An evaluation of the detection and support facilities available for women of child-bearing age with haemoglobinopathies at the antenatal clinic of a hospital in Kingston, Jamaica and their impact on these clients

ABSTRACT

The haematology laboratory can be regarded as playing a pivotal role in the delivery of quality health care. Accuracy and early detection of many genetically transmitted diseases hinge on the reliability of screening tests, their interpretation and the liaison betweem nurse/clinician, the laboratory and their clientele. This project evaluated the laboratory services offered for screening haemoglobinopathies among persons attending the antenatal clinic of the University Hospital of the West Indies, Kingston, Jamaica. A case control study was conducted during the months December 1996 through July 1997 by means of accessing laboratory records, patients' dockets and the administering of questionnaires to mothers with the haemoglobinopathies (cases) and those without, (controls). Findings analysed from the dockets and questionnaires reveal that the antenatal clinic accounts for approximately one third of the requests made to the laboratory by the hospital for haemoglobin electrophoresis. The relative frequencies of haemoglobinopathies with that of other studies AS 10 percent; AC 3 percent; SS < or = 1 percent; SC < or = 1 percent. The screening test used was fairly reliable for preliminary screening but needs to be followed by diagnostic tests which are not being done at this time, for confirmation of genotypes. Both groups were similar in age distribution but differed in respect of knowledge of sickle cell status of self, family members and sickle cell disease. Among the case group greater than 60 percent of the times they did not know their husbands'/partners's sickle status or that of his family members. Only 82 percent of respondents knew their correct sickle status (74 percent of cases; and 90 percent of the controls). The study groups differed with regard to educational level, race of fathers and union status. More subjects with a haemoglobinopathy than those in the control group attained college and university level and this may be responsible for the impact on level of awareness. Race of both groups were similar except that fathers in the case group were significantly less likely to be black when compared to the control group. Women in the control group were more likely to be married or in common-law union than those in the case group. Plans for having children were similar in both groups and showed the "high-risk" women either had no regard for, or are ignorant of the implication for transmitting the sickle cell gene.(Au)