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 STD
Poverty: 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.

1
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 sexes
Social 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.

3
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

4
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, 2008

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

5
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 couples
Individuals 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.

6
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
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.

7
Department of Microbiology, University of Nairobi, Kenya (2002) studied that 30
% of men reported consistent condom use during extramarital sex throughout the
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% , Bacterial
Vaginosis 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

8
Bhiringi , Scabies and Gonorrhea . The study also reported 78% of the respondents
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.

9
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
Working environment
culture
customs
awareness
Socio-economic status
Dependent 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 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.
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:

11
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.

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.

12
4.1 Demographic characteristics of respondents
Table no-4.1.1: Distribution of respondents according to demographic
information
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 80
Magar 5 8.33
Newar 2 3.33
Chhetri 2 3.33
Rai 2 3.33
Dalit 1 1.66
4 Religion:
Buddhist 49 81.67
Hindu 9 15
Christian 2 3.33
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

13
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
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 Percentage

1 1 2 3.32
2 2 8 13.32
3 3 3 5
4 4 8 13.32
5 5 7 11.65
6 6 2 3.32
7 7 5 8.32
8 8 4 6.65
9 9 5 8.32
10 10 4 6.65
11 11 4 6.65
12 12 2 3.32
13 14 1 1.65
14 15 3 5
15 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.

14
Figure no-4.3: Distribution of respondents according to heard about
STI:
n=60

30%

yes
No

70%

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=60
SN 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*

16
Figure no-4.5: Distribution of respondents according to knowledge on
listing the different name of STIs

n=60

50
50
45
40
35
No of respondents

Shyphilis
30
Gonorrhea
25 HIV/AIDs
20 Don't know
15
10 8
4 1
5
0

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*

17
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

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

18
 n=60
SN Knowledge about sign and symptoms Frequency Percentage
of STI
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=60
SN Knowledge about how couldn't Frequency Percentage
transmit STI from one person to

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=60
SN knowledge about who are the Frequency Percentage
venerable group for STI
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%

yes
No
Don't know

80%

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

40
35
30
No of respondents

25
20
9
15

10
5

0
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
 40 37

35

30
No of respondents

25

20

15

10 7
4
5

0
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
 35
31
30
26
Death
No of respondents

25
Don't know
HIV/AIDs
20
Infection in child

15 Abortion
Infertility
10

5 4 4
1 1
0

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%

Yes
No

77%

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

26
 36%

Yes
No

64%

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=60
SN Knowledge about prevention of STI Frequency Percentage

27
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

28
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 = 60
SN Subject frequency Mean score Percentage
1 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.

29
 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 STIs
25% had knowledge on condom use is the way of prevention from STIs.
36.67% had no knowledge about way of prevention from STIs.

30
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

The study findings might be helpful to conduct different awareness program by
nurses and other health personnel by gathering information to their knowledge on
STIs
The study findings might be helpful to the students for further research.

5.4. Recommendation
Same 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.
The researcher had gained confidence to conduct research.

31
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 Campus

Research advisor

BIBLIOGRAPHY

Books
Park's,2007 19th edition, text book of preventive and social medicine
pg 278-282.

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.

32
MOH, National Centre for AIDs and STD control, Cumulative HIV and AIDs
situation of Nepal as of October, September, July 2008.

Journals

Awashthi S et al (200)study on Developing an interactive STD-prevention program

for youth: Lesions from a North Indian Slum, Studies in Family planning
Vol.31,no2,pg138-148
BS Hemalatha(August 2008) Women's knowledge on reproductive tract infections in
selected area of Raichur,India,Nursing Journal of India,Vol.XCIX No.8 pg 180-182

News letter of the international union against sexually transmitted infections(July

2008)

Reports as for month of July, September, and October, 2008, Ministry of health and
population, National centre for AIDs and STD control

Trani F et al(February 2008)A study assessed knowledge and sexual behavior

regarding sexually transmitted infection among female sex street workers and
sexually transmitted infection their knowledge and behavior in Italy, BMJ
http://hinari-gw.who.int

Alexandra Mc Manus et al (January 008) study of knowledge, perception and attitude

of adolescent girls towards STIs/HIV, safer sex and sex education (Across sectional
survey of Urban adolescent school girls in South Delhi, India) http://creative
commons.org/licenses/by/20

STI Global Update, News latter of the International Union against Sexually
Transmitted Infection (July, 2008).

Nepal Redcross Society HIV, AIDs and STIs Program.(2007)

Fact sheet N'110 revised October, WHO(2007)

E J Mmbaga etal (Feb, 2005), sexually transmitted infections knowledge and its
impact in the practice of risky sexual behavior and HIV serostatus: results from rural
Kilimanjaro, Tanjania.

A Andersson E et al (2002),Study on knowledge about the prevention of sexually

transmitted diseases: a longitudinal study of young women from 16-23 years of age,
BMJ, http://pubmed.gw.who.org

Gibney L et al (2001) Prevalence of infectious diseases in Bangladeshi women living

adjacent to a truck stand: HIV/STD/Hepatitis/ Genital tract infection, The University
of Alabama at Biringham, School Of Public Health, Department of Epidemiology and
International Health, Birinham, Alabama 35294-0022 USA,
http://pubmed.gw.who.org.

33
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.

SS Lal et al (2000) Knowledge awareness and perception of sexually transmitted

disease among antenatal at Newi, Nigeria Journal of obstetrics and Gynecology
2001 Vol.21 no.3,292-294.

Thapalia et al(2000) Assessment of knowledge attitude and practice concerning

HIV/AIDs and STD among the youth in Dang, Kailali and Surkhet district, submitted
to NCASC.

Puri M (January2001) study on sexual risk behavior & sexual transmitted disease
among young factory workers in Nepal, Centre for search on environment Health &
Population Activities (CREHPA), Ekantakuna Jawalakhel, Nepal, Kathmandu
File://H:/Carpet

P Adams et al(2002) study on a risk behavior, healthcare access and prevalence of

infection with Chlamydia, trichomatis, Neisseria gonorrhea in population based
sample in adults in Barbades,BMJ journal,http://hinari.gw.who.int/whale
comsti.bmj.com/whale com 0/content/vol.84/issues3/

Lye MS Archibald (2002) pattern of risk behavior for patients with sexually
transmitted diseases and surveillance for human immunodeficiency virus in Kuala
Lumpur, Malaysia. http://pubmed.gw.who.org

Unpublished research

Ghimire R (2005)Astudy on knowledge attitude, behavior and practice of truckers on

STIs and HIV/AIDs
www.scholar.google.com.
http://www.oic,it/iusti-europe 2008
http://www.sexualhealthconference.com.au
www.iusti.org.com
http://www.virology-education.com/
http://creativecommons.org/licenses/by/20
http://www.mediachannel.org./
www.jiom.com.np.
www.altavista.com
www.who.org.com
www.who.int/hinari
http://pubmed.gw.who.org.
www.hinari.com

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