CHAPTER-I

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.

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
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.

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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).
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 STI.

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 STATEMENT OF THE PROBLEMS
Knowledge Regarding Sexual Transmitted Infection among the Workers of Carpet
Factory.

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

In Nepal, due to the lack of education and awareness, more people are suffering
from STI. In such a way, most of the workers who are working in carpet factory are
uneducated and unaware of STIs. (London School of Hygiene and Tropical
Medicine).

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 (WHO).

The research will expect the following significant outcomes:

• Study will help to conduct different awareness programme by nurses and other
health personnel by gathering information of their knowledge on STIs.
• This study may help the student for further research.
• It will be helpful for the concerned expert, curriculum former and teacher,
programmer etc for designing a programme for the carpet factory workers.

OBJECTIVES OF THE STUDY:

To assess the knowledge regarding sexual transmitted infection of carpet factory

workers.

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 HYPOTHESIS

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

• Sexual transmitted infection: It refers to the infection of the genital

tract which is transmitted primarily through sexual contact or sexual activity.

• 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.

LIMITATION OF THE STUDY

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

• Time: Limited according to curriculum.

• Budget: Self finance

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 2.1. LITERATURE REVIEW

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 Chlamydial 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. Estimated
that worldwide, between 100 and 4000 new born babies become blind every year
because of this condition.

Ministry of health and Population,

National centre For AIDs and STD control

Cumulative STD situation of Nepal, 2008

SN Month Male Female Total
1 July 5342 104 5446
2 September 5496 104 5600
3 October 5496 104 5600

Puri M et al(2007) 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.

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,

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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.

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 Technique
Purposive 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.Variables
• Independent variables:
 Demographic area
 culture
 awareness
 Socio-economic status

2.Dependent Variables:
• Education

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3.8.Data Gathering tools( Instruments for data collection):
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.
1. Question related to demography information.
2. 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
participants
• None 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.

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 • 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.
• 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.

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 CHAPTER- IV
Data analysis and interpretation:
• Demographic information.
• Knowledge about sexually transmitted infection.

4.1 Demographic characteristics of respondents

Table no-4.1.1: Distribution of respondents according to their age:

n=60
SN Subject Frequency Percentage
1 Age:
15-20 years 16 26.67%
21-25years 20 33.33%
26-30years 12 20%
31-35years 8 13.33%
36-40years 4 6.67%
2 Sex:
Male 33 55%
Female 27 45%

2 Marital status:
Married 41 68.3%
Unmarried 19 31.7%
3 Residence:
Within the factory 50 83.3%
Outside the factory 10 16.7%

4 Cast:
Tamang 48 81%
Magar 5 8%
Newar 2 3%
Chhetri 2 3%
Rai 2 3%
Dalit 1 2%
4 Religion:
Buddhist 49 81.67%
Hindu 9 15%
Christian 2 3.33%

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5 Educational Status:
Illiterate 28 46.67%
Literate 21 35%
Upto 5 class 8 13.33%
Upto 10 class 2 3.3%
SLC pass 1 1.67%

Figure no-4.2:The knowledge score about sexually transmitted infection of

the carpet factory workers
n=60

10

7
Knowledge score

5 Series1
4

0
1 2 3 4 5 6 7 8 9 10 11 12 13 14
No of respondents

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

30%

yes
No

70%

Table no-4.4: Distribution of respondents according to sources of information:

n=60
SN Subject Frequency Percentage

1 TV 14 33.33%
2 Radio 16 38.09%
3 FM 5 12%
4 Friends 15 35.71%
5 Health Personnel 11 26.19%

* Multiple responses*

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Table no-4.6:Distribution of respondents according to knowledge about
transmission of STI:
N=60
SN Knowledge about transmission of Frequency Percentage
STI

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%

*Multiple responses*

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

and symptoms of STI
n=60
SN Knowledge about sign and symptoms of STI Frequency 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%

*Multiple responses*

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

35
31
30
26
25 Death
Don't know
20
HIV/AIDs
Infection in child
15
Abortion
10 Infertility

5 4 4
1 1
0
Death Don't HIV/AIDs Infection Abortion Infertility
know in child

*Multiple resposes*

Figure-4.14:Distribution of respondents according to have sexual relation with

multiple sex partner
n=60

23%

Yes
No

77%

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

36%

Yes
No

64%

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

prevention of STI
n=60
SN Knowledge about prevention of STI Frequency Percentage

1 Avoid multiple sex partners 28 46.67%

2 Use of condom 15 25%
Don’t know 22 36.67%

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

n=60

SN Education Frequency Mean score Percentage

1 Literate 32 8.37 37.78%
2 Illiterate 28 5.5 25%

Figure -4.18: Distribution of respondents according to knowledge about STI

between male and female

n = 60
SN Subject frequency Mean score Percentage
1 Male 33 8.39 36.49%

2 Female 27 5.25 22.86%

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 CHAPTER-V
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 STUDY

Majority of the respondents heard about STIs and some had accurate knowledge
about transmission of STIs. Even majority of the respondents did not know about
sign and symptoms and prevention of STIs. Some were also exposed in risk
behaviors of STIs. So, it is very essential to give health education to the carpet
factory workers that will help to prevent from STIs.
The result of this study highlights the need to give health education about STIs.
This would provide background to other related studies in future.

5.4. RECOMMENDATION
 Can be studied in large scale sample in different factories of the whole
Lalitpur district.
 Comparative study can be carried out between municipality and village.
 Comparative studied can be carried out between married and unmarried
workers.

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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.
 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 DESSEMINATION

 Lalitpur Nursing Campus

 Carpet factories of Balkumari,Lalitpur.
 Reseach advisor

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