Prevalence of beta-thalassaemia knowledge, attitude, practices and associated factor among high risk families coming to six facilities in Karachi, Pakistan
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Beta-thalassaemia poses an increasing problem for the Mediterranean region, especially Pakistan. The aim of the present study was to assess the proportion of adequate knowledge, positive attitude, correct practices and associated factors in high-risk families of Karachi, Pakistan. Methodology Using stratified sampling, a cross-sectional survey was carried out at six facilities of Karachi. We administered 360 questionnaires to parents attending these centers for regular treatment of their children. A scoring system was developed for all the three outcomes under study, by keeping in view W.H.O guidelines. Findings: The proportion of adequate knowledge, positive attitude and correct practices were not satisfactory among these high-risk families. The proportion of adequate knowledge came out to be 27%, 95% CI (24%, 30%), proportion of positive attitude was 29%, 95% CI (24%, 33%), and proportion of positive practices was 13%, 95% CI (10%, 17%). An important finding of this study is the prevalence of consanguineous marriages among these parents, which was 79%, 95% Cl (75%, 82%). Multiple logistic regression analysis was used to identify the factors associated with three outcome variables. For adequate knowledge as outcome variable, the significant associated factors were father's education above matric (Adjusted OR: 2.0; 95% CI: 0.9, 4.2) and an interaction between number of thalassaemic children and mother's education. For positive attitude as outcome variable, the significant associated factors were mother's education above matric (Adjusted OR : 4.0; 95% CI: 1.9, 8.2) and presence of only one thalassaemic child in the family (Adjusted OR: 1.5;95% CI: 0.9, 2.5). TV For correct practice as outcome variable, the significant associated factors were mother's education up to matric (Adjusted OR: 1.9; 95% CI: 0.9, 3.9) and mother's education above matric (Adjusted OR: 5.0; 95% CI: 1.6, 14.8). Another significant factor was per capita income, parents with income category of Rs. 501-1500 (Adjusted OR: 2.2 95% CI 1.0, 4.8) and income category >1500 (Adjusted OR: 3.5; 95% CI: 1.2, 10.2), taking Rs. < 500 as reference. Conclusions: The levels of knowledge, attitude and practices were not satisfactory among high-risk families coming to six centers of Karachi, There is a gear need for increasing the level of education among these high-risk families, which would have an indirect impact on decreasing the number of new thalassaemic births. Educating these couples for prevention of thalassaemia (genetic counseling) is an issue which could be addressed and further explored. Improving education can increase the levels of knowledge and attitude among these families but for prevention to be effective there would always be a problem of financial accessibility. Carrier screening and prenatal diagnosis should be made available to these families at subsidized rate or free of cost, enabling them to practice prevention effectively.
Lasi, S. Z. (2003). Prevalence of beta-thalassaemia knowledge, attitude, practices and associated factor among high risk families coming to six facilities in Karachi, Pakistan (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.