Comprehension of Premarital Screening and Genetic Disorders
Main Article Content
Abstract
Introduction: In Saudi Arabia, thalassemias and hemoglobinopathies are prevalent hereditary genetic disorders that result in considerable morbidity and mortality, imposing a substantial financial burden on society. Premarital testing can diminish the incidence of infants afflicted with genetic or other bloodborne illnesses.
Aim: This review seeks to inspire the general populace and rekindle the interest of stakeholders engaged in the management of hereditary genetic disorders, while presenting recommendations and proposals for the implementation of premarital screening programs in Saudi Arabia.
Materials & Methods: Relevant material was obtained from various journals and websites to elucidate the definition, benefits, and significance of premarital screening, the types of investigations involved in the screening programs, and the methodology for administering this program.
Discussion: An examination of various literature reveals that premarital screening programs constitute a multifaceted social, theological, and ethical dilemma, including legal issues related to the violation of fundamental liberties, the right to marry, and the consequences of non-consensual blood extraction. In areas with a high prevalence of hereditary genetic disorders, awareness and understanding of the diseases, as well as the acceptance of voluntary counseling, are minimal. This is likely due to the prevalence of these illnesses in developing and underdeveloped countries, where reading and comprehension levels are low. Cultural factors and individual attitudes also influence the efficacy of testing.
In Asia, voluntary premarital screening programs for hereditary and sexually transmitted diseases commenced in countries such as China, Taiwan, Malaysia, India, Indonesia, Maldives, Singapore, and Thailand; however, no data exists concerning premarital screening programs in Pakistan, Nepal, Sri Lanka, Bhutan, and Saudi Arabia.
Conclusion: The scarcity of resources and qualified health experts in the field of medical genetics significantly hinders the implementation of premarital screening programs in Saudi Arabia. Additionally, religious views, cultural norms, social practices, and illiteracy may constitute further obstacles to the implementation of premarital screening programs in Saudi Arabia. It is imperative to initiate motivational programs and pilot projects to conduct premarital screening initiatives aimed at reducing inherited genetic illnesses, particularly thalassemias and hemoglobinopathies.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Al Sulaiman A, Sulaiman A, Al Mishari M, Al Sawadi A, Owaidah TM. Knowledge and attitude toward the hemoglobinopathies premarital screening program in Saudi Arabia: Population-based survey. Hemoglobin 2008; 32 (6):
-8.
El-Hamzi MA. Pre-marital examination as a method of prevention from blood genetic disorders. Community views. Saudi Med J 2006; 27(9): 1291-5.
WHO. Hereditary anaemia: genetic basis, clinical features, diagnosis and treatment. Bull World Health Organization 1982; 60: 643-60.
Mitwally HH, Abd El-Rahman DA, Mohammad NI. Premarital counseling: view of the target group. J Egypt Public Health Assoc 2000; 17 (1): 31-51.
WHO. Hereditary anaemia: memorandum from a WHO meeting. Bull World Health Organization. available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536044/
World Health Organization. Health impact assessment (HIA); 2005. Available at: www.who.int.
Alwan A, Modell B. Community Control of Genetic and Congenital Disorders, EMRO Technical Publications 24, World Health Organization, 1997.
WHO Secretariat Report. Thalassaemia and other haemoglobinopathies. Provisional agenda item 5.2, EB 118 (5). Geneva: World Health Organization 2006.
Silvestroni E, Bianco I, Graziani B, Carboni C, D’Arca SU. First premarital screening of thalassaemia carriers in intermediate schools in Latium. J Med Genet 1978; 15: 202-7.
Neal-Cooper F, Scott RB. Genetic counseling in sickle cell anaemia: experiences with couples at risk. Public Health Rep 1988; 103: 174-8.
Tosun F, BilginA, Kizilok A. Five year evaluation of premarital screening program for haemoglobinopathies in the province of Mersin, Turkey. Turk J Hematol 2006; 23: 84-89.
Al-Arrayed SS. Review of the spectrum of genetic diseases in Bahrain. Eastern Mediterranean Health Journal 1999; 5: 1114-20.
Samavat A, Modell B. Iranian national thalassaemia screening programme 2004. BMJ 329:1134-1137.
Hamamya H, Al-Hatib S, Alwanc A, Ajlounia K. Jordan: Communities and community genetics. Commun Genet 2007; 10:52-60.
Kuliev AM, Modell B. Problems in the control of genetic disorders. Biomed SCi 1990; 1:3-17.
Naylor EW. Genetic screening and genetic counseling: knowledge, attitudes and practices in two groups of family planning professionals. Soc Biol Winter 1975; 22: 304-14.
Al-Arrayed SS, Hafadh N, Al-serafi S. Premarital counseling: an experience from Bahrain. East Meditter Health J 1997; 3(3): 415-9.
Schumm WR, West DR. Development of three new scales for assessing client’s perspectives on premarital counseling. Psychol Rep 2002; 88: 1071-4.
Angastiniotis M, Modell B. Global epidemiology of hemoglobin disorders. Ann NY Acad Sci 1998; 850: 251-69.
Therese H. Getting married in china: Pass the medical first. BMJ 2003; 326:277-9.
Inati A, Zeineh N, Ismaeel H. Beta-thalassaemia: the Lebanese experience. Clin Lab 2006; 28: 217-27.
AlHamdan NA, AlMazrou YY, AlSwaidi FM, Choudary AJ. Premarital screening for thalassaemia and sickle cell disease in Saudi Arabia. Genet Med 2007; 9: 372-7.
Schmidt RM. Haemoglobinopathy screening: approaches to diagnosis, education and counseling. Am J Publ Hlth 1974; 64: 799-804.
Eshra DK, Dorgham LS, el-Sherbini AF. Knowledge and attitudes towards premarital counseling and examination. J Egypt Publ Hlth Assoc 1989; 64 (1/2): 1-15.
Karimi M, Jamalian N, Yarmohammadi H, Askarnejad A, Afrasiabi A, Hashemi A. Premarital screening for beta-thalassaemia in Southern Iran: option for improving the programme. J Med Screen 2007; 14: 62-66.
Monaghan S. Genetics: for better or for worse. Middle East Health 2007; 19-26. Available at: http://216.236.204.101/mehealth/sep03_article.pdf(last accessed November 2008).
Albar MA. Counseling about genetic disease: an Islamic perspective. East Mediterr Hlth J 1999; 5: 1129-33.
AlKhaldi YM, Al-Sharif AI, Sadiq AA, Ziady HH. Attitudes towards premarital counseling among students of Abha Health Sciences College. Saudi Med J (Aug 2002); 23: 986-90.
Awatif A. Perception of female students of King Saud University towards premarital screening. J Fam Commu Med 2006; 13: 83-8.
Angastiniotis MA, Hadjiminas MG. Prevention of thalassaemia in Cyprus. Lancet 1981; 1: 369-71.
Colah R, Surve R, Wadia M, Solanki P. Genetic Testing. June 2008, 12 (2): 181-5.
Murray CE, Murray TL Jr. Solution-focused premarital counseling: helping couples build a vision for their marriage. J Marital FamTher 2004; 30: 349-58.
Christine EM. Couples Resource Map Scales study. University of North Carolina (USA). Available at: http://www. couplesresourcemap.org/ (last accessed November 2008).
Monaghan S. Genetics: For better or for worse. Middle East Health 2007: 19-26. Available at: http://216.230.204.101/mehealth/sep03_article 1.pdf (last accessed last November 2008).