CHAPTER 1 THE PROBLEM AND ITS SCOPE INTRODUCTION Rationale of the Study A study made by the Department of Education

and the University of the Philippines ranked Pediculosis or head lice disease as the third most common health problem after tooth decay and dental problems. A research study revealed that 59 percent of Philippines households suffer from head lice and female children aged 4 to 10 are the most susceptible. In addition, 34 percent of elementary school children in public schools are infected. (GfK NOP, 2006) There have been many anti-lice products invented to address this problem. To name a few are Licealiz and Ulesfia. But still, lice infestation continues to be a dilemma. Possible causes could be that some people are careless about their health, have no proper hygiene, have no knowledge on treatment, or the most probable one, not enough money to buy the anti-lice products. Most of the population with lice infestation falls on children in public school. More often than not, parents with kids in public schools tend to overlook problems because it means that they will need to shelf out money which they cannot afford to do. Also, some people do not trust chemically mixed products because they are afraid that it may affect them in a way. Knowing this, nature is usually the one turned to for help. There have been many research conducted on natural resources that can help eradicate the lice infestation problem. Some natural products that have been proven to cure lice are Guyabano, White Vinegar and Atis. Atis fruits are abundant in the

Philippines. They are not seasonal so they can be easily planted at home. Also, Atis fruits can be sold all year round. Knowing this, the researchers came up with the research problem: The Effectiveness of Annona Squamosa Seeds Immersed in Coconut Oil as an Alternative Treatment for Head-Lice. This study aims to determine if atis seeds are effective in annihilation of lice infestation among school age children of Sitio Isla Verde, Barangay Isidro, Talisay Cebu. The researchers wanted to find out whether the atis seeds solution could totally eradicate or just minimize the number of head-lice.

Review of Literature Pediculosis or infestation with lice, especially of the genus Pediculus, is the third most common ailment among public schoolchildren aged 7 to 12 years, next only to dental caries, according to the DepEd. According to Thelma Guerrero-Santos, then the DepEds assistant director for health, nearly 8 million young public school children were afflicted with pediculosis. Students with lice have difficulty catching lessons in school. Pediculosis had become a serious problem for teachers, who could not seem to hold the attention of the children because of the perennial scratching in class according to Thelma Guerrero Santos. She cited a DepEd study in 1999 showing that 7.88 million children in public schools were afflicted with the ailment. This represented 84 percent of the 9.38 million elementary children examined by mobile nurses in Metro Manila and the provinces. Southern Tagalog and Central Visayas had the largest number of students who suffered from pediculosis, according to the study.

A research study conducted in 2006 by GfK NOP (Gesellschaft fr Konsumforschung National Opinion Polls) revealed that 59 percent of Philippine households suffer from head lice and female children aged 4 to 10 are the most susceptible. In addition, 34 percent of elementary school children in public schools are infected. According to DepEd, the classroom is an ideal setting for lice to spread because of the humid situation and children are seated very close to each other. The findings also put multiple burdens on parents who inevitably bear the responsibility of ensuring the health and well-being of their children. A child with lice is often ostracized by classmates, barred by other kids from participating in games or group activities because
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of fear that head lice will spread. Thus, an infected child may develop behavioral problems or adversely affect his or her academic performance. This is a social problem that will continue to escalate if not prevented. Base from the study conducted by the DepEd, they found out that louse infestation is the culprit in lowering the scholastic performance of children in grade school. Lice distract pupils from paying attention to their daily lessons as they continuously experience itchiness of scalp due to the blood-sucking lice and the sensation of lice crawling on their scalp. Furthermore, DepEd cited that such itchiness make the pupils always scratch their heads instead of listening to what is being tackled in class. The itchiness interrupts any routine in school and prevents pupils from faring well not only in academics but also in extra- and co-curricular activities. In fact, the DepEd observed that little attention is put on the impact common diseases like head lice creates on the physical and mental development of children like school attendance, school performance and ultimately quality of life. Head lice (Pediculus humanus capitis) are small, clear to gray colored, blood sucking insects measuring 1/16 to 1/8 inch in length. They live on the scalp, particularly behind the ears and at the nape of the neck and are a common menace, particularly to young children (Pollack, 1998). Head lice infestation is most frequent on children aged 310 and their families (Burgess, January 2004). Head lice feed on human blood (hematophagy), and itching from louse bites is a common symptom of this condition. Lice infestation in general is known as pediculosis, and occurs in many mammalian and bird species (Taylan, 2007).

Atis is a small tree that grows between 10 to 20 feet high when fully matured with oblong leaves and green heart-shaped fruits with polygonal tubercles. The Atis fruit has a white, sweet flesh and black seeds. The Atis tree is easy to grow. Just plant a seed on almost any soil and Atis will grow. However, it requires tropical or near tropical weather. When planted, Atis will begin to bear fruit in about a year's time. It will bear fruit about 3 times a year and the sweetest fruits are those borne during the summer months. (DOH, 2010) Annona squamosa (Custard apple) is a plant belonging to the family Annonaceae. It is popularly cultivated in all parts of Thailand, especially in the northeast as a sweet fruit. Atis is native to Central America, the Caribbean and northern South America. Atis was introduced to the Philippines during the Spanish times.. The seed of this plant is well known for killing head lice in many countries (Boonyaprapasara, 1998).

Puapatanakul (1980) reported that the extract of custard apple seeds in coconut oil at the ratio of 1:2 can kill 98% of head lice within two hours, while the leaf extract shows less potency. Gritsanapan et al (1996) found that the petroleum ether extract of the leaves and seeds dissolved in coconut oil at a ratio of 1:1, kill 90% of head lice in vitro by 53 and 26 minutes, respectively. A 20% cream (oil/ water) preparation of petroleum ether extract of custard apple seeds can kill 93% of head lice. Chromatographic and spectroscopic techniques revealed that two major compounds of the hexane seed extract were oleic acid and triglyceride with one oleate ester. The yields of these compounds were 13.25% and 7.74% dry weight, respectively. The compounds were tested in vitro against head lice, comparing to the crude hexane extract of the seed. The triglyceride with one oleate ester and the crude hexane extract diluted with coconut oil 1:1. These

compounds were found to kill all tested head lice in 49, 11 and 30 minutes, respectively. The triglyceride ester can be used as a marker for quantitative analysis of the active compound for quality control of the raw material A. squamosa seed and its extract. Coconut fruit of the coco palm (Cocos nucifera), a tree widely distributed through tropical regions. The seed is peculiarly adapted to dispersal by water because the large pod holding the nut is buoyant and impervious to moisture. The Trees therefore establish themselves naturally on small islands and low shores bordering the tropical seas. The tree grows to a height of 60-100 ft (18-30m), with a smooth cylindrical stem marked by the ring like scars of formers leaves. It bears at the top a crown of frond like leaves and yellow or white blossoms. (Columbia Encyclopedia, 6th Edition, 2008). The coconut is one of the most widespread and useful palms of tropic, where it occurs both wild and activated. The acreage would difficult to calculate; it has been estimated that about 6, 250,000 acres are in coconut cultivation. (Standford, 1934) Coconut Oil is predominantly composed of saturated fatty acids (about 94%), with a good percentage (above 62%) of Medium Chain Fatty Acids among them. These saturated fats are actually medium chain fatty acids like Capric Acid, Caprylic Acid, Caproic Acid & Lauric Acid can do wonder for you. They increase the rate of metabolism in your body, thereby aiding weight loss, increase level of good cholesterol (High Density Lipoproteins) and lower the level of bad cholesterol (Low Density Lipoproteins). They are great sources of energy.

How do you prepare the Atis Seeds?

According to Introduction to: Natural Farming with Organic & Biological Technology (An Attempt to Go Back to Mother Nature) By Rex Rivera, Collect / gather and clean Atis seeds. Chop / cut into small pieces Atis seeds. Pound seeds or grind. Mix pounded Atis seeds with coconut oil (1/2 kilo pounded seeds + 100 ml coconut oil). Filter / screen mixture. A similar method is cited by in Healing Wonders of Herbs by Herminia de Guzman Ladion where one pounds cup of Atis seeds. Mix it with cup of oil.

Conceptual Background Pediculosis or head lice disease ranked as third most common health problem after tooth decay and dental problems according to a study conducted by Department of Education and University of the Philippines. (GfK NOP, 2006) on a research, revealed that 59 percent of Philippine households suffer from head lice and female children aged 4-10 are the most susceptible. In addition 34 percent of elementary school children in the public school are infected. Various kinds of commercially prepared anti head lice are sold around but not everybody infested with head lice are able to avail and use these products because of financial incapabilities and knowledge deficiency. Annona squamosa or commonly known as atis are commonly found in the community. It grows anywhere and is abundant here in the Philippines. All its parts are known to have medicinal values except for the seeds. However, its seeds are considered to have an insecticidal effect. The idea made the researchers decide to use the seeds on eliminating head lice especially for those who are most susceptible, school age children. Evaluation of the effectiveness of atis seeds can be determined after the application of the solution to the subject participants. Eradication of head lice indicates effectivity.

Conceptual Model FIGURE 1

School Age Children (6-12 years old) with head lice infestations

Annona Squamosa seeds solution with coconut oil

Evaluation of the effectiveness of Annona Squamosa seeds solution

Eradication of head lice

THE PROBLEM

Statement of the Problem

The study entitled The Effectiveness of Annona Squamosa Seeds Immersed in Coconut Oil as an Alternative Treatment for Head-Lice seeks to find out:

1. What is the profile of the respondent: a. Age b. Gender 2. How effective the seeds of Annona Squamosa as an alternative treatment in eliminating head lice.

Statement of Hypothesis

The following hypothesis is submitted to quantify the results:

1. Annona Squamosa seeds solution is effective in eliminating head lice among school age children.

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Significance of the Study School-Age Children. This study can help in improving the scholastic performance of children in grade school who were infested with lice. Children will now pay attention to their daily lessons since they would no longer experience itchiness of scalp due to the blood sucking lice and the sensation of lice crawling on their scalp. The children can already participate in games and activities without the fear of spreading the head lice to others thus enhancing their social skills. y Parents and Community People. This study is essential to parents and the community in general. The study helps them to find cheaper, easy to prepare and effective alternative treatment to head lice. Necessary materials are nature friendly and easy to find since Atis is commonly found in the community. y Nursing Practice. This study is of great help in the field of nursing practice especially in the community settings. The research can be best applied in the community hence, giving the community nurses the opportunity of teaching, disseminating and introducing Atis seeds as an alternative way of eliminating head lice. This can not only enhance community nurses skills but helps as well in promoting independence and self reliance to the community people. y Pharmaceutical Companies. This study will give them the fresh impetus to develop new products using herbal plants commonly found in the Philippines. y Future Researchers. This research can also be used as reference and source of information to readers, other researchers and similar studies. y Current Researchers. This study taught the researches to use Gods given creations properly, wisely and effectively.
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RESEARCH METHODOLOGY Research Design The researchers used experimental design: pre-test-post-test (before-after) experimental instrument. The researchers chose this design because it was the most appropriate design for the study.

Research Participants The respondents of the study were the school age children selected through snowball/network/chain sampling from Sitio Isla Verde of Barangay San Isidro Talisay. Snowball sampling, also called network or chain sampling is a variant of convenience sampling whose an early sample member is asked to refer after people who are eligible as study participants. From the population of school children living in the said sitio, the researchers only asked 20 to be participants of their study.

Research Environment Barangay San Isidro is bounded by Barangay Cansojong on the north, Bohol strait on the south and Barangay Dumlog on the north east, Barangay Poblacion on the south east and Barangay Lawaan II on the north west. It has a land area of 171, 863 hectares with (13) thirteen sitios. The Barangay belongs to the 5th income class of the City of Talisay. Having the total population of 8, 491 people, 4,161 males and 4, 330 females. According to the profile registration showed, there are 2590 children belong to 6 12 age. The experiment was done in Sitio Isla Verde, one of the sitios of Barangay San
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Isidro. The place is a congested area and has a problem with the drainage system. The researchers decided to conduct the experiment in the said area because one of the researchers is a resident of Sitio Isla Verde.

Researcher Instruments The researchers used a tool that incorporated a checklist and assessment. The checklist comprised the procedures that were implemented by the researchers for 7 days. The assessment consisted of two parts: before intervention and after intervention which were conducted within 7 days. The tool was accomplished by the researchers themselves

Research Procedures The study was conducted at Sitio Isla Verde, Barangay San Isidro, Talisay Cebu. The selected sample consisted of 20 subjects selected through snowball/network/chain sampling. The researchers created informed consents which were given out to the participants or their guardians and the barangay captain before conducting the experiment. The researchers prepared the materials for making the solution to be used for their experiment; namely: grinded Atis seeds, coconut meat where coconut oil were extracted, cloth and containers. The researchers first separated the atis seeds from the fruit. One half cup of these seeds was subjected for milling for it to be thoroughly pulverized. The researchers then collected the extract from the coconut meat and boiled it. After boiling the oil, the researchers set aside the oil and let it cooled. After, one fourth cup of the boiled coconut oil was added to the one half cup of grinded atis seeds. The

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mixture was set aside to settle for one hour. After one hour, the mixture was strained using a clean cloth and placed on a clean container labeled Atis seed solution. The researchers divided the twenty respondents into two. One group was for the control group and the other half was for experimental group. The experimental group was assessed first including their scalp, lice and nits. Then, researchers prepared the annona squamosa seeds immersed in coconut oil solution. The solution was applied onto the hair and scalp of the participants. The scalp and hair of the participants was massaged and covered with a shower cap for thirty minutes. After, the hair and scalp was assessed then a fine-tooth comb was used to collect the participants lice or nits. The participants hair was then washed with shampoo and water. The control group on the other hand was assessed before and after washing the hair with shampoo and water, withholding the application of atis seed solution. The application of atis seed solution to the experimental group was conducted for seven (7) consecutive days. The results were tallied individually for each participants and interpreted using tables and graphs.

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DEFINITION OF TERMS

Atis seed solution a solution filtrated from grinded Annona Squamosa seeds mixed with coconut oil. Alternative Treatment - the use of various non-drugs, non-surgical related therapies. It is the use of natural means of treatment such as those found in nature e.g., trees, fruits, seeds. Annona squamosa seeds to be used as an anti head lice can be considered as an alternative treatment. Annona squamosa - a small well-branched tree or shrub that bears edible fruits called sugar-apple, species of the genus Annona and member of the family Annonaceaemore willing to grow at lower altitudes making it the most widely cultivated species. It is commonly known as atis in Philippines, and its the center of the study. Barangay San Isidro - a barangay bounded by Barangay Cansojong on the north, Bohol strait on the south and Barangay Dumlog on the north east, Barangay Poblacion on the southeast and Barangay Lawaan II on the north west. It has a land area of 171, 863 hectares with (13) thirteen sitos. The Barangay belongs to the 5th income class of the City of Talisay. Having the total population of 8, 491 people, 4,161 males and 4, 330 females. According to the profile registration showed, there are 2590 children belong to 6 12 age. This is where the study was being conducted.

Coconut oil -it is the oil extracted from the mature coconut fruit. It is one of the ingredients being used in this study together with the Annona squamosa seeds. Effectiveness - the capability of producing an effect, and is most frequently used in connection with the degree to which something is capable of producing a specific, desired

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effect. It relates to how well a treatment works in practice. In this study, it talks more on how many lice were killed upon administration of the atis seed solution to children and how fast can it kill the head lice. Experiment -is the step in the scientific method that arbitrates between competing models or hypotheses. Experimentation is also used to test existing theories or new hypotheses in order to support them or disprove them. It is the research design used in this study. Head Louse (Pediculus humanus capiti) -is an obligate ectoparasite of humans. Head lice (either young or adult) are wingless insects spending their entire life on the human scalp and feeding exclusively on human blood. It can be mostly found on children ages 6-12 years old. Head Louse Infestation ( Pediculosis capitis) -is a human medical condition caused by the colonization of the hair and skin by the parasitic insect. Pediculus humanus capitis-the head louse. Typically, only the head or scalp of the host is infested, although the disease can occur in other hairy parts of the body, like leg hairs. Head lice feed on human blood (hematophagy), and itching from lice bites is a common symptom of this condition. Pre-test-Post-test Experimental Design - basically means before and after the test. In this study, it is the utilized research design, specifically, pre-test - post-test experimental design. It means gathering data and observation to chosen subjects before and after the administration of the test. School-age - these are children ages 6-12 years old. This age group is high risks and is the major recipient of head lice infestations.

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