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Introduction: Premarital screening (PMS) is an essential global measure that seeks to reduce the occurrence of specific genetic disorders and sexually transmitted diseases common in consanguineous marriages. Due to the lack of a nationwide study, this research was designed to comprehend how unmarried individuals perceive the risks and benefits of PMS., Method: A cross-sectional study was conducted using an online questionnaire distributed through different social media platforms, responses from the native adult population (18-49 years) Saudi Arabia was only included in the study. The questionnaire was based on the Health Belief Model (HBM) to assessing seven different constructs including susceptibility, seriousness, benefits-, barriers-, & cues- to action, self-efficacy, and social acceptance. Data frequency was represented by mean and standard deviation; chi-square and t -tests were conducted for the comparison of independent and dependent variables. A multinomial logistic regression was used to predict factors influencing decisions related to PMS., Results: 1,522 participants completed the survey, mostly 18-25 years old and most of them were women. The majority were single with 85 men and 1,370 women. Most participants (59.6%) believed their parents were related, while 40.5% did not. 122 respondents reported they had to marry within their tribe. Findings revealed significant correlations among all HBM themes, with varying strengths. Notably, a moderate positive relationship was found between the perception of benefits and cues to action, suggesting that enhancing the perceived benefits of PMS could facilitate safe marriage practices. Multinomial regression analysis revealed that demographic factors and health beliefs significantly influence individuals' intentions and behaviors toward PMS and safe marriage., Conclusion: The study concludes that by identifying and addressing barriers, and promoting positive social acceptance, PMS can significantly contribute to preventing genetic diseases and promoting safe marriage practices, although the cross-sectional design limits the establishment of causal relationships and further research is needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Alwhaibi, Almuwais, Alotaibi, AlTaleb, Alsamiri and Khan.)

The prevalence of consanguineous marriages (CMs) varies worldwide from one country to another. However, the Middle East stands out as a region with a notably high rate of CMs. CM is particularly widespread in Saudi Arabia, where the prevalence of autosomal recessive genetic diseases has increased. This study aims to identify the Saudi population's awareness of genetic diseases and premarital screening tests (PMSTs). It also seeks to understand couples' perceptions of genetic diseases before and after marriage and their attitudes towards PMSTs and genetic counselling (GC) in reducing the risk of CM. Through the administration of online questionnaires, this cross-sectional study surveyed 2,057 participants to assess their awareness of genetic diseases and their understanding of testing and preventive measures for inherited diseases. Descriptive analysis, nonparametric chi-square tests and logistic regressions were performed to assess the association of categorical responses. This study included 2,035 Saudi Arabian respondents. A significant correlation was found between positive family history and partner selection (p = 0.001), as well as between partnering within the same tribe (p = 0.000139), with a different tribe (p = 0.000138) and from another family (p = 0.000489). About 91.3% of participants expressed agreement regarding the need to enhance public awareness and knowledge concerning genetic disorders, while 87% agreed that increased government regulations are required to prevent the spread of genetic diseases in affected families. Despite increased awareness of genetic diseases and PMSTs, there appears to be a lack of understanding regarding the limitations of PMSTs. The persistently high rate of CM underscores the challenge of altering marriage customs. Further governmental efforts are required to promote awareness of alternative reproductive options, establish new regulations and expand screening programmes., (© 2024. The Author(s).)

Objectives: This study aimed to explore high school students' awareness and attitude towards premarital screening (PMS)., Methods: This cross-sectional study was conducted in 10 public high schools in Muscat, Oman from May to July 2016. A three-part self-administered questionnaire was used to collect data from grade 12 students. The first part focused on respondents' sociodemographic characteristics, while the second part dealt with awareness of the national PMS programme and the third part explored attitudes towards the national PMS programme., Results: A total of 1,541 participants (response rate: 91.1%) completed the questionnaire. Most participants (78.1%) were aware of the availability of the PMS programme and their main source of information was family and friends (34.3%). The majority of students (87.4%) believed that PMS is important and most students (87.2%) indicated that they would undergo PMS. Over half of the students (55.3%) agreed that PMS should be mandatory before marriage and approximately one-third (38.3%) were in favour of having laws and regulations to prevent consanguineous marriages. Females were significantly more in favour of making PMS mandatory ( P = 0.002) and enforcing PMS laws ( P = 0.010) compared to males., Conclusion: Most respondents had good levels of knowledge about the PMS programme and half thought it is important to be tested. However, some students were not in favour of PMS. Increasing awareness about Oman's PMS programme is important and motivating students could contribute significantly to increasing the utilisation of the PMS programme and to limiting genetic blood disorders., Competing Interests: CONFLICT OF INTEREST The authors declare no conflict of interest., (© Copyright 2019, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Thalassemia and hemoglobinopathies are a major public health problem in Turkey. Hemoglobinopathy prevention programs (HPPs) were started in 33 provinces situated in Thrace, Marmara, Aegean, Mediterranean and South Eastern regions of Turkey in 2003. A premarital hemoglobinopathy test is mandatory and free of charge in this program. According to the Ministry of Health reports, 46 first level hemoglobinopathy diagnostic centers were established for premarital tests. Within the last 10 years, approximately 79.0% of married individuals per year were screened by the centers. While the percentage of premarital screening tests was 30.0% of all couples in 2003, it reached 86.0% in 2013. The number of newborn with thalassemia and hemoglobinopathies were 272 in 2002 and dropped to 25 in 2013. There has been a 90.0% reduction in affected births. Our hemoglobinopathy diagnostic center was established in 2003 and licensed by the Ministry of Health in 2004. We studied a total of 89,981 blood samples from premarital tests for 10 years and the incidence of β- and α-thalassemia (β- and α-thal) trait was found to be 6.57 and 3.56%, respectively. The distribution of the most common abnormal hemoglobins (Hbs) was: Hb S (HBB: c.20A > T) (0.31%), Hb D-Los Angeles (HBB: c.364G > C) (0.15%), Hb G-Coushatta (HBB: c.68A > C) (0.06%) and Hb E (HBB: c.79G > A) (0.02%). A total of 60 couples, both carrying β-thal trait, were directed to the prenatal diagnosis (PND) center in 10 years. The premarital hemoglobinopathy screening program is running successfully at our center and other centers in Turkey.

Background: In Sub-Saharan Africa, an estimated 1.8 million became infected with the HIV in 2009 and Nigeria currently has about 3.4 million people living with HIV. Measures put in place by religious organizations to combat HIV/AIDS in Nigeria include mandatory premarital HIV testing. The knowledge of HIV/AIDS amongst religious leaders in Nigeria has not been sufficiently explored . In this study, we assessed the knowledge of HIV/AIDS amongst religious leaders in Sokoto and if they routinely demand for mandatory premarital HIV testing for all intending couples., Methods: This was a descriptive cross-sectional study involving 158 religious leaders (30 Christians and 128 Muslims) who officiate or assist during marriages. Data was collected using interviewer and self administered questionnaire which sought such information as biodata, knowledge of HIV/AIDS , speaking to congregation about AIDS and using Premarital HIV status as a pre-requisite for contracting marriages. Data was entered into and analysed using Epi-info computer soft ware program. Level of statistical significance was put at P = 0.05., Results: The ages of the respondents ranged from 35 to 78 years with a mean age of 26.3 ± 20.3 years. Forty nine percent of the respondents had adequate knowledge of HIV/AIDS with more Christian clerics compared to Muslim Clerics having better knowledge of HIV/AIDS (P < 0.0001). All the Christian clerics opined that they would insist on mandatory premarital HIV testing for their subjects before joining them in marriages., Conclusion: The results of the study have shown that most of the religious leaders lacked adequate knowledge of HIV/AIDS and the use of mandatory premarital HIV testing is yet to be adopted by the Muslim clerics. Awareness campaigns should be intensified for the religious leaders to improve their knowledge of HIV/AIDS.

Despite the important frequency of the gene "S" in Togo, essential information remains insufficient to elaborate a prevention campaign on this affection. In order to assess the knowledge on sickle cell diseases as well as the prevention practices in the Togo population in one of the five districts of the township of Lomé, a cross sectional study was conducted in the third district of the township of Lomé from January 21, 2004 to January 26, 2004 in 210 natives from Togo aged of 15 and over, through a semi-structured questionnaire. The variables studied were: - the socio-demographic features and the knowledge of sickle cell disease characteristics (symptoms, biological diagnosis, treatment and means). Data collected were analysed through software Statically Package for Social Science (SPSS) version 10.0 of Windows using the chi2 test with 5% significance in the comparison of some variables. 117 women and 93 men were interviewed. Sickle cell disease was known in almost all ethnic groups but incompletely: 79.5% of the individuals knew about premarital check up but only 12.4% knew about haemoglobin electrophoresis check up. 74,8% of the people had a good knowledge of the cause of sickle cell disease, 78.6% had a fairly good knowledge of its symptoms, 57.6% knew the factors inducing attacks, 64.3% the prognosis and 69.5% the prevention methods, but a poor knowledge of the complications (62.4%), biological diagnosis (71%) and treatment (97.2%). The prevention practices were poorly adopted: 12% had an haemoglobin electrophoresis check up and 15% of them had their husband to have one as well. Professional status influenced the level of knowledge of the biological diagnosis (p=0.001) and prevention means (p=0.018). The educational level influenced biological diagnosis knowledge (p = 0.000) and prevention means (p = 0.02). On the whole, sickle disease was linked to marital status (p = 0.00). Sickle cell disease remains quite unknown in spite of the gene "S" important frequency in Togo. These results are to be taken into account to implement information, education and communication program to struggle against sickle cell disease.

This literature review is a comprehensive summary of premarital (prenuptial) screening programmes for the most prevalent hereditary haemoglobinopathies, namely thalassaemia and sickle cell disease, and the important infections HIV (human immunodeficiency virus) and hepatitis viruses B and C (HBV and HCV). It describes the background to premarital screening programmes and their value in countries where these diseases are endemic. The use of premarital screening worldwide is critically evaluated, including recent experiences in Saudi Arabia, followed by discussion of the outcomes of such programmes. Despite its many benefits, premarital testing is not acceptable in some communities for various legal and religious reasons, and other educational and cultural factors may prevent some married couples following the advice given by counsellors. The success of these programmes therefore depends on adequate religious support, government policy, education and counselling. In contrast to premarital screening for haemoglobinopathies, premarital screening for HIV and the hepatitis viruses is still highly controversial, both in terms of ethics and cost-effectiveness. In wealthy countries, premarital hepatitis and HIV testing could become mandatory if at-risk, high-prevalence populations are clearly identified and all ethical issues are adequately addressed.

A descriptive study was conducted on premarital HIV screening programme in Johor over a three year period. HIV screenings were done at government clinics and confirmed by accredited laboratories. As a result, 123 new HIV cases were detected (0.17%) from 74,210 respondents. In 2004, 24 cases (64.9%) advanced to marriage (n = 37) after they underwent counselling and six of them married among themselves. Positivity rate from this programme (0.17%) is higher than antenatal screening (0.05%). Despite the implementation of the premarital HIV screening programme, marriage application in Johor rose 2.8% in 2004 compared with 2002. This programme had partly contributed to public awareness against HIV and provides another option in early detection of the disease.

The prevalence of HIV infection among individuals referred from faith-based organizations (FBOs) in south-eastern Nigeria for mandatory pre-marital HIV screening was determined. Of the total of 319 individuals (148 males, 171 females) screened, 25 (7.8%, 95%CI: 4.9-10.7%) were confirmed HIV-positive, comprising 13 (8.8%, 95%CI: 4.2-13.4%) males and 12 (7%, 95%CI: 3.2-10.8%) females. No significant difference was observed in the association between HIV infection and gender (chi2=0.58, df = 1, P < 0.05). The highest prevalence of HIV infection (8.9%) was recorded among individuals in the 21-30 years age category, while the least HIV infection prevalence (5.3%) was observed among persons above 40 years old. There was no significant difference in the association between HIV infection and age (chi2=0.68, df = 3, P < 0.05). Mandatory pre-marital HIV screening could generate social stigmatization and infringement of the fundamental human rights of infected individuals. Voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing are more desirable. Guidelines for the management of test-positive individuals and non-concordant couples and the safeguarding of confidentiality should be developed. Training and capacity building for religious leaders, to appropriately manage social issues associated with HIV/AIDS as it affects their organizations, are recommended.

We explored the attitudes and opinions of 90 Palestinian decision-makers about the draft law on premarital examination. The findings revealed that decision-makers were aware of the spread of genetic diseases but not infectious diseases. The majority agreed on the draft law; however, they differed on the mode of its application. Half believed that the law is not ready yet for application due to insufficient financial support to establish the needed infrastructure. The most significant recommendations made by the decision-makers were to: enhance community awareness of the law, ensure proper coordination among the concerned ministries and institutions, and establish a national organization to work on endorsement of the tests and issuance of the appropriate application strategies and regulations.

Evaluation of Toxoplasmosis seroprevalence was conducted in 2416 women of childbearing age by Pasteur Institute of New-Caledonia. The estimated seroprevalence was 56.7%, significantly higher in the North-East part of the territory (79.1%), area characterized by strong precipitations, and in the Melanesian ethnic group (62.1%). The habits of this population could enhance contamination by ingestion of oocysts during childhood or adolescence, particularly in the North-East territory. Melanesian women living in the North-East and being not immunized against toxoplasmosis represent the population with the highest risk for Toxoplasma gondii infection.

The development of effective programs to prevent marital dysfunction has been a recent focus for marital researchers, but the effective dissemination of these programs to engaged couples has received relatively little attention. The purpose of this study is to determine which factors predict couples' participation in premarital counseling. Predictive factors were derived from the health prevention literature, with a particular focus on the health belief model (HBM). Couples' beliefs and attitudes about premarital counseling were assessed at least six months before their wedding, and participation was assessed after their wedding. Results indicate that the strongest predictors of couples' participation were couples' perceptions of barriers to counseling and whether they had counseling recommended to them. These variables predicted participation even after controlling for important demographic variables. Recommendations for recruiting engaged couples for premarital counseling are made based on the findings.

Aim: To determine factors influencing voluntary counseling and premarital testing on human immunodeficiency virus (HIV) in Malawi., Method: We analyzed the data collected by the Malawi Demographic and Health Survey (MDHS) 2000 to determine the likelihood of Malawi population to accept HIV testing. The MDHS was a nationwide cross-sectional study where cluster sampling technique and an interviewer-administered questionnaire were used. We applied the Logit model of analysis to determine the HIV testing likelihood according to the following parameters: age, place of residence (urban vs. rural), belief that sexual abstinence protects from HIV infection, knowledge of a location of HIV testing, belief that diagnosis of HIV should be kept secret, and knowledge of anyone with AIDS., Results: Out of 3,092 participants, 23.3% lived in urban and 76.7% in rural areas. Willingness to have premarital HIV counseling and testing was positively associated with increased age, urban residence, and wish to keep one's own HIV testing result confidential. However, knowledge of a person with HIV/AIDS, HIV testing location, and other sexually transmitted infections/diseases, as well as belief that abstinence protects against HIV were inversely related to desire to take an HIV test., Conclusion: Not all population groups have an equal likelihood of accepting voluntary HIV counseling and testing. Public health intervention on HIV counseling and testing should be tailored specifically for each population group.

Premarital counselling and examination have begun to play a very important role in the management of many genetic disorders. 600 villager's knowledge and attitudes toward premarital counselling and examination in Menofia Governorate was studied in order to predict the community acceptance and behaviour toward utilization of such service. The result showed a big lack in knowledge even among educated respondents about the term. The main source of information was mass media followed by medical personnel who should participate more in this service. Most respondents, except unmarried males, have a favourable attitude toward either premarital counselling and examination or consanguinous marriage. This may be related to certain social changes in village life such as declining illiteracy, increased economic pressures, increase number of nuclear families and accordingly delay in beginning a family. It was unlikely that non-contraceptive users would resort to induced abortion rather to use contraceptive methods. Educational programs should be directed toward: (a) unmarried males so that their attitude toward premarital counselling and examination can be changed to correct direction, (b) unmarried females to make consanginous marriage more undesirable, and (c) non-contraceptive users to make them more intended to use safe contraceptive methods than induced abortion.