title: Evaluation of married haemoglobinopathic carrier couples for prevention of haemoglobinopathic births.
abstract: BACKGROUND
  Abnormal haemoglobins (Hb) and thalassaemias are some of the most frequently observed hereditary disorders in the world, but especially in the Mediterranean region where Turkey is located. Hatay province is one of the largest provinces in the region, suggested as a target area to be selected for preventive programs after studies by three Turkish universities, i.e. Çukurova, Akdeniz and Hacettepe Universities in Turkey.
  
  
  OBJECTIVE
  The aim of this study was to determine demographic and family characteristics of all haemoglobinopathy carrier married couples registered in the Hatay Provincial Health Directorate registry and to educate the target population about pregnancy, births, prenatal diagnosis and genetic counselling with the particularly emphasised scope of eliminating all haemoglobinopathic births.
  
  
  METHODS
  Descriptive cross-sectional and intervention study.
  
  
  METHODS
  1065 couples both being haemoglobinopathic carriers, registered in the Hatay Provincial Health Directorate registry were investigated for socio-demographic characteristics, obstetrical status and especially for a present pregnancy, the presence of any haemoglobinopathic patients or carrier children in the family.
  
  
  RESULTS
  Among women with a history of pregnancy, 47.3% reported that they had never had any prenatal testing, while 33.1% had got received testing in each of their pregnancies. The most frequent reason for not having the test was declared as unawareness of the test (66.0%), followed by economic insufficiencies (17.1%), destiny/religious reasons (9.1%) and family interference (7.8%). After a series of descriptive analyses, the results of the final binary logistic regression model constructed to find out the risk factors significantly affecting the presence of a sick child in the family were grouped as risk increasing factors like age (95%CI between 1.002 and 1.122), marriage before 1994 (95%CI=1.081-4.161), and risk decreasing factors like family willingness for screening (95%CI=0.167-0.854), rate of prenatal testing (95%CI=0.147-0.414), age at first pregnancy (95%CI=0.469-0.882); while the frequency of births was found to have no significant effect (p>0.05).
  
  
  CONCLUSIONS
  Besides all legal regulations and applications, time is still needed for real success against such a diffuse and congenitally transferred disease. The education of the target populations appears to be crucial. Official applications should be forced based upon present or future laws.
authors.affiliation: Department of Public Health, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Nazlıcan
authors.affiliation: Projects Departmant, Provincial Health Directorate, Hatay, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Celenk
authors.affiliation: Vice Chancellor, Antakya State Hospital, Hatay, Turkey.
authors.forename: Bayram
authors.initials: B
authors.lastname: Kerkez
authors.affiliation: Department of Public Health, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Demirhindi
authors.affiliation: Department of Public Health, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Muhsin
authors.initials: M
authors.lastname: Akbaba
authors.affiliation: Projects Departmant, Provincial Health Directorate, Hatay, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kiremitçi
keywords: Haemoglobinopathies; Mediterranean; Turkey; birth; prenatal diagnosis