Annual adult health screening: barriers, challenges and effectiveness

Although it has been well-established that screening for early detection and intervention practices has been associated with favorable outcomes, there have been many concerns about the potential of these approaches to cause harm to the patients. In addition, evidence also shows some associated barriers and challenges to these approaches that need to be considered by healthcare authorities when planning for such approaches. The present literature review discusses annual adult health screening programs' effectiveness, barriers, and challenges. There is no doubt that these screening programs can help identify undiagnosed disorders among many patients with various conditions, like diabetes mellitus, hypertension, and different cancers. Moreover, the effectiveness of these screening programs can be best highlighted by the premarital screening program in Saudi Arabia, which targets high-risk couples for developing certain conditions and infections. However, it should be noted that there are many barriers and challenges to conducting health screening campaigns, like cultural and economic factors. Other challenges might also include the rates of false-positive tests, overdiagnosis, and knowledge about the screening programs.

Fear of abortion and emotional divorce in women with minor thalassemia: a population-based study in Yazd, Iran

Background Thalassemia is the most common genetic disorder in humans that can be controlled and treated by, premarital screening, prenatal diagnosis and abortion. Aortion can be a critical issue for many families based on the cultural and religious backgrounds and have different consequences for couples, such as emotional divorce. Therefore, the present study aimed to investigate the association between fear of abortion and emotional divorce in women with minor thalassemia in Yazd City, Iran. Materials and methods This retrospective study was conducted on 61 women with minor thalassemia (case group) and 100 healthy women (control group), who referred to health centers in Yazd. The census sampling was applied to select the case group and multistage (cluster andsimple) random sampling was adopted to select the control group. Data were collected using Gutman Emotional Divorce Questionnaire and a researcher made scale for measuring fear of Abortion. Data were analyzed by SPSS using descriptive statistics and chi-square, independent t-test, Pearson correlation, and linear regression. Results The mean scores of emotional divorce (6.62 vs. 4.26) and fear of abortion (25.85 vs. 17.4) were higher in the case than control group (P ˂ 0.01). There was a positive and significant correlation between fear of abortion and emotional divorce in the case (P ˂ 0.05, r = 0.275) and control (P ˂ 0.05, r = 0.570) groups. Fear of abortion in the case group predicted 25% of the variance in emotional divorce. Conclusion Given the high level of fear of abortion in women with minor thalassemia and its effect on increasing the emotional divorce, designing and implementing psychological interventions with ongoing follow-up are recommended for thalassemia carrier couples.

Knowledge and Challenges Associated With Hearing Impairment in Affected Individuals From Cameroon (Sub-Saharan Africa)

Background: This study aimed to gain an understanding of the challenges faced by people with hearing impairment (HI) in Cameroon, their understanding of the causes of HI, and how challenges could be remedied to improve the quality of life of persons with HI.Methods: Semi-structured one-on-one in-depth interviews and observation of participant behaviour when answering questions were used to collect data from 10 HI professionals (healthcare workers and educationists), and 10 persons affected by HI (including caregivers).Results: The results show that the different groups associate the causes of HI to genetics, environmental factors, and a spiritual curse. There were reported cases of stigma and discrimination of persons with HI, with people sometimes referring to HI as an “intellectual disorder.” Interviewees also highlighted the difficulty persons with HI have in accessing education and healthcare services and suggested the need for the government and health researchers to develop strategies for the prevention and early diagnosis of HI. These strategies include (1) the awareness of the general population regarding HI, (2) the development of facilities for the proper management and new-born screening of HI, and (3) the implementation of a premarital screening to reduce the burden of HI of genetic origin.Conclusions: This study confirms the difficult social interaction and access to proper management faced by persons with HI in Cameroon and further highlights the need to educate populations on the causes of HI for a better acceptance of individuals with HI in the Cameroonian society.

The Prevalence of β-Thalassemia and Other Hemoglobinopathies in Kuwaiti Premarital Screening Program: An 11-Year Experience

This study aims to estimate the prevalence rates of β-thalassemia and Sickle cell disorders in the adult population screened (n = 275,819) as part of the Kuwaiti National Premarital Screening Program. All the individuals who applied for a marriage license during the years 2009 and 2020 were covered by the program. A network of four reception centers in the Ministry of Health facilities and one Premarital Diagnostic Laboratory (PDL) in Maternity Hospital were involved in performing all investigations for hemoglobinopathies. The total number of individuals identified with β-thal trait was 5861 (2.12%), while 22 individuals (0.008%) were diagnosed with β-thal disease. A total of 5003 subjects (1.81%) were carrying the Sickle cell trait, while 172 subjects (0.062%) had Sickle cell disease including Sickle cell anemia (SCA). Results showed that the program succeeded indeed in preventing the marriage of 50.4% of risky couples by issuing unsafe marriage certificates. Yet more efforts are needed to improve the program’s main objective of decreasing high-risk marriages. In particular, health care systems should be ameliorated in a way to intensify the counselling mechanism for the high-risk couples, strengthen the awareness of the general population and induce earlier age screening policies.

Seroprevalence of hepatitis B and C viral infections in the premarital adult population of Al Majmaah, Saudi Arabia

BackgroundViral hepatitis is a major global health problem affecting millions of people worldwide. The main objective of the present study was to estimate the seroprevalence of hepatitis C and hepatitis B in Saudi adults undertaking premarital screening voluntarily.Methodology This observational retrospective study was conducted at King Khaled General Hospital, Al Majmaah, Saudi Arabia, for a period of 3 years (October 1, 2016 to September 30, 2019). The prevalence of hepatitis B and hepatitis C infections was calculated using Microsoft Excel and the hematological data analysis was performed using SPSS software. A total of 3755 premarital Saudi adults who voluntarily participated in the premarital screening were included in this study. Subjects were screened for hepatitis C virus (HCV) and hepatitis B virus (HBV). The demographic and epidemiological parameters included patient age, sex, nationality, and seropositivity for HBV and/or HCV. ResultsOf the 3755 subjects, eight (0.242%) and 12 (0.364%) subjects were positive for HCV and HBV, respectively. Among the 12 HBV-positive subjects, nine (75%) subjects were men, and three (25%) subjects were women. However, among the eight HCV-positive subjects, five (62.5%) subjects were men, and three (37.5%) subjects were women.Conclusion This study concluded that the prevalence of HBV infection was slightly higher than that of HCV infection among the Saudi adult population of Al Mjamaah. In addition, both HBV and HCV were less prevalent in women than in men in the study population.

The parental perspective of thalassaemia in Bangladesh: lack of knowledge, regret, and barriers

Background Thalassaemia, a hereditary haemoglobin disorder, is a major public health concern in some parts of the world. Although Bangladesh is in the world’s thalassaemia belt, the information on this disease is scarce. Additionally, the awareness of this life threatening, but potentially preventable disease is surprisingly poor. However, mass awareness is pivotal for the development of an effective preventive strategy. In this context, the understanding of parental perspectives is essential to grasp the magnitude of the problem. Therefore, this study aimed to investigate the parental knowledge gaps and perceptions regarding thalassemia, the barriers confronted by the parents for caring for their thalassaemic children and their attitude to prenatal screening and prenatal diagnosis. Methods This cross-sectional study was conducted between January 2018 and December 2018 at a dedicated thalassemia hospital located in Dhaka. A structured questionnaire was used for face-to-face interviews with parents of thalassaemic children. Descriptive statistics were used to analyse data. Results Of 365 respondents, nearly all respondents (97%) had not heard about the term, ‘thalassemia’ before the disease was diagnosed in their children; all (100%) were unscreened for carrier status prior to marriage. Mean knowledge scores were significantly higher in respondents with higher income and education. Most respondents (~ 91%) had a guilty feeling for not undergoing premarital screening. Only around 36% of them had heard about prenatal diagnosis. Approximately 25% participants would consider prenatal diagnosis in a future pregnancy, while 70% of them were unsure and only ~ 5% would decline prenatal diagnosis. Only 9.3% mothers had prenatal diagnosis in a previous pregnancy. Nearly 80% of the parents faced difficulty for obtaining blood donors regularly and a similar proportion (~ 81%) of them did not receive support from any organized blood clubs. More than 40% of the parents reported they felt socially stigmatized. Conclusion This study suggests poor parental knowledge regarding thalassaemia including prenatal diagnosis and the challenges faced while caring for their children. These findings would be of paramount importance in planning and devising effective prevention and intervention strategies in Bangladesh as well as other countries with similar sociocultural setting.

Premarital screening for genetic blood disorders — an integrated review on the knowledge and attitudes of Middle Eastern university students

Background Genetic blood disorders are prevalent in the Middle Eastern countries causing physical, mental, and economic handicap. Premarital screening (PMS) is actively implemented to reduce the burgeoning load of these disorders. Literature shows a low response rate for PMS in this region. This integrated review aims to identify the knowledge and attitude of university students on PMS, as they are at the verge of entering into marriage relationships. Main body of the abstract We systematically reviewed the electronic databases like MEDLINE, PubMed, CINAHL, and Scopus. Studies reporting about the knowledge and attitudes of Middle Eastern university students between 2010 and 2020 are included in the review. Twelve cross-sectional descriptive studies conducted in six countries met the inclusion criteria. Majority of the studies reported good level of knowledge on PMS among the university students, whereas not all of them agreed to undergo PMS due to various religious and cultural beliefs. Short conclusion We recommend massive health education programs at the higher secondary and university levels to create better awareness on PMS. To improve the attitude towards PMS, life cycle approach and support of the religious leaders could be sought.

Thalassemia and Hemoglobinopathies Screening by Osmotic Fragility (OF) and Dichlorophenol Indophenol Precipitation (DCIP) Tests Among Vocational Students in Ubon Ratchathani Province

Background: Thalassemia and hemoglobinopathies are the most common and clinically serious single gene disorders. Screening by osmotic fragility (OF) test and dichlorophenol indophenols precipitation (DCIP) test have been found to be effective and low-cost approaches to identify those who are carriers especially among young population. Objective: To study the prevalence rates of abnormal of OF test and/or abnormal DCIP test among vocational students in Ubon Ratchathani province. Methods: This cross-sectional research collected data from 311 students aged 15 to 19 years in a vocational school in Ubon Ratchathani, Thailand. OF and DCIP tests were done after participants signed consent to join the study. Knowledge and attitude towards thalassemia and thalassemia screening was obtained from self-administered questionnaires. Chi-square and Fisher exact tests were performed to examine the association between variables. Results: Of 311 students, 124 (39.9%) students had abnormal OF test or DCIP test or both, 72 (23.2%) students had both DCIP and OF tests positive. The final diagnosis was that 75.8% had hemoglobin E, 21.8% and 2.4% were α-thalassemia and β-thalassemia carriers respectively. Approximately, 91.4% of them considered thalassemia screening useful and necessary for premarital screening. Conclusions: High incidence of abnormal OF test and/or DCIP test was found among vocational students in Ubon Ratchathani province, showing a predominance of hemoglobin E. Most of them agreed that thalassemia screening is useful for adolescents to avoid marriage among carriers.