Factors influencing knowledge, perception and attitude towards premarital Sickle cell disease screening among pregnant women attending antenatal clinic at Muhimbili National Hospital

Abstract

ABSTRACT Background: Tanzania has a high burden of Sickle Cell Disease, with approximately 11,000 babies born with Sickle Cell Disease (SCD) each year, ranking 5th in the world. This calls for effective premarital screening to reduce this burden. However, limited data exist on factors influencing pregnant women's knowledge, attitudes, and perceptions toward premarital screening (PMS) for sickle cell disease. Objective: The study aimed to assess factors influencing knowledge, perception, and attitude toward premarital sickle cell disease screening among pregnant women attending the antenatal clinic (ANC) at Muhimbili National Hospital (MNH). Material and Methods: This was a cross sectional study whereby 400 pregnant women were recruited from December 2023 to January 2024. Structured questionnaire was used to collect socio demographic, obstetric characteristics associated with knowledge, attitude and perception reagarding premarital SCD screening. Multivariable logistic regression was conducted to identify independent factors associated with knowledge, perception and attitude towards premarital screening for sickle cell disease. Results were reported using Odds Ratio (OD). A p-value of less than 0.05 was considered significant. Result: The mean age of participants was 29 years (SD ± 6.2) and 48% of pregnant women were aged 26-35. The proportion of women with adequate knowledge was 6.5%, positive perception 68.7% and positive attitude 68.0% towards premarital screening for sickle cell disease. The multivariate regression analysis shows, college education (OR=3.0, 95% CI=1.46-6.19), secondary education (OR=2.26, 95% CI=1.10-4.64), are associated with a positive attitude towards PMS. Positive perceptions of PMS are associated with being employed (OR=2.42, 95% CI=1.21-4.86). Conclusion: The study identified a significant knowledge gap of PMS for SCD screening among pregnant women. Education and employment status influenced attitude and perception. Improving education and opportunities for work will enhance knowledge, perception and attitude for PMS.