Two years of premarital screening program for hemoglobinopathies in Karbala, Iraq; Outcome and options for improving the program.

Background: Thalassemia and sickle cell disease are common autosomal recessive disorders and are the most widespread single gene disorder that considered important public health problems. Premarital screening is important step in prevention of hemoglobinopathies. Aim: to evaluate the outcome of 2 years of the premarital screening program in Karbala and options to improve that program. Methods: A descriptive cross-sectional study by assessment of 2 years of premarital screening in Karbala Blood Disease Center started from January 2019 till December 2020. Total number of individuals screened for hemoglobinopathies in that period was 1306 (653 couples) referred from five marital clinics, Complete blood count was done for all screened couples. Results: The bulk number of tested individuals was in 2019 because of the corona pandemic, nearly half of those couples were relatives, the majority was referred from Al-Husseini hospital, about 5% of these marriages were contraindicated to be accomplished and 3 % were cautious. β-Thalassemia minor was the main type of abnormal hemoglobinopathies discovered. Conclusion: Some risky marriages were prevented by doing the premarital screening but still we need other concerted efforts to improve the outcome of the program.