Five-year evaluation of premarital screening program for hemoglobinopathies in the province of Mersin, Turkey.

The prevalences of hemoglobin S (HbS) and β-thalassemia (β-thal) are high in Mersin, Turkey. In this study, the results of a five-year premarital screening program in Mersin province are reported. A total of 79,000 persons including 31,498 couples were screened in this program. Hematological analyses and electrophoresis were done to identify carriers. The results were given confidentially and at-risk couples were counselled on reproductive options and prenatal diagnosis. The carrier rates of hemoglobins (Hb) (HbS, HbD, HbE) and of β-thal were 1.21%, 0.17%, 0.04% and 2.04%, respectively. One hundred and thirty-four couples were at-risk, of whom 67.2% had health insurance. Twenty-seven couples did not become pregnant, six were divorced and 11 could not be reached. Of the 135 pregnancies, 80 had prenatal diagnosis. Five stillbirths occurred, and 18 homozygous babies were born to couples that did not seek prenatal diagnosis. Two families with prenatal diagnosis had affected babies: one was a late referral and the other due to religious reasons. For a successful screening program, emphasis must be on extensive and intensive informative programs for the public as a whole. Prenatal diagnosis should be offered free of charge as a basic public service. For a healthy population, knowledge and a shared responsibility between the public and the government are necessary.