Pre-marriage/Prenatal Diagnosis, Prevention, and Control of Thalassemia in Iran’s Fars Province

Thalassemia is an inherited disorder, passed from parents to children through defective hemoglobin genes. It occurs most often in people of Italian, Greek, Middle Eastern, southern Asian and African ancestry. With increasing migration rates from these regions to North America, there are now established centers in the US to deal with this disorder. Many countries with high incidence rates of Thalassemia have also taken preventive measures to control and or manage this disorder. Iran, with relatively high prevalence rate of Thalassemia, has implemented integrated strategies/innovative public policy aiming at controlling Thalassemia in the newborns. This study focuses on one of these strategies, the requirements by the Family Laws that all individuals intending to marry must undergo Thalassemia-related screening and they must receives either clearance, or if diagnosed with disorder, be empowered with pertinent knowledge, prior to obtaining marriage license from designated officials in districts and provinces. With a retrospective approach, this study reviewed 71761 would be couples who formally applied for marriage licenses in 2007. Four hundred thirty three were identified as Thalassemia carriers (347 would be couples were carriers for sure and 86 couples needed further screening). Analysis indicates that from among the 433 couples: 35.1% decided not to get married, 55.4% got married and 9.5% did not show up. From among the 347 would be couples identified as the carrier for sure: 36.6% decided not to get married, 51.9% got married, and 11.5% did not show up. And from among the 86 couples who needed further testing: 29% did not marry, 69.8% married and the rest did not show up. The remaining segment of this presentation deals with how 27 genetic centers operating in the Fars Province (southern Iran) are equipped to deal with Thalassemia-related disease prevention and health education/promotion aspects of the matter at hand (including some 88 legal abortions in a country that has made abortion illegal under normal circumstances). With only 2 documented cases of Thalassemia in 2007 (while the figure prior to implementing the current strategies were 200 cases), this paper concludes that integrated social policies combined with proactive preventive measures, and sound public health practices, can indeed reduce human suffering significantly.