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Chapter 1
The Problem and Its Background

Introduction
Zika virus is a disease that is spread to people primarily through the bite of an
infected Aedes species mosquito. The most common symptoms of Zika virus are fever, rash,
joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for
several days to a week after being bitten by an infected mosquito. People usually dont get sick
enough to go to the hospital, and they very rarely die from the Zika virus. For this reason, many
people might not realize they have been infected. Once a person has been infected, he or she is
likely to be protected from future infections.
In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding
the first confirmed Zika virus infection in Brazil and on Feb 1, 2016, the World Health
Organization (WHO) declared Zika virus a Public Health Emergency of International Concern
(PHEIC). Local transmission has been reported in many other countries and territories. Zika
virus is a mosquito-borne first isolated in Uganda from a sentinel monkey in 1947. Mosquito and
sentinel animal surveillance studies have demonstrated that is endemic to Africa and Southeast
Asia, yet reported human cases are rare with <10 cases reported in the literature. In June 2007, an
epidemic of fever and rash associated with Zika virus was detected in Yap State, Federated States
of Micronesia. We report the genetic and serologic properties of the Zika virus associated with
this epidemic.

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Mosquitoes and their breeding sites pose a significant risk factor for Zika virus
infection. Prevention and control relies on reducing mosquitoes through source reduction
(removal and modification of breeding sites) and reducing contact between mosquitoes and
people. This can be done by using insect repellent regularly; wearing clothes (preferably
light-colored) that cover as much of the body as possible; using physical barriers such as
window screens, closed doors and windows, additional personal protection, such as sleeping
under mosquito nets during the day. It is extremely important to empty, clean or cover
containers regularly that can store water, such as buckets, drums, pots etc. Other mosquito
breeding sites should be cleaned or removed including flower pots, used tires and roof gutters.
Communities must support the efforts of the local government to reduce the density of
mosquitoes in their locality. Instructions should be strictly followed, special attention and help
should be given to those who may not be able to protect themselves adequately, such as young
children, the sick or elderly.
During outbreaks, health authorities may advise that spraying of insecticides be
carried out. Insecticides recommended by the WHO Pesticide Evaluation Scheme may also be
used as larvicides to treat relatively large water containers. Travelers should take the basic
precautions described above to protect themselves from mosquito bites.
East and West Africa during routine arbovirus surveillance studies in the absence of
epidemics. Additional serologic studies in the 1950s and 1960s detected Zika virus infections
among humans in Egypt, Nigeria, Uganda, India, Malaysia, Indonesia, Pakistan, Thailand, North
Vietnam, and the Philippines. These data strongly suggest wide-spread occurrence of Zika virus
from Africa to Southeast Asia west and north of the Wallace line. In 1977, Zika virus infection
was confirmed among seven patients in central Java, Indonesia, during an acute fever study data

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on these seven Zika virus cases and several previously reported human infections indicated that
clinical characteristics of infection with Zika virus included fever, headache, malaise, stomach
ache, dizziness, anorexia, and maculo papulo rash, in all cases infection appeared relatively mild,
self-limiting.
In the Philippines many people suffer from Dengue Fever and Malaria year around.
Philippines is a hot spot for this dangerous Zika virus because of its tropical climate its a perfect
breeding ground for mosquitos. At the end of 2015 to present there is yet another dangerous
mosquito born virus called the Zika Virus aka Zika Fever. Our group decided to do a
research about this topic because we find it very important for the whole world especially
tropical countries, and third world countries such as the Philippines to learn about this deadly
virus which is spreading quickly.
Many people believe that the Zika virus is a fairly new virus but it has been around since
the 40s It was first discovered in Africa in 1947, then it spread to Asia during the years 19511981, then in 2007 in Micronesia. At the end of 2015 to present day it is starting to spread
through South America. The Zika virus is not well known like the Dengue Virus or Malaria
this makes it a great topic so people could get more information on this fatal virus.
Our group feels that its very important for people here in the Philippines to learn more
about this virus. The Filipino people should know the differences between the Zika virus and the
well-known Dengue Virus. Knowing the difference between the two will make our fellow
Filipinos of the signs of symptoms of the Zika virus and can find ways to control or eradicate this
virus from their household. We believe by teaching about the Zika virus we will help people that
are vulnerable to have knowledge to fight against the spread of this dangerous virus.

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Zika virus can be spread during sexual transmission and from a pregnant mother to the
baby. This makes barangays with higher birth rates a concern for this growing epidemic. Unlike,
the Dengue virus the Zika virus is much more transferable from person to person.
Moreover, our groups objectives are to educate Filipinos who are female and who are
OFWs who are vulnerable to this virus. Also, to furthermore educate the barangays who are by
nearby bodies of water and barangays who have history of mosquito borne illnesses. Our group
will also conduct surveys on how much does an average person know about the Zika virus and
observe what aspect of the study the group must focus on to teach people about the dangerous
virus.
We believe this is a great topic for the nursing community because it deals with a
dangerous virus that can be easily spread around the world. As Nurses and Student Nurses it is
very important to stay on top of current world events especially on deadly viruses and diseases
that are rare or not well known. It is part of our duty to share our knowledge of new viruses and
diseases to everyone and how to prevent them.
Lastly, we are very excited to conduct health education within the community because
there is a lot of information that we need to collect and learn about. We are here to teach the local
community that prevention is better than care and to determine the level of knowledge about
Zika Virus among Filipinos. Our group is passionate in helping the country by determining the
knowledge level of the community to determine a plan that is tailored fit for the Filipino
community and lastly this will help in sustaining the developmental goal of Good Health.

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Background of Study
Zika Virus and its reported auto-immune complications continue to be an important
public health problem in South America, Central America and other parts of the world. It has
been epidemic began in April 2015 in Brazil, and has spread to other countries in South America,
Central America, Mexico, and the Caribbean (WHO, 2015).
The suspected link of Zika to newborn babies with microcephaly and the rise of GuillainBarre syndrome is far more of a concern than the disease common signs and symptoms. This
makes the Zika Virus very unique from the other mosquito borne illnesses.
The Zika virus is fairly recent the virus was first identified in Uganda in 1947 in rhesus
monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified
in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika Virus
Disease have been recorded in Africa, the Americas, Asia and the Pacific (WHO 2016).
As of March 2016 there are a total of 170,683 suspected cases and 3,542 confirmed Zika
cases with 12 deaths (PAHO 2016). One of the main problems faced in Zika epidemiology is the
inadequate knowledge on the risk factors and the association among them. According to the CDC
the first Zika virus infection in the Philippines was back in 2012 and the most recent being an
American who tested positive in the US after his Philippine trip.
The Zika Virus like Dengue comes from the Aedes Aegypti mosquito. The Philippines
has a high number of Dengue cases every year. This makes Philippines a very easy target for the
Zika virus. More over with the rise of population Philippines will be a dangerous place for
pregnant mothers with the Zika virus suspected cases of microcephaly in babies.

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Statement of the Problem

This study will seek to determine the level of knowledge on Zika Virus in a selected
community in Bacoor City.

Significantly the study seeks to answer the following questions:

1. What is the demographic profiles of the respondent according to?
1.1 Age
1.2 Sex
1.3 Civil Status
1.4 Socio-economic Status
1.5 Educational Attainment
2. Have you ever had a mosquito borne illness? Yes, or No?
3. What is the level of knowledge on Zika Virus according to?
a. Transmission
b. Signs and Symptoms
c. Complications

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d. Prevention and Treatment

4. Is there a significant difference between the levels of knowledge when grouped according
to the demographic profile?
5. Is there a significant difference between the level of knowledge when grouped according
to those where mosquito borne illness and havent?

Null Hypothesis
1.) There is no significant difference of knowledge between people who had mosquito borne
illnesses to the people who havent.
2.) There is no significant difference of concern between the respondents on different age
groups and different gender.

Significance of the Study

To Nurses
Nurses can design healthcare plans and can impart knowledge in terms of the Zika Virus
signs and symptoms, mode of transmission, treatment and preventing complications.

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To Clinical Instructor
As people being in the medical field, The Clinical Instructor may be updated to the latest
trends about the level of awareness on Zika virus. They can also impart new knowledge and
ideas to their students when it comes to preventing complication in maternal health.
To Society
Through the results of this study, the level of knowledge on Zika Virus will increase and
educate the public on what the disease is all about.
The Municipal Health Office
This will serve as documentation on the evidences on the residents knowledge of Zika
virus as a basis for action on health education and information dissemination.

Local government of the City of Bacoor

With this new knowledge and information, the city of Bacoor will be able to conduct
health teaching to its citizen providing basic but very informative facts about the Zika virus. Also
be able to provide more programs to raise the level of knowledge to its citizens.
Future researchers
The future researchers will be able to utilize this study as a reference to their research
paper, also this study will broaden their knowledge about the Zika Virus. This study is very
important in the Philippines especially Philippine is being a tropical country with many

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mosquitos that cause many diseases. The people in the Philippines, and also the whole world can
appreciate this study because only a few information about Zika is out there.

Scope and Limitations

The study will be focused on determining the level of knowledge on Zika Virus as a basis
on health education campaign for prevention. Being in the city of Bacoor, the researchers had
chosen the barangays at the heart of it. Among others that were chosen has been selected due to
its varying demographics and location. The data will be limited to residents of Bacoor City,
Cavite. Data will be gathered using a survey questionnaire and through an interview that will be
distributed and conducted on June to July 2016. Collection of data will greatly depend on the
respondents and researchers availability.

The accuracy of the results of this study will be largely dependent on the information that
the respondents will provide.

Definitions of Terms
To provide understanding on the terms being used in the study, the researchers have
defined the following terms operationally.

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Knowledge- They the people of the city of Bacoor and the group will use their knowledge to
understand the Zika Virus and will help each other to improve the level of knowledge that the
community has about the Zika Virus though research.
Mosquito borne illness- are diseases caused by bacterial, viruses or
parasites transmitted by mosquitoes. They can transmit disease without being affected
themselves.
Prevention - They the people of Bacoor and the group will help together to prevent the Zika virus
from becoming an epidemic in Bacoor, Cavite. Prevention will be the ultimate goal of the group
and the citizens of Bacoor.
Zika Virus - A virus spread to a human by Aedes mosquitoes- the same mosquitoes that spread
dengue, chikungunya and yellow fever. It usually causes mild illness, with most people sick with
the virus getting a slight fever and skin rash.

Chapter II

Review of Related Literature

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The Zika virus was first identified in monkeys in Uganda in 1947. The first human case,
however, was detected in Nigeria in 1954, and following that there have been further outbreaks
in Africa, South East Asia and the Pacific Islands. While the symptoms of Zika typically pass
within the space of a week, there have been recent concerns about the virus are due to a potential
link between Zika and birth defects such as microcephaly.
In light of a strongly suspected causal relationship, the World Health Organization
(WHO) declared that the Zika virus outbreak constituted a Public Health Emergency of
International Concern on 1 February 2016. (Written by Lori Smith BSN MSN CRNP Last
updated: Mon 15 February 2016).
A growing concern that is currently under investigation is a possible link
between maternal Zika virus infection and infant microcephaly. Brazil in particular has seen a
surge in infants born with microcephaly since October 2015, at rates that have been reported to
be 10 times higher than those in previous years.
These infants have been tested for Zika virus with mixed results - some positive and
some negative for the virus. Zika virus has been confirmed to be present in two amniotic fluid
samples of microcephalic babies. Researchers have confirmed more than 460 of these cases as
microcephaly and identified evidence of Zika infection in 41 of these cases, but have not proven
the virus can cause microcephaly. There are so far no recorded cases of Zika-linked
microcephaly in Colombia, the government has said. Officials are still examining figures from
countries such as Brazil, but say Colombia can expect between 500 and 600 cases this year.
There is no vaccine or treatment for Zika, which causes mild fever, rash and red eyes. An
estimated 80 percent of people infected have no symptoms.

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The institute said 29.4 percent of pregnant women with Zika live in Norte de Santander
province, along the eastern border with Venezuela. Colombia's Caribbean region, which includes
popular tourist destinations Cartagena and Santa Marta, had more than 12,488 cases of the virus,
the bulletin showed. The government has said pregnant women with Zika are eligible to access
much-restricted abortion services. Many women struggle to find abortion providers even when
they meet strict legal requirements and illegal abortions are widespread.
Zika virus, an emerging mosquito-borne flavivirus, was initially isolated from a rhesus
monkey in the Zika forest in Uganda in 1947.1 It is transmitted by various species of aedes
mosquitoes. After the first human Zika virus infection, sporadic cases were reported in Southeast
Asia and sub-Saharan Africa. Zika virus was responsible for the outbreak in Yap Island of
Micronesia in 2007 and for major epidemics in French Polynesia, New Caledonia, the Cook
Islands, and Easter Island in 2013 and 2014. In 2015, there was a dramatic increase in reports of
Zika virus infection in the Americas. Brazil is the most affected country, with preliminary
estimates of 440,000 to 1.3 million cases of autochthonous Zika virus infection reported through
December 2015. The classic clinical picture of Zika virus infection resembles that of dengue
fever and chikungunya and is manifested by fever, headache, arthralgia, myalgia, and
maculopapular rash, a complex of symptoms that hampers differential diagnosis. Although the
disease is self-limiting, cases of neurologic manifestations and the GillianBarr syndrome were
described in French Polynesia and in Brazil during Zika virus epidemics. Recent reports from the
Ministry of Health of Brazil suggest that cases of microcephaly have increased by a factor of
approximately 20 among newborns in the northeast region of the country, which indicates a
possible association between Zika virus infection in pregnancy and fetal malformations.

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We present a case of vertical transmission of Zika virus in a woman who was probably
infected with Zika virus in northeastern Brazil at the end of the first trimester of pregnancy. Our
discussion includes details of fetal imaging and pathological and virologic analyses.
The World Health Organization has declared the Zika virus an international public health
emergency, prompted by growing concern that it could cause birth defects. As many as four
million people could be infected by the end of the year. Officials at the Centers for Disease
Control and Prevention have urged pregnant women against travel to about two dozen countries,
mostly in the Caribbean and Latin America, where the outbreak is growing. The infection
appears to be linked to the development of unusually small heads and brain damage in newborns.
Some pregnant women who have been to these regions should be tested for the infection, the
agency said. Here are some answers and advice about the outbreak. (Donald G. Mcneil
Jr., Catherine Saint Louis and Nicholas St. Fleur updated February 12, 2016).
In 2008, a scientist studying malaria in Africa returned to Colorado and apparently
infected his wife before developing symptoms himself. Both had fever, rash and headaches. A
year later, tests on their blood, which had been frozen, revealed that both had had Zika virus. In
2013, live virus was found in the semen of a 44-year-old Tahitian man; whether he infected
anyone is unknown.
In early February, health officials in Texas announced that a traveler who had returned to
Dallas from Venezuela apparently had infected a sexual partner. In the first two cases, the men
had genital pain and blood in their semen, suggesting that their testes or prostates had been
infected. Details regarding the third case were not released. Based on these reports, the C.D.C.
issued tentative new guidelines suggesting that pregnant women avoid contact with semen from

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men who have recently returned from areas with Zika virus transmission. Men returning from
these regions should consider using condoms, the agency said.
On Jan. 19, the C.D.C. issued interim guidelines for women in that situation and for their
doctors. The guidelines are complex and may change. In general, they say that pregnant
women who have visited any area with Zika transmission should consult a doctor. Those who
have had symptoms of infection like fever, rash, joint pain and bloodshot eyes during their trip or
within two weeks of returning should have a blood test for the virus. That recommendation is
controversial, because even women with no symptoms may have been infected 80 percent of
those who get the virus do not feel ill and there is no evidence that babies are hurt only when the
mother has been visibly ill. But at the time the guidelines were issued, the C.D.C. and state
health departments simply did not have the laboratory capacity to test every pregnant woman
who visited Latin America and the Caribbean in the last nine months, as well as every pregnant
woman in Puerto Rico.
On Feb. 5, the agency added a recommendation that pregnant woman who do not show
any Zika symptoms should also receive testing two to 12 weeks after returning from a Zikaaffected country. Even for women who get blood tests, the news is not entirely reassuring. Tests
for the virus itself only work in the first week or so after infection. Tests for antibodies can be
done later, but they may yield false positives if the woman has had dengue, yellow fever or even
a yellow fever vaccine. Under the C.D. Cs testing algorithm, pregnant women who have been to
affected regions whether they have symptoms or not, and whether they have negative or
positive blood tests should eventually have an ultrasound scan to see if their fetuses are
developing microcephaly or calcification of the skull.

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Unfortunately, an ultrasound usually cannot detect microcephaly before the end of the
second trimester. Some women also should have amniocentesis to test the fluid around the fetus
for Zika virus. But amniocentesis involves piercing the amniotic sac with a long needle through
the abdomen; it is slightly risky for the fetus and is not recommended before 15 weeks gestation.
Several companies are working on rapid tests for Zika infection. The C.D.C. also usually
distributes test kits and training materials to state health departments during outbreaks, which
should increase testing capacity. (Donald G. Mcneil Jr., Catherine Saint Louis and Nicholas St.
Fleur updated February 12, 2016)
More than 5,000 pregnant Colombian women are infected with the mosquito-borne Zika
virus, the country's national health institute said on Saturday, as the disease continues its rapid
spread across the Americas with the virus was up 57.8 per cases of the virus total 31,555, the
institute said in a epidemiology bulletin, among them 5,013 pregnant women. Zika, which has
spread to more than 30 countries, has been linked to birth defect microcephaly and to
neurological disease Guillain-Barre syndrome. Total reported Zika cases increased by 23 percent
over last week's figures, while the number of pregnant women. Much remains unknown about
Zika, including whether the virus actually causes microcephaly. Brazil is investigating the
potential link between Zika infections and more than 4,300 suspected cases of the birth defect, a
condition marked by abnormally small head size that can result in developmental problems.
One Bogota abortion clinic said several women with Zika had come for consultations, but
would not confirm if procedures took place. Local media reported what they said was the first
abortion in the country because of Zika last week. Colombian authorities have urged women to
delay pregnancy for six to eight months. The World Health Organization estimates Zika could

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eventually affect as many as 4 million people. Colombia expects up to 600,000 cases this year.
The health minister has said he believes three deaths are connected with Zika. (Reporting by
Julia Symmes Cobb; Editing by Alison Williams)
Since November, Brazil has seen 404 confirmed cases of microcephaly in newborns.
Seventeen of those cases have a confirmed link to the Zika virus. There were only 146 cases in
2014. So far, 15 babies have died from the condition, with five linked to Zika. An additional 56
deaths are under investigation, and authorities are investigating 3,670 suspected cases. October
2015, a 25-year-old previously healthy European woman came to the Department of
Perinatology at the University Medical Center in Ljubljana, Slovenia, because of assumed fetal
anomalies. Since December 2013, she had lived and worked as a volunteer in Natal, the capital
of Rio Grande do Norte state. She had become pregnant at the end of February 2015. During the
13th week of gestation, she had become ill with high fever, which was followed by severe
musculoskeletal and retroocular pain and an itching, generalized maculopapular rash. Since there
was a Zika virus epidemic in the community, infection with the virus was suspected, but no
virologic diagnostic testing was performed. Ultrasonography that was performed at 14 and 20
weeks of gestation showed normal fetal growth and anatomy.
Laos joined a total of 41 countries that have reported local transmissions of the virus
since the beginning the year, a WHO report said. Laos is the latest country to report a local
transmission of Zika virus, according to the World Health Organization, as fears mount over the
mosquito-borne illness that has been linked to birth defects. Asia has seen only a sprinkling of
cases of the virus, but a surge in Latin America this year has pushed the UN health agency to
declare Zika a global health emergency. Laos joined a total of 41 countries that have reported
local transmissions of the virus since the beginning the year, a WHO report said. Health

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authorities in Laos, a rural Communist country with minimal infrastructure, were not available to
comment. Neighboring Thailand reported one case last month of a 22-year-old who contracted
the illness domestically and has since recovered. Thailand's health ministry urged the public not
to panic, saying there have been an average of five cases per year since 2012 with no outbreaks.
The sickness is carried by the Aedes aegypti mosquito, which also spreads dengue fever. It
breeds in tropical areas, including Southeast Asia, which has seen a spike in cases of dengue in
recent months and most often causes mild, flu-like symptoms. A growing body of evidence
suggests Zika can also trigger microcephaly, a severe deformation of the brain among newborns,
in babies born to mothers infected while pregnant. Brazil was first to sound the alarm on the
apparent link with birth defects. It has since become the hardest hit country, with an estimated
1.5 million cases of active Zika transmission and 641 confirmed cases of microcephaly. On
Friday scientists in the United States said they found the first concrete evidence of a link between
the virus and the birth defect, which has so far been circumstantial. The findings may help to
identify drugs to prevent or cure the Zika virus, which currently lacks a vaccine or specific
treatment. (WHO Mar 5, 2016).
Zika has been in Asia and the Pacific for at least 60 years, though its mostly mild
symptoms have prompted little cause for concern. But with the World Health Organization
declaring a global emergency after an outbreak in Brazil that's been linked to serious birth
defects, some countries in the region are taking special precautions. Tonga has declared an
epidemic, and the government of the Cook Islands has advised women to delay becoming
pregnant. Japan, South Korea, Nepal and India have issued advisories to pregnant women against
travelling to infected countries. South Korea has announced a fine of two million won (about

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$1,700) on doctors who fail to immediately report suspected cases, while Malaysia has asked
travelers to the country to report to health centers if they have symptoms.

Nepal is trying to get rid of any standing water where the Aedes mosquito, which carries
the Zika virus, can easily breed, said Dr. Babu Ram Marasini, director of the disease control
division at the Department of Health Services. We carry out search and destroy campaigns, and
request people to throw the water from external containers and dry them out for a few hours, he
said. India has set up a technical group to monitor the situation, posted warnings at international
airports and has promised to ramp up community awareness to stop mosquito breeding. Although
no cases of infection have ever been documented in India, it was in that country, back in 1953,
where the first evidence emerged that Zika had jumped from animals to humans. In that study
just six years after Zika was discovered in monkeys in Uganda, researchers from the National
Institute of Virology, in the city of Pune, found that 33 out of 196 people surveyed had immunity
to the virus.

For the most part, symptoms have not been particularly serious, usually a rash and a
fever, and little attention was paid to Zika for a long time after the study. But in 2007, Zika
exploded in the tiny Pacific island of Yap, in the Federated States of Micronesia, where almost
three quarters of its approximately 10,000 inhabitants tested positive. Six years later, Zika
infected about 35,000 people in French Polynesia. It was there that researchers discovered the
potential connection between the virus and Guillian-Barr syndrome, according to a 2014 article
in Eurosurveillance, a scientific journal that focuses on communicable diseases. Guillian-Barr
syndrome causes the immune system to attack the nervous system, leading to a weakening of the
limbs and sometimes paralysis. It is unclear how Zika arrived in Brazil, but researcher published

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in a US Center for Disease Control journal theorized last year that it may have arrived with
participants from Pacific countries at the World Canoeing Championships in Rio de Janeiro in
August 2014. Zika is now spreading rapidly through the Americas after recently showing up first
in Brazil, where there have been about 1.5 million cases. Preliminary research appears to show a
link between Zika and Guillian-Barr syndrome as well as microcephaly, which can cause babies
to be born with small heads and underdeveloped brains. Despite Zika's relatively benign history
in Asia and the Pacific, there is risk that a stronger form of the virus may have emerged, and that
it could spread throughout the region with much more severe consequences than previous
outbreaks. "The strain in Brazil could be new because mutation rates in these viruses are high.
Moist tropical climates, population explosion and international travel mean Asia is susceptible to
Zika," said Dr. Shailendra Saxena, of the Indian Virological Society. He said that rapidly growing
populations in many Asian countries make them vulnerable to an outbreak of Zika. As migration
to cities increases, so do slums with poor sanitation and stagnant water where mosquitoes can
breed. (By Nimisha Jaiswal DELHI, 16 February 2016).

The literature review will present a broad review of the relevant articles, journals and
research work in order to contextualize in a more focused and detailed way regarding the
compliance of the citizens of the Philippines to the Zika Virus. This perception is further
enhanced by reporting the findings of the effects of Zika Virus and how vital it is to maternal
mothers in promoting healthy pregnancy. Brazilian Soldiers help with fight against Zika Virus.
Brazilian soldiers to be deployed in 'mega' Zika prevention drive Hundreds of thousands of
Brazilian soldiers are to be deployed in towns and cities in a one-day push to raise awareness of
mosquito breeding grounds amid the Zika virus outbreak.

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Officials and 220,000 soldiers aimed to visit 3m homes in more than 350 locations on
Saturday, handing out leaflets and giving advice on how to stop the spread of the Aedes aegypti,
the mosquito species that carries the virus. It is part of a mega operation planned by the
Brazilian government to eliminate potential mosquito breeding sites just months before athletes
and fans travel to the country for the Olympic Games. (Damien Gayle is a Guardian reporter
Feb.13, 2016)
This is a great article on Brazil trying their best to fight against the spread of the Zika
virus. They are using 220,000 soldiers to visit 3 million homes. They will be passing out
pamphlets and teaching people how to stop the spread of the virus. I wish they would do that to
in the Philippines when we have an epidemic. Its always great to have the military help in
anyway. They are fast and efficient when there is a crisis. I hope that this will help Brazil control
the Zika virus before the start of the summer Olympics.
Previously, the agency said there was not yet enough scientific evidence to say the virus
caused these conditions, although it was likely. More than 1,000 cases of microcephaly and other
fetal malformations believed to be Zika-associated have been reported from six countries,
according to the WHO. There have been nearly 400 cases of Guillain-Barre syndrome in
patients with confirmed or suspected Zika virus infection in 13 countries. The agency said
research continues to determine a "causal link" between the Zika virus and neurological disorders
in fetuses, newborns, infants and adults. This includes trying to quantify what the risk is for
pregnant women and others.
Since last year the virus has infected hundreds of thousands of people in nearly 60
countries. Symptoms include a rash, fever, joint pain and red eyes (conjunctivitis). However,

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80%of those infected have no symptoms. The virus is primarily transmitted via infected Aedes
aegypti mosquitoes, but it is also sexually transmitted.
In February the WHO declared a public health emergency of international concern over
the virus. This was prompted largely by how fast the outbreak was spreading and because of the
link just suspected, at that time -- to microcephaly and other possible neurological defects. The
agency predicts 3 to 4 million people will be infected within a year. (By Debra Goldschmidt,
CNN April 7, 2016).
Colombia is one of the countries at the front line of the Zika crisis. It has also seen an
alarming number of cases of Guillain-Barre syndrome -which can cause devastating paralysis.
Scientists are cautious of making a direct connection between the two, but on the frontline the
panic is real - and growing. Imagine losing control over the muscles in your body. It starts with
pins and needles in your feet. You lose feeling in your legs. Then you can't even blink. Victims of
Guillain-Barre can sometimes show the whites of their eyes, as if they are the living dead. And,
in the worst cases, it can mean you can no longer breathe. This Zika Virus is getting scarier every
day. Columbia has been hit really hard with this crippling disease. Now with Zika relating to
paralysis which is caused by the Guillain-Barre syndrome. These scientific claims are still
undergoing, but I wouldn't doubt it because just like dengue fever it also can caused sever joint
and muscle aches and pain. Now we can truly say that this Zika virus has worst symptoms than
Dengue Fever. (By John Sweeney BBC News night in Cucuta, Colombia 13 February 2016)

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As the Zika virus spreads, hitting 52 countries to date according to the World Health
Organizations Friday update, health authorities are increasingly worried about microcephaly. At
the same time, new research is tightening the connection between the virus and this potentially
devastating birth defect. Only Brazil and French Polynesia have experienced sustained outbreaks
of microcephaly, but that could potentially change quickly. Zika has reached the Americas, the
Caribbean, Europe and the Pacific, according to the WHO. (On Friday, researchers in Colombia
reported they had found infants with microcephaly there too.) The WHO says that just two
pregnancies exhibiting the defect have been confirmed in women who were infected while
pregnant and traveling in the Zika zone: one in Slovenia, and one in Hawaii. In Brazil, 641 cases
of microcephaly have been confirmed since the virus arrived in the country last year, according
to the Ministry of Health; there have been 139 miscarriages and infant deaths from complications
of microcephaly. Another 4,222 are being investigated, and 1,046 suspected cases have been
rejected for not meeting the case definition of microcephaly. (By Maryn McKenna PUBLISHED
MARCH 7, 2016).
In March 2012, a prospective longitudinal cohort study, which included active
surveillance for acute febrile illness, was initiated in Cebu City, Philippines (I. Yoon, unpub.
data). Participants contacted study staff to report fever and were also contacted weekly by staff to
determine if they had fever during the previous 7 days. Fever episodes triggered an acute-illness
visit by a study nurse, who performed a clinical assessment of the patient and collected an acutephase blood sample. During the first year of surveillance, 270 acute febrile illnesses were
detected; 267 of the patients had samples available for serologic testing for evidence of
influenza, dengue, chikungunya, Japanese encephalitis, and Zika virus infections.

Level of Knowledge...

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In May 2012, a 15-year-old boy in Cebu City reported a subjective fever; an acute-illness
investigation followed. Other symptoms included headache, conjunctivitis, sore throat, myalgias,
stomach pain, anorexia, nausea, and vomiting, but no rash. The boy did not seek medical care or
require hospitalization; his only treatment was acetaminophen. He had no recent travel history,
and no other members of his household were ill. The boy recovered fully by the 3-week study
follow-up visit. An acute-phase blood sample, collected 2 days after symptom onset, was
negative for dengue and chikungunya viruses by reverse transcription PCR. ELISA and
chikungunya ELISA were used to test paired acute- and convalescent-phase blood samples; all
results were negative. ZIKV ELISA was not available at the testing laboratory. However, by
using real-time reverse transcription PCR targeting the gene that encodes the precursor of
membrane protein, we detected ZIKV RNA in the patients serum sample. (CDC Volume 21,
Number 4April 2015).

The Department of Health (DOH) in a press briefing on Sunday (March 6) said it is not
observing any case of possible Zika virus at the moment, as four individuals tested negative in
the last month. Zika virus disease is caused by a virus transmitted by Aedes mosquitoes but it can
also be transmitted through sexual contact. People affected with the disease usually have
symptoms that include mild fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, or
headache.
The World Health Organization (WHO) said there are 55 counties and territories that
have reported local Zika transmission from January 2007 to March 3, 2016. Zika virus is said to
lead to Microcephaly and Guillain-Barr syndromes in fetuses, making pregnant women the
most vulnerable. Garin claimed that in the past 10 years, 332 microcephalic cases are reported in

Level of Knowledge

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the Philippines, but this number is not showing signs of increase, and so there are still no cases of
anomalous Guillain-Barre and Microcephaly births in the Philippines. The health secretary also
pointed out, the public should exercise maximum effort to prevent mosquito bites especially by
destroying places where mosquitoes breed, like flower vases and water containers. (By Isabella
Montano, CNN Philippines Mon, March 7, 2016).
As of February 2016, three reported cases indicate that Zika virus could possibly be
sexually transmitted. In 2004, Zika virus capable of reproducing itself was found in the semen of
a man a least two weeks (and possibly up to 10 weeks) after ill with Zika fever. The second
report is of a United States biology isnt who had been many times while studying mosquitoes in
Senegal. Six days after returning home in August 20008, he fell ill with symptoms of Zika fever
but not before having unprotected intercourse with his wife, who had not been outside the US in
2008. She subsequently developed symptoms of Zika fever, and Zika antibodies in both the
biologists and his wifes blood confirmed the diagnosis. In the third case, in early February 2016
the Dallas Country Health and Human Services department reported that a person contracted
Zika fever after sexual contact with an ill person who had recently returned from a high risk
country. This case is still under investigation.

Theoretical Framework
One of the theories anchored in this study is the Florence Nightingales Environmental
Theory, ventilation is important because a person who breathes his own air repeatedly would
become sick. The greater part of nursing consists in preserving cleanliness the cleaner and area is
the less mosquito or totally eliminate mosquitos. After being infected with Zika virus we also

Level of Knowledge...

25

could use Virginia Henderson 14 Activities for Client Assistance some activities we can use is
breathe normally, eat and drink adequately, eliminate body wastes, move and maintain desirable
postures sleep and rest maintain body temperature within normal range by adjusting clothing and
modifying environment, keep the body clean and well-groomed and protect the integument.
Avoid dangers in the environment and avoid injuring others and worship according to ones faith.
Conceptual Framework

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Figure 1. Chain of Infection

These are the chain of infection of Zika Virus. It is different from other mosquito borne
illnesses because the Zika Virus can also be spread through sexual intercourse also from mother
to infant. The Zika virus is very transferable disease this makes the virus spread very fast and can
be an epidemic at any time.

In this Paradigm explains how the Zika Virus exist. The Zika Virus thrives through these
three specific parameters which include social, ecology, and biology, these 3 elements will
sustain the growth and spread of the Zika Virus. Without any of the 3 elements the Zika Virus
would not be sustained. Thus, we need to eliminate on of these elements so that the Zika virus
will be eradicated.
Conceptual Paradigm

Level of Knowledge...

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Figure 2. Factors Affecting the Level of Knowledge on Zika Virus.

The compliance level of soon to be mothers and OFWs can greatly be attributed by
several factors including Ecology, Social, and Bio. This study claims that education, motivation
and understanding of the Zika health program of the DOH. The paradigm represents the
dependent variables of contacting the Zika Virus. All these dependent factors contribute to the
Zika Virus. We need to identify the major variables that is affecting our correspondents. As we
found out these dependent variables then we can develop a system that we can now educate the
people who live in high risk areas.

Synthesis

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Getting proper information to a certain disease is very hard to achieve among the poor.
Unless they do their own research or is they go out of their way to find information with their
local government facility. The government should invest more money and new ways to get the
right information out to the public. The government does well with the news on TV but how
about the people who dont have access to television or the internet? As researchers we need to
know the important gaps in knowledge that are required to guide the introduction of proven,
effective interventions. These gaps can only be filled through continued funding support for
formative and health systems research that provides the knowledge necessary for well-informed,
pro-poor health policies and the widespread application of effective, affordable and acceptable
interventions.

Input

Data Collected from

respondents
containing.

Demographic
Profile
Age
Research
Paradigm
Sex
Civil Status
Socioeconomic
Status
Educational
Attainment

Level of Knowledge...

29
Process

Interpretation and
Analysis of data
collected through:
Graphs
Calculations
Related
Literature
Knowledge on Zika
virus.
Sign and
Symptoms
Mode of
Transmission

Output

Design Programs to
increase information
dissemination on
Zika virus for
readiness and
prevention.

Figure 3. Research Paradigm

Our research paradigm the input will be gathering from data that is collected from the
respondents. We will be getting their demographic profile, we will be testing their knowledge on
the Zika virus such as what signs and symptoms to look for, and the different modes of
transmission, and lastly, what are the treatments and preventions against the Zika Virus. During
the process stage we will gather all the data we collected and calculate and will display our
information using graphs. With all this information and related literature then we can design
programs to increase information on the preventions and dissemination of the Zika Virus.

Chapter III

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Research Methodology
This chapter describes how study will be conducted. It aims the future readers and
researchers to understand the processes that were involved in arriving at the analysis of research
findings and conclusions. This presents a description of the research design, instrumentation, and
participants of the study, sampling technique, and statistical treatment of data.

Research Design.
Quantitative study will be utilized in the course of this study specifically, descriptive and
comparative method. The descriptive design is used for the purpose of to gain information and to
determine the extent or direction of attitudes and behaviors. The research design will be utilized
to describe the study and to test the difference between variables.

Instrumentation
According to our questionnaire we would learn a great deal about what our
correspondents know about the Zika Virus. With this information we will know their level of
knowledge about the Zika Virus. After we conclude this surveys we would now develop a
program to help people by giving them further information about the dangers of the Zika virus.
Lastly, our questionnaire covers in depth about the Zika virus and what our correspondents need
to know about it.

Participants of the Study

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The participants of the study will be obtained from Bacoor City Cavite. Due to its
location, water level is at varying levels resulting to floods during rainy seasons, moreover,
stagnant water, that could lead to breeding grounds for mosquitoes. The total population will be
identified and from that a sample size of 200 respondents will be obtained. The researchers will
utilize Non-probability sampling specifically, Convenience sampling. It is a method whereby the
researchers select the sample based on convenience or availability at the moment.

Data Gathering Procedure

First we make an approval letter to be signed by the Dean of School of Health Sciences
and Professions. After which, the researchers submitted a letter to the City Health Office for the
conduction of the study; then the researchers went to the Barangay health center and coordinated
with the Barangay Health Nurse to obtain data needed for the study. Lastly, the researchers
tallied the obtained data in the two Barangay Health Centers.

Level of Knowledge

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32

Make an approval letter to conduct the study

Make a letter address to the City Health Office

Barangay Health Center and coordinated the Barangay Health Nurse

Data Gathering

Figure 3. Data Gathering Flow Chart

Data Analysis and Statistical Treatment of Data

Data will be arranged using graphs to show the average number of respondents according
to their demographics and answers on the survey questionnaire. A Likert Scale will be used in
determining the level of knowledge on Zika Virus of the respondents. The respondents will rate
themselves in the scale of 1 to 4. Four (4) being the highest and one (1) being the lowest. The
scaling will be 4- strongly agree, 3-agree, 2-disagree and 1-strongly disagree. They will put

Level of Knowledge...

33

check mark on the column wherein they agree or disagree in the prepared statements of the
questionnaires.
To obtain the average,

Where:
= Mean/ Average

= summation of x
N

= sample

To test the hypothesis, T-test will be utilized

Where:
= mean of first data set

Level of Knowledge

34

= mean of first data set

S12

= standard deviation of first data set

S22

= standard deviation of first data set

N1

= number of elements in the first data set

N2

= number of elements in the first data set

Ethical Considerations
According to Bryman and Bell (2007) the following ten principles of ethical
considerations have been compiled as a result of analyzing the ethical guidelines of nine
professional social sciences research associations:
The research participants should not be subjected to harm in any way whatsoever we also
have to respect for the dignity of research participants should be prioritized. Full content should
be obtained from the participants prior to the study. The protection of the privacy of research
participants has to be ensured. Adequate level of confidentiality of the research data should be
ensured. Anonymity of the individuals and organizations participating in the research has to be
ensured.
Any deceptions or exaggeration about the aims and objectives of the research must be
avoided. Affiliation in any form, sources of funding, as well as any possible conflicts of interests
have to be declared. Any type of communication in relation to the research should be done with
honesty and transparency. Any type of misleading information, as well as representation of
primary data findings in a biased way must be avoided.

Level of Knowledge...

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Through these statements, the researchers will not use coercion to respondents but will
implement voluntary participation. Also, the researchers will protect the confidentiality of their
answers and their identity. Related studies, theories, articles and other secondary information
gathered will be properly acknowledged. Lastly, the researchers will maintain the highest level of
objectivity in the analyses of research results.

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