Effectiveness of the model for prenatal control of severe thalassemia.

OBJECTIVE: The aim of the research was to determine effectiveness of the model for prenatal control in reducing new cases of severe thalassemia. METHODS: Pregnant women at six tertiary centers were recruited to follow the model, consisting of (1) carrier screening using mean corpuscular volume (for alpha-thal-1 and beta-thal) and CMU-E screen (for HbE trait), (2) carrier diagnosis, (3) the couples at risk were counseled and offered prenatal diagnosis, and (4) termination of affected pregnancy. All neonates were evaluated for thalassemia. RESULTS: Of the 12,874 recruited pregnancies, 7008 were valid for analysis. Of them, 281 couples were identified to be at risk, Of the 281, 58 affected fetuses were identified and 55 pregnancies were terminated, whereas three did not accept pregnancy termination. All 6727 neonates at no risk were proven to be unaffected. The model had sensitivity and positive predictive value of 100% and 20%, respectively. The model could detect all of affected fetuses. CONCLUSION: The model could prenatally identify affected fetuses with a detection rate and negative predictive value of 100%. The model was highly effective to prenatally detect affected fetuses with an acceptable false positive rate.

Causes and attitude of husbands toward thalassemic carrier screening test when their partners have abnormal screening tests.

OBJECTIVE: To assess the attitude of husbands toward the thalassemic carrier screening test and to explore the causes of non-participation of having a blood test. STUDY DESIGN: Descriptive study. MATERIAL AND METHOD: During 2007-2008, 100 husbands of pregnant women with screening-positive test for thalassemia who refused to have blood test were enrolled by voluntariness. They would fill out a structured questionnaire designed for the present study which was divided into 3 parts; (1) participant's personal characteristics (2) their attitudes toward thalassemic carrier screening test with the score ranging from 1-5, and (3) reasons for their refusal of having a blood test. RESULTS: The husbands had a favorable attitude toward testing for thalassemia, with overall mean score and standard deviation of 3.57 and 0.38. Commonly expressed reasons against testing were the self-belief of having a non-affected child and the inconvenience of coming to the hospital. CONCLUSION: Husbands had a favorable attitude toward test for thalassemia.