Premarital Screening Program for Hemoglobinopathies in Karbala, Iraq

Waleed Khalid Al-Najafi

doi:10.70863/karbalajm.v13i1.737

المؤلفون

Waleed Khalid Al-Najafi Karbala Teaching Hospital of Children

DOI:

https://doi.org/10.70863/karbalajm.v13i1.737

الكلمات المفتاحية:

Premarital screening, hemoglobinopathies, thalassemia, sickle cell anemia, Karbala

الملخص

Abstract:

Background:
Premarital screening is a very important step in the prevention of thalassemia and other hemoglobinopathies.
Aim:
Evaluation of the pre-marital screening program in Karbala city to find its weak points, trying to correct them.
Introduction:
Hemoglobinopathies are the most common single gene disorder worldwide. More than 330000 affected infants are born globally annually. World Health Organization (WHO) in 2006 urged member states to implement national programs for management and prevention of hemoglobinopathies. Iraqi ministry of health mandated premarital screening for hemoglobinopathies in all Iraqi governorates. The program started in Karbala in June 2012.
Methods:
five premarital clinics established in Karbala governorate. Couples screened in this study from March 2016 to October 2018 were 26007 (52014 individuals). If both man and woman have MCV < 80 fl. and/or MCH < 27 pg. they should be referred to Karbala hereditary blood diseases center to be tested for abnormal hemoglobin. Prevalence of abnormal hemoglobin calculated by Punnett Square equation and Hardy-Weinberg law.

Results:
1780 individuals (890 couples) were referred from peripheral premarital clinics to our center. Individuals included in the study were1560 (87.7%) from Karbala city, the rest with missing address or from other governorates were excluded. The most prevalent abnormal hemoglobin in referred individuals was B-thalassemia hemoglobin 344(22.05%). Referred individuals with sickle hemoglobin were 51(3.26%). Prevalence of B-thalassemia and sickle hemoglobin in our study was 3.8% (95% CI 3.64 – 3.96) and 0.56% (95% CI 0.5 – 0.62), respectively. High-risk marriage couples were 84 (3.2/1000).

Conclusion:
the burden of supporting health needs of thousands of continuously increasing numbers of thalassemia and other hemoglobinopathies patients emphasizes the importance of launching a well-established nationwide prevention program. The program in Karbala city still needs more support and optimization.

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