Factors associated with public awareness of the crown health program in the Al-Jouf region

A community-based intervention, the Crown Health Project [CHP], was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics [e.g., age, gender, education, occupation, urban/rural residence] and CHP awareness [its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities]. Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP [odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5], "noncommunicable diseases" as the main diseases targeted [OR, 4.8; 95% CI, 3.6-6.4] and "attention to health" as the purpose [OR, 6.0; 95% CI, 4.0-8.9]. The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf

Six-year outcome of the national premarital screening and genetic counseling program for sickle cell disease and beta-thalassemia in Saudi Arabia

Saudi Arabia has a high prevalence of hereditary hemoglobin disorders. Data has been collected by the Saudi Premarital Screening and Genetic Counseling Program on the prevalence of sickle cell disease and beta-thalassemia but the outcomes were not quantified. We used six years of premarital screening data to estimate the burden of sickle disease and beta-thalassemia over the program period and to assess the frequency of at-risk marriage detection and prevention. Retrospective review, premarital couples attending premarital and genetic counseling clinics with marriage proposals between 2004 and 2009. Blood samples obtained from all couples with marriage proposals between 2004 and 2009 were tested for sickle cell disease and beta-thalassemia. Test results were shared with all examinees and genetic counseling was offered for all at-risk couples. Marriage certificates were issued irrespective of the results and compliance with medical advice was voluntary. Out of all men and women examined, 70962 [4.5%] and 29006 [1.8%] were carriers or cases of sickle cell disease and beta-thalassemia, respectively. While the prevalence of sickle cell disease was constant between 2004 and 2009 [average 45.1 per 1000 examined persons, P=.803], the prevalence of beta-thalassemia steadily decreased from 32.9 to 9.0 per 1000 examined persons [P<.001]. The frequency of at-risk couples decreased by about 60% between 2004 and 2009 [from 10.1 to 4.0 per 1000 examined persons, P<.001]. The frequency of voluntary cancellation of marriage proposals among at-risk couples showed more than 5-fold increase between 2004 and 2009 [from 9.2% to 51.9%, P<.001]. The eastern region had 58% of all detected at-risk marriages and showed the greatest decline in detection and increase in prevention over time compared to other regions of Saudi Arabia. Six years of premarital screening in Saudi Arabia markedly reduced the number of at-risk marriages, which may considerably reduce the genetic disease burden in Saudi Arabia in the next decades