CHAPTER-I

1.1: Background:

We are running at the first decade of 21st century which is known as the advanced age of science and technology. From jungle to the present time, human civilization has made tremendous progress in multiple field like- information technology, transportation and public health and so on. As we have witnessed the magical development in the sector of public health and treatment system, many fetal diseases have been eradicated. Once there were days when Cancer and TB used to be counted as a giant figure of death but nowadays TB is fully cured and some kinds of cancers are also curable as the boon of modern medicine and treatment therapy. Not only has this, but also the most fearful diseases of the past days like malaria and smallpox have already been eradicated. However, though we are benefited by the modern ways of treatment, new diseases and challenges are not absent yet. HIV/AIDs have been standstill as the major threat all over the globe at present. Diabetes and heart diseases are also standing as the major problem in front of the people of the 21st century. Furthermore, in the latest days, with the progress of urbanization, different types of sexually transmitted diseases are increasing rapidly. So, the sexually transmitted infection has been stood as the major headache in the different part of the world.

The term sexually transmitted infection (STIs) refers to any infection contracted primarily through sexually activity or contact. STIs are very serious public health problems. These diseases are associated with substantial morbidity. The incidence of STIs is increasing worldwide and infection is becoming more severed. STI also facilitates the development of HIV infection and AIDs. (WHO)

STIs continue to be a major and growing public health problem in many parts of the world, an estimated annual incidence of curable STI( syphilis, gonorrhea, Chlamydia and trichomoniasis) is 340 million new cases occur in the world (WHO 2007)

Over 20 pathogens have been found to be spread by sexual contact. The diseases are such as gonorrhea, syphilis, cancroids, granuloma inguinal, acute, and chronic hepatitis, genital and anal warts, AIDs, vaginitis, etc. The Social factors for spreading STIs are:

Prostitution: This is the major factors for spreading infection.Broken Homes: Homes which are broken either due to death of one or home is unhappy.Sexual Disharmony: Divorced and separated persons are often victims of STDPoverty: In most of the developing world, prostitution is simply a reflection of poverty. It provides an occupation for earning easy money.Urbanization and Industrialization: These are causes of life style that contributes to high level of infection, since long working hours and relative isolation from family and social mobility.Emotional Immaturity. Social Disruption: caused by disaster, wars and civil unrest.

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International Travel: Travelers export and import of infection.Changing Behavioral Pattern: The value traditionally set on chastity is in conflict with the more recent ideas of independence, freedom from supervision and equal rights for both sexesSocial Stigma:Alcoholism (K Park 007).

Nepal being the landlocked and least developed country in the world, the people of Nepal are facing immense problems such as poverty, illiteracy, ignorance and youth unemployment. These all are the predisposing factors for spreading sexually transmitted infection including.

In spite of the availability of effective antibiotics and treatment of sexual transmitted infection, it remains common because of lack of awareness social taboos and stigma. Beside, there is a high proportion of poverty, lack of awareness on STI and unsafe sex practice and traditional practice as well as girls trafficking and temporary migration due to the open boarder between India and Nepal which are the main risk factors for STI.

Sexually transmitted infections are serious health concern, particularly among adolescents and young people. They cause physical discomfort, personal embarrassment and infertility as well as marital discord especially in developing country like Nepal.

In Nepal, total no. of 5202 STIs cases were reported in 2006. (National AIDs and STD control Program).

The major objectives of National AIDs and STI control programme:

The government has formulated policy, program and strategies for AIDs and STDs control program with much priority. This program is integrated with national and PHC program. The major objectives of AIDs and STI control programmes:Reduction of STIs and HIV/AIDS transmission through blood and blood product and from mother to child.Reduction to impact of STIs and HIV/AIDs through appropriate management.

In order to achieve these objectives government has provided training to health workers for STIs case management guideline in collaboration with the National center for AIDs and STD control program. In this context, knowledge of sexually transmitted infection in grass root level is the most important factor for prevention and control of the infection but due to the lack of education and awareness many people are still suffering from STIs

1.2: Significance of the study

The sexually transmitted infections remain major causes of acute illness, morbidity and worse health. It affects the health of million of men and women as well as children all over the world. In fact, the consequences of STIs can be very serious even

2

life threatening for women and her baby, if the women become infected with STI while she is pregnant.

Incidence of acute STIs is high in many countries and failure to diagnose and treat STIs at an early stage may result in serious complications including infertility, fetal wastage, neonatal infection, ectopic pregnancy, cervical cancer and death, STIs also account for massive expenditure (WHO2007)In Nepal, due to the lack of education and awareness, more people are suffering from STI. Therefore it is most important that the workers of the carpet factory should be aware about STIs and know how to protect themselves against STIs. This research will be helpful to assess the knowledge of STIs among the carpet factory workers. In addition it will help in preventing from STIs among the carpet factory workers by bringing awareness regarding STIs.

1.3: Statement of the problems

Knowledge regarding Sexual Transmitted Infection among the Workers of Carpet Factory.

1.4: Objectives of the study

General objective

To assess the knowledge regarding sexual transmitted infection of carpet factory workers.

Specific objectives:

To asses the knowledge of sexually transmitted infection towards the workers of the carpet factory.To give education to the carpet factory workers who do not have adequate knowledge about sexually transmitted infection.

1.5: Hypothesis

Literate carpet factory workers have more knowledge than illiterate workers.Male workers have more knowledge than female workers

1.6: Operational definition

Sexual transmitted infection: It refers to the infection of the genital tract which is transmitted primarily through sexual contact or sexual activity.

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Sexually transmitted disease: Groups of communicable disease which are transmitted from sexual contact.

Knowledge: Refers to possession of fact on various aspects of STIs.

Literate: Those persons who can read and write.

Illiterate: Those persons who cannot read and write.

Education: Education refers to information about sexually transmitted infection.

Carpet worker: The person who works in a carpet factory.

1.7: Limitation of the study

Area: The study covers the carpet factories of the Balkumari, Lalitpur.

Time: Limited according to curriculum.

Budget: Self finance.

CHAPTER-II

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2.1. Literature review

Literature review concerns with the review of related literature, which includes research and non- research reports, articles, journals, books and literature available in internet, which support research data and provide the basis for the study. So the brief descriptions of the review of literature are given below.

Ministry of health and Population,National centre For AIDs and STD control

Cumulative STD situation of Nepal, 2008SN Month Male Female Total1 July 5342 104 54462 September 5496 104 56003 October 5496 104 5600

USTI (July 2008) Published in News letter that 174,506 number of new syphilis cases were reported in china in 2006. Among patients visiting STI clinics in eight cities of south –western China, syphilis prevalence was found to be 11.9% with female sex low education, high income, and multiple reported sex partners being significantly associated with positive infection status.

Trani F. et al(February 2008) Studied on female sex street workers and sexually transmitted infections: their knowledge and behavior in Italy, that only 11.7% knew that STIs are transmitted by unprotected sexual intercourse and that kissing was not a mode of transmission. This knowledge was significantly higher in female sex street workers with a higher number of years in sex work and among those who received information from physician, and associations about STIs. The mean score of fear for STIs was 7.5. And being younger, practicing prostitution for shorter period of time and requiring more information about STIs were significantly associated with this fear. Overall, 83.5%0f female sex street workers used a condom every time. Improving the level of knowledge of STIs is strongly needed.Alexandra Mc et. al(July 2008) studied in urban adolescent school girls in south Delhi India the majority of respondents (71%) had no knowledge about the effects of Genital Herpes infection , two fifths did not know the consequences of acquiring syphilis (43%) and 28% were unaware that Gonorrhea was on STI. One third of the girls (33%) didn’t consider ulcer in the genital area and pain during urination (31%) as sign symptoms of STIs in women. In addition, vaginal discharge was an important sign of STIs in women, alternatively, students in the survey reported chest pain (24%) and throat pain (9%) as symptoms. The findings of this study indicated good awareness about the modes of HIV transmission (77%) and prevention among adolescent girls

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B.S. Hemlata ( August 2008) studied that the majority of women (84%) had adequate knowledge about the reproductive tract infection, three fourth of women (75%) responded correctly to the risk factors of sexual transmitted infection, and nearly 72% had adequate knowledge about sign and symptoms of sexually transmitted infections, 80.5% women answered correctly about treatment aspects, 46% of women responded correctly to the nature of white discharge and only 4.5% had knowledge about complications of sexual transmitted infections. Very few women responded correctly about preventive measures of sexually transmitted infection.

WHO (2007) reported that sexually transmitted infections are public health issue. An estimated annual incidence of curable STI (syphilis, gonorrhea, Chlamydia and trichomoniasis) is 340 million new cases occur in the world. Between 10% and 40% of women with untreated Chlamydia infections develop symptomatic pelvic inflammatory disease. Post infection tubal damage is responsible for 33 to 40% of cases of female infertility. In pregnant women with untreated early syphilis, 25% of pregnancies result in still birth and 14% in neonatal death- in overall perinatal mortality of about 40%, 10% perinatal death due to gonorrhea, 30% of infants born to mother with chlamydial infection develop a serious eye infection. WHO Estimated that worldwide, between 100 and 4000 new born babies, becomes blind every year. K Park (2007) reported that over 20 pathogens have been found to be spread by sexual contact. The highest rate of incidents of STIs is observed in 20-24 years old, followed by the 25-29 and 15-19 year age groups. The most serious morbidity is observed during fetal development and in the neonate. Overall morbidity rate is higher for men than for women, but the morbidity caused by infection is generally much more sever in women.The frequency of STD infection is higher among single divorced and separate persons than among married couplesIndividuals from the lower socio- economic groups have the highest morbidity rate.

BT Basabhanthapa (2007) reported that STDs are worldwide, have high prevalence from 1 to 14% in the vulnerable population groups. The trend in gonorrhea and primary syphilis is on the increase, since the late 1970s which is posing a serious barrier.

The highest rate of incidence is found between 20 to 24 years and both sexes are prone. STD is more prevalent in divorced and separated person and even in singles.Lowest socioeconomic status has the highest morbidity rate.Prostitution is the major factors for spread of infection.

Family planning association of Nepal (2007) reported that nearly one third of young people were aware of STIs through their knowledge on means of transmission

6

and prevention was relatively low. Access to STI services is poor while the use of condom for effective infection prevention is not commonly known.

Periodic Plan of HIV/AIDs, District Development Committee Sunsari (2064) reported that there are 2500 to 3000 sexually infected people in Sunsari district. Majority of the infected people hide their disease. They have access to medical treatment facility in hospital, primary health centre and health post. However majority of them do not like to visit such facilities.Chen B. et.al (July 2004 to may 2006) Shanghai, China studied that Of the 5067 students who provided valid answer sheets, 50.05% were female 49.95% were male. A total of 38.4% of respondents had received reproductive health education previously.Premorital sex behavior was opposed by 17.7% of survey participants, and 37.5% could identify all the three types STIs listed in the questionnaire. Although 83.7% knew how HIV is transmitted, only 55.7% knew when to use condom and 57.8% knew that the use of condoms could reduce the risk of HIV infection. The reproductive health service is lagging behind current attitude and demands of university students; there knowledge about reproductive health and STI/AIDs is still limit

National Centre For AIDs and STD Control (2006) reported on national guidelines on STIs that syphilis prevalence was 1-2% among sentinel surveillance STIs patients in six surveillance sites (Mahendranagar, Nepalgunj, Pokhara,Birgunj, Katmandu maternity hospital, AMDA Hospital, Damak). In total of 5547 cases were reported in 2000. The proportion of STIs cases to total OPD patients was 4%, 2.3%, 3.2% with an overall proportion of 3.02% respectively for each year.

Training Manual on HIV and AIDs for Health Service providers, National Centre for AIDs and STD control program (2006) reported that only 75% teenager knew that they should use condoms when having sex and only two third (69%) said that they should not have sex with commercial sex workers. The study also shows that almost 20% of teenagers consider premarital sex as proper. One in five boys and nearly one in ten girls interviewed had had a sexual experience.65% boys said that they had used condoms, while 74%of girl said that their partners used condom during

E J Mmbaga et.al (February 2005): studied on sexually transmitted infections knowledge and its impact in practice of risky sexual behaviors and HIV serostatus, rural Kilimanjaro, Tanzania: stated that overall knowledge of STIs was 38.6%.Knowledge of STI complication including HIV transmission, was very low (22.0%) in this community. The low knowledge of STI complications was significantly associated with recent (past 4 weeks), practice of multiple sex partners 95%, not using condom with causal partner 95%. Overall STI knowledge was alarmingly low. Knowledge should more emphasize on raising awareness of complication.

Department of Microbiology, University of Nairobi, Kenya (2002) studied that 30 % of men reported consistent condom use during extramarital sex throughout the

7

study period. The change in heterosexual risk behavior was accompanied by a significant decrease in the incidence of gonorrhea, nongonococcal urethritis, and genital ulcer disease. The percentage of men reporting extramarital sex decreased from 49% to 36% while contact with female prostitutes declined from 12% to 6%.

A Andersson et al (2002) studied in Knowledge about the prevention of sexually transmitted diseases: a longitudinal study of young women from 16–23 years. The testing knowledge about the mode of transmission and prevention of STD, gave a total score of correct answers varying between 44% and 64%, with less knowledge about human papilloma (HPV) and herpes viruses than about Chlamydia. Awareness of the possibility of asymptomatic transmission was low. The highest scores were obtained at the age of 18 years. Experience of many partners, a history of STD, smoking, and more frequent use of alcohol were associated with a higher level of knowledge. Knowledge was fairly good and consistent, but was more often incorrect regarding viral infections and the possibility of asymptomatic transmission, and in total did not ensure an adequate protective behavior. A higher level of knowledge was associated with a more risky behavior, indicating that information was best received by those who could identify with the problem.

Puri M et al (2002) studied that large majority of young carpet factory workers (70%) had heard about STD.Large majority 80% boys and 62% girls heard about STD among the factory workers. Only 2% factory workers heard about gonorrhea. Roughly one in ten young factory workers suffered from at least one sign and symptoms of STD is higher among girls than in boys (girls14%), boys (4%) 7% have reported smelly discharge, 2% boys reported sore in genital area. Knowledge about different preventive measure is also satisfactory. 91% workers have knowledge about condom is the preventive measure of STI.Gibny L et al(2001) studied in Bangladeshi women, in 261 women had a physical examination,19.5% trichomoniasis, Chlamydia in 3.4%,Gonorrhea in 5.4% , BacterialVaginosis in 37.2%, and candidacies in 10%. In the full sample of 384 women with test of urine and blood, prevalence infection with Chlamydia, gonorrhea, syphilis, and herpes was detected in 0%, 6.3%, 5.7%, and 32% respectively. Almost 50 % of the subjects had ever been exposed to Hepatitis B, 3.6% were currently infective, and 1.6% had hepatitis c, and had hepatitis D.

The UNICEF 2001 survey among adolescents revealed that though Nepalese adolescence are highly aware of the risk of HIV, this sexual behavior, Although a vast majority (92%) had heard about HIV/AIDs, a significance proportion (23%) had the misconception about HIV transmission. Only 74% of them know that they should use condoms to protect themselves from HIV and over 69% said that they should not have sex with commercial sex workers to avoid HIV/AIDs.

Karmic society of Nepal(2001) studied that was conducted to access the knowledge , attitude and practice concerning HIV/ AIDs and STDS among the youth in Dang , Kailali and Surkhet The study reveled that the common types of STDs called Bhiringi , Scabies and Gonorrhea . The study also reported 78% of the respondents

8

agreed that condom is best measure to protect them form STD, while 78% think the best way to avoid STD is to avoid multiple sex partners

Shally A.et.al (2000): Studied that nearly half of the youths in the studied continued to believe that washing the penis with disinfectant after sex helped to prevent disease and 30-40% continued to believe that urinating after sex greatly reduced their chances of developing STIs. From 58% to 21% of youths who thought that taking medicines before or after sex could prevent STIs and that using a vaginal birth control or antifungal tablet reduced the chance of disease ( from 45 to 26) sexual intercourse. Unprotected sex led to a 14% pregnancy rate and 13% STD in boys. Girls with their traditionally lower social status sometimes have knowledge about STDs and HIV/AIDs, but no any access to means of protection.

S.S. Lal et al (2000) studied on knowledge and attitudes of college students in Kerala towards HIV/AIDs, sexually transmitted diseases (STIs) and sexuality in India. The study showed that only 34 % knew that STDs are associated with an increased risk of AIDs. There is a gap of knowledge between boys and girls as well as between rural and urban students.

2.2. Summary of the literature review

Sexually transmitted infections are public issues. Estimated 340 million new cases of curable STI occur annually in the world.

According to many literature reviews, unsafe sexual intercourse with an infected partner is the major risk factor for the transmission of infection.

Many studies showed that low education and low socio-economic groups have the highest morbidity rate of STI and prostitution is the major factor to spread of infection.

In developing countries like Nepal, many people are actively involved in prostitution and most of them do not use any preventive measures for prevention of STIs. Most of the people in developing countries have no knowledge about STI because of illiteracy, low socioeconomic condition and lack of public awareness.

Many studies have reported that the highest rate of incidence of STI is observed in young adult. Overall morbidity is higher for men than women, but the infection is severe in women.

Though the people in developed countries are educated and have high socioeconomic status, but the level of knowledge about STI is still limited. So, public awareness about STI is urgently needed.

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CHAPTER-III

RESEARCH DESIGN AND METHODOLOGY

3.1. Research Design:A simple descriptive research design was used for this study.

3.2. Study area: The study was conducted at carpet factories of Balkumari Lalitpur.

3.3. Population of the study:All male and female entire workers of the carpet factory

3.4. Sample size of the study:Sample size of this study was 60.

3.5. Sampling TechniquePurposive sampling technique was used to collect data.

3.6. Criteria for sample collection:

Inclusion criteria:

The entire workers of the carpet factories of Balkumari Lalitpur.Both male and female.Both literate and illiterate.Workers who want to participate in this study.

3.7. VariablesIndependent variables:Demographic areaWorking environmentculturecustomsawarenessSocio-economic statusDependent Variables:

Education

3.8. Data Gathering tools (Instruments for data collection):

10

Questionnaire was developed on the basis of research objectives and hypothesis where the researcher was composed structured close ended and open ended questions by dividing into two parts.Question related to demography information.Question related to knowledge on STI.

3.9. Data collection procedure:

The formal permission was taken from concerned authority of carpet factory for research by submitting the official letter from the Lalitpur nursing campus.Before collecting the data, the verbal consent was taken from the respondent.The respondents were explained the purpose of study.Data was collected by researcher only.Interview was taken individually.

3.10. Validity and reliability of the instrument

In order to maintain validity and reliability of the instrument, the structured question which was developed according to related literature and consulted with adviser, research teacher, faculty export, and some modifications were made according to pre test results.

3.11. Pre test / Pilot study:

To find out the reliability, validity and practicability, of the instrument, a pilot study was done on 10% of the total sample size before the actual study. The instrument was modified according to the necessities before carrying out the study.

3.12. Ethical consideration:Study was conducted only after the approval of the faculty teachers, research advisors, assistant campus chief and campus chief.Verbal as well as written permission was obtained from authority of carpet factory.The respondents .The objective of the study was explained clearly to the participantsNone of the respondents was forced to participate in study.The respondent's right was protected while collecting data by informed consent and confidentiality, and anonymity.The Privacy was maintained by interviewing each respondent.

3.13. Data analysis procedure:All the collected data were tabulated analyzed and categorized on the basis of research objectives and hypothesis by using simple statistical methods such as percentage number and mean. The findings were summarized by using table, bar, graph and pie chart.

3.14. Budget and time:The time period was 5 weeks.

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The small scale budget, self financed.

3.15. Knowledge scoring procedure:

For knowledge related question 1 score was given in each correct answer and '0' score for wrong answer for the questions having only one correct answer. Then question no. 15, 16, 17, 18 22, 25 have more than one answer. In such questions, if respondent's answers don't know they got 0 score. If they answer only one correct option, they got ' 1 score'. Thus the total score of question 23, questions relating to knowledge = 11.

CHAPTER- IV

Data analysis and interpretation:

This chapter deals with the analysis and interpretation of data concerning demographic information and knowledge of carpet factory workers regarding sexually transmitted infection. After collecting all the data, they are analyzed and interpreted on the basis of research objectives and hypothesis, using simple statistical tool. Findings of the study are presented into two parts:

Demographic information.Knowledge about sexually transmitted infection.

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4.1 Demographic characteristics of respondents

Table no-4.1.1: Distribution of respondents according to demographic information n=60SN Subject Frequency Percentage1 Age:

15-20 years 21-25years26-30years31-35years36-40years

16201284

26.6733.332013.336.67

2 Sex:MaleFemale

3327

5545

2 Marital status:MarriedUnmarried

4119

68.331.7

3 Residence:Within the factoryOutside the factory

5010

83.316.7

4 Cast:TamangMagarNewarChhetriRaiDalit

4852221

808.333.333.333.331.66

4 Religion:BuddhistHinduChristian

4992

81.67153.33

5 Educational Status:IlliterateLiterateUpto 5 classUpto 10 classSLC pass

2821821

46.673513.333.31.67

Table no -4.1. shows that the majority 20(33.33%) of the respondents were of age from 21-25 years, 16(26.70%) respondents were 15-20 years,12(20%) respondents

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were 26-30 years,8(13.33%) respondents were 31-35 years, and 4(6.76%) were 36-40 years. 50(83%) respondents were lived temporarily in within the factory and 10(16.70%) outside the factory. 49 ( 81.67% ) respondents were Buddhist,9( 15% ) respondents were Hindu and 2 (3.33%) were Christian. majority of the respondents 33(55%) were male and 27(45%) respondents were female. The majority of the respondents 48(81%), were Tamang, 5(8%) Magar, 2(3%) Newar, 3% Chhetri, 3% Rai and 1(2%) were dalit.Figure no-4.2: The knowledge score about sexually transmitted infection of the carpet factory workers n=60

SN Score Frequency Percentage1 1 2 3.322 2 8 13.323 3 3 54 4 8 13.325 5 7 11.656 6 2 3.327 7 5 8.328 8 4 6.659 9 5 8.3210 10 4 6.6511 11 4 6.6512 12 2 3.3213 14 1 1.6514 15 3 515 17 2 3.32

Figure no- 4.2.shows that the knowledge score of respondents ranged from low of 1 to high of 17 in which 11 questions related to knowledge were asked to the respondents, total marks of these question was 23. The 2(3.32%) respondents were obtained 1 score and 2 (3.32%) respondents were obtained 17 score.

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Figure no-4.3: Distribution of respondents according to heard about STI: n=60

70%

30%

yes

No

Figures no-4.3: Shows that the majority 42(70%) respondents had heard about STI and only18 (30%) respondents had not heard about STI. All workers of the carpet factory were come from rural area. Who were exposed in media, had heard about STI. Who had not heard about STI may not be exposed in media.

15

Table no-4.4: Distribution of respondents according to sources of information: n=60SN Subject Frequency Percentage

1 Radio 16 38.09

2 TV 14 33.33

3 Friends 15 35.71

4 Health Personnel 11 26.19

5 FM 5 12

6 Don't know 5 12

Table no 4.4. Shows that Radio is the effective media to transfer of massage. In this study, 16(38.09%) respondents had heard about STI on the radio and 15(35.71%) respondents heard from the friends. 14(33.33) had heard from TV and 11(26.19%) heard from health personnel. 5(12%) respondents had not heard about STIs.

* Multiple responses*

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Figure no-4.5: Distribution of respondents according to knowledge on listing the different name of STIs

n=60

4 1

8

50

0

5

10

15

20

25

30

35

40

45

50

No

of r

esp

on

den

ts

Shyphilis

Gonorrhea

HIV/AIDs

Don't know

Figure no-4.5: shows that the majority of the respondents were unaware about the name of sexually transmitted infection, that was 50 (83.33%), 8(13.33%) respondents listed the name of HIV/AIDs, 4(6.66) respondents listed the name of syphilis and 1(1.66%) respondents listed the name of gonorrhea.

*Multiple responses*

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Table no-4.6: Distribution of respondents according to knowledge about transmission of STI:

n=60SN Knowledge about transmission of

STIFrequency Percentage

1 Unsafe sexual contact 46 76.66

2 From mother to child transmission 4 6.66

3 Infected blood 4 6.66

4 Don't know 14 23.33

Table no-4.6: shows that the majority of respondents said that unsafe sexual contact is the way of transmission of STI, that was 46(76.66%), 4(6.66%) had knowledge about mother to child transmission is the way of transmission of STI, and 4(6.66%) said from infected blood and 14(23.33%) had no knowledge about transmission of STI. Media frequently gave information about HIV AIDs. Most workers of the carpet factory were uneducated but they had knowledge about STI because of the media

*Multiple responses*

Table no-4.7: Distribution of respondents according to knowledge about sign and symptoms of STI

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n=60SN Knowledge about sign and symptoms

of STIFrequency Percentage

1 Don't know 37 61.66

2 Having sore in private part 15 25

3 Excessive white vaginal discharge 12 20

4 Lower abdomen pain 6 10

5 Swelling in groin 3 5

Table no- 4.7. shows that the majority of the respondents37(61%) were unaware about sign and symptoms of STI. 15(25%) respondents had knowledge about having sore in private part,12(20%) respondents had knowledge about excessive white vaginal discharge, 6(10%) had knowledge about lower abdomen pain, 3(5%) respondents had knowledge about swelling in groin. Most of the people were illiterate and come from the rural area. So they had no knowledge about sign and symptoms of STI. Majority of the respondents, who gave one right answer, had also inadequate knowledge about all sign and symptoms of STI.

*Multiple responses*

Table no- 4.8: Distribution of respondents according to knowledge about how could not transmission of STI:

n=60SN Knowledge about how couldn't

transmit STI from one person to Frequency Percentage

19

another.

1 Don't know 32 53.33

2 Sharing of toilet 21 35

3 Sharing of food and utensils 19 31.66

3 Use of condom 4 6.66

4 Coughing and sneezing 2 3.33

Table no- 4.8. Shows that 32(53.33%) had no knowledge about how could not transmitted STI. 21(35%) respondents expressed that STI is not transmitted by sharing of toilet, 19(31.66%) STI is not transmitted through sharing of food and utensils, 4(6.66%) expressed that STI could not transmitted through use of condom, 2(3.33%) expressed that STI is not transmitted through coughing and sneezing. All of the carpet factory workers were come from the rural area and most of them were illiterate. They were not exposed in media also. So they had not knowledge about how couldn't transmit STI.

*Multiple responses*

Table no-4.9: Distribution of respondents according to knowledge about who are the vulnerable group for STI:

n=60SN knowledge about who are the

venerable group for STIFrequency Percentage

1 Female sex workers 26 43.33

2 Don't know 25 41.66

20

3 Multiple partner/ mother to child 11 18.33

Table no- 4.9.shows that 25(41.66%) respondents had no knowledge about who are the venerable group for STI, 26(43.33%) respondents expressed that female sex workers are the vulnerable group for STI, 11(18.33%) respondents expressed that multiple partners are the vulnerable group for STI. Most of the respondents were exposed in media and some were exposed with health workers. So they had knowledge about STI.

*Multiple response*

Figure-4.10: Distribution of respondents according to knowledge about treatment is possible or not possible for STI n=60

21

10%

10%

80%

yes

No

Don't know

Figure no- 4.10. Shows that 48(80%) respondents had knowledge about treatment is possible for STI, 6 (10%) respondents expressed that treatment is not possible for STI and 6(10%) have not knowledge about treatment of STI is possible.

Figure no-4.11: Distribution of respondents according to knowledge on place for treatment of STI n=48

22

39

9

0

5

10

15

20

25

30

35

40

No

of r

esp

on

den

ts

Health facility Don't know

Figure no-4.11: shows that 39(81.25%) respondents said that health facility is the place for treatment of STIs and 9 respondents said that they had no knowledge about place for treatment of STIs.

Figure no-4.12: Distribution of respondents according to knowledge about both should be treated for STI n=48

23

37

47

0

5

10

15

20

25

30

35

40N

o o

f res

po

nd

ents

Yes No Don't know

Figure no-4.12: shows that within the 48 respondent, 37(77%) respondents who said both should be treated for STI,4(61.66%)respondents said that both should not be treated for STI, 7(11.66%)respondents have no knowledge about single or both should be treated for STI. Majority of the respondents had knowledge about treatment of STI because they were exposed with media and health workers.

4.13: Distribution of respondents according to knowledge about complication of STIs n=60

24

31

26

4 41 1

0

5

10

15

20

25

30

35N

o o

f res

po

nd

ents Death

Don't know

HIV/AIDs

Infection in child

Abortion

Infertility

The figure 4.13: shows that the 31(51.66%) respondents expressed that death is the complication of STIs, 4(6.66%) expressed that infection in child, 4(6.66%) expressed that VIV/AIDs is the complication of STIs, and 26(43.33) % had no knowledge about STIs.The majority of respondents had no adequate knowledge about complication of STIs.

Figure-4.14: Distribution of respondents according to have sexual relation with multiple sex partner n=60

25

23%

77%

Yes

No

Figure 4.14: shows that 44(77%) respondents were not have sexual relation with multiple sex partners, 14(23%) respondents were expressed that we have sexual relation with multiple sex partners. Majority of the respondents were married and they were living husband and wife together. So they had not sexual relation with multiple sex partners. Most of the workers were come from rural area of the Nepal. They were living in common house of carpet factory and lack of parental supervision. So they had risk behavior of sexual relation with multiple sex partners.

Figure no-4.15: Distribution of respondents according to have sexual relation without using condom: N=14

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36%

64%

Yes

No

Figure no-4.15: shows that 9(64%) respondents were expressed that they have not used condoms during sexual contact. 5(36%) respondents had expressed that they have used condom during sexual contact. The majority of the respondents were not used condoms during sexual contact. So they were in risk behaviors of STI, They had no adequate knowledge about STI. Some who were used condom during intercourse had knowledge about prevention of STI.

Table no-4.16: Distribution of respondents according to knowledge about prevention of STI

n=60SN Knowledge about prevention of STI Frequency Percentage

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1 Avoid multiple sex partners 28 46.67

2 Use of condom 15 25

Don’t know 22 36.67

Table no-4.16: shows that most of the respondents had knowledge about avoiding of multiple sex partner is the way of prevention from STI, that was 28 (46.67 %) respondents, the 15(25%) respondents expressed that use of condom is the way of prevention of STI. 22( 36.67% %) respondents had no knowledge about the way of prevention of STI. Majority of the respondents had knowledge about prevention of STI, because they were exposed in media and some with health workers. Most of the respondents were illiterate and were not exposed in media. So they had no knowledge about STI.

*Multiple responses*

HYPOTHESIS TESTING

Figure-4.17: Distribution of respondents according to knowledge about STI between literate and illiterate: N=60

SN Education Frequency Mean score Percentage

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1 Literate 32 8.37 37.78

2 Illiterate 28 5.5 25

Table-4.17: shows that 37.78% respondents were literate and 25% respondents were illiterate mean score of knowledge from literate respondents is 8.37 and mean score of knowledge from illiterate respondents is 5.5. Mean knowledge score and percentage is higher in literate respondents compared to illiterate respondents. So the hypothesis is accepted.

Figure -4.18: Distribution of respondents according to knowledge about STI between male and female

n = 60SN Subject frequency Mean score Percentage1 Male 33 8.39 36.49

2 Female 27 5.25 22.86

Table 4.18: shows that the mean score of knowledge of male respondents is 8.39 and mean score of knowledge from female respondents is 5.25. Male respondents had 36.49% and female respondents had 22.86% knowledge. Knowledge score and percentage is higher in male respondents compared to female respondents. So the hypothesis is accepted.

CHAPTER-V

SUMMARY, CONCLUSION AND RECOMMENDATION

This chapter gives a brief account of the total picture of the findings, conclusion drawn from the study, implications recommendation for research, difficulties faced during the study, strength of the study and limitation for the study.

The statement of the problem was the knowledge on sexually transmitted infection among the workers of the carpet factory.

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The study was based on the simple descriptive methodology. The purposive sampling technique was used. An interview schedule was developed with the help of relevant literature and consultation with the teachers and experts. The tool was prepared in two parts (I) demographic information (II) Knowledge related to sexually transmitted infection. Validity and reliability was maintained. Permission from the authority was obtained and the pre-testing was conducted in the carpet factory of the Balkumari, Lalitpur, on 10% of the respondents. This subject was not included in the final study. After the pre-testing some required modification were made in the instrument.

5.1. Summary of the findings

Findings related to demographic information The majority of the respondents were (50%) 15- 25 years old.(15-20 years-26.67%) and 21-25 years -33.33%).Majority of the respondents (68.3%) were married and 31.7% were unmarried.Majority of the respondents were Buddhist (81.67%) and most of them were Tamang (80%).83.3% respondents lived within the factory.53.33% respondents were literate and 46.67% respondents were illiterate.Findings related to knowledge

70% respondents heard about STIs and 30% respondents were unaware of STI.Majority of respondent heard about STI on media in which, 38.09% had heard about STIs on radio, 35.71% heard from friends, 33.33% had heard from TV. 26.19% respondents had heard from health personnel, and 12% respondents had not heard about STIs.76.66% respondents had knowledge about is the mode of transmission of infection, 6.66% had knowledge on mother to child transmission, 6.66% had knowledge about infected blood is the mode of transmission.61.66% respondents were unaware about sign and symptoms of STI, only 25% had knowledge on excessive white vaginal discharge, 10% respondents had knowledge on lower abdomen pain, 5% respondents had knowledge on swelling in groin.43.33% respondents had knowledge about female sex workers are the vulnerable group for STIs.80% respondents had knowledge about treatment of STIs, and 20% respondents had no knowledge on treatment of STIs.77% had not sexual relation with multiple partners and 23% respondents had sexual relation with multiple sex partners. 64% of 14 respondents expressed that they had not used condom during sexual contact.46.67% respondent had knowledge on avoiding multiple sexual partner is the way of prevention from STIs25% had knowledge on condom use is the way of prevention from STIs.36.67% had no knowledge about way of prevention from STIs.

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5.2. Conclusion

This study was conducted on carpet factory workers. Most of the workers were living separate room of common house. Most of them were young adult. They had lack of parental supervision. 68.3% were married; both husband and wife were living together. 31.7% were unmarried. All respondents had come from rural area of the country. Most of them were illiterate. Majority of the respondents (70%) had heard about STIs from various sources of information. Though the majority of the respondents heard about STI, most of the workers were unaware about sign and symptoms and prevention of STIs.

Knowledge score was different between literate and illiterate workers. Literate respondents had more knowledge of STIs than illiterates.

The level of knowledge was different between male and female. Male had more knowledge than female. Most of the workers were unaware about STIs.

5.3 Implication of the studyThe study findings might be helpful to conduct different awareness program by nurses and other health personnel by gathering information to their knowledge on STIsThe study findings might be helpful to the students for further research.

5.4. RecommendationSame type of study can be done in large scale sample in different factories of the whole Lalitpur district.Same type of study can be done in attitude of workers about STI.Comparative study can be carried out between married and unmarried workers.

5.5. Strength of the study

This study tries to explore the actual knowledge of respondents about STIs.Focus was given to protect the right of the respondents by maintaining anonymity and confidentiality.The questionnaire was based on literature, article and books.

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The researcher had gained confidence to conduct research.

5.6. Difficulties faced during study

Sometimes interview took longer time than estimated time because more time needed to convince them.Sometimes respondents were embarrassed to participate in this study.

5.7. Plan for dissemination

Lalitpur Nursing CampusResearch advisor

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BT Basavantthapa, Second edition 2008, Community Health Nursing, pg782-789 Ministry of Health and Population ,National Centre For AIDs And STD Control, Revised on 2006, National Guideline on sexually transmitted infection case management

MOH, National Centre For AIDs & STDs Control,Teku, 2007,National HIV/AIDs strategy(2006-2011) pg19-21

District Development Committee, Sunsari, Periodic Plan Of HIV/AIDs strategy (2006-2011), pg 5.

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MOH, National Centre for AIDs and STD control, Cumulative HIV and AIDs situation of Nepal as of October, September, July 2008.

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Chen B et al (2004 to May 2006), A study on sexual and reproductive health service needs of university/college students: updates from a survey in Shanghai China, http://pubmed.gw.who.org.

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