title: The first five years of a preventive programme for haemoglobinopathies in Northeastern Iraq.
abstract: OBJECTIVE
  To evaluate the feasibility and effectiveness of a preventive programme for haemoglobinopathies in a single centre in Northeastern Iraq.
  
  
  METHODS
  Premarital screening, genetic counselling and prenatal diagnosis (PND) were implemented over a 5 year period.
  
  
  RESULTS
  Among a total of 108,264 screened individuals (54,132 couples), β-thalassaemia trait, δβ-thalassaemia trait, and sickle cell trait were diagnosed in 3.98%, 0.11% and 0.07%, respectively. Of 130 at risk couples (2.4/1000), 107 (82%) were available for follow up, with 105 couples (98.1%) proceeding with their marriage after counselling. In the 125 registered pregnancies in the latter couples, PND was performed in 85 (in 80 couples, uptake 76%). Selective termination was chosen in 10 of the 11 pregnancies with an affected fetus. Six affected babies were born among couples who declined PND. At the same time 30 already married couples with at least one thalassaemic child underwent PND, revealing three affected fetuses; all three pregnancies were terminated.
  
  
  CONCLUSIONS
  The programme revealed that most at risk couples diagnosed by premarital screening chose to proceed with their marriage, with 76% seeking PND followed by selective termination of an affected fetus. A 65% reduction in number of affected births was reported over the 5 year period. This regional programme could serve as a prototype for a national haemoglobinopathy prevention programme.
authors.affiliation: Department of Pathology, Faculty of Medical Sciences, University of Duhok, Duhok, Iraq.
authors.forename: Nasir A S
authors.initials: NA
authors.lastname: Al-Allawi
authors.forename: Sana D
authors.initials: SD
authors.lastname: Jalal
authors.forename: Najmaddin H
authors.initials: NH
authors.lastname: Ahmed
authors.forename: Azad H
authors.initials: AH
authors.lastname: Faraj
authors.forename: Awaz
authors.initials: A
authors.lastname: Shalli
authors.forename: Hanan
authors.initials: H
authors.lastname: Hamamy
mesh_terms: D005260:Female; D005817:Genetic Counseling; D006453:Hemoglobinopathies / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D007493:Iraq; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D017086:beta-Thalassemia / Q000235:genetics
keywords: Haemoglobinopathies; Iraq; genetic counselling; premarital screen; prenatal diagnosis