Factors Affecting Premarital Sickle Cell Screening Uptake Among Pregnant Women Attending Antenatal Clinic at Lira Regional Referral Hospital: A Cross-Sectional Study.

Abstract

Background: Sickle cell disease (SCD), a genetic disorder marked by abnormal hemoglobin, poses a significant public health burden globally, affecting 20–25 million 22 people, with a high prevalence and mortality in sub-Saharan Africa where over 300,000 infants are born annually with the disease. Uganda bears the fifth-highest global burden of SCD and ranks first in East Africa. Lira City reports a sickle cell trait prevalence of over 20% and a disease prevalence of 2%. The high teenage pregnancies in the region further underline the need for targeted premarital sickle cell screening. Objective: To determine the level of uptake and factors affecting the premarital sickle cell screening among pregnant women aged 18 to 35 years attending antenatal clinic at Lira Regional Referral Hospital. Methods: A hospital-based cross-sectional study was conducted among 170 pregnant women aged 18 to 35 years attending Antenatal care at Lira Regional Referral Hospital. Sample size was determined using the Kish-Leslie formula, 1965. Systematic random sampling was used to select study participants. Data were collected using a structured questionnaire administered via Kobo Collect and analysed using STATA version 18. Descriptive statistics, binary logistic regression were used at bivariate and multivariate level. Results: Of the 170 respondents, only 14.7% had undergone premarital sickle cell screening. Uptake was significantly associated with having seen a PSCS-related poster (AOR = 7.71, 95% CI: 1.60–37.17) and having visited a health facility specifically for 40 PSCS (AOR = 9.09, 95% CI: 15.54–54.22). Conclusion: The uptake of Premarital Sickle Cell Screening (PSCS) was low at 14.7%, mainly due to limited awareness and poor health-seeking behavior. Exposure to PSCS posters and visits to health facilities were significantly associated with higher uptake. The study recommends increased sensitization and promotion of good health-seeking practices to improve screening rates.