Abstract:
Background: Hemoglobinopathies are increasingly recognized as a global public health concern, with β-thalassemia major and sickle cell disease posing significant health burdens, particularly in southern Iraq. Specific Background: In response, eight Middle Eastern countries, including Iraq, have implemented mandatory premarital screening and genetic counseling programs to mitigate the transmission of inherited blood disorders. Knowledge Gap: However, limited data exist regarding the prevalence and types of hemoglobinopathies detected through such screening in Basrah province. Aim: This study aimed to determine the frequency of hemoglobinopathies among individuals undergoing premarital screening in Basrah. Results: A retrospective cross-sectional analysis was conducted on 384 randomly selected participants screened between February and June 2018. Females comprised 53.7% and males 46.3% (mean age: 22.8 ± 7.78 years). The prevalence rates were: β-thalassemia trait (2%), sickle cell trait (1.8%), sickle cell anemia (0.2%), sickle-thalassemia (0.5%), Hb D (0.1%), and Hb C (0.2%). A statistically significant association was found between hemoglobinopathies and both consanguinity (33.7%) and positive family history. Novelty: This study provides region-specific epidemiological data on hemoglobinopathies identified through premarital screening. Implications: Findings underscore the need to strengthen genetic counseling and raise awareness about consanguinity-related risks to reduce hereditary blood disorders in the region.
Highlight:
Beta thalassemia trait was the most common disorder detected.
Consanguinity showed significant correlation with hemoglobinopathies.
Premarital screening is vital for early genetic risk detection.
Keywords: Premarital Screening, Premarital Counselling, Hemoglobinopathy, Thalassemia, Sickle Cell Anemia.
References
A. M. Aboalam, A. A. Al-Mousa, S. Alamri, and O. A. Mostafa, "Assessment of Premarital Screening for Prospective Couples in Aseer Region, Saudi Arabia, 2021," Middle East Journal of Family Medicine, vol. 7, p. 74, 2022.
M. S. Hossain, E. Raheem, T. A. Sultana, S. Ferdous, N. Nahar, S. Islam, et al., "Thalassemias in South Asia: Clinical Lessons Learnt from Bangladesh," Orphanet Journal of Rare Diseases, vol. 12, pp. 1–9, 2017.
R. Lafta, R. Sadiq, and Z. Muhammed, "Burden of Thalassemia in Iraq," Public Health Open Access (PHOA), vol. 7, p. 000242, 2023.
N. H. T. Sidabutar and E. N. Hadi, "Premarital Screening: A Catalyst for Achieving Good Health and Well-Being," Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, vol. 12, 2024.
W. A. Al-Shroby, S. M. Sulimani, S. A. Alhurishi, M. E. Bin Dayel, N. A. Alsanie, and N. J. Alhraiwil, "Awareness of Premarital Screening and Genetic Counseling Among Saudis and Its Association With Sociodemographic Factors: A National Study," Journal of Multidisciplinary Healthcare, pp. 389–399, 2021.
M. Al-Shafai, A. Al-Romaihi, N. Al-Hajri, N. Islam, and K. Adawi, "Knowledge and Perception of and Attitude Toward a Premarital Screening Program in Qatar: A Cross-Sectional Study," International Journal of Environmental Research and Public Health, vol. 19, p. 4418, 2022.
N. Rouh AlDeen, A. A. Osman, M. J. Alhabashi, R. Al Khaldi, H. Alawadi, M. K. Alromh, et al., "The Prevalence of β-Thalassemia and Other Hemoglobinopathies in Kuwaiti Premarital Screening Program: An 11-Year Experience," Journal of Personalized Medicine, vol. 11, p. 980, 2021.
C. L. Harteveld, A. Achour, S. J. Arkesteijn, J. Ter Huurne, M. Verschuren, S. Bhagwandien‐Bisoen, et al., "The Hemoglobinopathies, Molecular Disease Mechanisms and Diagnostics," International Journal of Laboratory Hematology, vol. 44, pp. 28–36, 2022.
H. H. Abdul-Ra’aoof, W. A. Mizher, A. M. Tiryag, M. M. Al-Khalissi, T. M. Neama, and N. H. Nayef, "Moderate Knowledge and Attitudes Toward Tonsillitis Among Nursing Students," Academia Open, vol. 10, pp. 10.21070/acopen.10.2025.11323, 2025.
A. M. Tiryag, "Nurses’ Knowledge and Attitudes Toward Pacemaker: A Cross-Sectional Study," Academia Open, vol. 9, pp. 10.21070/acopen.9.2024.8845, 2024.
S. S. Hamid, A. F. Kareem, A. M. Tiryag, and H. H. Abdul-Ra’aoof, "A Study Regarding the Basic Anatomy and Physiology of the Eye Among Nursing Students: A Cross-Sectional Study," Indonesian Journal on Health Science and Medicine, vol. 2, pp. 10.21070/ijhsm.v2i2.127, 2025.
Z. Abbass, S. K. Jassim, A.-F. Sadeq, S. Hafedh, A. M. Tiryag, and H. H. A. Al-Hadrawi, "Determination of Self-Efficacy Level: The Capacity of Patients With Hypertension to Manage Their Chronic Disease," Indonesian Journal on Health Science and Medicine, vol. 1, pp. 10.21070/ijhsm.v1i2.15, 2024.
M. Saffi and N. Howard, "Exploring the Effectiveness of Mandatory Premarital Screening and Genetic Counselling Programmes for β-Thalassaemia in the Middle East: A Scoping Review," Public Health Genomics, vol. 18, pp. 193–203, 2015.
S. K. Jassim, Z. Abbass, and A. M. Tiryag, "A Study of Diabetes Correlated Emotional Distress Among Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study," Academia Open, vol. 9, pp. 10.21070/acopen.9.2024.10292, 2024.
H. K. Al-Hakeim, A. K. Abdulla, A. F. Almulla, and M. Maes, "Hereditary Haematologic Disorders in Najaf Province-Iraq," Transfusion Clinique et Biologique, vol. 27, pp. 213–217, 2020.
S. S. Aziz, B. K. Hamad, H. O. Hamad, M. I. Qader, E. N. Ali, R. H. Muhammed, et al., "Estimation of the Prevalence of Hemoglobinopathies in Erbil Governorate, Kurdistan Region of Iraq," Iraqi Journal of Hematology, vol. 11, pp. 19–24, 2022.
F. A. Jassim, A. M. Tiryag, and S. S. Issa, "Effect of Bad Habits on the Growth of School Students: A Cross-Sectional Study," Indonesian Journal on Health Science and Medicine, vol. 1, pp. 10–21070, 2024.
E. S. Alsaeed, G. N. Farhat, A. M. Assiri, Z. Memish, E. M. Ahmed, M. Y. Saeedi, et al., "Distribution of Hemoglobinopathy Disorders in Saudi Arabia Based on Data From the Premarital Screening and Genetic Counseling Program, 2011–2015," Journal of Epidemiology and Global Health, vol. 7, pp. S41–S47, 2017.
I. Zainel, H. Abdul-Ra’aoof, and A. Tiryag, "Mothers' Knowledge and Attitudes Towards Her Children With Neonatal Jaundice: A Cross-Sectional Study," Health Education and Health Promotion, vol. 10, pp. 565–570, 2022.
A. M. Tiryag and H. H. Atiyah, "Nurses’ Knowledge Toward Bariatric Surgery at Surgical Wards at Teaching Hospitals in Al-Basra City," Indian Journal of Forensic Medicine & Toxicology, vol. 15, pp. 5152–5159, 2021.
D. J. Weatherall, "The Thalassemias: Disorders of Globin Synthesis," Williams Hematology, vol. 8, pp. 675–707, 2010.
E. H. Rahi, Z. M. H. Al-Hejaj, and A. M. Tiryag, "Nurses' Knowledge of Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study," Academia Open, vol. 9, pp. 10.21070/acopen.9.2024.10306, 2024.
A. M. Tiryag and H. H. Atiyah, "Nurses' Knowledge Toward Obesity in Al-Basra City," Annals of the Romanian Society for Cell Biology, vol. 25, pp. 4667–4673, 2021.
F. Z. A. Khan and S. B. Mazhar, "Current Trends of Consanguineous Marriages and Its Association With Socio-Demographic Variables in Pakistan," International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 7, pp. 1699–1705, 2018.
Z. A. Omaima, "Assessment of Women's Awareness of Reproductive Health Concepts in an Iraqi Community," African Journal of Reproductive Health, vol. 28, pp. 17–25, 2024.
M. N. Attiyah and W. K. Al-Najafi, "Premarital Screening Program for Hemoglobinopathies in Karbala, Iraq," Kerbala Journal of Medicine, vol. 13, 2020.
M. Hassan, J. Taha, L. Al-Naama, N. Widad, and S. Jasim, "Frequency of Haemoglobinopathies and Glucose-6-Phosphate Dehydrogenase Deficiency in Basra," Eastern Mediterranean Health Journal, vol. 9, pp. 45–54, 2003.
M. K. Sozmen and E. Turha, "Evaluation of Premarital Health Screening," Evaluation, vol. 6, pp. 1–5, 2018.
M. V. Capanzana, M. A. L. Mirasol, G. Smith, I. Angeles-Agdeppa, L. Perlas, M. S. Amarra, et al., "Thalassemia and Other Hemoglobinopathies Among Anemic Individuals in Metro Manila, Philippines and Their Intake of Iron Supplements," Asia Pacific Journal of Clinical Nutrition, vol. 27, pp. 519–526, 2018.
R. A. A. Salama and A. K. Saleh, "Effectiveness of Premarital Screening Program for Thalassemia and Sickle Cell Disorders in Ras Al Khaimah, United Arab Emirates," Journal of Genetic Medicine, vol. 13, pp. 26–30, 2016.
W. M. Saed, M. Al-Sabbak, and M. Al-Badran, "Foeto-Maternal Outcome for Pregnant Women With Hemoglobinopathies in Basrah–Southern Iraq," International Journal of Medical Sciences, vol. 7, pp. 9–17, 2024.
E. Onuoha, B. Eledo, P. Anyanwu, and E. Agoro, "Premarital Screening of HIV, Haemoglobin Genotype, ABO and Rhesus Blood Group Among Intending Couples in Yenagoa, Nigeria," Journal of Biology, Agriculture and Healthcare, vol. 5, p. 14, 2015.
S. Datar, S. Poflee, and A. Shrikhande, "Premarital Screening of College Students for Carrier Detection in Thalassemia and Sickle Cell Disease: Need of the Hour," International Journal of Medical Science and Public Health, vol. 4, pp. 420–423, 2015.
D. Canatan and S. Delibas, "Report on Ten Years’ Experience of Premarital Hemoglobinopathy Screening at a Center in Antalya, Southern Turkey," Hemoglobin, vol. 40, pp. 273–276, 2016.
N. A. Al-Allawi, A. A. Al-Doski, R. S. Markous, K. A. Mohamad Amin, A. A. Eissa, A. I. Badi, et al., "Premarital Screening for Hemoglobinopathies: Experience of a Single Center in Kurdistan, Iraq," Public Health Genomics, vol. 18, pp. 97–103, 2015.
R. G. Zaini, "Sickle-Cell Anemia and Consanguinity Among the Saudi Arabian Population," Archives of Medicine, vol. 8, pp. 3–15, 2016.
A. Ud Din and M. S. Iqbal, "Premarital Genetic Screening for Beta Thalassemia Carrier Status of Indexed Families Using HbA2 Electrophoresis," 2015.