 3 groups: comprehensive, student and control group. Intervention in comprehensive group consisted of encouraging children, parents and school staff to increase frequency of brushing and flossing. In the student group intervention targeted only children. Control group received no intervention. Results revealed change in oral health behavior, oral hygiene and change in periodontal indices. Brushing and flossing significantly improved in comprehensive group. Promising results were seen when education targets both school and home setting.

Hietasalo P (2005) conducted a randomized clinical trial to determine children’s oral health related knowledge, attitude and belief as predictors of success in dental caries control among 493 children of 11-12 yrs of age in Finland. Data was based on clinical examination of 2001, 2005 and questionnaire on 2005.Results revealed concern about getting decay in one’s teeth was associated with caries increment. Less concerned child was with new caries lesion and cavities. Children who knew whether their mother had cavities was more likely to control cavities than who did not know.

SECTION-D : REVIEWS RELATED TO HAND WASH

Schmidt WP; et al (2009) conducted a cross sectional study to survey in 800 household in Kenya to explore cultural constraints that limit better hygiene. A total of 5182 critical opportunities for hand washing were observed .Results revealed that 25% washed hands with soap.32% practiced hand washing after fecal contamination. There was strong association with media exposure and hygiene promotion.

Curtis VA; et al (2009) reviewed the results of formative research studies from 11 countries to understand motivating factors in hand washing.17% of child care takers washed hands with soap after the toilet. Hand washing were not inculcated at an early age. Key motivations for hand washing were disgust, nurture, comfort and affiliation. `Plans’ involving hand washing included to improve health to teach children good manners.

Lopez-Quientro c; et al (2009) conducted a study on hand washing behavior and interventions among school children, Columbia. From 2042students of 6th to 8th grade students in 25 schools 33.6% of them always washed, hands with soap and clean water before eating and after using toilet.7% of students reported regular access to soap and clean water. Students with proper hand washing behavior were less likely to report previous month gastrointestinal symptoms.

Izadi S; et al (2006), conducted a study to determine epidemiological of cholera outbreak epidemiological of cholera outbreak in Iran. In the case control study 90 cases were positive for vibrio cholera. Risk factors cholera were no hand washing with soap after toilet use (CI: 2.63) no hand washing with soap before meals (CI: 1.03) illiteracy (CI: 2.63). Development of primary health care can improve conditions that control spread of epidemic.

Zerr DM ; et al (2005) conducted a study to assess the effectiveness of hand hygiene in preventing hospital associated rotavirus infection in children’s hospital in USA. After the hand hygiene program the overall hand hygiene compliance improved from 62% to 81% (p < 0.001). The rate of hospital associated rota virus infection decreased from 5.9 episodes per 1000 discharged patients to 2.2 episodes (p= 0.01)

Yalasin SS; et al (2004) conducted a study to evaluate how and when school students washed their hands and to detect conditions affect hand washing with likert scale in Turkey. Out of 1074 students 42.4% had proper basic hand wash. Female sex living at home, high knowledge level and urban school were associated with high proper basic hand wash. Lessons on hand washing and communicable disease should be given.

SECTION-E: REVIEWS RELATED TO BATHING

Mohammed AL (2010) conducted a cross sectional study to evaluate the related factors of head lice infestation in school children at Jordan. Out of 394 schools 1550 children were screened. 412 (26.6%) were infected with lice, result showed significant verification in head lice by factors such as frequency of hair washing per week, and bathing per week. Improving personal hygiene might significantly reduce pediculosis capitis in school children at Jordan.

Albashtawg M; et al (2010) conducted a cross sectional study to assess the prevalence of pediculosis capitis and risk factors for infestation. Among 1550 primary school children prevalence of pediculosis capitis was 26.6%. Frequency of hair washing, bathing and sharing of articles were significantly associated with infestation (p<0.001). Programs are needed to increase awareness of pediculosis capitis and importance of good personal hygiene.

Egimol RI; et al (2008) conducted a study to evaluate effects of interventions to promote hand washing on diarrheal episodes in children and adults. Eight trials were institution based, five were community based and one was in a high risk group. Intervention promoting hand washing resulted in a 29% reduction in diarrheal episodes in institutions in high income countries and 31% reduction in episodes in low or middle income countries. Hand washing can reduce diarrhea episode significantly.

Wagbatsome VA; et al (2008) conducted a cross sectional descriptive study to assess the effect of hygienic practices on intestinal helminthes burden of primary school children in Nigeria. Out of 384 participants 77 (21.1%) of pupils were infected with one or more helminthes ova. pupils in public school were more infected 74 (30.8%) than those in private schools 5 (3.8%). Regular hand washing with soap reduced the prevalence of heliminthiasis.

Wahl E; et al (2007) studied the outbreak of Giardia in Norway in 23 child care centers. Out of 12 verified cases 9 had clinical gastroenteritis. Stool samples were collected from all children 44% were infected. Washing hands after toilet and before food were possibilities identified.

Karim SA ; et al (2007) conducted a community based study among children from 6 residential Islamic education institutes in Dhaka to evaluate the personal hygiene of children among 492 children. Among them 55.1% of their fathers had low paid laboring jobs, 99% of children’s mothers were house wives

98 % of children had scabies. They had poor personal hygiene: bathed infrequently. Disease severity and re-infections were associated with infrequent washing of clothes, overcrowding, infrequent bathing (p<0.001) with soap (p<0.001) Immediate attention should be given to combat scabies and to save 1000s of children from impending complications.

SECTION-F: REVIEWS RELATED TO PERINEAL HYGIENE

Vivas AP; et al (2010) conducted a study to assess the Knowledge, attitudes and practices (KAP) of hygiene among school children in Ethiopia, Among 669 students. Results showed Approximately 52% of students were classified as having adequate knowledge of proper hygiene. Most students reported hand washing before meals (99.0%), but only 36.2% reported using soap. Although 76.7% of students reported that washing hands after defecation was important, only 14.8% reported actually following this practice. Students with adequate knowledge of proper hygiene were more likely to have clean clothes (AOR 1.62, CI 1.14-2.29) and to have a lower risk of parasitic infection

Mc mohan; etal (2009) conducted a study to assess anal cleansing practices and faecal contamination in schools in rural Kenya. Six focus group discussions were held with boys and girls ages 12-15 in three rural schools. Results revealed that Anal cleansing behaviour is linked with access to materials, age, social pressure, perceived personal risk of illness and emotional factors. Materials used for anal cleansing include schoolbook paper, leaves, grasses, stones, corncobs and one’s own hands. Students have knowledge gaps in terms of perineal hygiene. Almost no schools budgeted for or provided anal cleansing materials regularly.

Betancour AB, Amel LA (2007) conducted a epidemiological survey among 883 students from 5 to 6 years of elementary education in Argentina to find out the risk factors for e-coli infections in school children. Only 30.2% of students washed their hands after going to the toilet and only 43.5%reported hand washing before eating. Institutional framework must provide necessary resource to implement change and emphasize the importance of personal hygiene.

SECTION-G: REVIEWS RELATED TO EFFECTIVENESS OF

EDUCATIONAL PROGRAM ON SELF CARE.

Patel MK; et al (2012) conducted a study to evaluate effectiveness of intervention on hygiene practices in rural Kenya, under Centre for Disease Control, baseline information from 42 schools were collected. Comparison of effect of the improvement in proper hand washing technique after the school program was introduced. Results revealed decrease in the median percentage of students of students with acute respiratory illness among those exposure to the program on hygiene practices.

Lang MC (2012) conducted a study to evaluate the evidence-based hygiene public health initiative in elementary schools of Ghana.All 4 participating schools gained the necessary resources to carry out proper hand hygiene practice. Furthermore pupils were more likely to wash hands after using toilets remarkable outcome is that school children were the initiations of a behavior change in their community.

Anderson ME, et al;(2012) conducted a study to evaluate the effectiveness of hand hygiene practices and the impact of hand hygiene interventions. Hand hygiene compliance was 58% (340/583).Verbal hand hygiene reminders had significant positive association with hand hygiene compliance. Findings suggest that active, rather than passive interventions are more effective for increasing compliance.

Schulte JM; et al (2012) presented the investigation of outbreak of gastro-intestinal illness in Texas 10% of students in the school building were ill and 15 households had secondary cases. Installing liquid soap in students’ room was initial control measure followed by sustained institution in hand washing scheduled hand washing times and monitoring cleaning procedures. Enhanced surveillance detected no new cases in the school district.

Holyogke D (2010) states in his article “controlling poor hand hygiene to improve hand washing” on how a group of third year Child health nursing students at university of wolver Hampton examined the way they perceived hand washing. During 3 day workshop students moved from regarding hand washing as a simple act of hygiene to seeing it as a social behavior.

Zacharia S ; et al (2005) conducted a cross sectional study in Kerala, India to assess sustainability of changed hygiene behavior after hygiene promotion intervention in homes. Good hand washing was reported in more than half of intervention area. but < 10 % in control area. Participating in hygiene promotion classes were significantly associated with good hygiene.(OR 2.04, CI 1.05-3.96).Hygiene promotion is a cost effective intervention.