A Comprehensive Evaluation of Premarital Screening Program in Basrah (2020-2025): Statistical Trends, Genetic Counseling Impact, and Infrastructure Readiness
Keywords:
Premarital Screening, Thalassemia, Genetic Counseling, Infrastructure Readiness, Marriage Cancellation, Basrah, Iraq, Public HealthAbstract
Premarital screening (PMS) is a vital preventive strategy for managing hereditary blood disorders and infectious diseases. In Basrah, despite the program's long-standing implementation, the gap between clinical diagnosis and behavioral change remains a significant challenge. This study evaluates the effectiveness of the PMS program in Basrah (2020–2025), focusing on statistical trends, infrastructure readiness, and the impact of genetic counseling on the decision-making of high-risk couples. A multi-dimensional approach was employed, including a longitudinal analysis of 252,361 individuals (2020–2024) and a detailed cohort study of 58,034 participants in 2025. Data collection involved automated extraction from electronically linked centers and manual verification from peripheral outlets, supplemented by telephone interviews with high-risk couples. The findings revealed a 33% increase in screening volume over five years. In 2025, the prevalence of Thalassemia and Sickle Cell traits was 2.2% and 3.4%, respectively. Infrastructure assessment identified a technological divide, with 40% of centers still relying
on manual entry systems. In 2025, follow-up with high-risk couples revealed that 76.9% (176 couples) proceeded with marriage despite intensive counseling, while 23.1% (53 couples) chose to cancel their marriage plans. This reflects a growing but still limited impact of genetic counseling on behavioral change due to the late timing of the screening. While the program demonstrates high diagnostic efficiency, its preventive impact is severely hindered by socio-cultural pressures and late-stage testing. The study advocates a strategic shift toward routine school-based screening for adolescents to ensure early genetic awareness. Additionally, it recommends full digital integration of all centers and the establishment of a judicial requirement for intensive counseling for high-risk cases.
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