Stop Demographic-Based Health Disparity in Down Syndrome Screening. A Cross-Sectional Study Among Muslim Women Found Awareness of Screening Is Associated with A Favorable Attitude Toward Testing.

Abstract Objective There is a general assumption that Muslim women refuse Down syndrome screening, and therefore, many health practitioners do not offer it or briefly discuss it with their patients. This study aims to objectively assess women's awareness, knowledge, and attitudes toward Down Syndrome screening (D.S.S) in a Muslim-majority population. Methods We conducted a cross-sectional study among attendees of antenatal clinics at a major university hospital in Saudi Arabia, aiming for a sample size of at least 385. A semi-structured questionnaire assessed generic and specific awareness and knowledge of D.S.S (14 items) and attitudes (4 items). The knowledge and attitudes scores were calculated using a five-level agreement Likert-type scale. Results Of the 434 participants, 178 (41.0%) reported awareness of D.S.S. Factors associated with increased awareness were maternal age above 40 or under 30, nulliparity, and extended family history of D.S. (P value = 0.03,0.015, and 0.017, respectively). Recognized tests were ultrasound measurement of nuchal translucency (71.9%) and first-trimester serum screening (58.4%). The sources of knowledge were obstetricians (53.9%), followed by family and friends (27%). The mean overall knowledge score was 53.9 ± 8.7 out of 70, and the mean attitude score was 17.4 ± 2.9 out of 20. Having (1–2) children is associated with a higher knowledge score, and most participants who reported awareness of D.S.S. (51.7%) had a favorable attitude toward screening. Conclusion Awareness of D.S.S. is associated with favorable attitudes towards testing, contradicting the general assumption highlighting the need for systematic education to increase testing uptake.