CHAPTER-ONE

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 fields’ 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
now days, TB is fully cured and some kinds of cancers are also curable as
the boom 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 glob 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 sexual diseases are increasing
rapidly. So at late the sexual transmitted infection have 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 part
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)

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

In spite of the availability of effective antibiotics and treatment of sexual

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

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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 such a way, 5988
HIV positive cases were detected in 2006. (National AIDs and STD control
Program).

Definition of STI:
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 continue it increase worldwide
and infection are becoming more severed. STI also facilitates the
development of HIV infection and AIDs.

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.

Though the government has these objectives,

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.

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 (The researchers from the Centre for Research on Environment
Health and Population Activities -CREHPA, UK) They may be more
likely to engage in high-risk behavior due to:

• living in mixed-gender hostels

• peer pressure
• lack of parental supervision
• low income
• lack of job security
• exploitation by employers
• Isolation and loneliness.

The workers of the carpet factories come from different ethnic group. Both
male and female live together in industrial area. Most of them are illiterate.

STATEMENT OF THE PROBLEMS

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Knowledge regarding sexual transmitted infection among the workers of
carpet factory.

SIGNIFICANCE OF THE STUDY

The sexual 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 becomes infected with STI while she is pregnant.

In Nepal, due to the lack of education and awareness, more people are
suffering from STI. In such a way, most workers of the carpet factory are
uneducated and unaware of STIs.

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 significance 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:

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

Specific objectives:

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

HYPOTHESIS

• Literate carpet factory workers have more knowledge than illiterate

workers.
• The carpet factory workers will have more knowledge that involve in
health education and are curious in the health related program of FM,
Radio, TV paper and pamphlet than other who do not participate.

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 is transmitted from sexual contact.

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

• Literate: Those person who cannot read and write.

• Illiterate: Those person who cannot read and write.

• Education: Education refers to giving information about sexually

transmitted infection.

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

LIMITATION OF THE STUDY

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  Area: For this study area was limited to the carpet factories of the
Balkumari, Lalitpur.

 Time was limited for data collection for only five weeks

 The budge was limited due to being a student/self finance.

CHAPTER-TWO

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 literature are given below.

According to recent study conducted by the family planning association

of Nepal"
Nearly one third of young people was 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. Leading to increasing
incidence of sexually transmitted infections among young people.

According to WHO/Searo" Fact sheets on young people and HIV/AIDs"

Knowledge of AIDs is much higher among young men than young women.
Two out of every five young women and four in five men believe there is a
way to avoid HIV/AIDs. Knowledge of AIDs is very low among rural
women and among those who have not had any formal education.

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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.

According to "Department of Urology, Renji HOspital, School of

medicine, Sanghai Jiao Tong university, Sanghai, Chana from July 2004
to may 2006" 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

According to "Alexandra Mc Manus and Lipidhar Curtin University of

technology, Perth ,Australia (july23,2008)" 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

A study on the Karmic society of Nepal 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 agreed that condom is best measure to

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

According to B.S. Hemlata, the nursing journal of IndiaVol.XCIX no.8

August 2008: 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.

CHAPTER- THREE

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:

Both male and female entire workers of the carpet factory.

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

3.5.Sampling Plan:
Purposive sampling plan 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

1. Independent variables:
• Demographic area
• Working environment
• culture
• customs
• awareness
• Socio-economic status

2.Dependent Variables:
• Education

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

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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 respondent was 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 will be 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 will be explained clearly
to the participants
 None of the respondents will be forced to participate in study.

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  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.
 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 ane 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- FOUR
Data analysis and interpretation:
This chapter deals with the analysis and interpretation of data concerning demographic
information and knowledge of carpet factory workers regarding on sexually transmitted
infection. After collecting all the data was 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.

4.1. Demographic characteristics of respondents

Table -1:

Distribution of respondents according to their age:

N=60
SN Subject Frequency Percentage Remarks
1 Age:
15-20 years 16 26.67%
21-25years 20 33.33%
26-30years 12 20%
31-35years 8 13.33%

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 36-40years 4 6.67%

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 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%

Table 1 shows that the majority 20(33.33%) of the respondents were 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.

Distribution of respondents according to their sex:-

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 35 33

30 27
25

20 Male
15 Female

10

0
Male Female

Above figure shows that the majority of the respondents 33(55%) were male and
27(45%) female.
Distribution of respondents according to their cast:-

3% 2% Tamang
3% 3%
8% Magar
Newar
Chhetri
Rai
Dalit
81%

Above figures denotes that the majority of the respondents 48(81%) respondents were
Tamang, 5(8%) Magar, 2(3%) Newar,3% Chhetri 3% Rai and 1(2%) were dalit.

The knowledge score about sexually transmitted infection of the carpet factory
workers

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 N=60

18
17
16
15
14 14
Knowledge score

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

Above figure shows that the knowledge score of respondents ranged from a low of 2 to
high of 17.

Distribution of respondents according to heard about STI:

15
 30%

yes
No

70%

Above figures shows that the majority 42(70%) respondents had heard about STI and
only18(30%) respondents had not heard about STI.

Distribution of respondents according to sources of information:

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%

Above chart denotes that the Radio is the effective media to transfer the
massage. In this study 16(38.o9%) 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.

Distribution of respondents according to knowledge on listing the different

name of STIs

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 50
50
45
40
35 Shyphilis
30 Gonorrhea
25 HIV/AIDs
20
Don't know
15
10 8
4
5 1
0

Above figure 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( )
respondents listed the name of gonorrhea.

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%

Above table 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.

*Multiple responses*

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Distribution of respondents according to knowledge about sign and
symptoms of STI
N=60
SN Knowledge about sign and symptoms of Frequency Percentage
STI
1 Excessive white vaginal discharge 12 20%
2 Having sore in private part 15 25%
3 Lower abdomen pain 6 10%
4 Swelling in groin 3 5%
5 Don't know 37 61.66%

Distribution of respondents according to knowledge about how could not

transmission of STI:

SN Knowledge about how couldnot transmit Frequency Percentage

STI from one person to another.
1 Sharing of toilet 21 35%
2 Sharing of food and utensils 19 31.66%
3 Coughing and sneezing 2 3.33%
4 Use of condom 4 6.66%
5 Don’t know 32 53.33%

Table no- … 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.

Distribution of respondents according to knowledge about who are the

vulnerable group for STI:

SN knowledge about who are the venerable Frequency Percentage

group for STI
1 Female sex workers 11 18.33%

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2 Multiple partner/ mother to child 26 43.33%
3 Don’t know 25 41.66%

Above table 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 multiple partners are the
vulnerable group for STI.

Distribution of respondents according to knowledge about treatment is

possible or not possible for STI
N=60
10%

10%

yes
No
Don't know

80%

Above figure shows that 48(80%) respondents have 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.

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.

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Distribution of respondents according to knowledge about both should
be treated for STI
N=48

40 37

30

20
Yes
10 No
4 7
Don't know
0
Yes
No
Don't
know

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.

Distribution of respondents according to have sexual relation with multiple sex

partner

N=60

20
 23%

Yes
No

77%

Above figure 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.

Distribution of respondents according to have sexual relation without using

condom:
N=14

36%

Yes
No

64%

Among figure shows that among 14 respondents, the 5(36%) respondents expressed that
they have used condom during sexual contact and 9(64%) respondents expressed that
they have not used condoms during sexual contact.

Distribution of respondents according to knowledge about prevention of

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

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1 Condom use 15
2 Avoid multiple sex partners 28
3 Don’t know 22

Above table shows that most of the respondents had knowledge about avoiding of
multiple sex partner is the way of prevention from STI, that was 28 (… %) respondents,
the 15(..%) respondents expressed that use of condom is the way of prevention of STI.
22( %) respondents have no knowledge about the way of prevention of STI.

Distribution of respondents according to knowledge about STI between literate and

illiterate:

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