Since 1425 a premarital screening program for Sickle Cell Anemia and Thalassemia was implemented in Saudi Arabia. The main aims of this study were to identify the socio-demographic, cultural and healthcare counseling effect on the decision and to recommend the possible modifications in the premarital screening program to prevent high risk marriages.
Methodology
A cross-sectional study was conducted to estimate the number of mismatched results in Saudi Arabia including all the Saudi couples (male and female) whom have undergone the premarital screening test from 21/2/2004 to 10/2/2005 then, a case control study was the second stage. A phone-call based questionnaire was used to collect the information. Cross tables were constructed to compare different risk factors.
Results
From 582 responders, who were interviewed, 302 were khatib (male) and 280 were makhtooba (females). The ages of the khatib ranged from 17 to 46 years with a mean and standard deviation of 27.4 ± 4.5 years. The ages of the makhtooba ranged from 15 to 44 years with a mean and standard deviation of 23 ± 4.69 years.
Only 8 (2.7%) from the 302 khatib (males) was illiterate and 89 (29.4%) university level. From the 280 makhtooba (females) was 5 (1.8%) illiterate and 89 (31.8%) university level.
Only 17 (32.7%) who decided not to marry and 40 (16.7%) who decided to marry knew about their disease status before they did the premarital screening test. 21 (40.4%) from who decided not to marry and 60 (25.1%) from who decided to marry have a family history of Sickle Cell Anemia. 12 (23.1%) who decided not to marry and 23 (9.6%) who decided to marry have a family history of Thalassemia. 72 (67.9%) of who were asked to visit the counseling clinic, visited the clinic. 167 (90.3%) were not asked to visit the counseling clinic and also they did not visit the clinic.
Conclusion
Premarital screening program has a universal reach, but has been able to avert only one-eighth of the marriages among incompatible couples. The significant promotive factors in deciding not to marry included knowledge about disease status before screening, family history of Thalassemia and if both of them suffer from Sickle Cell Disease. Health facilities have failed to advice people to visit counseling clinics, which themselves were unable to significantly modify the marital decision of couples.