Prevention they say is better than cure. Can you imagine living in a world that is disease-free? Doing what is recommended to reduce the spread of diseases is applaudable. Thus, focusing on preventive medicine is vital in life because it stops or reduces the rate of increase of a particular disease. 

One of the most important strategies for the prevention of genetic disorders and infectious disease is premarital screening. This is defined as testing couples who are planning to get married for some common genetic blood disorders ( mainly hemoglobinopathies e.g thalassemia and sickle cell anemia) and infectious diseases ( hepatitis B, Hepatitis C, and HIV/AIDS). This is important because it will reduce or prevent the spread of the disease to the spouse and to their unborn babies. 

GENETIC DISORDERS

The most common is β-thalassemia and sickle cell anemia. β-thalassemia is an inherited blood disorder where the production of the main component of blood is reduced.  Couples who are carriers can transmit to their unborn babies.  This child will have the tendency to always having low blood levels. 

Sickle cell anemia is the most common and the test is done in nearly all countries as one of the most important tests. It is a genetic disorder where the blood cells have but sickled (curved-moon) shapes instead of circular shapes. This type of blood is easily destroyed thereby causing the child to always have a shortage of blood, infection, and other complaints like severe pain. In such a case, If a test is carried out, the results could either be AA (no traits of sickle cell, normal gene), AS ( some traits of the sickle cell), or SS ( sickle cell patient). 

Recommendations for couple testing

AA + AA=NO SICKLE CELL DISEASE

AS + AA= HIGHLY RECOMMENDED

AA + SS=RECOMMEND

AS + AS= NOT RECOMMENDED

AS + SS= HIGHLY NOT RECOMMENDED

SS + SS= DO NOT EVEN TRY.

The majority of the problem is seen in couples who are AS and AS. This is because they have only the traits and don’t present with symptoms of pains, shortage of blood, and recurrent infections. So they have a 25% chance of having children with sickle cell disease. On another hand, all the children can be born with the disease or only some of them can have the disease. Again, in very few cases, all the children can be fine. So, this test is very important for all couples; those who have children already and are planning to have more children because this last child might just be within this 25%. So, go and do your test even when you have healthy children. Just do it for the sake of the children so that they should not experience future misfortunes.

We should note that the sickle cell test is different from the blood group test. The blood group is not really compulsory to do but it’s important to know in case of an emergency. That is to know if your spouse will be able to donate blood in an emergency situation and also important during pregnancy. 

INFECTIOUS DISEASES

Hepatitis B, Hepatitis C, HIV/AIDS, and sexually transmitted infections are the most common infectious diseases screened before marriage.

Hepatitis B and C are viral infections of the liver which in the long run can lead to cancer of the liver or hardening of the liver and thus liver failure. If one partner is infected with hepatitis B, the other partner has to take the 3 doses of the vaccine in order to stay protected. But with hepatitis C, there is no vaccine available yet. Proper follow-up is therefore needed to know how active the virus is before placing the person on medications.

Nowadays, it is very possible to have a couple with one partner HIV positive and the other negative and they have a child who is negative. For this to happen, certain conditions have to be met. The person must be adherent to the antiretroviral, the viral level should be very low that is not detected and proper use of condoms to ensure safe sex. But if pregnancy is desired, an ovulation planned sexual intercourse is advised; that is unprotected sex during the fertile period.

For sexually transmitted infections, syphilis, chlamydia, and gonorrhea are the most common. Infections with these STIs have long-term effects on the sexual reproductive organ causing infertility and chronic lower abdominal pains. So if diagnosed early, treatment is administered immediately and by so doing complications might be prevented.

The first step to healthy living and a healthy family is for you to know your status. This will help decrease the spread of the disease and decrease the financial and psychological burden placed on any victim.

Thanks

DR GWANYAMA NOELLA MBUSA (Founder of Talk Pregnancy with Dr. Noella)