Knowledge, Attitude and Practices Related to Pre-Marital Screening for Sickle Cell Anemia in Jazan Region, Saudi Arabia

Background: Sickle Cell Anemia (SCA) is considered relatively common in the Kingdom of
Saudi Arabia, particularly in the Eastern and Southwestern parts of the country. Previous
studies showed significant widespread of misconceptions and poor knowledge about sickle
cell disease in the Eastern region; however, data from the Southwestern areas are limited.
Objective: Therefore, the present study aims to assess the knowledge, attitude and practices
related to pre-marital screening for SCA in Jazan region. Methods: A cross-sectional study
was carried out among 230 male Saudis who had been married in 2004 or after with positive
SCA test for either partner or both. The participants were interviewed to fill up structured
questionnaires at five public health centers (PHCs) in Jazan region (3 urban and 2 rural
PHCs). Results: Overall, an average level of knowledge about SCD was reported among the
participants, with 17.4% of them had poor knowledge. About half of the participants had the
knowledge from their friends and neighbours. Interestingly, about 60% of the participants
supported consanguinity, with about two-thirds had consanguineous marriage. Almost all
(95.2%) of the respondents were in favour of performing screening for SCA and 83.5% of
them preferred to do it before engagement. Participants with at-risk marriages had
significantly higher level of knowledge compared to those with safe marriages (χ2 = 9.19, P =
0.010). Similarly, consanguineous marriage increased the odds of at-risk marriages by four
times (OR = 3.7, 95% CI = 1.9, 7.0). Conclusion: The participants had an average level of
knowledge about SCD. However, percentages of consanguineous marriages and completing
at-risk marriages were unexpectedly high. Thus, health education should play a significant
role in preventing genetic diseases and this might be integrated in the curriculum of secondary
and university levels. Screening for SCA before engagement will help significantly to avoid
at-risk marriage and to reduce these diseases.