Attitude toward prenatal diagnosis and difficulties of abortion for beta thalassaemia in Bangladesh

Author(s): Abdul Aziz

β-thalassaemia is the most common genetic disorder among different ethnic groups in which majority are muslim in Bangladesh. The prevalence of β-thalassaemia trait and Hb-E b 4.1% and 6.1% respectively. It is estimated that about more than 14000 children are born annually with thalassaemia. This study, the first in Bangladesh, aims to evaluate the view of point of acceptability about prenatal diagnosis among parents who have a child or children with β-thalassaemia major or Hb-E β-thalassaemia as well as difficulties of abortion due to socio demographic factors. A pre-structured questionnaire was distributed to parents of children with beta thalassaemia major and Hb-E β thalassaemia. To complete this survey 95.7% respondent had given response. Out of 230 respondents, the majority (215/93.5 %) were agreeable for prenatal diagnosis, but only 171 (74.4 %) agreed to both prenatal diagnosis and abortion followed by termination of affected foetuses. The main reason of declined abortion was religious restriction 52.3% and economic problem 42.7% and their religious background and economical background were a significant factor (p = 0.001) and (P=0.003). Majority of the participants were Muslim (85.9%) compared to Hindus (12%), Christians and others (2.1%). Gender, age, highest education level and number of thalassemic children were non-significant predictors in decision-making regarding abortion. The acceptance rate for termination of foetuses with β-thalassaemia major and Hb-E β thalassaemia in Bangladesh is low especially among the Muslims due to religious non-permissibility, low economic situation and not getting support by gynecologists and obstricians for abortion especially if diagnosis is late. Therefore, strong counseling and economic support of authorities are needed among Muslim religious individuals as well as poor people to do successful prevention programme.