Prevalence and factors associated with premarital sickle cell screening among couples at the different religious institutions in Kampala District: a cross-sectional study.

Abstract

Introduction: Premarital screening provides an opportunity for intending couples to know their phenotype or genotype and be aware of the risk of having children with genetic diseases like sickle cell disease (SCD) and adopt rational preventive measures. Objectives of the study: To determine the prevalence and factors associated with premarital sickle cell screening (PMSCS) among couples at the different religious institutions in Kampala district. Methods: A cross-sectional study was conducted that comprised 246 couples (492 participants) at the different religious institutions in Kampala district. The religious institutions were selected from each of Uganda's 6 main domains, including Anglican, Catholic, Muslim, Adventist, Orthodox and Pentecostal. Questionnaires were used to collect the data from the couples. The data was entered into the Epidata manager and exported to STATA for further analysis. The outcome of interest was testing together for sickle cell trait (SCT) denoted with a “Yes” or “No”. Logistic regression was used to analyze the data and to assess the association of the independent variables with PMSCS while adjusting for clustering at religion and place of worship. Results: PMSCS prevalence among couples at different religious institutions was 14.6% (95% CI 7.3 - 26.4). Having been in marriage counselling sessions for more than 3 months (aOR - 3.8, 95% CI 2.3 – 6.3) and assumed the cost of SCD test below 50000shs (aOR - 3.3, 95% CI 1.4 – 7.6) and above 50000shs (aOR – 2.0, 95% CI 0.8 – 2.3) were significantly associated with PMSCS among couples at the different religious institutions in Kampala district. Conclusion: The PMSCS prevalence was found in only about one in every 7 couples which is low compared to what the Ministry of Health (MoH) encourages of every couple screening before marriage. The more time couples spent in marriage counseling sessions and the lower cost of the SCT test were positively associated with PMSCS. The National Disease Control Department under MoH should work hand in hand with different religious institutions to integrate sickle cell screening (SCS) services earlier in couples before they can plan on marriage.