2. RESEARCH REPORT
SUBMITTED BY
ABHIRAMI P DILEEP
ANAKHA K P
ASWATHY ANAND
ATHIRA RAVI
BINIMOL K B
ROSEMARY MATHEW
THASNIYA N
VIDHYA MOHANAN
3. TITLE OF THE STUDY
KNOWLEDGE ON LEPTOSPIROSIS AMONG MGNREGS WORKERS
NAME OF THE GUIDE: Ms. PONNI S
Ms. MIDHU M
NAME OF THE STUDENTS:
ABHIRAMI P DILEEP
ANAKHA K P
ASWATHY ANAND
ATHIRA RAVI
BINIMOL K B
ROSEMARY MATHEW
THASNIYA N
VIDHYA MOHANAN
4. ABSTRACT
Leptospirosis is a widespread and potentially fatal zoonosis that is endemic in many
tropical regions and cause large epidemic after heavy rainfall and flooding.
Leptospirosis have potential risk of exposure among outdoor workers especially
MGNREGS workers. A descriptive study was conducted to assess the knowledge on
leptospirosis among MGNREGS workers in 13 and 15 wards of Maravanthuruthu
panchayath,Vaikom Taluk . The objectives of the study were (i) to describe the
sociodemographic variables of MGNREGS workers in selected wards of
Maravanthuruthu panchayath (ii) to assess knowledge on leptospirosis among
MGNREGS workers in selected wards of Maravanthuruthu panchayath (iii) to find
the association between knowledge on leptospirosis among MGNREGS workers in
selected wards of Maravanthuruthu panchayath and their selected sociodemographic
variables
5. Quantitative research approach was used for the study. 40 samples
were selected using purposive sampling technique. The data were
collected by structured interview schedule and the obtained data were
analyzed using descriptive and inferential statistics. The study result
revealed that 45% of MGNREGS workers had good knowledge
regarding leptospirosis, 50% had average knowledge and 5% had
poor knowledge and the mean knowledge score is 18. The study
interprets that there is a significant association between knowledge on
leptospirosis and source of information and there is no significant
association between knowledge on leptospirosis and other selected
sociodemographic variables. The study concludes that awareness of
MGNREGS workers need to be improved on prevention of
leptospirosis.
6. INTRODUCTION
Leptospirosis is a zoonotic disease caused by the spiral shaped
bacteria of the genus leptospira.
It is also known as “mud fever”or “fall fever”.
Leptospirosis is an occupational hazard with potential risk of
exposure among outdoor workers especially Mahatma Gandhi
National Rural Emplyoment Gurantee Scheme (MGNREGS)
workers.
7. Mahatma Gandhi National Rural Employment Guarantee
Scheme Workers are field workers under Mahatma Gandhi
National Rural Employment Guarantee Scheme which is an
employment scheme in India for providing 100 days
guaranteed wage employment for all employment seekers
above 20 years of age and willing to do work.
8. BACKGROUND OF THE STUDY
Leptospirosis is found in countries around the world. It is common in
temperate or tropical climate regions.
When a person gets an infection leptospires appears in blood and invades to
tissues and organs such as kidney and liver, but it is cleared from the body
by host-immune response. It may also settle in the convoluted tubules of
kidney and shed in the urine for few weeks to months, and then
subsequently cleared from the kidney and other organs. Endotoxins
produced by the bacteria attaches to the endothelial cells and leads to
capillary vasculitis, hypovolemic shock and vascular collapse.
9. Field workers under MGNREGS are mostly engaged in outdoor work in
rural areas. The reason for increase in the fatality rate among the workers
due to leptospirosis is their poor knowledge about the disease, its
prevention and control also the lack of initiation in taking precaution
during their work and certain factors such as geographical areas, age,
immunological factors contribute to their susceptibility towards
leptospirosis.
10. INCIDENCE RATE OF LEPTOSPIROSIS
GLOBALLY : Every year, between 500000 and 1.03
million cases are reported,with a mortality rate over 10 %.
ASIA :the incidence is estimated from 0.1 – 1 per 100000
in temperate climate to 10-100 per 100000 in humid
tropics.
INDIA : The positivity rate for the disease is notable in the
southern part of India at 25.6%, followed by 8.3%, 3.5%,
3.1% and 3.3% in northern, western, eastern and central
India.
11. KERALA :In 2022,leptospirosis outbreak has
been confirmed. The fatality rate of leptospirosis
reported so far is 68.
KOTTAYAM :From the month of January till
march 2022 ,83 cases were reported and 4 deaths
has been confirmed.
12. Sohail M.L., Muhammed I., (2018) conducted a cross sectional study to estimate
seroprevalence of human leptospirosis in distinct climatic regions of Pakistan. Blood
sample were taken from 360 humans through convenient sampling, 120 from each of three
study areas. Serological testing was performed using ELIZA kit. The study result revealed
that an overall prevalence of leptospirosis was 40.83%. Statistical analysis showed
difference in leptospiral seroprevalnce in three different geographical location with the
highest in humid subtropical climate region (50.83%) followed by semi-arid region
(44.16%) and lowest in hot and dry region (0.73%). The study concluded that there is
effect of climate on prevalence of leptospira in the region.3.14
13.
14. Zoonotic infections are potentially fatal if not treated
properly, leptospirosis is one among them. The poor
knowledge about the disease, its prevalence, prevention
and management increase the fatality rate among
occupational workers. These diseases are mostly
preventable and curable if properly managed from the
beginning.
15. Leptospirosis is a bacterial infection commonly
affecting outdoor workers especially field workers
under Mahatma Gandhi National Rural Employment
Guarantee Scheme. The mild form of leptospirosis is
rarely fatal and an estimated 90% of cases fall into this
category. The mortality rate in severe leptospirosis
averages approximately 10%, but has been described
as ranging from 5-40%.
Elderly and immunocompromised people are at the
highest risk of mortality overall.
16. NEED
Leptospirosis is deadly disease and delay in availing
medical care will affect the functioning of key organs in the
body and will lead to death but it is preventable by
educating the people working in the field by using
protective wears like gown, boots and gloves and taking
prophylactic medications such as penicillin, doxycycline.
Therefore, it is important to implant awareness program on
leptospirosis at risk group, Thozhilurappu workers.
17. Nair C.C., Roy A., A Asheeta., C.S Hima, M.I Beena, N.Najiya
(2020) conducted a cross sectional study on knowledge and
prevention of leptospirosis in South India. 200 participants were
selected using random sampling technique. Data was collected
using self administered questionnaire. The study revealed that 181
responded with a rate of 90.5%, 64.64% respondents were aware
that leptospirosis is caused by rat, 61.87% participants knew that
fever is the main symptom, but did not know all signs and
symptoms of the disease. The study concluded that respondents
had lack of knowledge regarding leptospirosis.2.2
18. SIGNIFICANCE
During our community health nursing field visit we met many
MGNREGS workers at their workplace and found that none
of the workers were using any form of protective measures.
This incidence showed that they were not having awareness
about the preventive measures of leptospirosis so the
investigators thought of conducting a study regarding
knowledge on leptospirosis among MGNREGS workers.
19. STATEMENT OF THE PROBLEM
A Study to assess the knowledge on leptospirosis
among MGNREGS workers in selected wards of
Maravanthuruthu panchayath.
PURPOSE OF THE STUDY
Purpose of the study is to identify the knowledge
regarding leptospirosis among MGNREGS workers
in Maravanthuruthu panchayath.
20. OBJECTIVES
To describe the sociodemographic variables of MGNREGS
workers in selected wards of Maravanthuruthu panchayath.
To assess knowledge on leptospirosis among MGNREGS
workers in selected wards of Maravanthuruthu panchayath.
To find the association between knowledge on leptospirosis
among MGNREGS workers in selected wards of
Maravanthuruthu panchayath and their sociodemographic
variables.
21. OPERATIONAL DEFINITIONS
1.Knowledge
In this study knowledge refers to the response of
MGNREGS workers to an interview schedule
regarding the risk factors, clinical features, prevention
and control of leptospirosis.
2.Leptospirosis
It is an infectious disease caused by the bacteria of the
genus leptospira and is occurring in rodents which can
be transmitted to humans.
22. 3.MGNREGS workers
MGNREGS workers are the field workers and adult
members of rural household who volunteer to do unskilled
manual work under Mahatma Gandhi National Rural
Employment Guarantee Scheme.
4.Selected wards of Maravanthurathu panchayat
In this study,the selected wards of Maravanthuruthu
panchayat were 13 and 15 wards.
23. HYPOTHESIS
H0-There will be no significant association between the
knowledge of MGNREGS and their selected
sociodemographic variables.
24.
25. A literature review is the synthesis of the available literature regarding the
research topic. The purpose of a literature review is to survey the journals,
articles and scholarly books to prevent duplication of research paper and
also provide the credit of the original researcher of the journals, articles or
books.
In this chapter review of literature is divided into three categories;
1.Review of literature related to prevalence of leptospirosis
2.Review of literature related to knowledge of leptospirosis
3. Review of literature related to knowledge of leptospirosis among
MGNREGS workers
26. Review of literature related to prevalence of leptospirosis
Daud B A., Fuzi M.H., Kamarudin S., (2018) conducted a cross sectional study on leptospirosis and workplace
environmental risk factors among cattle farmers in north eastern Malaysia. 120 cattle farmers were selected
using random sampling technique and data were collected using interviewer guided questionnaire. Blood
samples and environmental samples were collected from cattle farmers and farms. The study revealed that over
all seroprevalence of leptospiral antibodies was 72.5% and the prevalence of pathogenic leptospira in the cattle
farm environment was 12.1%. The study concluded that incidence of leptospirosis can be prevented by changes
in the working environment of cattle farmers.3.9
27. Review of literature related to knowledge of leptospirosis
Shafie J.N., Najma S., Federico C., Albert I.K., Shukor, Fabiana P., etal (2021) conducted a
cross sectional study on knowledge, attitude and practice on leptospirosis among visitors of
recreational forest in Malaysia. 345 samples were selected by using random sampling
technique and a structured questionnaire was used to collect the data. The study result
revealed that the majority of respondents had high knowledge (63%) and 23% had poor
knowledge on leptospirosis. The study concluded that it is important to increase knowledge
especially on transmission routes of leptospirosis among visitors in recreational areas. 3.20
28. Review of literature related to knowledge of leptospirosis among
MGNREGS workers
Sebastian R.S., (2017) conducted a cross sectional study on knowledge and self-reported practices
regarding leptospirosis among MGNREGS workers in a rural area in Trivandrum among 250
participants. The samples were selected by using random sampling technique and data was collected
using pretested semi-structured questionnaire. The study concluded that out of 250 participants 103
(41%) individuals had good knowledge and 147 (59%) individuals had poor knowledge about
leptospirosis.2.1
30. Research Approach: Quantitative Research
Research Design: Descriptive survey design
Population: All MGNREGS workers
Target Population: MGNREGS workers in Maravanthuruthu panchayath
Accessible Population: MGNREGS workers in selected
Wards of Maravanthuruthu panchayath
Sampling Technique: Purposive sampling technique
Sample: Sample is 40 MGNREGS workers in 13th and 15th wards of
Maravanthuruthu Panchayath
31. CRITERIA FOR SELECTION OF SAMPLE
INCLUSION CRITERIA
The study inclusion criteria were,
MGNREGS workers who were,
in the age group of 20-65 years
able to read and write Malayalam.
available at the time of data collection.
32. EXCLUSION CRITERIA
In the study exclusion criteria was,
MGNREGS workers who are not willing to participate in the study
TOOLS AND TECHNIQUES
Tools for the present study has two parts; section A and section B.
DESCRIPTION OF TOOL
Section A:
It consists of selected socio-demographic variables such as age, sex, education, monthly
income, years of service and source of information.
33. Section B:
It consists of interview schedule to identify the knowledge of
MGNREGS workers regarding risk factors, signs and symptoms,
prevention and management of leptospirosis.
SCORING GRADING
0-12 POOR
13-18 AVERAGE
19-30 GOOD
34. PILOT STUDY
The pilot study will be conducted among 10% of the samples.
After obtaining the permission from the authority samples were selected
by using purposive sampling technique .Informed consent was taken
from the participants after explaining the research study and data were
collected. After pilot study, it is found that statistically amenable for the
main study.
35. DATA COLLECTION PROCESS
Administrative permission for data collection will be obtained
from Principal, BCF College of Nursing and president,
Maravanthuruthu panchayath. The period of data collection
will be two weeks.
36. After obtaining the permission, samples that fulfills the
inclusion criteria will be selected using purposive
sampling technique. Informed written consent will be
taken from samples. Socio demographic data will be
collected and structured knowledge questionnaire will
be administered to the samples to identify knowledge
regarding leptospirosis.
37. PLAN FOR DATAANALYSIS
Planning for data analysis is most significant part of the
research process. Before initiating the study, the researcher
selects suitable statistics to analyze the data. Analysis and
interpretation of data is the most important face of research
process which involve computation of certain measure along
with searching for pattern of relationship that exist among data
group.
38. Analysis will be done using appropriate descriptive and
inferential statistical method. The socio demographic
variables will be described using frequency and percentage
distribution. Knowledge score will be given in mean and chi
square test is used to find association between knowledge
regarding leptospirosis and selected to socio demographic
variables.
39. ETHICAL CONSIDERATIONS
Permission will be obtained from the Principal, BCF College
of Nursing Vaikom and president, Maravanthuruthu
panchayath to conduct the study.
Informed written consent will be obtained from each
participant.
40. SUMMARY
The chapter explains the research approach, research design,
setting of the study, population and the sample and sampling
technique, sample criteria, content validity, pilot study, data
collection process, plan for data analysis and ethical
consideration.
43. Age Frequency Percentage
20-35
36-50
51-65
Total
0 0%
11 27.5%
29 72.5%
40 100%
Table 1
Frequency and percentage distribution of MGNREGS workers according to age
(n=40)
Table1 shows that 0 (0%) samples belongs to the age group of 20-35 years, 11 (27.5%) samples belongs
to the age group of 36-50 years, and 29 (72.5%) samples belongs to the age group of 51-65 years.
44.
45. Table 2
Frequency and percentage distribution of MGNREGS workers according to gender
(n=40)
Gender Frequency Percentage
Male 0 0%
Female 40 100%
Total 40 100%
Table 2 depicts that 100% samples were females.
46. Fig 3 : Percentage distribution of MGNREGS workers according to gender
47. Table 3
Frequency and percentage distribution of MGNREGS workers according to educational status
(n=40)
Education Frequency Percentage
Primary 20 50%
High school 16 40%
Higher secondary 4 10%
and above
Total 40 100%
Table 3 reveals that 20 (50%) samples studied upto primary school, 16 (40%) up to high school, and
4 (10%) up to higher secondary and above.
49. Table 4
Frequency and percentage distribution of MGNREGS workers according to monthly income
(n=40)
Monthly income Frequency Percentage
<Rs.5000 34 85%
Rs.5001-10000 5 13%
>Rs.10000 1 3%
Total 40 100%
Table 4 depicts that, 34 (85%) samples had monthly income below Rs. 5000, 5 (13%) had between Rs.
5001-10000, and 1 (3%) above 10000.
51. Table 5
Frequency and percentage distribution of MGNREGS workers according to years of service
(n=40)
Years of service Frequency Percentage
<5 years 4 10%
5-10 years 24 60%
>10 years 12 30%
Total 40 100%
Table 5 reveals that, 4 (10%) had less than 5 years of service, 24 (60%) had 5-10 years of service,
and 12 (30%) had more than 10 years of service.
52. 10%
60%
30%
Years of service
<5 years
5-10 years
>10 years
Fig 6 : Frequency and percentage distribution of MGNREGS workers according to years of service
53. Table 6
Frequency and percentage distribution of MGNREGS workers according to source of
information
(n=40)
Source of information Frequency Percentage
Family 14 35%
Friends 5 13%
Mass media 21 53%
Total 40 100%
Table 6 reveals that 14 (35%) got information from their family, 5 (13%) from friends and 21
(53%) got information from mass media.
54. FAMILY FRIENDS MASS MEDIA
SOURCE OF INFORMATION
35%
13%
53%
Fig 7 : Frequency and percentage distribution of MGNREGS workers according to source of information
56. Table 7
Frequency and percentage distribution of knowledge regarding leptospirosis.
(n=40)
Knowledge Grade Knowledge Score Frequency Percentage
Poor 0-12 2 5%
Average 13-18 20 50%
Good 19-30 18 45%
Total 40 100%
Table 7 shows that 2 (5%) samples had poor knowledge, 18 (45%) had good knowledge and 20
(50%) had average knowledge regarding leptospirosis.
58. Table 8
MEAN KNOWLEDGE SCORE OF MGNREGS WORKERS REGARDING
LEPTOSPIROSIS
(n=40)
Area of assessment Maximum possible Knowledge score
Score
Mean Percentage
Knowledge regarding 30 18 60%
Leptospirosis
Table 8 shows that the mean knowledge score of MGNREGS workers regarding leptospirosis is 18 and score
percentage is 60%.
59. SECTION 3
ASSOCIATION BETWEEN SELECTED SOCIO
DEMOGRAPHIC VARIABLES AND KNOWLEDGE
REGARDING LEPTOSPIROSIS AMONG MGNREGS
WORKERS
60.
61. Table 9 shows that the calculated value for sociodemographic variables like age, sex, education, monthly income
and year of service were less than the table value. The calculated value for the variable source of information is
higher than table value which shows that there is significant association at 0.05 level.
Hypothesis (H0) stated for the study was there is no significant association between knowledge on leptospirosis
among MGNREGS workers and their selected socio-demographic variables. To find the association, Chi square
test was done. The computed value is less than the table value for socio-demographic variables such as age, sex,
education, monthly income, year of service at 0.05 level of significance except for source of information where
the computed value is more than the table value. Hence for the variable source of information there is a
significant association at 0.05 level, therefore the null hypothesis(H0) is rejected.
63. SALIENT FINDINGS OF THE STUDY
The salient findings of the study were presented under the following headings:
SECTION 1: Frequency and percentage distribution of sociodemographic variables of
MGNREGS workers in selected wards of Maravanthuruthu panchayath.
SECTION 2: Knowledge on leptospirosis among MGNREGS workers .
SECTION 3: Association between knowledge on leptospirosis among MGNREGS
workers and their selected sociodemographic variables.
64. The present study findings revealed that among 40 MGNREGS workers, 45% had good knowledge, 50% had average
knowledge and 5% had poor knowledge regarding leptospirosis.
CONCLUSION OF THE STUDY
Based on the analysis of the study, the following conclusions were made.
45% of the samples had good knowledge, 50% of samples had average knowledge and 5% had poor knowledge regarding
leptospirosis.
There is significant association between knowledge of MGNREGS workers and source of information and there is no
association between knowledge of MGNREGS workers and other sociodemographic variables such as age, sex,
education, monthly income and year of service. So the knowledge score of the MGNREGS workers are dependent of their
selected sociodemographic variables.
65. NURSING IMPLICATIONS
The nursing implications emerged out of the study have implications in the field of Nursing practice, Nursing education,
Nursing administration and Nursing research.
Implications in public health nursing practices
The public health nurses can conduct regular individual and group health education to create awareness on
leptospirosis for MGNREGS workers.
IEC materials may be supplemented with verbal instructions.
The public health nurses can conduct home visit to identify the high risk group and should teach about control
measures among the family members and MGNREGS workers.
66. Implications for nursing education
Leptospirosis has already been included in the curriculum of nursing. More emphasis may
be added on the community areas as a regular education programme consisting of
prevention of leptospirosis.
Educational program may be organised for health care workers to update their knowledge
so as to equip them to impart knowledge to the public.
Nurse educators should facilitate the student nurse to prepare innovative IEC materials
related to prevention of leptospirosis.
Conduct staff development program on prevention of leptospirosis.
67. Implications for nursing administration
Nursing administrators can periodically assess the standard of practice on prevention of
leptospirosis.
The nurse administrators should be initiative in organising in service educational program
for nurse and motivate the nurse to participate in such activities.
68. Limitations of the study:
The sample size is limited to 40 MGNREGS workers in selected wards,
Maravanthuruthu panchayath.
• The knowledge aspect alone is identified in the study
Implications for nursing research
The study result can be utilised as a baseline data for other studies.
The study findings should be utilised for community level epidemiological study.
Study result can be utilised by the local self government for policy making and
project submission.
69. Suggestions and recommendations
In the light of the study finding, the following recommendations are:
a) The study can be replicated in a large sample so that the findings can be generalised
for a large population.
b) An interventional study can be planned to evaluate the effectiveness of specific
interventions on improving the MGNREGS workers knowledge on leptospirosis.
c) Study can be conducted to find the practice of public regarding prevention of
leptospirosis .
70. SUMMARY
This chapter has covered area like summary, discussion,
conclusion, limitations of study and suggestions for
future research and nursing implications.
