Premarital Screening is Pivotal in Reducing the Births of Babies Affected with Thalassemia Major in Iraq

Abstract

Thalassemia major is one of the health problems in Iraq, especially in Kurdistan. Pre-marriage mandatory preventive screening program was established in Kurdistan in 2008, which allowed us to study the prevalence of different hemoglobinopathies among newly married young adults in this region. A total of 1154 subjects (577 couples) attending the Koya district, premarital Health center, were screened using red cell indices. Those who had mean corpuscular volume (MCV)<80 fl and mean corpuscular hemoglobin (MCH)<27 pg had high-performance liquid chromatography and iron studies. Out of 1154 individuals that were evaluated, 183 (11.9%) had low MCV and MCH. Of the former 183 subjects, 69 (5.97%) had β-thalassemia trait, 10 (0.86%) had δβ-thalassemia trait, and no other hemoglobinopathies were recorded in our study. There was second-degree consanguinity in 4.7% of all 577 couples. In two couples, both partners had β-thalassemia trait and both were consanguineous. Both couples decided to separate after counseling. Based on the current study, the role of the premarital screening program in decreasing the number of new thalassemia major cases among the Kurdish population is laudable. Therefore, mandatory premarital screening is advised in all parts of Iraq.

Keywords:

• Hemoglobinopathies
• β-thalassemia trait
• premarital screening
• Kurdistan
• Iraq

Acknowledgements

The authors would like to thank the Department of Hematology, Shahid Dr. Khalid Teaching Hospital, Koya General Health Directorate, Erbil, Iraq, who have been involved in the premarital screening procedure.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Ethical approval

The procedure performed in this study was approved by the College of Medicine Research Committee, Kurdistan Regional Government, Kurdistan/Iraq.

Research involving human participants

All procedures performed in this study involving human participants were by the ethical standards of the College of Medicine Research Committee, Kurdistan Regional Government, Kurdistan/Iraq.

Informed consent

The patients agreed to the procedure by signing an informed consent form.

Author contributions

JJO performed the procedures from the preparation of the sample to the acquisition and preparation of the lab report for the premarital screening. Later, NK and RNM analyzed all the data and created the tables with the statistical analysis. NK, JJO, ZSH and RNM wrote the manuscript and were all involved in reviewing and preparing all the aspects of the manuscript.

Data availability statement

The data sets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

The Shahid Dr. Khalid Teaching Hospital is funded and maintained by the Erbil Directorate of Health, Ministry of Health, Kurdistan Regional Government, Kurdistan, Iraq.