DE LA SALLE HEALTH SCIENCES INSTITUTE COLLEGE OF MEDICINE DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE CM2 SY 2011-2012

REVISED OUTPUT 4: SAMPLING METHOD

SUBMITTED ON: AUGUST 31, 2011

SUBMITTED TO: DR. JOVILIA M. ABONG

SUBMITTED BY: GROUP 1A ARCAIRA, JOSHUA A. ABAD, RAINA ANCHETA, JONATHAN B. BASUL, CHARINE CARAVEO, JULIEN NICOLE CRUZ, SPICA ESPINOZA, FAITH KRISTINE GARCIA, RAY WILSON KALALO, GERARD MICHAEL

OUTPUT 4: SAMPLING METHOD (REVISED) I. Group 1A, Dr. Jovilia M. Abong

II. Research Question: Among second year high school students with allergic rhinitis of selected schools in Dasmarias, Cavite, will exposure to air-conditioned school rooms affect the severity of their allergic rhinitis? General Objective: To determine if the exposure to the air-conditioning system affects the severity of allergic rhinitis in second year high school students of selected schools in Dasmarias, Cavite. Specific Objectives: 1. To identify the prevalence of allergic rhinitis among second year high school students of selected schools in of Dasmarias, Cavite based on their exposure to air-conditioned rooms. 2. To identify the prevalence of allergic rhinitis among second year high school students of selected schools in Dasmarias, Cavite based on their exposure to non-air-conditioned classrooms. 3. To determine the severity of allergic rhinitis according to ARIA classifications. 4. To identify the risk factors of allergic rhinitis present in the classroom or school, such as the presence of pollen, molds, and cockroaches. 5. Compare the severity of allergic rhinitis in students who are exposed to air-conditioned classrooms and those who are not exposed to air-conditioned classrooms. III. Research Design: Cross-Sectional Study IV. Definition of: 1. Study Population: Second year high school students with allergic rhinitis 2. Sample Population: Second year high school students of selected high schools in Dasmarias, Cavite with allergic rhinitis. 3. Sampling Frame: List of Schools in Dasmarias, Cavite 4. Sampling Unit: Two selected schools (1 school with air conditioned classrooms and 1 without) 5. Elementary Unit: Second year high school student with allergic rhinitis V. Selection of: 1. Subjects This study will be conducted using Multi-Stage Sampling Design to select the subjects. In doing so, the list of schools in Dasmarias, Cavite will be obtained from Municipal Hall of Dasmarias City. Then, the schools will be divided into two strata, one having air-conditioned classrooms and the latter without an air-conditioning system. One school will be chosen to represent each group via a fishbowl method. Then, a letter will be sent to the chosen schools asking permission for their involvement in the study. After the school has granted permission, we will then ask for a list

of the sections of second year level and again, by fishbowl method, select particular sections from which we will screen students. List of Schools in Dasmarinas, Cavite

School with Airconditioned classrooms

School without Airconditioned classrooms

1 Representative School Selected Randomly

1 Representative School Selected Randomly

Class list of Second Year Sections

Class list of Second Year Sections

Random Selection of Sections to Participate in the Study

Random Selection of Sections to Participate in the Study

Figure 1. Schematic Diagram of the Multi-Stage Sampling Design to be employed in the study.

2. Cases and Controls The cases for the study, defined as those who have exposure to air-conditioned classrooms, will be chosen by screening each subject using a questionnaire that follows the International Study of Asthma and Allergies in Childhood (ISAAC) guidelines. The control group, who will have no exposure to air-conditioning system in the classroom, will also be chosen by screening each student with the same questionnaire. Based on the results, only those with allergic rhinitis will be chosen as the subjects for the study. The selected students are those who experience sneezing or a runny or blocked nose when they do not have a cold or flu. Those who have experienced hay fever before will also be selected for the studys control group. Those who do not present with symptoms or have never experienced hay fever will be removed from the study. Figure 2 illustrates the screening procedure and is seen as follows:

Figure 2. Schematic diagram of the selection of cases and controls to be included in the study.

APPENDIX A ISAAC QUESTIONNAIRE FOR SCREENING STUDENTS Study Instruments for 13/14 year olds Instructions for Completing Questionnaire and Demographic Questions (Section 7.1) On this sheet are questions about your name, school, and birth dates. Please write your answers to these questions in the space provided. All other questions require you to tick your answer in a box. If you make a mistake, put a cross in the box and tick the correct answer. Tick only one option unless otherwise instructed.

___________________________________________________________________________________ SCHOOL: TODAYS DATE: Day YOUR NAME: YOUR AGE: years Month Year

YOUR DATE OF BIRTH: Day Month Year

(Tick all your answers for the rest of the questionnaire)

Are you:

MALE

FEMALE

Core Questionnaire for Allergic Rhinitis (Section 7.3) All questions are about problems which occur when you DO NOT have a cold or the flu. 1 Have you ever had a problem with sneezing, or a runny, or blocked nose when you DID NOT have a cold or the flu? Yes No

IF YOU HAVE ANSWERED NO PLEASE SKIP TO QUESTION 4. In the past 12 months, have you had a problem with sneezing, or a runny, or blocked nose when you DID NOT have a cold or the flu? IF YOU HAVE ANSWERED NO PLEASE SKIP TO QUESTION 4. 3 In the past 12 months, has this nose problem been accompanied by itchy-watery eyes? Have you ever had hay fever? 2 Yes No

Yes No Yes No

Interpretation: If the student answers yes to question number 1, it will indicate the presence of allergic rhinitis. If the patient answers no to question number 1 but answers yes to question number 4, then the patient has allergic rhinitis that does not manifest. Questions 2 and 3 are important only to characterize further the frequency and severity of the allergic rhinitis.

APPENDIX B CHECKLIST FOR CLASSROOM CONDITIONS Checklist for the presence of MOLDS (http://www.moldunit.com/mold-detection.html) Yes No Yes No Yes No Yes No 1. Presence of water leaks from ceiling, walls and pipes or stagnant water. 2. Wet cellulose materials such as paper, cardboard, ceiling tiles and wood products. 3. Appearance of a cottony, velvety, granular or leathery like dirt (in any shade of color). 4. Inspect walls, under carpeting, under cabinets and air ducts for hidden molds.

Checklist for the presence of COCKROACHES (http://www.ehow.com/how_7744440_tellroaches.html) (http://www.roebourne.wa.gov.au/Assets/environment/hs0025%20cockroach%20management.pdf) Yes No Yes No 1. Presence of dripping faucets and bathrooms. 2. Presence of eggs of roaches, dead roaches, insect parts or feces (black gritty substance, pepper-like) under the cabinets or behind walls and appliances, and sight of cockroaches themselves. 4. Evidence of holes from chewing such as paper and cardboards. 5. Describe hygiene of area.

Yes No

Checklist for the presence of HOUSE DUST Yes No Yes No 1. Presence of curtains, pillows, carpets, and describe each. 2. Presence of dust above the tables, chairs, window sills, fans, etc. (even the floor is checked)

Checklist for the presence of CHALK DUST Yes No Yes No 1. Presence of chalk (for writing on the board) and specify if it is dustless or not. 2. Presence of chalk dust in corners of the board, on the floor, on the board eraser. 3. Describe the method of cleaning the chalk board eraser and black board.

Interpretation: Presence of Molds: If the classroom is positive for questions 1, 2, and 4, it may indicate possible growth of molds. If question 3 is positive, regardless if the other questions are negative, will confirm the presence of molds. Presence of Cockroaches: If the classroom is positive for question number 2, it confirms the presence of cockroaches. Positive results 1, 3, and 4 may suggest the presence of cockroaches. Presence of House Dust: If either one of the questions is positive, it will indicate the presence of dust. Presence of Chalk Dust: If the chalk produces dust, and there is presence of chalk dust in the corners of the board, on the floor, and on the board eraser, and there is absence of a container to collect the chalk dust for cleaning purposes or just by means of clapping the board erasers together. 7

APPENDIX C ARIA QUESTIONNAIRE 1. What symptoms do you have?

(Answer Yes for any of the symptoms listed below that apply. Answer No for all that do not.)

Watery runny nose Sneezing (especially violent and in bouts) Nasal obstruction (feeling of being unable to breathe through your nose) Itchy nose Watery, red, itchy eyes 2. How long do your symptoms last?
(Answer Yes or No for each time frame below.)

Yes No Yes No Yes No Yes No Yes No

More than four days a week More than four weeks in a row 3. How do your symptoms affect you?

Yes No Yes No

(Answer Yes for any of the symptoms listed below that apply. Answer No for all that do not.)

My symptoms disturb my sleep. My symptoms restrict my daily activities (sports, leisure, etc.) My symptoms restrict my participation in school or work. My symptoms are troublesome to me. 4. How much do your symptoms bother you?

Yes No Yes No Yes No Yes No

(On a scale of 0 to 10, with 0 being Not at all and 10 as Very much, indicate how much your symptoms bother you Tick only one.)

0 1 2 3

4 5 6 7

8 9 10

Interpretation: Presence of symptoms of allergic rhinitis gives an insight and may be indicative of having allergic rhinitis. Symptoms include rhinorrhea, nasal obstruction or blockage, nasal itching, sneezing, and postnasal drip that are reversible spontaneously or under treatment. Under the ARIA classification, AR may be classified according to frequency intermittent or persistent and severity mild or moderate to severe. Descriptions of each classification are as follows: Classification of allergic rhinitis Frequency o Intermittent symptoms are present less than 4 days a week or for less than 4 weeks. o Persistent symptoms are present at least 4 days a week and for at least 4 weeks. Severity o Mild none of the following is present. o Moderate-severe at least one of the following is present: Sleep disturbance Impairment of daily activities, leisure and/or sport Impairment of school or work Troublesome symptoms