Premarital Screening Program in Saudi Arabia Research Paper

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Evaluating Premarital Screening Knowledge in Saudi Students

The purpose of this research was to investigate the impact of premarital screening (PMS) in Saudi Arabia. The use of PMS as a means to identify and approach both and infectious and hereditary disease was investigated in order to determine the impact of this practical approach.

A cross-sectional study was conducted at Jazan University from January to June 2014 to perform this research. A self-administered questionnaire was distributed to 1000 Jazan University Students, both males and females. The questionnaire consisted of 3 main parts. The first part was based on socio-demographic data, the second part dealt with the students' knowledge about the premarital screening program while the third part explored their attitudes towards the screening program.

Results

The vast majority of the participants (922; 94%) believed that a PMS program was a preventive measure. More than two thirds of the participants (613; 72.5%) favored having regulation & law for premarital screening and most of the students (891; 90.8%) believed PMS programs limited the spread of hereditary (HD) and infectious diseases (ID). Most of the participants (756; 77.1%) reported that PMS tests should be done before engagement.

Conclusions

A large majority of the participants believed PMS program worked as a preventive measure; most of participants believed PMS program limited the spread of HD & ID. This reflects the importance of health education as a backbone in improving knowledge and attitude towards premarital screening programs.

Keywords

Premarital Screening, prevention, marriage, Saudi Arabia, heredity

Introduction

The common marriage practices within the Kingdom of Saudi Arabia in today's world has caused certain health risks and genetic problems stemming from an emphasis on inbreeding that is socially accepted within the deep and varying cultures within this region. Particularly, the Southern regions are characterized by high consanguineous marriages rates. The Southern regions in Jazan contains several cultures and topographies such as mountains, coastal, rural, and urban territories which vary in its approach to marriage.

This study will assist the national premarital screening program to identify the extent of people's knowledge and practice of PMS, which may positively reduce the burden and costs of transmitted diseases such as HBV, AIDs, Sickle Cell Anemia, and thalassemia on the Kingdom of Saudi Arabia (KSA) and reduce the cost related to these diseases. The economic cost of these diseases that can be avoided by Premarital Screening Program which is currently very high. The estimated annual cost of treatment for an individual who is infected with thalassemia or sickle cell anemia is nearly 100000 SR, and the estimated annual treatment for an individual who is infected with hepatitis B or AIDs is around 120000 SR, and the estimated cost of bone marrow replacement for one person is around 500000 SR. 2.

Under the Royal decree of 4/1/1423 H (i.e. 8/3/2002 G), the Ministry of Health in Saudi Arabia set organizational arrangements for the Saudi Premarital Screening Program, which started on 1/1/1425 H. under the second Royal decree, which made premarital screening for genetic diseases mandatory for all couples who plan to marry, and the third started on 8/4/1429 H. under the third Royal decree which included the addition of some infectious diseases ( hepatitis B&C and AIDs ) . The marriage contract would not be issued until the result of this screening test was submitted. However, couples still have the choice of getting married in spite of incompatible results.

Saudi Arabia is one of the significant countries who suffer from the hemoglobinopathies (sickle cell anemia & Beta thalassemia ) diseases located mostly in the Eastern & Southern region of the kingdom.3 Sickle cell anemia is considered a dangerous and debilitating disease, not only medically but also socially, economically, psychologically. These diseases create financial burdens for the patients, parents, family and relatives seeking good health services.4-5 As compared with beta thalassemia patients, the situation is worse, as the symptoms of beta thalassemia manifest early within few months, and need recurrent blood transfusion, followed by endocrine abnormalities in the second decade of life as evidence, and may lead to growth retardation.6

Whereas the evidence that hepatitis B prevalence lessens after conducting hepatitis B vaccine to approximately 2% in developed countries & North America, this rate remains high in the developing countries seen up to 8%. With hepatitis C, there is no vaccination yet, so the burden of infection is still a major public health problem worldwide.

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The World Health Organization estimated that around 170 million people, or around 3% of the world population are infected with hepatitis C8

Premarital screening programs are considered as a valuable solution and can be applied to minimize and reduce the incidence of genetic and infectious diseases especially in the middle eastern countries which are characterized with high consanguineous marriages and considered as a major reason contributing to genetic disorders.9 The Kingdom of Saudi Arabia is a large country with vast regions, and each region has its own different culture, social, and demographic features. The premarital screening program in Saudi Arabia has a major role in the effort to minimize and decrease the incidence of genetic disorders which reduce these risks.

Methods

Research Objectives:

To assess the knowledge of the Jazan University students regarding importance of PMS.

To assess the attitude of the Jazan University students regarding importance of PMS.

To explore the relationship between knowledge and attitude regarding PMS among Jazan University students.

To determine the association of knowledge and attitude of PMS with demographic variables (college, academic year, age, marital status, gender & place of residency) of Jazan University students.

Research Questions:

1- Are Jazan university students aware about the importance of PMS?

2- Is there any relationship between knowledge and attitude regarding PMS among Jazan university students?

3- Is there any association of knowledge and attitude of PMS with demographic variables of Jazan university students?

Hypothesis:

1- Knowledge and attitudes about PMS among Jazan students is poor.

2- There is a significant relationship between knowledge and attitude regarding PMS among Jazan students.

3- There is a significant association of knowledge and attitude of PMS with demographic variables of Jazan students.

Study Design:

Quantitative observational descriptive cross sectional study.

Study Setting:

The study was conducted in Jazan University at Jazan region southern of Saudi Arabia.

Study Population:

Students (Male & Female) age from (18 -- 27 years) who are attending Jazan University, southern region, Saudi Arabia 2014.

Study Period:

From January 2014 until June 2014

Sample size:

The total number of students attending Jazan University during this time was listed as 18,048. The students are distributed as 4910 students in the health related colleges 2229 male and 2731 female. 7579 students in the humanity college, 3,427 male and 4,152 female. There are 5,559 students in the scientific college with 2828 males and 2731 females. The sample size was calculated on the assumption that the knowledge is 30% and degree of precision is 3% at level of significance 0.05. The minimum sample size required to achieve the study objectives is 328 students (male & female) stratified according to college. To compensate for strafication, non- response and incompleteness of questionnaires, 1000 were recruited to participate in the study.

Sampling Technique:

Participants were selected using random sampling according to the inclusive criteria (unmarried or engaged) students. 1000 participants were distributed according to their tracks (related health colleges, scientific colleges, and humanity colleges) with 70 questionnaires (35 male, and 35 female) in each college. Every participant was selected using a random sample technique according to inclusive criteria of university students.

Inclusion Criteria:

1- Unmarried university students in Jazan region, Saudi Arabia 2014.

2- Engaged university students in Jazan region, Saudi Arabia 2014.

Exclusion Criteria:

3- Married university students in Jazan region, Saudi Arabia 2014.

4- University students are not willing to participate in the study.

5- University student who are not available during the time of data collection.

Instruments:

A structured questionnaire was constructed and used for data collection .The questionnaire consisted of 3 sections.

Section 1: Demographic Data.

This part of the questionnaire was used to explore the demographics of Jazan University students toward premarital screening program. It contained 10 questions about several factors including College, Academic Year, Age, Marital Status, and Gender & Place of Residency, Level of Family Income, Level of Father's Education, and Level of Mother's Education).

Section 2:

Questions to assess the knowledge of PMS among Jazan university students, Saudi Arabia 2014 (from question 11 to question 24).

These questions assessed the students regarding the knowledge of premarital screening programs which included general information about premarital screening program, importance, source of information, included diseases, complications, and knowledge about compatible & incompatible certificate to be given after results.

A "correct answer" was given 1 score, "wrong answer" was.....

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