Knowledge and Attitude Regarding Sickle Cell Anemia Among Tharu Students of Selected School, Bardiya

Knowledge and Attitude Regarding Sickle Cell Anemia Among Tharu Students of Selected School, Bardiya | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge and Attitude Regarding Sickle Cell Anemia Among Tharu Students of Selected School, Bardiya Pratima Dawadi, Khem Kumari Tharu, Anjali Dev, Praba Poudel This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9000350/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim: Sickle-cell anemia (SCA) is a common genetic condition due to a hemoglobin disorder – inheritance of mutant hemoglobin genes from both parents. The Tharu ethnic group of Nepal is one of the most affected by SCA. They should be highly aware of its control and prevention. Despite such a necessity, limited research has been conducted to identify their level of knowledge. The present study aimed to assess the level of knowledge and attitude regarding sickle cell anemia among Tharu students of selected school, Bardiya. Methods: A cross-sectional analytical study was conducted among 175 Tharu students from classes 8 to 12. The school was selected based on having the highest number of Tharu students in the municipality and simple random sampling technique was used to select the sample. Data were collected through face to face interview technique using a semi-structured questionnaire. Data entry was done in MS Excel, and analysis was carried out using descriptive and inferential statistics (chi-square test) through the Statistical Package for the Social Sciences (SPSS) version 22 to identify associations between knowledge and selected socio-demographic variables. Results: The study revealed that the majority (58.9%) of respondents demonstrated average knowledge regarding SCA and there was a significant association in between the level of knowledge and sex of respondents at (P=0.006). Although average level of knowledge was prevalent among the respondents, majority showed a positive attitude, particularly towards newborn and premarital screening, which proved to be highly influential among them. Conclusion: The findings indicated that sex plays a significant role in influencing knowledge about SCA. Specific health education to improve awareness, with gender-specific deficits, is needed. Their positive attitudes towards premarital and neonatal screening can be attached to improve preventive interventions. Culturally targeted programs to aid in correcting misconceptions about life impact and reproductive choice are needed. knowledge Attitude Sickle Cell Anemia Figures Figure 1 Background Sickle-cell anemia (SCD) (also known as sickle-cell disorder or sickle-cell disease) is a common genetic condition due to a hemoglobin disorder – inheritance of mutant hemoglobin genes from both parents. About 5% of people on the planet have trait genes for hemoglobin diseases, primarily thalassemia and sickle-cell disease. Every year, more than 300,000 newborns are born with serious hemoglobin abnormalities 1 . According to the Global Burden of Disease (GBD), national incidence of sickle cell disease stayed mostly similar between 2000 and 2021, while the number of sickle cell disease-affected newborns born worldwide rise by 13.7% in the Caribbean and western and central sub-Saharan Africa 2 . Sickle cell anemia can cause a variety of complications, including stroke, acute chest syndrome, avascular necrosis, pulmonary hypertension, organ damage, splenic sequestration, blindness, leg ulcers, gallstones, priapism, deep vein thrombosis, and pregnancy complications 3 . A study of Ghana reveled 98.6% university students were aware about SCD, with major source of information was school (84.6%), while distributing it with level of knowledge only 7.1% had excellent level of knowledge 4 . A descriptive cross-sectional study was done with university undergraduates. More than half of respondents (59%) knew someone with SCD, and 77% indicated the Hb phenotype would influence their choice of a life partner. While 79% indicated they would end their connections if they found out their Hb genotype predisposes them to having children with SCD, 5% were unsure, and 16% said they would continue the connection 5 . The study conducted on the Tharu community of Bardiya identified that 14.67% had sickle cell anemia. Among them, 75% patients had sickle cell trait and 25% patients had sickle cell illness 6 . The survey conducted in Kanchananpur district revealed that 55.4% respondents had basic knowledge of sickle cell anemia. The majority of respondents learned about sickle cell anemia primarily through medical staff 7 . Sickle cell disease (SCD) is critical due to the disorder's high frequency and significant impact on morbidity and death. There was a Lack of understanding of SCD, particularly in terms of inheritance patterns, underlining the significance of comprehensive public health education. By addressing myths and expanding knowledge through trustworthy sources such as schools, media, health centers, and churches, awareness and personal reproductive decisions could be enhanced, which ultimately reduce the occurrence of SCD 8 . Conducting research on sickle cell anemia within the Tharu community is crucial due to the high prevalence of the disorder and the community's vulnerability. This study aims to improve genetic literacy among the Tharu people, who are at significant risk of inheriting sickle cell anemia. With the community knowledge gaps, the research can inform policymakers and healthcare providers, leading to better-targeted interventions, screening programs, and educational initiatives. Ultimately, this research seeks to enhance healthcare services, early diagnosis, and treatment plans, thereby improving the overall health and quality of life for the Tharu community. Despite the investigation of knowledge and attitudes of sickle cell anemia in Nepal, researchers discovered a scarcity of research studies on the subject. So the researcher was compelled to undertake a study to identify the level of knowledge and attitude regarding sickle cell anemia among Tharu students of selected school, Bardiya. Method Study Design and Participants A cross- sectional analytical study design was done to assess the knowledge and attitude regarding sickle cell anemia among Tharu students of selected school, Bardiya. The study population were students of Tharu communities (class 8–12) of selected school in Gulariya Municipality of Bardiya. All the Tharu students’ studying in Shree Banglamukhi Radhakrishna Tharu Secondary School of Gulariya, Bardiya from grade 8 to 12 were included. Firstly the school was selected according to the highest number of Tharu students in this municipality then students were selected by using simple random sampling technique. Hence the sample size was 175. Data collection Data was collected by face to face interview method using a semi-structured questionnaire by the researcher herself. The interview was taken in a separate corner or in a room as feasible to maintain privacy of participants. The interview was taken in a separate corner or in a room as feasible to maintain privacy of participants. The time duration for each respondent was 20–25 minutes. Data was collected from 25th February 2025 to 12th March 2025 (10 am to 4 pm). The data collection period was 14 days and 15 data was collected each day. Statistical Analysis After data collection, data was analyzed on the basis of research objectives. Every day, all of the data was reviewed and checked for consistency, accuracy, and completeness. The data was organized, coded and tabulated and entered in Microsoft Excel before being transferred to SPSS (Statistical Package for Social Science) version 22 for statistical analysis. At the same time data was analyzed by using a descriptive method (Mean, Median, Mode, Standard deviation) and inferential statistics (chi square test) to identify the association between the knowledge and selected variables. Ethical Consideration Research proposal approval was taken from Paropakar Nursing Campus, Kupondole. Then the ethical clearance was taken from the Institutional Review Committee (IRC) of Paropakar Maternity and Women's Hospital, Thapathali (Ref. no: 65/1478). In the same way, formal permission was obtained from the head of the educational department and verbal consent was obtained from the principal of the selected school for data collection. Informed assent and verbal consent was taken from the age below 18 years and verbal and written consent was taken from the age above 18 years prior to data collection. The objective of the research was explained to the selected Tharu students and informed consent of each respondent was taken prior to data collection. The respondent’s decision to withdraw participation in the study was respected. Confidentiality was maintained by assigning codes instead of filling names. The respondent’s queries were addressed. Similarly, confidentiality was ensured by keeping the questionnaires safely, maintaining non-disclosure and using obtained information for research purposes only. Results Table 1 Socio-demographic Characteristics of Respondents n =175 Variables Frequency Percent Age (in years) 11-15 66 37.7 ≥16 109 62.3 Mean ± SD:15.94±1.66, Min:11, Max=21 Sex Male 72 41.1 Female 103 58.9 Education Class 8 37 21.1 Class 9 35 20.0 Class 10 33 18.9 Class 11 25 14.3 Class 12 45 25.7 Religions Hindu 164 93.7 Christian 11 6.3 Tharu sub-group Rajbanshi 44 25.1 Hardiula 28 16.0 Kusumya 42 24.0 Dahit 12 6.9 Pachhaldangiya 6 3.4 Bakharya ultahuwa 5 2.9 Dangaha 4 2.3 Dukurpuchhya 4 2.3 Others 30 17.1 Residency Rural 20 11.4 Urban 155 88.6 Types of family Nuclear family 106 60.6 Joint family 69 39.4 Others cast (Jolariya, Bhagoria, Thakuri, Gamuwa etc.) Table 1 shows the socio-demographic characteristics of the respondents. Regarding age, the majority of the respondents (62.3%) belonged to the age ≥16 years and 37.7% of the respondents belonged to the age group 11-15 years. Mean age and standard deviation (SD) were 15.94 and 1.66 respectively. Minimum and maximum age is 11 and 21 years respectively. The majority of the respondents regarding sex, (58.9%) were female. While 41.1% of the respondents were male. In the same way, 25.7% respondents were from class 12, and 14.3% of the respondents were class11. Similarly, almost all of the respondents were (93.7%) Hindu and only 6.3% were Christian. Regarding the Tharu sub-group, less than one third of respondents (25.1%) were Rajbanshi and only 2.3% of the respondents were Dangaha and Dukurpuchhya. Regarding marital status all despondent were unmarried. On the other hand, most of the respondents ( 88.6%) were from urban areas and only few respondents (11.4%) were from rural areas. In the same way, about six ten respondents (60.6%) were from nuclear families and 39.4% were from joint families. Table 2 Socio-demographic Characteristics of Respondent’s Mothers n=175 Variables Frequency Percent Mother’s ethnicity Dalit 1 0.6 Tharu and sub-ethnicities 172 98.3 Brahman/Chhetri 2 1.1 Educational status of mother Illiterate 7 4.0 Literate 168 96 Education level of mother (n=168) literate without formal education 86 51.2 Basic level 57 33.9 Secondary level and above 25 14.9 Occupation of mother Home maker 95 54.3 Agriculture 49 28.0 Others 31 17.7 Table 2 presents the socio-demographic characteristics of the parents. Regarding the mother’s ethnicity, almost all of the mothers (98.3%) belonged to the Tharu ethnic group, while very few (0.6%) were from the Dalit community. In terms of educational status, almost all of the mothers (96%) were able read and write, while 4.0% were unable to read and write. Regarding the level of education, the majority of the mothers (51.2%) had received education without formal schooling, and 14.9% had achieved secondary level education and above. As for occupation, the majority of the mothers (54.3%) were homemakers, while 17.7% were engaged in other occupations. Table 3 Socio-demographic Characteristics of Respondent’s Fathers and Family income n=175 Variables Frequency Percent Educational status of father Illiterate 3 1.7 Literate 172 98.3 Education level of father (n=172) literate without formal education 25 14.5 Basic 80 46.5 Secondary and above 67 39.0 Occupation of Father Agriculture 65 37.1 Foreign employee 29 16.6 Service holder 29 16.6 Daily wages 34 19.4 Business 18 10.3 Estimated monthly income ≤ Rs. 20000 92 52.6 Rs. 21000-40000 51 29.1 ≥ Rs. 41000 32 18.3 Mean ± SD:28180.00±23090.85, Min=Rs. 1,000, Max=Rs. 1,50,000 Table 3 shows the socio-demographic characteristics of the fathers and family income. Regarding the educational status of the fathers, almost all of the fathers (98.3%) were literate, while a small proportion (1.7%) were illiterate. Concerning their level of education, nearly half of the fathers (46.5%) had received basic level education, and 14.5% had received education without formal schooling. With respect to occupation, more than one third of the fathers (37.1%) were involved in agriculture, while 10.3% were engaged in business. In terms of monthly family income, the majority of the families (52.6%) earned less than Rs. 20,000, while 18.3% earned Rs. 41,000 or more per month. Table 4 Respondent’s Exposure and Personal Experience Related to Sickle Cell Anemia Students n=175 Variables Frequency Percent Heard about sickle cell anemia (n=175) No 4 2.3 Yes 171 97.7 Source of information*(R=319) Personal experience 4 1.3 Health professionals 89 27.9 Social media 37 11.6 Family and relatives 97 30.4 Peers 86 27.0 Posters 6 1.9 Knows someone with sickle cell anemia No 109 63.7 Yes 62 36.2 Any family suffering from SCA No 147 85.9 Yes 9 5.2 Don't know 15 8.7 Relation with sufferer (n=9) Mother 2 22.2 Sister 1 11.1 Brother 3 33.3 Self 2 22.2 Aunt(Fupu) 1 11.1 Ever suffered from SCA No 169 98.83 Yes 2 1.1 Suffering from (in years) (n=2) 1 1 50 >1 1 50 I nformation disclosure from*(R=5) Medical person 2 40 Parents 2 40 Relatives 1 20 *Multiple response Table 4 shows the respondents personal information related to sickle cell anemia. Regarding sickle cell anemia, almost all of the respondents (97.7%) had heard and 2.3% of the respondents had not heard. However, a source of information about sickle cell anemia, one third of the respondents (30.4%) got information through the family and relatives and only 1.3% got information through personal experience. Regarding knowledge about sickle cell anemia infected persons, the majority of the respondents (63.7%) did not know about sickle cell anemia infected persons and 36.2 % knew about sickle cell anemia infected persons. However, for any family suffering from SCA, most of the respondents (85.9%) had said no and 5.2% had said yes. Also related with sufferers, more than one third (33.3%) had a brother and 11.1% had a sister and aunt. Similarly, in the respondent's family suffering from sickle cell anemia, almost all of the respondents (98.83%) had not suffered and 1.1% had suffered. However, less than half of the respondents (40%) were from medical persons and parents while 20% had got from relatives. Table 5 Knowledge of Sickle Cell Anemia among Respondents n=171 Variables Frequency Percent Sickle cell anemia Kidney disease 13 7.6 Liver disease 2 1.2 Blood disease 108 63.2 Heart disease 12 7.0 Bone disease 36 21.1 Person can carry SCA traits without having disease No 55 32.2 Yes 74 43.3 Don't know 42 24.6 Newborns screening is necessary No 14 8.2 Yes 141 82.5 Don't know 16 9.4 Most prevalent ethnic group Tharu 167 97.7 Bhraman/ chhetri 3 1.8 Others 1 0.6 Table 5 shows the variables related to Knowledge on Sickle cell anemia. Regarding the definition of sickle cell anemia, the majority of the respondents (63.2%) had said blood disease and very few (7.0%) had said liver disease. However, related to respondents who can carry sickle cell anemia traits without having disease, less than half of the respondents (43.3%) had yes and 24.6% had said to not know. On the other hand newborns screening is necessary, most of the respondents (82.5%) had given yes and 8.2% had given no. Similarly in the context of Nepal most prevalent ethnicity by sickle cell anemia, almost all of the respondents ( 97.7%) had Tharu ethnic group and very few (0.6%) had others. Table 6 Knowledge on Causes and Signs and Symptoms of Sickle Cell Anemia among Respondents n=171 Variables Frequency Percent Primary cause of sickle cell anemia Genetic 116 67.8 Environmental pollution 22 12.9 Viral 12 7.0 Bacterial 21 12.3 Consanguinity cause SCA No 54 31.6 Yes 117 68.4 Is transfer through Inheritance 130 76.0 Shaking hand 2 1.2 Through respiration 39 22.8 Is sickle cell anemia Major problem of Tharu Community No 6 3.5 Yes 150 87.7 Don't know 15 8.8 Sign and symptoms of SCA*(R=320) Pale 93 29.1 Jaundice 58 18.1 Delay growth 82 25.6 Frequent infection 87 27.2 *Multiple response Table 6 shows the variables related to causes and signs and symptoms of sickle cell anemia. Regarding the primary cause of sickle cell anemia, the majority of the respondents (67.8%) had said genetic while 7.0% had said viral. Similarly consanguinity causes sickle cell anemia, the majority of the respondents (68.4%) had yes and 31.6% had no. However, related to its transfer through, most of the respondents (76.0%) had said that through inheritance and very few (1.2%) had said it through shaking hands. In the same way related to sickle cell anemia, a major problem of the Tharu community, most of the respondents (87.7%) were given answer yes and (3.5%) were given no answer. Related to signs and symptoms of sickle cell anemia, nearly one third (29.1%) had responded on Pale and (18.1%) had responded on Jaundice. Table 7 Knowledge on Prevention of Sickle Cell Anemia among Respondent n=171 Variables Frequency Percent Pre-marital test is necessary No 7 4.1 Yes 152 88.9 Don't know 12 7.0 Is preventable No 9 5.3 Yes 141 82.5 Don't know 21 12.3 Prevention (n=141) Genetic sickling test 123 87.2 Not eat food left by sufferers 18 12.8 Table 7 shows the variables related to prevention of sickle cell anemia. Regarding whether a pre-marital test is necessary, most of the respondents (88.9%) had yes and 4.1% had answered no. Similarly is preventable, most of the respondents (82.5%) had answered yes and 5.3% had answered no. In the same way as prevention, most of the respondents (87.2%) were given a genetic sickling test and 12.8% did not eat food left by sufferers. Table 8 Knowledge on Treatment and Management of Sickle Cell Anemia among Respondents n=171 Variables Frequency Percent Treatment No 38 22.2 Yes 62 36.3 Don't know 71 41.5 Best treatment (n=62) Blood transfusion 54 87.1 Perform surgery 8 12.9 SCA may create complication No 8 4.7 Yes 128 74.9 Don't know 35 20.5 Is curable No 79 46.2 Yes 54 31.6 Don't know 38 22.2 Type of support from government of Nepal Full free treatment 66 38.6 50 % discount 105 61.4 Table 8 shows that less than half of the respondents (41.5 %) answered don’t know while only 22.2% answered no about respondents who think sickle cell anemia has treatment. Similarly, if yes, the best treatment of sickle cell anemia most of the respondents (87.1%) were blood transfusion while only 12.9% performed surgery. In the same way sickle cell anemia may create any complication, the majority of the respondents (74.9%) answered yes while only 4.7% answered no. Regarding Is curable, nearly half of the respondents (46.2%) had answered no and 22.2% had answered don’t know. Also, the majority of the respondents (61.4%) were answered 50% discount while only 38.6% were answered full free treatment support from government of Nepal. The study showed that 60% respondents had average knowledge, 24% had poor knowledge and only 16% had excellent knowledge on Sickle Cell anemia. Table 9 Statement Related to Attitude on Sickle Cell Anemia among Respondents n=171 Statement Strongly Agree Agree Neutral Dis-agreed Strongly dis-agreed Need to encourage friends and relatives for genetic counseling before marriage 93(54.4%) 76(44.4%) NA 2(1.2%) NA Individual must to do premarital counseling and screening 64(37.4%) 93(54.4%) NA 14(8.2%) NA Every Tharu new born should be screened for SCA 79(46.2%) 72(42.1%) NA 20(11.7%) NA Partners should go for genetic counseling and testing before marriage 51(29.8%) 104(60.8%) NA 11(6.4%) 5(2.9%) A person should continue the relationship despite their partner testing positive for sickle cell disease 109(63 %) 59(34.5%) NA 3(1.8%) NA I seem healthy so I do not have sickle cell anemia 6(3.5%) 9(5.3%) NA 125(73.1%) 31(18.1%) A person with Sickle cell anemia can’t continue his/her life 4(2.3%) 41(24.0%) NA 113(66.1%) 13(7.6%) Sickle cell anemia may cure after changing the religion NA 1(0.6% ) NA 45(26.3%) 125(73.1%) Baby plan should be avoid if the person have sickle cell anemia 16(9.4%) 73(42.7%) NA 64(37.4%) 18(10.5%) Sickle cell anemia is a preborn sin NA NA NA 46(26.9%) 125(73.%) Table 9 shows the attitude on Sickle Cell Anemia of the respondents. Regarding the need to encourage friends and relatives to go for genetic counseling before marriage, the majority of the respondents (54.4%) had strongly agreed and very few (1.2%) had dis-agree. Similarly, related to all individuals who must do premarital counseling and screening, the majority of the respondents (54.4%) had agreed and 8.2% had dis-agree. However every Tharu newborn should be screened for sickle cell anemia, nearly half of the respondents (46.2%) had strongly agreed while 11.7% were dis-agree. Regarding whether all partners should go for genetic counseling and testing before marriage, the majority of the respondents (60.8%) had agreed while 2.9% strongly dis-agree. Similarly, it is necessary to continue with a relationship despite the result of the life partner having the positive sickle cell disease, the majority of the respondents (63.7%) had strongly agreed and very few (1.8%) were dis-agree. In the same way they seem healthy so do not have sickle cell anemia, the majority of the respondents (73.1%) were dis-agree and 3.5% had strongly agreed. Also person with Sickle cell anemia can’t continue his/her life, the majority of the respondents (66.1%) had dis-agree while 2.3% had strongly agree. Regarding Sickle cell anemia may be cured after changing the religion, the majority of the respondents (73.1%) had strongly dis-agree while very few (0.6%) had agreed. However, baby plans should be avoided if the person has sickle cell anemia, less than half of the respondents (42.7%) had agreed and 9.4% had strongly agreed. Regarding Sickle cell anemia as a preborn sin, the majority of the respondents (73.1%) had strongly dis-agree and 26.9% had dis-agree. Table 10 Association between Level of Knowledge on Sickle cell anemia and Selected Socio-demographic Variables n=171 Variables Level of Knowledge No. (%) Chi-square P-value Poor Average Excellent Age in years 11-15 19(11.1) 37(21.6) 8(4.7) 2.770 0.250 ≥16 21(12.3) 66(38.6) 20(11.7) Sex Male 24(14.0) 41(24.0) 6(3.5) 10.406 0.006 * Female 16(9.4) 62(36.3) 22(12.9) Education level Secondary level 26(15.2) 63(36.8) 14(8.2) 1.641 0.440 Higher secondary and above 14(8.2) 40(23.4) 14(8.2) Religion Hindu 38(22.2) 94(55.0) 28(16.4) 4.694 $ 0.096 Christian 2(1.2) 9(5.3) 0(0.0) Tharu sub-group Most common 27(15.8) 76(44.4) 20(11.7) 0.568 0.753 Less common 13(7.6) 27(15.8) 8(4.7) Residency Rural 6(3.5) 12(7.0) 1(0.6) 2.716 $ 0.257 Urban 34(19.9) 91(53.2) 27(15.8) Types of family Nuclear family 22(12.9) 67(39.2) 15(8.8) 1.959 0.376 Joint family 18(10.5) 36(21.1) 13(7.6) Estimated monthly income ≤ Rs.20000 20(11.7) 53(31.0) 18(10.5) 8.940 0.063 Rs.21000-40000 7(4.1) 34(19.9) 7(4.1) Rs.41000 and above 13(7.6) 16(9.4) 3(1.8) $=Likelihood ratio *=P value is significant at <0.05 level Table 10 presents the association between the level of knowledge on sickle cell anemia and selected socio-demographic variables. A statistically significant association was observed between sex and the level of knowledge on sickle cell anemia (p = 0.006). However, no significant association was found between the level of knowledge and other socio-demographic variables, including age (p = 0.250), education (p = 0.440), religion (p = 0.096), Tharu sub-group (p = 0.753), residency (p = 0.257), type of family (p = 0.376). Table 1 1 Association between Level of Knowledge on Sickle cell anemia and socio-demographic Characteristics of Respondent’s Parents n=171 Variables Level of Knowledge No. (%) Chi-square P-value Poor Average Excellent Mother’s ethnicity Tharu and sub-group 39(22.8) 102(59.6) 27(15.8) 4.784 $ 0.310 Others than Tharu 1(0.6) 1(0.6) 1(0.6) Education level of mother (n=164) literate without formal education 16(9.8) 55(33.5) 13(7.9) 1.784 0.775 Basic level 14(8.5) 32(19.5) 10(6.1) Secondary level and above 7(4.3) 13(7.9) 4(2.4) Occupation of Mother House maker 26(15.2) 54(31.6) 12(7.0) 3.947 0.413 Agriculture 8(4.7) 30(17.5) 11(6.4) Others 6(3.5) 19(11.1) 5(2.9) Education level of father (n=168) literate without formal education 6(3.6) 15(8.9) 4(2.4) 0.165 0.997 Basic 18(10.7) 49(29.2) 13(7.7) Secondary and above 16(9.5) 37(22.0) 10(6.0) Occupation of Father Agriculture 9(5.3) 43(25.1) 13(7.6) 9.830 $ 0.277 Foreign employee 12(7.0) 15(8.8) 2(1.2) Service holder 6(3.5) 16(9.4) 4(2.3) Daily wages 8(4.7) 19(11.1) 6(3.5) Business 5(2.9) 10(5.8) 3(1.8) $=Likelihood ratio *=P value is significant at <0.05 level Table 11 presents Association between Level of Knowledge on Sickle cell anemia and socio-demographic Characteristics of Respondent’s Parents. There is no significant association was found between the level of knowledge and socio-demographic Characteristics of Respondent’s Parents including mother’s ethnicity (p = 0.310), mother’s education level (p = 0.775), mother’s occupation (p = 0.413), father’s education level (p = 0.997), father’s occupation (p = 0.277), and estimated monthly income (p = 0.063). Discussion This study is a cross-sectional analytical study conducted to assess the knowledge and attitude regarding sickle cell anemia among Tharu students in Bardiya. A total of 175 students from different sub-ethnic groups of the Tharu community participated in the study. The main objective of this study is to assess the level of knowledge and attitude regarding sickle cell anemia among Tharu students of selected schools in Bardiya. In the present study, around 62.3% of the respondents were above 16 years of age, which contrasts with the findings of a descriptive cross-sectional study conducted among university undergraduates in Nigeria, where nearly 43.5% of the respondents were between 19 and 22 years of age 5 . Similarly, a descriptive cross-sectional study conducted in Ghana found that nearly 45.1% of the respondents were in the age range of 18 to 20 years 8 . In contrast, a cross-sectional observational study of parents conducted in Saudi Arabia found that nearly 40.9% of the respondents were in the age range of 30 to 39 years 9 . In the present study, more than half of the respondents (58.9%) were female, which is similar to the findings of a cross-sectional study conducted in Saudi Arabia, where 74.0% of the respondents were female 10 . However, in the present study, only around four out of ten respondents were male, which contrasts with the findings of a cross-sectional observational study conducted in Saudi Arabia, where 56.1% of the respondents were male 9 . In the present study, the highest proportion of respondents (25.7%) were from the school level (60%). In contrast, a descriptive cross-sectional study conducted at the University of Ghana reported that the majority of respondents (81.4%) were undergraduates 4 .Similarly, a cross-sectional study conducted in Saudi Arabia found that the majority of respondents (76.8%) had a university-level education 10 . In the present study, the majority of respondents (93.7%) were Hindu, which is similar to thjje findings of a descriptive cross-sectional study conducted in Ghana, where the majority of respondents (92.6%) 8 . However, while Nepal is predominantly a Hindu country, Ghana is not. Therefore, the similarity in religious distribution may be coincidental and influenced by the specific population sampled in each study. In the current study, the highest number of respondents (25.1%) belonged to the Rajbanshi sub-group. However, a cross-sectional study on the prevalence of sickle cell anemia conducted among the indigenous Tharu tribes of the Rupandehi district in the Mid-Western Terai of Nepal found that more than half of the respondents (53.84%) belonged to the Kanwar sub-group 11 . The difference in sub-group representation—Rajbanshi in the current study and Kanwar in the Rupandehi study—may be due to regional demographic variations and differences in sampling methods, as the current study focused on school-based respondents in Bardiya, while the Rupandehi study likely targeted a broader community sample. In the present study, more than half of the respondents (58.9%) demonstrated average knowledge about sickle cell anemia, while 24% had poor knowledge and only 16.0% showed excellent knowledge. This finding is consistent with a study conducted in Nigeria, where 51% of respondents had fair knowledge, 11.5% had poor knowledge, and the remainder had good knowledge 5 . Similarly, a descriptive study conducted in Kanchanpur district of Nepal among 130 individuals from the Tharu community reported that only 55.4% of participants had basic knowledge of sickle cell anemia 7 . Similarly, a descriptive cross-sectional study conducted in Ghana stated that 45.1%, 47.8%, and 7.1% respondents had poor, moderate and excellent knowledge respectively 4 . However, a meta-aggregative review study conducted in Ghana found that 27.5% of healthcare personnel demonstrated good knowledge of sickle cell disease (SCD), while a concerning 72.5% of nurses displayed poor knowledge levels 12 . In present study, a significant association was found between sex (p = 0.006) and the level of knowledge on sickle cell anemia among Tharu students. However, no significant association was observed between knowledge level and variables such as age (p = 0.250), education (p = 0.440), religion (p = 0.096), Tharu sub-group (p = 0.753), residency (p = 0.257), type of family (p = 0.376), mother’s ethnicity (p = 0.310), mother’s education level (p = 0.775), mother’s occupation (p = 0.413), father’s education level (p = 0.997), father’s occupation (p = 0.277), or estimated monthly income (p = 0.063). Similarly, a descriptive cross-sectional study conducted in Ghana found a significant association between being an undergraduate (p = 0.03) and the level of knowledge on sickle cell anemia 4 . In this study find a significant association between sex and knowledge of sickle cell anemia (p = 0.006). However, a descriptive cross-sectional study conducted among university undergraduates in Nigeria reported a not significantly associated with sex (p = 0.628) may be due to study setting difference 5 . Similarly, A cross-sectional observational study was conducted during the period July 2021-October 2025 among the general public in Saudi Arabia to find out the statistically found that there no significant difference between age and knowledge level on sickle cell disease 10 . In contrast findings, A descriptive study conducted in Kanchanpur district of Nepal among 130 individuals from the Tharu community reported highly significant between age and the level of knowledge on sickle cell disease (p = 0.001) the result might be varied this study was done in community level so that different age group of respondents were involved 7 . In present study almost all of the respondents shows the positive attitude regarding sickle cell anemia related statements. However, a descriptive cross-sectional study was conducted among students in public and private secondary schools within Osun State, Nigeria, One third of the respondents (65%) had positive attitude towards SCD the findings may be differ due to sampling technique and data collection method were not same 13 . In this study findless than half of the respondents (42.7%) had agreed on baby plans should be avoided if the person has sickle cell anemia. Similarly, a descriptive cross-sectional study conducted in Ghana, approximately one-third of the participants (32.8%) could not decide whether they would choose not to have a child than to give birth to a child with SCD the result might be similar this study also done in among college students and same age group respondents 8 . Limitations The area of study was limited to Tharu students (grades 8 to 12) from selected schools. This study focused solely on exploring knowledge and attitudes regarding sickle cell anemia among Tharu students, which may limit the generalizability of the findings to other ethnic groups or age ranges. Conclusion The study found that more than half of the respondents have average knowledge regarding sickle cell anemia. The findings indicate that sex plays a significant role in influencing knowledge about sickle cell anemia among respondents. In contrast, other socio-demographic factors such as age, education, religion, ethnic sub-group, residency, family type, parental background, and income do not show a meaningful impact on knowledge levels in this study. In the same way, most of the Tharu students showed positive attitudes towards premarital and newborn screening, and genetic counseling for Sickle Cell Anemia. Misconceptions that SCA is a sin or curable by changing religion were refuted to a large degree, but still there are gaps regarding its life impact and reproductive choices. Future studies Future studies could be done with people female of reproductive age groups and from other ethnic groups, age ranges to get a broader view of knowledge and attitudes about sickle cell anemia. Abbreviations WHO: World Health Organization GBD: Global Burden of Disease MFMER: Mayo Foundation for Medical Education and Research PMWH: Paropakar Maternity and Women's Hospital SCD: Sickle Cell Disease SCA: Sickle Cell Anemia SCT: Sickle Cell Traits Declarations Ethics approval and consent to participate This study was carried out following the ethical guidelines laid down by researchers who conduct studies involving human participants. Ethical clearance was obtained from the Institutional Review Committee (IRC) of Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal (Ref. No: 65/1478), and permission was obtained from the concerned school authorities before the study was carried out. As per the laws of Nepal, the age of majority is below 18 years, and any person below this age is a minor. Informed assent was obtained from the minors, while informed consent was obtained from the parents/guardians of the minors. Informed consent was obtained from the participants who are 18 years of age or above, using both verbal and written methods. The objective of the research was explained to the selected Tharu students and informed consent of each respondent was taken prior to data collection. The respondent’s decision to withdraw participation in the study was respected. Confidentiality was maintained by assigning codes instead of filling names. Consent for Publication Not applicable since there are no details, images or videos relating to an individual person. Availability of data and materials All authors had full access to the data and materials. Data are available within this article. Detailed data is available from the authors upon reasonable request. Competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding This work was not supported by any funding agencies. Authors’ Contributions KKT and PD conceptualized and designed the study. KKT acquired, analyzed, and interpreted data for the work under the supervision of PD.KKT and AD drafted the work, and PD reviewed it critically for important intellectual content. PD and PP approved the final version for publication and agreed to be accountable for all aspects of the work. Acknowledgment Heartfelt thanks goes to Principal and Assistant Principal of Shree Bagalamukhi Radhakrishna Tharu Secondary School Gulariya, Bardiya for granting permission and platform for data collection. The authors thank all the participants in the survey as well as the as well as the team member of this study. Clinical trial number: Not applicable. References World Health Organization. Sickle-cell anaemia. Geneva: WHO; 2024. Available from: https://apps.who.int/gb/ebwha/pdf_files/wha59/a59_9-en.pdf GBD 2021 Sickle Cell Disease Collaborators. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(8):e585–e599. doi:10.1016/S2352-3026(23)00118-7 Mayo Foundation for Medical Education and Research (MFMER). Sickle cell anemia—Symptoms & causes. Mayo Clinic; 2024. Available from: https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876 Addoah T, Boadu I. Knowledge, beliefs and attitude towards sickle cell disease among university students. 2024. Available from: https://doi.org/10.4172/2161-0711.1000593 Uche E, Olowoselu O, Augustine B, Ismail A, Akinbami A, Dosunmu A, et al. An assessment of knowledge, awareness, and attitude of undergraduates toward sickle cell disease in Lagos, Nigeria. Niger Med J. 2017;58(6):167–172. doi:10.4103/nmj.NMJ_111_18 Pandey S, Shrestha N. Sickle cell anaemia among Tharu population visiting the outpatient department of general medicine of a secondary care centre: a descriptive cross-sectional study. J Nepal Med Assoc. 2022;60(253):774. doi:10.31729/jnma.7651 Khadayat S, Ghaju R, Shrestha K. Knowledge and DdeI based confirmation of sickle cell anemia among the Tharu community. 2022. Available from: http://103.69.126.140:8080/handle/20.500.14356/906 Boadu I, Addoah T. Knowledge, beliefs and attitude towards sickle cell disease among university students. J Community Med Health Educ. 2018;8:593. doi:10.4172/2161-0711.1000593 Halawani SH, Khan SA, Zughaibi TAA, Khan SA. Attitude and behavior of parents of children with sickle cell disease toward the disease: an observational study in Saudi Arabia. Cureus. 2024;16(3):e55552. doi:10.7759/cureus.55552 Khalifa AM, et al. Knowledge and awareness of sickle cell anemia: cross-sectional study among the general population in Saudi Arabia. 2024. Available from: https://doi.org/10.54393/pbmj.v5i3.328 Tharu MK, Singh NB. Distribution of sickle cell allele in ethnic sub-groups of Tharu in Nepal. EPRA Int J Multidiscip Res. 2023;9:112–115. doi:10.36713/epra14333 Druye AA, Agyare DF, Akoto-Buabeng W, Zutah J, Offei FO, Nabe B, et al. Healthcare professionals’ knowledge, attitudes, and practices in the assessment and management of sickle-cell disease: a meta-aggregative review. Diseases. 2024;12(7):156. doi:10.3390/diseases12070156 Olayiwola SD, O. AD. Knowledge, attitude and control practices of sickle cell diseases among senior secondary students in Osun State, Nigeria. Pan Afr Med J. 2021;38:350. doi:10.11604/pamj.2021.38.350.20894 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9000350","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617809086,"identity":"919797b6-16ef-4ea8-8f13-d73111185ce3","order_by":0,"name":"Pratima Dawadi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYLCCBAYGxgYgLcHAYAOkGBsPENDA2ICkJQ0sQFgLA0LLYbAQXi3m0oefP3iYYyfbPyP54Y0PFeft1rYfBtpSYxONS4tlX5phQ+K2ZOMZN9KMLWecuZ287UwiUMuxtNwGHFoMzjCAtDAnNtxOMJPmbbudbHYAqIWx4TAeLewfgVrqE+ffTv8m/fffuWSz8w8JaeEB2XI4ccPtHDNpYFjZmd0gYItlD0/hjMRtx4033n9TbNlzLDnB7AbQlgQ8fjHnYd/w8ee2atl5Z45vvPGjxs7e7Hz6wwcfamxwOwxdIBGsMgGHcqxa7PEoHgWjYBSMghEKAM+hbP7os66xAAAAAElFTkSuQmCC","orcid":"","institution":"Paropakar Maternity and Women's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Pratima","middleName":"","lastName":"Dawadi","suffix":""},{"id":617809088,"identity":"81fdb14d-899b-477f-9ded-a7e19a9d3bec","order_by":1,"name":"Khem Kumari Tharu","email":"","orcid":"","institution":"Paropakar Maternity and Women's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Khem","middleName":"Kumari","lastName":"Tharu","suffix":""},{"id":617809089,"identity":"78e68f60-763f-44bd-8434-5a82c3f31d4c","order_by":2,"name":"Anjali Dev","email":"","orcid":"","institution":"Paropakar Maternity and Women's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Anjali","middleName":"","lastName":"Dev","suffix":""},{"id":617809091,"identity":"702a2d5b-735d-4624-8dc8-96f561023dc4","order_by":3,"name":"Praba Poudel","email":"","orcid":"","institution":"Paropakar Maternity and Women's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Praba","middleName":"","lastName":"Poudel","suffix":""}],"badges":[],"createdAt":"2026-03-01 09:08:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9000350/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9000350/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106382933,"identity":"8952b38d-d23f-48d7-8ebe-ca7bcb52a91c","added_by":"auto","created_at":"2026-04-08 05:31:18","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":39694,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eknowledge on Sickle cell anemia\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9000350/v1/ff9dad2afb46536f4eef553b.jpg"},{"id":109289560,"identity":"c3230cca-6bd2-4e28-9e51-37022e2d9cc6","added_by":"auto","created_at":"2026-05-15 06:31:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":551687,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9000350/v1/8da811d5-0ec4-4ce0-a9ba-92a8170e496d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eKnowledge and Attitude Regarding Sickle Cell Anemia Among Tharu Students of Selected School, Bardiya\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eSickle-cell anemia (SCD) (also known as sickle-cell disorder or sickle-cell disease) is a common genetic condition due to a hemoglobin disorder \u0026ndash; inheritance of mutant hemoglobin genes from both parents. About 5% of people on the planet have trait genes for hemoglobin diseases, primarily thalassemia and sickle-cell disease. Every year, more than 300,000 newborns are born with serious hemoglobin abnormalities\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. According to the Global Burden of Disease (GBD), national incidence of sickle cell disease stayed mostly similar between 2000 and 2021, while the number of sickle cell disease-affected newborns born worldwide rise by 13.7% in the Caribbean and western and central sub-Saharan Africa\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Sickle cell anemia can cause a variety of complications, including stroke, acute chest syndrome, avascular necrosis, pulmonary hypertension, organ damage, splenic sequestration, blindness, leg ulcers, gallstones, priapism, deep vein thrombosis, and pregnancy complications\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. A study of Ghana reveled 98.6% university students were aware about SCD, with major source of information was school (84.6%), while distributing it with level of knowledge only 7.1% had excellent level of knowledge \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. A descriptive cross-sectional study was done with university undergraduates. More than half of respondents (59%) knew someone with SCD, and 77% indicated the Hb phenotype would influence their choice of a life partner. While 79% indicated they would end their connections if they found out their Hb genotype predisposes them to having children with SCD, 5% were unsure, and 16% said they would continue the connection\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The study conducted on the Tharu community of Bardiya identified that 14.67% had sickle cell anemia. Among them, 75% patients had sickle cell trait and 25% patients had sickle cell illness\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. The survey conducted in Kanchananpur district revealed that 55.4% respondents had basic knowledge of sickle cell anemia. The majority of respondents learned about sickle cell anemia primarily through medical staff\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Sickle cell disease (SCD) is critical due to the disorder's high frequency and significant impact on morbidity and death. There was a Lack of understanding of SCD, particularly in terms of inheritance patterns, underlining the significance of comprehensive public health education. By addressing myths and expanding knowledge through trustworthy sources such as schools, media, health centers, and churches, awareness and personal reproductive decisions could be enhanced, which ultimately reduce the occurrence of SCD\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Conducting research on sickle cell anemia within the Tharu community is crucial due to the high prevalence of the disorder and the community's vulnerability. This study aims to improve genetic literacy among the Tharu people, who are at significant risk of inheriting sickle cell anemia. With the community knowledge gaps, the research can inform policymakers and healthcare providers, leading to better-targeted interventions, screening programs, and educational initiatives. Ultimately, this research seeks to enhance healthcare services, early diagnosis, and treatment plans, thereby improving the overall health and quality of life for the Tharu community. Despite the investigation of knowledge and attitudes of sickle cell anemia in Nepal, researchers discovered a scarcity of research studies on the subject. So the researcher was compelled to undertake a study to identify the level of knowledge and attitude regarding sickle cell anemia among Tharu students of selected school, Bardiya.\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Participants\u003c/h2\u003e \u003cp\u003eA cross- sectional analytical study design was done to assess the knowledge and attitude regarding sickle cell anemia among Tharu students of selected school, Bardiya. The study population were students of Tharu communities (class 8\u0026ndash;12) of selected school in Gulariya Municipality of Bardiya. All the Tharu students\u0026rsquo; studying in Shree Banglamukhi Radhakrishna Tharu Secondary School of Gulariya, Bardiya from grade 8 to 12 were included. Firstly the school was selected according to the highest number of Tharu students in this municipality then students were selected by using simple random sampling technique. Hence the sample size was 175.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eData was collected by face to face interview method using a semi-structured questionnaire by the researcher herself. The interview was taken in a separate corner or in a room as feasible to maintain privacy of participants. The interview was taken in a separate corner or in a room as feasible to maintain privacy of participants. The time duration for each respondent was 20\u0026ndash;25 minutes. Data was collected from 25th February 2025 to 12th March 2025 (10 am to 4 pm). The data collection period was 14 days and 15 data was collected each day.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eAfter data collection, data was analyzed on the basis of research objectives. Every day, all of the data was reviewed and checked for consistency, accuracy, and completeness. The data was organized, coded and tabulated and entered in Microsoft Excel before being transferred to SPSS (Statistical Package for Social Science) version 22 for statistical analysis. At the same time data was analyzed by using a descriptive method (Mean, Median, Mode, Standard deviation) and inferential statistics (chi square test) to identify the association between the knowledge and selected variables.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Consideration\u003c/h3\u003e\n\u003cp\u003e Research proposal approval was taken from Paropakar Nursing Campus, Kupondole. Then the ethical clearance was taken from the Institutional Review Committee (IRC) of Paropakar Maternity and Women's Hospital, Thapathali (Ref. no: 65/1478). In the same way, formal permission was obtained from the head of the educational department and verbal consent was obtained from the principal of the selected school for data collection. Informed assent and verbal consent was taken from the age below 18 years and verbal and written consent was taken from the age above 18 years prior to data collection. The objective of the research was explained to the selected Tharu students and informed consent of each respondent was taken prior to data collection. The respondent\u0026rsquo;s decision to withdraw participation in the study was respected. Confidentiality was maintained by assigning codes instead of filling names. The respondent\u0026rsquo;s queries were addressed. Similarly, confidentiality was ensured by keeping the questionnaires safely, maintaining non-disclosure and using obtained information for research purposes only.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cem\u003eSocio-demographic Characteristics of Respondents\u0026nbsp;\u003c/em\u003en =175\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"550\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 550px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (in years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e37.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u0026ge;16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e62.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 550px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD:15.94\u0026plusmn;1.66, Min:11, Max=21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 550px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e41.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e58.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eClass 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eClass 9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eClass 10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eClass 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eClass 12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligions \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eHindu\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e93.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eChristian \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTharu sub-group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eRajbanshi\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eHardiula\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eKusumya\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eDahit\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003ePachhaldangiya\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eBakharya ultahuwa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eDangaha\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eDukurpuchhya\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e17.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eRural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e20 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e11.4\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eUrban\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e155 \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e88.6\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of family \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eNuclear family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e60.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003eJoint family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e39.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOthers cast (Jolariya, Bhagoria, Thakuri, Gamuwa etc.)\u003c/p\u003e\n\u003cp\u003eTable 1 shows the socio-demographic characteristics of the respondents.\u0026nbsp;Regarding age, the majority of the respondents (62.3%) belonged to the age \u0026ge;16 years and 37.7% of the respondents\u0026nbsp;belonged to the age group 11-15 years. Mean age and standard deviation (SD) were 15.94 and 1.66 respectively. Minimum and maximum age is 11 and 21 years respectively. The majority of the respondents regarding sex, (58.9%) were female. While 41.1% of the respondents were male. In the same way, 25.7% respondents were from class 12, and 14.3% of the respondents were class11. Similarly, almost all of the respondents were (93.7%) Hindu and only 6.3% were Christian. Regarding the Tharu sub-group, less than one third of respondents (25.1%) were Rajbanshi and only 2.3% of the respondents were Dangaha and Dukurpuchhya. Regarding marital status all despondent were unmarried. On the other hand, most of the respondents\u003cstrong\u003e\u0026nbsp;(\u003c/strong\u003e88.6%) were from urban areas and only few respondents (11.4%) were from rural areas. In the same way, about six ten respondents (60.6%) were from nuclear families and 39.4% were from joint families.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003e\u003cem\u003eSocio-demographic Characteristics of Respondent\u0026rsquo;s Mothers\u0026nbsp;\u003c/em\u003en=175 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"550\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s ethnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eDalit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eTharu and sub-ethnicities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e98.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eBrahman/Chhetri\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status of mother\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eLiterate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 550px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level of mother (n=168)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eliterate without formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e51.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eBasic level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e33.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eSecondary level and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eHome maker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e54.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eAgriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 328px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2 presents the socio-demographic characteristics of the parents. Regarding the mother\u0026rsquo;s ethnicity, almost all of the mothers (98.3%) belonged to the Tharu ethnic group, while very few (0.6%) were from the Dalit community. In terms of educational status, almost all of the mothers (96%) were able read and write, while 4.0% were unable to read and write. Regarding the level of education, the majority of the mothers (51.2%) had received education without formal schooling, and 14.9% had achieved secondary level education and above. As for occupation, the majority of the mothers (54.3%) were homemakers, while 17.7% were engaged in other occupations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003e\u003cem\u003eSocio-demographic Characteristics of Respondent\u0026rsquo;s Fathers and Family income\u0026nbsp;\u003c/em\u003en=175 \u0026nbsp;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"552\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 552px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status of father\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eLiterate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e98.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 552px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level of father (n=172)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eliterate without formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eBasic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e46.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eSecondary and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 552px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of Father\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eAgriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e37.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eForeign employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eService holder\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eDaily wages \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e19.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eBusiness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEstimated monthly income\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003e\u0026le; Rs. 20000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e52.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003eRs. 21000-40000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 360px;\"\u003e\n \u003cp\u003e\u0026ge; Rs.\u0026nbsp;41000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 90px;\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 552px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD:28180.00\u0026plusmn;23090.85, Min=Rs. 1,000, Max=Rs. 1,50,000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3 shows the socio-demographic characteristics of the fathers and family income. Regarding the educational status of the fathers, almost all of the fathers (98.3%) were literate, while a small proportion (1.7%) were illiterate. Concerning their level of education, nearly half of the fathers (46.5%) had received basic level education, and 14.5% had received education without formal schooling. With respect to occupation, more than one third of the fathers (37.1%) were involved in agriculture, while 10.3% were engaged in business. In terms of monthly family income, the majority of the families (52.6%) earned less than Rs. 20,000, while 18.3% earned Rs. 41,000 or more per month.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4\u0026nbsp;\u003c/strong\u003e\u003cem\u003eRespondent\u0026rsquo;s\u0026nbsp;\u003c/em\u003e\u003cem\u003eExposure\u003c/em\u003e\u003cem\u003e\u0026nbsp;and Personal Experience Related to Sickle Cell Anemia Students\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003en=175\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"542\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 173px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeard about sickle cell anemia (n=175)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of information*(R=319)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003ePersonal experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eHealth professionals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e27.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eSocial media\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eFamily and relatives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e30.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003ePeers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e27.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003ePosters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnows someone with sickle cell anemia\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e63.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e36.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAny family suffering from SCA\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e85.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRelation with sufferer (n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eMother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eSister\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eBrother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eSelf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eAunt(Fupu)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver suffered from SCA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e98.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSuffering from (in years) (n=2)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e\u0026nbsp; 1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003e\u0026gt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eI\u003c/strong\u003e\u003cstrong\u003enformation\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;disclosure\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;from*(R=5)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eMedical person \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eParents\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 268px;\"\u003e\n \u003cp\u003eRelatives\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 173px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e*Multiple response\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable 4 shows the respondents personal information related to sickle cell anemia.\u0026nbsp;Regarding sickle cell anemia, almost all of the respondents (97.7%) had heard and 2.3% of the respondents had not heard. However, a source of information about sickle cell anemia, one third of the respondents (30.4%) got information through the family and relatives and only 1.3% got information through personal experience. Regarding knowledge about sickle cell anemia infected persons, the majority of the respondents (63.7%) did not know about sickle cell anemia infected persons and 36.2 % knew about sickle cell anemia infected persons. However, for any family suffering from SCA, most of the respondents (85.9%) had said no and 5.2% had said yes. Also related with sufferers, more than one third (33.3%) had a brother and 11.1% had a sister and aunt. Similarly, in the respondent\u0026apos;s family suffering from sickle cell anemia, almost all of the respondents (98.83%) had not suffered and 1.1% had suffered. However, less than half of the respondents (40%) were from medical persons and parents while 20% had got from relatives.\u003cbr clear=\"all\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u0026nbsp;\u003c/strong\u003e\u003cem\u003eKnowledge of Sickle Cell Anemia among Respondents\u003c/em\u003e n=171\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"545\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSickle cell anemia\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eKidney disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eLiver disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eBlood disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e63.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eHeart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eBone disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerson can carry SCA traits without having disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e32.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e43.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e24.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNewborns screening is necessary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e82.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMost prevalent ethnic group\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eTharu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eBhraman/ chhetri\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5 shows the variables related to Knowledge on Sickle cell anemia.\u0026nbsp;Regarding the definition of sickle cell anemia, the majority of the respondents (63.2%) had said blood disease and very few (7.0%) had said liver disease. However, related to respondents who can carry sickle cell anemia traits without having disease, less than half of the respondents (43.3%) had yes and 24.6% had said to not know. On the other hand newborns screening is necessary, most of the respondents (82.5%) had given yes and 8.2% had given no. Similarly in the context of Nepal most prevalent ethnicity by sickle cell anemia, almost all of the respondents\u003cstrong\u003e\u0026nbsp;(\u003c/strong\u003e97.7%) had Tharu ethnic group and very few (0.6%) had others.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e6\u0026nbsp;\u003c/strong\u003e\u003cem\u003eKnowledge on Causes and Signs and Symptoms of Sickle Cell Anemia among Respondents\u0026nbsp;\u003c/em\u003en=171\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"545\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary cause of sickle cell anemia \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eGenetic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e67.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eEnvironmental pollution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eViral\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eBacterial\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConsanguinity cause SCA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e68.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs transfer through\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eInheritance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e76.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eShaking hand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eThrough respiration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs sickle cell anemia Major problem of Tharu Community\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSign and symptoms of SCA*(R=320)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003ePale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eJaundice\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eDelay growth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e25.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 320px;\"\u003e\n \u003cp\u003eFrequent infection\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e27.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e*Multiple response\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable 6 shows the variables related to causes and\u0026nbsp;signs and symptoms of sickle cell anemia. Regarding the primary cause of sickle cell anemia, the majority of the respondents (67.8%) had said genetic while 7.0% had said viral. Similarly consanguinity causes sickle cell anemia, the majority of the respondents (68.4%) had yes and 31.6% had no. However, related to its transfer through, most of the respondents (76.0%) had said that through inheritance and very few (1.2%) had said it through shaking hands. In the same way related to sickle cell anemia, a major problem of the Tharu community, most of the respondents (87.7%) were given answer yes and (3.5%) were given no answer. Related to signs and symptoms of sickle cell anemia, nearly one third (29.1%) had responded on Pale and (18.1%) had responded on Jaundice.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003cem\u003e\u0026nbsp;Knowledge on Prevention of Sickle Cell Anemia among Respondent\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003en=171\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"547\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 547px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-marital test is necessary\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e88.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs preventable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e82.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 547px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevention (n=141)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eGenetic sickling test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e87.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eNot eat food left by \u0026nbsp;sufferers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e12.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 7 shows the variables related to prevention of sickle cell anemia. Regarding whether a pre-marital test is necessary, most of the respondents (88.9%) had yes and 4.1% had answered no. Similarly is preventable, most of the respondents (82.5%) had answered yes and 5.3% had answered no. In the same way as prevention, most of the respondents (87.2%) were given a genetic sickling test and 12.8% did not eat food left by sufferers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e8\u0026nbsp;\u003c/strong\u003e\u003cem\u003eKnowledge on Treatment and Management of Sickle Cell Anemia among Respondents\u0026nbsp;\u003c/em\u003en=171 \u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"545\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e36.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e41.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBest treatment (n=62)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eBlood transfusion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e87.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003ePerform surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSCA may create complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e74.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs curable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e46.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 545px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of support from government of Nepal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eFull free treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003e50 % discount\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 116px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 8 shows that less than half of the respondents (41.5 %) answered don\u0026rsquo;t know while only 22.2% answered no about respondents who think sickle cell anemia has treatment. Similarly, if yes, the best treatment of sickle cell anemia most of the respondents (87.1%) were blood transfusion while only 12.9% performed surgery. In the same way sickle cell anemia may create any complication, the majority of the respondents (74.9%) answered yes while only 4.7% answered no. Regarding Is curable, nearly half of the respondents (46.2%) had answered no and 22.2% had answered don\u0026rsquo;t know. Also, the majority of the respondents (61.4%) were answered 50% discount while only 38.6% were answered full free treatment support from government of Nepal.\u003c/p\u003e\n\u003cp\u003eThe study showed that 60% respondents had average knowledge, 24% had poor knowledge and only 16% had excellent knowledge on Sickle Cell anemia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e9\u0026nbsp;\u003c/strong\u003e\u003cem\u003eStatement Related to Attitude on Sickle Cell Anemia among Respondents\u0026nbsp;\u003c/em\u003en=171\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"594\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Agree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeutral\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDis-agreed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly dis-agreed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eNeed to encourage friends and relatives for genetic counseling before marriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e93(54.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e76(44.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2(1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eIndividual must to do premarital counseling and screening\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e64(37.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e93(54.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e14(8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eEvery Tharu new born should be screened for SCA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e79(46.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e72(42.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e20(11.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003ePartners should go for genetic counseling and testing before marriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e51(29.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e104(60.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e11(6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e5(2.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eA person should continue the relationship despite their partner testing positive for sickle cell disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e109(63 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e59(34.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3(1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eI seem healthy so I do not have sickle cell anemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e6(3.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e9(5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e125(73.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e31(18.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eA person with Sickle cell anemia can\u0026rsquo;t continue his/her life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4(2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e41(24.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e113(66.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e13(7.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eSickle cell anemia may cure after changing the religion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1(0.6% )\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e45(26.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e125(73.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eBaby plan should be avoid if the person have sickle cell anemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e16(9.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e73(42.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e64(37.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e18(10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eSickle cell anemia is a preborn sin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e46(26.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e125(73.%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 9 shows the attitude on Sickle Cell Anemia of the respondents. Regarding the need to encourage friends and relatives to go for genetic counseling before marriage, the majority of the respondents (54.4%) had strongly agreed and very few (1.2%) had dis-agree. Similarly, related to all individuals who must do premarital counseling and screening, the majority of the respondents (54.4%) had agreed and 8.2% had dis-agree. However every Tharu newborn should be screened for sickle cell anemia, nearly half of the respondents (46.2%) had strongly agreed while 11.7% were dis-agree. Regarding whether all partners should go for genetic counseling and testing before marriage, the majority of the respondents (60.8%) had agreed while 2.9% strongly dis-agree. Similarly, it is necessary to continue with a relationship despite the result of the life partner having the positive sickle cell disease, the majority of the respondents (63.7%) had strongly agreed and very few (1.8%) were dis-agree. In the same way they seem healthy so do not have sickle cell anemia, the majority of the respondents (73.1%) were dis-agree and 3.5% had strongly agreed. Also person with Sickle cell anemia can\u0026rsquo;t continue his/her life, the majority of the respondents (66.1%) had dis-agree while 2.3% had strongly agree. Regarding Sickle cell anemia may be cured after changing the religion, the majority of the respondents (73.1%) had strongly dis-agree while very few (0.6%) had agreed. However, baby plans should be avoided if the person has sickle cell anemia, less than half of the respondents (42.7%) had agreed and 9.4% had strongly agreed. Regarding Sickle cell anemia as a preborn sin, the majority of the respondents (73.1%) had strongly dis-agree and 26.9% had dis-agree.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e10\u0026nbsp;\u003c/strong\u003e\u003cem\u003eAssociation between Level of Knowledge on Sickle cell anemia and Selected Socio-demographic Variables\u0026nbsp;\u003c/em\u003en=171\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"558\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 252px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of Knowledge\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eNo. (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChi-square\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExcellent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e19(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e37(21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e8(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2.770\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026ge;16\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e21(12.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e66(38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e20(11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e24(14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e41(24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e6(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e10.406\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.006\u003cem\u003e*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e16(9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e62(36.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e22(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eSecondary level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e26(15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e63(36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e14(8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e1.641\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eHigher secondary and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e14(8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e40(23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e14(8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e38(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e94(55.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e28(16.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e4.694\u003cem\u003e$\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e2(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e9(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0(0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTharu sub-group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eMost common\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e27(15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e76(44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e20(11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.753\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eLess common\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e13(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e27(15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e8(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eRural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e6(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e12(7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e1(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2.716\u003cem\u003e$\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eUrban\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e34(19.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e91(53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e27(15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of family\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eNuclear family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e22(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e67(39.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e15(8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.959\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.376\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eJoint family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e18(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e36(21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e13(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEstimated monthly income\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026le; Rs.20000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e20(11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e53(31.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e18(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eRs.21000-40000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e7(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e34(19.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e7(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eRs.41000 and above\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e13(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e16(9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e$=Likelihood ratio\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*=P value is significant at \u0026lt;0.05 level \u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable 10 presents the association between the level of knowledge on sickle cell anemia and selected socio-demographic variables. A statistically significant association was observed between sex and the level of knowledge on sickle cell anemia (p = 0.006).\u003c/p\u003e\n\u003cp\u003eHowever, no significant association was found between the level of knowledge and other socio-demographic variables, including age (p = 0.250), education (p = 0.440), religion (p = 0.096), Tharu sub-group (p = 0.753), residency (p = 0.257), type of family (p = 0.376).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e\u003cstrong\u003e1\u0026nbsp;\u003c/strong\u003e\u003cem\u003eAssociation between Level of Knowledge on Sickle cell anemia and socio-demographic Characteristics of Respondent\u0026rsquo;s Parents\u0026nbsp;\u003c/em\u003en=171\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"598\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of Knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;No. (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eChi-square\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExcellent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 598px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s ethnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Tharu and sub-group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e39(22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e102(59.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e27(15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 72px;\"\u003e\n \u003cp\u003e4.784\u003cem\u003e$\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Others \u0026nbsp; \u0026nbsp; than Tharu\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e1(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e1(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 598px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level of mother (n=164)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; literate without formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e16(9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e55(33.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e13(7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 72px;\"\u003e\n \u003cp\u003e1.784\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.775\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Basic level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e14(8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e32(19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e10(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary level and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e7(4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e13(7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 598px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of Mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; House maker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e26(15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e54(31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e12(7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 72px;\"\u003e\n \u003cp\u003e3.947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.413\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Agriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e8(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e30(17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e11(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e6(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e19(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 598px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level of father (n=168)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; literate without formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e6(3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e15(8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.997\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Basic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e18(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e49(29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e13(7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e16(9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e37(22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e10(6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 598px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of Father\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Agriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e9(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e43(25.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e13(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9.830\u003cem\u003e$\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.277\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Foreign employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e12(7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e15(8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Service holder\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e6(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e16(9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4(2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Daily wages \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e8(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e19(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e6(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp; Business\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e5(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e10(5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e3(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e$=Likelihood ratio\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*=P value is significant at \u0026lt;0.05 level \u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable 11 presents Association between Level of Knowledge on Sickle cell anemia and socio-demographic Characteristics of Respondent\u0026rsquo;s Parents. There is no significant association was found between the level of knowledge and socio-demographic Characteristics of Respondent\u0026rsquo;s Parents including mother\u0026rsquo;s ethnicity (p = 0.310), mother\u0026rsquo;s education level (p = 0.775), mother\u0026rsquo;s occupation (p = 0.413), father\u0026rsquo;s education level (p = 0.997), father\u0026rsquo;s occupation (p = 0.277), and estimated monthly income (p = 0.063).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study is a cross-sectional analytical study conducted to assess the knowledge and attitude regarding sickle cell anemia among Tharu students in Bardiya. A total of 175 students from different sub-ethnic groups of the Tharu community participated in the study. The main objective of this study is to assess the level of knowledge and attitude regarding sickle cell anemia among Tharu students of selected schools in Bardiya.\u003c/p\u003e \u003cp\u003eIn the present study, around 62.3% of the respondents were above 16 years of age, which contrasts with the findings of a descriptive cross-sectional study conducted among university undergraduates in Nigeria, where nearly 43.5% of the respondents were between 19 and 22 years of age\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Similarly, a descriptive cross-sectional study conducted in Ghana found that nearly 45.1% of the respondents were in the age range of 18 to 20 years\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e. In contrast, a cross-sectional observational study of parents conducted in Saudi Arabia found that nearly 40.9% of the respondents were in the age range of 30 to 39 years \u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn the present study, more than half of the respondents (58.9%) were female, which is similar to the findings of a cross-sectional study conducted in Saudi Arabia, where 74.0% of the respondents were female\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. However, in the present study, only around four out of ten respondents were male, which contrasts with the findings of a cross-sectional observational study conducted in Saudi Arabia, where 56.1% of the respondents were male\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn the present study, the highest proportion of respondents (25.7%) were from the school level (60%). In contrast, a descriptive cross-sectional study conducted at the University of Ghana reported that the majority of respondents (81.4%) were undergraduates\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.Similarly, a cross-sectional study conducted in Saudi Arabia found that the majority of respondents (76.8%) had a university-level education\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. In the present study, the majority of respondents (93.7%) were Hindu, which is similar to thjje findings of a descriptive cross-sectional study conducted in Ghana, where the majority of respondents (92.6%)\u003csup\u003e8\u003c/sup\u003e. However, while Nepal is predominantly a Hindu country, Ghana is not. Therefore, the similarity in religious distribution may be coincidental and influenced by the specific population sampled in each study.\u003c/p\u003e \u003cp\u003eIn the current study, the highest number of respondents (25.1%) belonged to the Rajbanshi sub-group. However, a cross-sectional study on the prevalence of sickle cell anemia conducted among the indigenous Tharu tribes of the Rupandehi district in the Mid-Western Terai of Nepal found that more than half of the respondents (53.84%) belonged to the Kanwar sub-group\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. The difference in sub-group representation\u0026mdash;Rajbanshi in the current study and Kanwar in the Rupandehi study\u0026mdash;may be due to regional demographic variations and differences in sampling methods, as the current study focused on school-based respondents in Bardiya, while the Rupandehi study likely targeted a broader community sample.\u003c/p\u003e \u003cp\u003eIn the present study, more than half of the respondents (58.9%) demonstrated average knowledge about sickle cell anemia, while 24% had poor knowledge and only 16.0% showed excellent knowledge. This finding is consistent with a study conducted in Nigeria, where 51% of respondents had fair knowledge, 11.5% had poor knowledge, and the remainder had good knowledge\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Similarly, a descriptive study conducted in Kanchanpur district of Nepal among 130 individuals from the Tharu community reported that only 55.4% of participants had basic knowledge of sickle cell anemia\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSimilarly, a descriptive cross-sectional study conducted in Ghana stated that 45.1%, 47.8%, and 7.1% respondents had poor, moderate and excellent knowledge respectively \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. However, a meta-aggregative review study conducted in Ghana found that 27.5% of healthcare personnel demonstrated good knowledge of sickle cell disease (SCD), while a concerning 72.5% of nurses displayed poor knowledge levels\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn present study, a significant association was found between sex (p\u0026thinsp;=\u0026thinsp;0.006) and the level of knowledge on sickle cell anemia among Tharu students. However, no significant association was observed between knowledge level and variables such as age (p\u0026thinsp;=\u0026thinsp;0.250), education (p\u0026thinsp;=\u0026thinsp;0.440), religion (p\u0026thinsp;=\u0026thinsp;0.096), Tharu sub-group (p\u0026thinsp;=\u0026thinsp;0.753), residency (p\u0026thinsp;=\u0026thinsp;0.257), type of family (p\u0026thinsp;=\u0026thinsp;0.376), mother\u0026rsquo;s ethnicity (p\u0026thinsp;=\u0026thinsp;0.310), mother\u0026rsquo;s education level (p\u0026thinsp;=\u0026thinsp;0.775), mother\u0026rsquo;s occupation (p\u0026thinsp;=\u0026thinsp;0.413), father\u0026rsquo;s education level (p\u0026thinsp;=\u0026thinsp;0.997), father\u0026rsquo;s occupation (p\u0026thinsp;=\u0026thinsp;0.277), or estimated monthly income (p\u0026thinsp;=\u0026thinsp;0.063). Similarly, a descriptive cross-sectional study conducted in Ghana found a significant association between being an undergraduate (p\u0026thinsp;=\u0026thinsp;0.03) and the level of knowledge on sickle cell anemia\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this study find a significant association between sex and knowledge of sickle cell anemia (p\u0026thinsp;=\u0026thinsp;0.006). However, a descriptive cross-sectional study conducted among university undergraduates in Nigeria reported a not significantly associated with sex (p\u0026thinsp;=\u0026thinsp;0.628) may be due to study setting difference \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSimilarly, A cross-sectional observational study was conducted during the period July 2021-October 2025 among the general public in Saudi Arabia to find out the statistically found that there no significant difference between age and knowledge level on sickle cell disease\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn contrast findings, A descriptive study conducted in Kanchanpur district of Nepal among 130 individuals from the Tharu community reported highly significant between age and the level of knowledge on sickle cell disease (p\u0026thinsp;=\u0026thinsp;0.001) the result might be varied this study was done in community level so that different age group of respondents were involved\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn present study almost all of the respondents shows the positive attitude regarding sickle cell anemia related statements. However, a descriptive cross-sectional study was conducted among students in public and private secondary schools within Osun State, Nigeria, One third of the respondents (65%) had positive attitude towards SCD the findings may be differ due to sampling technique and data collection method were not same\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this study findless than half of the respondents (42.7%) had agreed on baby plans should be avoided if the person has sickle cell anemia. Similarly, a descriptive cross-sectional study conducted in Ghana, approximately one-third of the participants (32.8%) could not decide whether they would choose not to have a child than to give birth to a child with SCD the result might be similar this study also done in among college students and same age group respondents\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe area of study was limited to Tharu students (grades 8 to 12) from selected schools. This study focused solely on exploring knowledge and attitudes regarding sickle cell anemia among Tharu students, which may limit the generalizability of the findings to other ethnic groups or age ranges.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study found that more than half of the respondents have average knowledge regarding sickle cell anemia. The findings indicate that sex plays a significant role in influencing knowledge about sickle cell anemia among respondents. In contrast, other socio-demographic factors such as age, education, religion, ethnic sub-group, residency, family type, parental background, and income do not show a meaningful impact on knowledge levels in this study. In the same way, most of the Tharu students showed positive attitudes towards premarital and newborn screening, and genetic counseling for Sickle Cell Anemia. Misconceptions that SCA is a sin or curable by changing religion were refuted to a large degree, but still there are gaps regarding its life impact and reproductive choices.\u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003eFuture studies\u003c/h2\u003e \u003cp\u003eFuture studies could be done with people female of reproductive age groups and from other ethnic groups, age ranges to get a broader view of knowledge and attitudes about sickle cell anemia.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eWHO:\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;World Health Organization\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGBD:\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Global Burden of Disease \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMFMER: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Mayo Foundation for Medical Education and Research\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePMWH: \u0026nbsp;\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Paropakar Maternity and Women\u0026apos;s Hospital\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSCD:\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Sickle Cell Disease\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSCA: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Sickle Cell Anemia\u003c/p\u003e\n\u003cp\u003eSCT: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Sickle Cell Traits\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003eEthics approval and consent to participate\u003c/h3\u003e\n\u003cp\u003eThis study was carried out following the ethical guidelines laid down by researchers who conduct studies involving human participants. Ethical clearance was obtained from the Institutional Review Committee (IRC) of Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal (Ref. No: 65/1478), and permission was obtained from the concerned school authorities before the study was carried out. As per the laws of Nepal, the age of majority is below 18 years, and any person below this age is a minor. Informed assent was obtained from the minors, while informed consent was obtained from the parents/guardians of the minors. Informed consent was obtained from the participants who are 18 years of age or above, using both verbal and written methods. The objective of the research was explained to the selected Tharu students and informed consent of each respondent was taken prior to data collection. The respondent’s decision to withdraw participation in the study was respected. Confidentiality was maintained by assigning codes instead of filling names.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable since there are no details, images or videos relating to an individual person.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors had full access to the data and materials. Data are available within this article. Detailed data is available from the authors upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis work was not supported by any funding agencies.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eAuthors’ Contributions\u003c/h3\u003e\n\u003cp\u003eKKT and PD conceptualized and designed the study. KKT acquired, analyzed, and interpreted data for the work under the supervision of PD.KKT and AD drafted the work, and PD reviewed it critically for important intellectual content. PD and PP approved the final version for publication and agreed to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHeartfelt thanks goes to Principal and Assistant Principal of Shree Bagalamukhi Radhakrishna Tharu Secondary School Gulariya, Bardiya for granting permission and platform for data collection.\u0026nbsp;The authors thank all the participants in the survey as well as the as well as the team member of this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e Not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization. Sickle-cell anaemia. Geneva: WHO; 2024. Available from: https://apps.who.int/gb/ebwha/pdf_files/wha59/a59_9-en.pdf\u003c/li\u003e\n\u003cli\u003eGBD 2021 Sickle Cell Disease Collaborators. Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000\u0026ndash;2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(8):e585\u0026ndash;e599. doi:10.1016/S2352-3026(23)00118-7\u003c/li\u003e\n\u003cli\u003eMayo Foundation for Medical Education and Research (MFMER). Sickle cell anemia\u0026mdash;Symptoms \u0026amp; causes. Mayo Clinic; 2024. Available from: https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876\u003c/li\u003e\n\u003cli\u003eAddoah T, Boadu I. Knowledge, beliefs and attitude towards sickle cell disease among university students. 2024. Available from: https://doi.org/10.4172/2161-0711.1000593\u003c/li\u003e\n\u003cli\u003eUche E, Olowoselu O, Augustine B, Ismail A, Akinbami A, Dosunmu A, et al. An assessment of knowledge, awareness, and attitude of undergraduates toward sickle cell disease in Lagos, Nigeria. Niger Med J. 2017;58(6):167\u0026ndash;172. doi:10.4103/nmj.NMJ_111_18\u003c/li\u003e\n\u003cli\u003ePandey S, Shrestha N. Sickle cell anaemia among Tharu population visiting the outpatient department of general medicine of a secondary care centre: a descriptive cross-sectional study. J Nepal Med Assoc. 2022;60(253):774. doi:10.31729/jnma.7651\u003c/li\u003e\n\u003cli\u003eKhadayat S, Ghaju R, Shrestha K. Knowledge and DdeI based confirmation of sickle cell anemia among the Tharu community. 2022. Available from: http://103.69.126.140:8080/handle/20.500.14356/906\u003c/li\u003e\n\u003cli\u003eBoadu I, Addoah T. Knowledge, beliefs and attitude towards sickle cell disease among university students. \u003cem\u003eJ Community Med Health Educ.\u003c/em\u003e 2018;8:593. doi:10.4172/2161-0711.1000593 \u003c/li\u003e\n\u003cli\u003eHalawani SH, Khan SA, Zughaibi TAA, Khan SA. Attitude and behavior of parents of children with sickle cell disease toward the disease: an observational study in Saudi Arabia. Cureus. 2024;16(3):e55552. doi:10.7759/cureus.55552\u003c/li\u003e\n\u003cli\u003eKhalifa AM, et al. Knowledge and awareness of sickle cell anemia: cross-sectional study among the general population in Saudi Arabia. 2024. Available from: https://doi.org/10.54393/pbmj.v5i3.328\u003c/li\u003e\n\u003cli\u003eTharu MK, Singh NB. Distribution of sickle cell allele in ethnic sub-groups of Tharu in Nepal. EPRA Int J Multidiscip Res. 2023;9:112\u0026ndash;115. doi:10.36713/epra14333\u003c/li\u003e\n\u003cli\u003eDruye AA, Agyare DF, Akoto-Buabeng W, Zutah J, Offei FO, Nabe B, et al. Healthcare professionals\u0026rsquo; knowledge, attitudes, and practices in the assessment and management of sickle-cell disease: a meta-aggregative review. Diseases. 2024;12(7):156. doi:10.3390/diseases12070156\u003c/li\u003e\n\u003cli\u003eOlayiwola SD, O. AD. Knowledge, attitude and control practices of sickle cell diseases among senior secondary students in Osun State, Nigeria. Pan Afr Med J. 2021;38:350. doi:10.11604/pamj.2021.38.350.20894\u003cstrong\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"knowledge, Attitude, Sickle Cell Anemia","lastPublishedDoi":"10.21203/rs.3.rs-9000350/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9000350/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAim: \u003c/strong\u003eSickle-cell anemia (SCA) is a common genetic condition due to a hemoglobin disorder – inheritance of mutant hemoglobin genes from both parents. The Tharu ethnic group of Nepal is one of the most affected by SCA. They should be highly aware of its control and prevention. Despite such a necessity, limited research has been conducted to identify their level of knowledge. The present study aimed to assess the level of knowledge and attitude regarding sickle cell anemia among Tharu students of selected school, Bardiya.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA cross-sectional analytical study was conducted among 175 Tharu students from classes 8 to 12. The school was selected based on having the highest number of Tharu students in the municipality and simple random sampling technique was used to select the sample. Data were collected through face to face interview technique using a semi-structured questionnaire. Data entry was done in MS Excel, and analysis was carried out using descriptive and inferential statistics (chi-square test) through the Statistical Package for the Social Sciences (SPSS) version 22 to identify associations between knowledge and selected socio-demographic variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003eThe study revealed that the majority (58.9%) of respondents demonstrated average knowledge regarding SCA and there was a significant association in between the level of knowledge and sex of respondents at (P=0.006). Although average level of knowledge was prevalent among the respondents, majority showed a positive attitude, particularly towards newborn and premarital screening, which proved to be highly influential among them.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe findings indicated that sex plays a significant role in influencing knowledge about SCA. Specific health education to improve awareness, with gender-specific deficits, is needed. Their positive attitudes towards premarital and neonatal screening can be attached to improve preventive interventions. Culturally targeted programs to aid in correcting misconceptions about life impact and reproductive choice are needed.\u003c/p\u003e","manuscriptTitle":"Knowledge and Attitude Regarding Sickle Cell Anemia Among Tharu Students of Selected School, Bardiya","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-08 05:31:15","doi":"10.21203/rs.3.rs-9000350/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2de03cda-4c49-4037-a237-c336945c313e","owner":[],"postedDate":"April 8th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-15T06:18:05+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-30T05:32:34+00:00","index":72,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-15T06:31:07+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-08 05:31:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9000350","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9000350","identity":"rs-9000350","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}