University students' knowledge, attitudes, awareness and practices (Pre-KAP) regarding thalassemia in a carrier screening campaign in Bangladesh

University students' knowledge, attitudes, awareness and practices (Pre-KAP) regarding thalassemia in a carrier screening campaign in Bangladesh | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article University students' knowledge, attitudes, awareness and practices (Pre-KAP) regarding thalassemia in a carrier screening campaign in Bangladesh Anamika Sarker, Himel Datta, Md Masuk Ur Rashid, Rubiat Afrin Ayon, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8496807/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction Thalassemia is the most common inherited hemoglobin disorder in the world. A thalassemia carrier is a recessive condition carrying one of the faulty genes that cause thalassemia. There is a 25% probability in every pregnancy of having this life-threatening disorder in a child. This study aims to investigate university students' knowledge, attitudes, awareness and practices towards thalassemia by conducting a pre-KAP study in a thalassemia carrier screening campaign in Bangladesh. Methods A cross-sectional descriptive study was conducted at Jahangirnagar University, Bangladesh, from January 2021 to March 2021. The study involved 290 university students participating in a thalassemia carrier screening campaign, who completed a self-administered questionnaire about thalassemia. Results The pre-KAP study showed that 82.69% of students were familiar with thalassemia, but 76.47% of students answered incorrectly that thalassemia spreads through blood. More than 90% of the students (93.77%) believed that premarital screening is necessary to reduce the occurrence of thalassemia, and (92.73%) believed that raising social awareness for thalassemia is important. There were no notable distinctions between male and female participants in terms of their knowledge, attitudes, and practices regarding thalassemia. Conclusions The findings indicate a critical deficit in accurate, specific knowledge despite general familiarity with the disease. his highlights the urgent need for targeted, evidence-based health education campaigns within academic institutions to correct misconceptions and empower future generations to make informed decisions about their health. Thalassemia pre-KAP study attitudes blood disorder awareness practices & university students Figures Figure 1 Introduction Thalassemia is a hereditary abnormality marked by measurable deficits in globin chain production 1 . It is a genetic blood condition that results in anemia due to accelerated red blood cell disintegration 2 , 3 . This genetic blood condition has a high prevalence in the so-called "thalassemia belt," which includes Southeast Asia, the Indian subcontinent, the Mediterranean, and the Middle East. 4 , 5 . Given its significant public health burden, a comprehensive understanding of its transmission dynamics and preventive strategies is essential 6 , 7 Thalassemia affects 1–5% of the world's population as carriers 5 . In Bangladesh, thalassemia poses a considerable health challenge, highlighting urgency for effective prevention and management strategies 8 . A report of The World Health Organization (WHO) in 1980 says that approximately 3% of the population are carriers of beta-thalassemia and 4% have hemoglobin E (Hb-E) 8,9 . More recent data from a study on Bangladeshi school children indicated even higher carrier rates, at 4.1% for beta-thalassemia and 6.1% for Hb-E. 9 The birth of a child with thalassemia major, a life-threatening condition, can only be prevented by identifying carriers and advising against marriage between two carriers 8 , 10 The effective control of genetic disorders such as thalassemia depends heavily on public awareness and engagement, underscoring the investigation of Knowledge, Attitudes, and Practices (KAP) a crucial approach 4 , 11 . KAP studies have been instrumental in designing and implementing successful public health interventions for various chronic and genetic conditions, including diabetes 12 and hypertension, 13,14 by identifying gaps in understanding and addressing behavioral barriers. 15 Despite the high prevalence of thalassemia in Bangladesh, there is a notable scarcity of comprehensive research on the KAP of the general population regarding this condition 11 This study builds upon previous work by the authors, which focused on a more limited sample of biological faculty students at Jahirnagar University 11 . The current research expands this investigation to a broader student body across various faculties who participated in a thalassemia carrier screening campaign. By targeting university students, who are poised to become future community leaders, this study aims to create a ripple effect of awareness 11 . The findings provide critical insights into the existing knowledge gaps and positive attitudes, which can inform the development of more effective and targeted public health interventions to mitigate the incidence of thalassemia in Bangladesh 11 Methodology Study Design and Participant Selection This study utilized a cross-sectional descriptive design to evaluate the Knowledge, Attitudes, and Practices (KAP) of Jahangirnagar University students who voluntarily consented to thalassemia carrier screening in our laboratory. Previously, we conducted a pre-KAP study among 911 students of the Biological Faculty of Jahangirnagar University, which generated a positive response among students to learn more about thalassemia, and we were able to encourage them to join our Thalassemia carrier screening campaign 11 . In 2021, due to a substantial positive response, 290 participants from various faculties, beyond the Biological Faculty included in our previous study, volunteered for thalassemia carrier screening. The study population comprised all students at Jahangirnagar University, estimated at 14,000 individuals. To determine a scientifically justified sample size, the standard formula for cross-sectional studies was used 16 : \(\:{n}_{\theta\:}=\frac{{z}^{2}\cdot\:\rho\:\cdot\:\left(1-P\right)}{{e}^{2}}\) where Z = 1.96 for 95% confidence, p = 0.5 (assumed proportion for maximum variability), and e = 0.05 as the margin of error. This calculation yielded an initial sample size of 384 participants. Applying the finite population correction for N = 14,000 resulted in an adjusted sample size of approximately 374 students 17 . Due to voluntary participation in the screening campaign, the final sample comprised 290 students, corresponding to a margin of error of approximately 5.7% , which remains acceptable for a descriptive KAP study. The following inclusion and exclusion criteria were applied: Inclusion Criteria : Individuals admitted to any department of Jahangirnagar University within the past 5–6 years and aged 18 years or older. Exclusion Criteria : Individuals unwilling to participate, those who did not provide written informed consent, or participants with incomplete questionnaire responses. Data Collection All participants provided written informed consent and completed a questionnaire covering demographic information, anthropometric variables, and hematological and biochemical parameters. 18 19 They also completed a self-administered questionnaire concerning thalassemia under the supervision of qualified students, which consisted of five sections including personal information, knowledge, attitudes, practices, and awareness regarding thalassemia. 20 The first section covered personal information such as age, sex, academic background, home district, marital status, religion, and family history of thalassemia 21 . The knowledge section consisted of six multiple-choice questions covering the understanding of thalassemia. The attitudes section was assessed through three multiple-choice questions, evaluating beliefs about thalassemia screening and marriage. The practices section assessed participants' views on informing others about thalassemia and encouraging blood donations for patients through three multiple-choice questions 22 .The awareness section consisted of five multiple-choice questions, evaluating participants' knowledge about the causes and consequences of thalassemia 23 . Statistical Analysis Descriptive statistics were used to summarize demographic data 24 . Normality testing was conducted using the Shapiro–Wilk test and Kolmogorov–Smirnov test , depending on sample size and data distribution 25 . Data were analyzed using SPSS version 19.0 (IBM Corporation, Armonk, New York, USA) and Microsoft Excel. Chi-square ( χ 2 ) analyses were used to evaluate the statistical significance of differences in categorical data 26 . Results were considered statistically significant with a p -value less than 0.05 27 . Ethical Approval The study protocol was approved by the Biosafety, Biosecurity and Ethical Committee of Jahangirnagar University, with the ethical approval reference number BBEC, JU/M 2022 (3) 2 18 . All participants provided written informed consent, and their privacy was strictly maintained throughout the study 28 . Participation was entirely optional 18 . Results The study involved a total of 290 participants, of which 289 responded and agreed to sign the consent form. One participant was excluded from the study due to incomplete responses. The study population consisted of 196 male participants (67.82%) and 93 female participants (32.17%) (Table 1). In terms of personal and family history of thalassemia, 1 participant (0.34%) gave a positive response, indicating that they had a personal and family history of Thalassemia. In this study, we explored the study population's understanding of thalassemia. As shown in table 2, it was found that 82.69% of participants had heard of the term thalassemia before, with 79.59% of male participants and 89.25% of female participants having prior knowledge. 15.92% of participants were unaware of the disease. 76.47% of students answered that thalassemia is spread through blood, while 18.34% thought it was spread through semen. 84.08% of participants correctly identified a connection between the disease and marriage, while 14.88% gave incorrect answers. Over 50% of participants were not aware of the treatment for thalassemia, and 29.41% of students knew someone affected by the disease. No significant differences in knowledge about thalassemia were evident between male and female participants (Table 2). To evaluate the study group's attitudes toward thalassemia, the questionnaire included several questions on topics such as the necessity of thalassemia screening before marriage, the importance of parental screening before pregnancy, and the approach to take upon discovering that a newborn is affected by thalassemia. As shown in table 3, the majority of students (93.77%) believed that premarital screening was necessary to prevent thalassemia, while 5.88% did not support this idea. 92.38% of students supported prenatal screening of neonates if the parents were carriers of thalassemia, while 4.84% did not. 62.63% of participants thought they would give birth to an affected neonate after screening, while 27.68% believed that abortion was the best way to prevent thalassemia. There was no significant difference between the male and female participants' attitudes towards thalassemia (Table 3). Top of Form The questionnaire included several questions to assess the study population's awareness of thalassemia, such as whether it is a blood disorder, if it can result from malnutrition, if it can be caused by marriage between blood relatives, the importance of raising social awareness for thalassemia, and whether patients require lifelong blood transfusions.71.28% of participants believed that thalassemia is only a blood disorder, while 27.33% did not. 79.93% of students responded negatively when asked if thalassemia was caused by malnutrition, while 15.22% responded positively. 77.16% of participants agreed that thalassemia can be caused by marrying between blood relatives, while 17.30% did not. 92.73% of students thought that raising social awareness for thalassemia is important, but 3.11% did not. 85.81% of students thought that thalassemia patients need blood transfusion throughout their life, while 8.99% responded ‘no’. No significant difference in awareness between male and female participants was evident (Table 4).Top of Form While assessing the practice of the study population regarding thalassemia, most participants (77.85%) were willing to inform others about the consequences of thalassemia, while 1.73% were not. 75.43% of participants knew that blood transfusion was the main treatment for Thalassemia, while 18.68% did not. 89.96% of participants would encourage others to give blood to a thalassemia patient, and 5.88% would not. There was no significant difference in the responses related to the practice of thalassemia between male and female participants (Table 5). Discussion This study provides insights into the knowledge, attitudes, and practices of university students participating in a carrier screening program for thalassemia in Bangladesh. In February of 2021, we launched a comprehensive initiative that combined a carrier screening program with an awareness campaign targeting university students to enhance their understanding of thalassemia. The aim was to educate them about the genetic nature of the disease and its potential impact on their conjugal life and future generations if both partners are carriers. We encouraged student participation in the campaign and testing for carrier status. Blood samples were collected at our laboratory for screening. Our study revealed that the majority of students (82.69%) were aware of thalassemia, and 84.08% believed it was related to marriage. However, 76.47% of students held the false belief that the disease spreads through blood. Only 50% of the students had adequate knowledge about the treatment of thalassemia. The results indicated that the overall understanding of thalassemia among university students was unclear. The study found that a higher percentage of female students (89.25%) compared to male students (79.59%) had heard about thalassemia, which is consistent with findings from studies conducted in Iran 29 and Bahrain 30 . Our study revealed a higher level of understanding about thalassemia among university students compared to a study conducted in Bahrain among university students, professionals, and married individuals 30 . In our study, 93.77% of students believed that premarital screening is necessary to reduce the incidence of thalassemia, and 92.38% felt that prenatal screening was important before pregnancy. However, a previous study in Bangladesh reported a poor understanding of thalassemia that led to negative attitudes 8 . In Oman, sociocultural factors such as fear of test results, embarrassment, marriage cancellations, and others contributed to the poor response to carrier screening 31,32 . Negative attitudes towards carrier screening in Pakistan were influenced by factors such as fear of rejection, a potential increase in abortion rates, and stress 33 . In our research, 77.85% of students showed a willingness to educate others about the consequences of thalassemia, and 89.96% said they would encourage others to donate blood to thalassemia patients. A previous study in Bangladesh found that 60.8% of college students were willing to donate blood to thalassemia patients, while 39% either declined or were uncertain about donating blood 34 . Our study aimed to increase awareness of thalassemia among university students so they could learn about the disease and its carrier form before entering into a safe relationship or marriage. A study by Hossain et al. focused on increasing awareness of this disease among college students 34 . Since there is no appropriate treatment for thalassemia besides blood transfusion, carrier screening, and increased knowledge before marriage are the only protective actions to reduce its frequency across generations. Previous studies have shown that a significant proportion of respondents knew that thalassemia is a hereditary disease, such as 60.05% in a study conducted at Kolkata Tertiary Care Hospital 35 and 82.6% in a study in Pakistan 36 . However, our research found that 71.28% of participants believed that thalassemia is a blood disorder only. Our study also showed that 92.73% of students felt that raising awareness about thalassemia is important, which is similar to a study in Saudi Arabia where 92.9% of Taif University students agreed to contribute to raising awareness about the importance of premarital screening 37 . In 1975, Silverstroni and the team in Latium, Italy, started the first pre-marriage thalassemia screening as part of a school-based preventive initiative 38 . During the 1970s, screening programs were established across Canada, Cyprus, Greece, Italy, and the UK. However, due to low literacy rates and limited knowledge and awareness in Bangladesh, the success of thalassemia prevention is hindered. To address this, mandatory screening policies are necessary in Bangladesh. Limitations of the Study The findings of this study should be interpreted in light of certain limitations. their First, it relied on a convenience sample of students who voluntarily joined the carrier screening, which may not represent the wider student body or general population. Their positive attitudes might be a consequence of their decision to participate 34 . Second , the cross-sectional design captures a single point in time and does not allow for the establishment of causal relationships or the tracking of changes in KAP over time 39 . Finally, the use of a self-administered questionnaire may have introduced social desirability bias, potentially inflating favorable responses 40 . Conclusions The findings of this study indicate that university students in Bangladesh lacked sufficient knowledge about thalassemia particularly regarding the hereditary nature of the disease, with many respondents incorrectly perceiving it as blood-borne. These gaps reflect limitations in existing public health communication and emphasize the importance of more personalized interventions. . However, university students demonstrated strong support for preventive measures, including premarital and prenatal screening which provide a unique opportunity to advance national strategies. To mitigate these challenges, it is recommended to implement targeted educational campaigns emphasizing the genetic nature of thalassemia, advocate for mandatory premarital screening policies,²¹,²² and integrate accessible genetic counseling services for carriers and affected families. Through dispelling prevalent misconceptions and capitalizing on favorable attitudes, Bangladesh has the potential to achieve meaningful reductions in the future burden of thalassemia. Abbreviations WHO World Health Organization Pre-KAP Pre-Knowledge, Attitude, Awareness and Practice Declarations Ethics approval and consent to participate The study protocol was approved by the Biosafety, Biosecurity and Ethical Committee of Jahangirnagar University and written informed consent was obtained from all participants. Privacy was ensured, and participation was made optional. Consent for publication All authors have read and approved the manuscript. Competing interests The authors declare that they have no competing interests. Funding This work was funded by the GARE (Grant for Advanced Research in Education), Education Ministry, Bangladesh (Grant LS20191009), and the University Grant Commission research grant (2020-2021). Acknowledgements The authors gratefully acknowledge the support of the Department of Biochemistry and Molecular Biology Jahangirnagar University, Savar, Dhaka 1342, for the support to conduct this research. References M A, S L, Thalassemias An Overview. Int J Neonatal Screen 5 (1). https://doi.org/10.3390/ijns5010016 Settin A, Al-Haggar M, Neamatallah M, Elsaid A (2006) Detection of Beta-Thalassaemia Mutations Using Primer-Specific Amplification Compared to Reversed Dot Blot Hybridization Technique in Egyptian Cases; https://www.researchgate.net/publication/221705004 Weatherall DJ, Clegg JB (2001) The Thalassaemia Syndromes. 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World Family Med J /Middle East J Family Med 19(8). https://doi.org/10.5742/MEWFM.2021.94106 Choudhury O, Dubey A, Saraswathy KN, Deb R, Ranjan R, Arora JS, Murry B, Mitra RP, Devi NK (2025) Knowledge, Attitude, and Practices of Beta Thalassemia: A Cross-Sectional Study among Young Adults in Delhi-NCR, India. BMC Public Health 25(1):2807. https://doi.org/10.1186/s12889-025-24065-5 Adams SA (2005) The Effect of Social Desirability and Social Approval on Self-Reports of Physical Activity. Am J Epidemiol 161(4):389–398. https://doi.org/10.1093/aje/kwi054 Tables Table 1: Gender distribution of participants in the pre-KAP study Gender Respondents (n%) Female 93 (32.17) Male 196 (67.82) Total 289 (100.0) Table 2: Knowledge of participants in a carrier screening program about thalassemia (n=289) Knowledge items n (%) χ 2 p Total (n=289) Male (n=196) Female (n=93) Have you heard the term thalassemia before? Yes 239 (82.69) 156 (79.59) 83 (89.25) 2.960 0.085 No 46 (15.92) 36 (18.37) 10 (10.75) Do you know how this disease spread? Blood 221 (76.47) 144 (73.47) 77 (82.79) 0.4128 0.521 Semen 53 (18.34) 37 (18.87) 16 (17.20) Is there any connection to this disease with marriage? Yes 243 (84.08) 164 (83.67) 79 (84.95) 3.812e-005 0.995 No 43 (14.88) 29 (14.79) 14 (15.05) Do you know the treatment of thalassemia? Yes 110 (38.06) 78 (39.79) 32 (34.41) 1.089 0.297 No 174 (60.21) 113 (57.65) 61 (65.59) Do you know any thalassemia patient(s)? Yes 85 (29.41) 62 (31.63) 23 (24.73) 1.324 0.250 No 203 (70.24) 134 (68.37) 69 (74.19) What is your relationship with the patients? Parents 3 (1.04) 2 (1.02) 1 (1.07) 1.108 0.775 Cousins 4 (1.38) 2 (1.02) 2 (2.15) Neighbors 7 (2.42) 4 (2.04) 3 (3.22) No relation 224 (77.51) 155 (79.08) 69 (74.19) Statistical significance at a p less than 0.05 Table 3: Attitude of participants in a carrier screening program towards thalassemia (n=289) Attitudes n (%) χ 2 p Total (n=289) Male (n=196) Female (n=93) Do you think that thalassemia screening is necessary before marriage? Yes 271 (93.77) 186 (94.89) 85 (91.39) 0.7083 0.400 No 17 (5.88) 10 (5.10) 7 (7.52) Do you think prenatal screening of neonatal is important before pregnancy, if parents are thalassemia carriers? Yes 267 (92.38) 184 (93.87) 83(89.25) 0.1325 0.716 No 14 (4.84) 9 (4.59) 5 (5.37) What should you do when you find that the neonatal is thalassemia-affected after screening? Give birth 181 (62.63) 126 (64.29) 55 (59.14) 0.2223 0.637 Abortion 80 (27.68) 58 (29.59) 22 (23.66) Statistical significance at a p less than 0.05 Table 4: Awareness of the participants in a carrier screening program about thalassemia (n=289) Awareness n (%) χ 2 p Total (n=289) Male (n=196) Female (n=93) Is thalassemia only a blood disorder? Yes 206(71.28) 137 (69.89) 69 (74.19) 1.263 0.261 No 79 (27.33) 58 (29.59) 21 (22.58) Is thalassemia caused by malnutrition? Yes 44 (15.22) 32 (16.33) 12 (12.90) 0.3243 0.569 No 231 (79.93) 158 (80.61) 73 (78.49) Can thalassemia be caused by marrying between blood relatives? Yes 223 (77.16) 151 (77.04) 72 (77.42) 1.317 0.251 No 50 (17.30) 38 (19.39) 12 (12.90) Raising social awareness for thalassemia is important? Yes 268 (92.73) 184 (93.88) 84 (90.32) 0.3384 0.561 No 9 (3.11) 7 (3.57) 2 (2.15) Do you think that thalassemia patients need blood transfusions throughout his/her life? Yes 248 (85.81) 170 (86.73) 78 (83.87) 0.005088 0.943 No 26 (8.99) 18 (9.18) 8 (8.60) Statistical significance at a p less than 0.05 Table 5: Practice of the participants in a carrier screening program about thalassemia (n=289) Knowledge items n (%) χ 2 p Total (n=289) Male (n=196) Female (n=93) Do you think you should inform other people about its consequences? Yes 225 (77.85) 138 (70.41) 87(93.55) 0.7215 0.396 No 5 (1.73) 4 (2.04) 1 (1.07) Do you know blood transfusion is the main treatment for thalassemia? Yes 218 (75.43) 149 (76.02) 69 (74.19) 0.6691 0.413 No 54 (18.68) 40 (20.41) 14 (15.05) Will you encourage others to give blood to thalassemia patients? Yes 260 (89.96) 179 (91.33) 81 (87.09) 0.1270 0.722 No 17 (5.88) 11 (5.61) 6 (6.45) Statistical significance at a p less than 0.05 Additional Declarations The authors declare no competing interests. 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Ashraful Hasan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYFACHiC2YZAxAHMq2BgYmEEMNkJa0hh4IFrOkKyFsQ0mikcLf//ZYx9+JBzmMWc//vBz4Ty+xO3sQO0fyg7j1CJxIy95Zg9Qi2VPjrH0zG1siTubeQwYZ5zDrYXhBo8xA++PwzwGB3IYpHmBWjYcZktg5m3DrUX+/Bljxj9AWwzOP3/8m3cOVMtfPFqAhhsz84C03Egwk+ZtAGlhPsDMiEeL4Q2gFpmEdKCWN2bWPMfYjEFaDvacS8epRQ7ksDcJ1nIG59Mf3+apOSa74fzBxgc/yqxxex8NHAOTB4hWDwQ1pCgeBaNgFIyCEQIA949UhzRcNDEAAAAASUVORK5CYII=","orcid":"","institution":"Laboratory of Preventive and Integrative Biomedicine, Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh","correspondingAuthor":true,"prefix":"","firstName":"Md.","middleName":"Ashraful","lastName":"Hasan","suffix":""},{"id":568117373,"identity":"c2047a55-e140-4072-8a76-b85f1e087df7","order_by":11,"name":"Md. 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06:10:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1480953,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8496807/v1/6bf321eb-057b-4a77-90f7-30a6ab7726b0.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eUniversity students' knowledge, attitudes, awareness and practices (Pre-KAP) regarding thalassemia in a carrier screening campaign in Bangladesh\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThalassemia is a hereditary abnormality marked by measurable deficits in globin chain production\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. It is a genetic blood condition that results in anemia due to accelerated red blood cell disintegration\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. This genetic blood condition has a high prevalence in the so-called \"thalassemia belt,\" which includes Southeast Asia, the Indian subcontinent, the Mediterranean, and the Middle East.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Given its significant public health burden, a comprehensive understanding of its transmission dynamics and preventive strategies is essential\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThalassemia affects 1\u0026ndash;5% of the world's population as carriers \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. In Bangladesh, thalassemia poses a considerable health challenge, highlighting urgency for effective prevention and management strategies\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. A report of The World Health Organization (WHO) in 1980 says that approximately 3% of the population are carriers of beta-thalassemia and 4% have hemoglobin E (Hb-E)\u003csup\u003e8,9\u003c/sup\u003e. More recent data from a study on Bangladeshi school children indicated even higher carrier rates, at 4.1% for beta-thalassemia and 6.1% for Hb-E.\u003csup\u003e9\u003c/sup\u003e The birth of a child with thalassemia major, a life-threatening condition, can only be prevented by identifying carriers and advising against marriage between two carriers\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe effective control of genetic disorders such as thalassemia depends heavily on public awareness and engagement, underscoring the investigation of Knowledge, Attitudes, and Practices (KAP) a crucial approach\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. KAP studies have been instrumental in designing and implementing successful public health interventions for various chronic and genetic conditions, including diabetes\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e and hypertension,\u003csup\u003e13,14\u003c/sup\u003e by identifying gaps in understanding and addressing behavioral barriers.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e Despite the high prevalence of thalassemia in Bangladesh, there is a notable scarcity of comprehensive research on the KAP of the general population regarding this condition\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThis study builds upon previous work by the authors, which focused on a more limited sample of biological faculty students at Jahirnagar University\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. The current research expands this investigation to a broader student body across various faculties who participated in a thalassemia carrier screening campaign. By targeting university students, who are poised to become future community leaders, this study aims to create a ripple effect of awareness\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. The findings provide critical insights into the existing knowledge gaps and positive attitudes, which can inform the development of more effective and targeted public health interventions to mitigate the incidence of thalassemia in Bangladesh\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Participant Selection\u003c/h2\u003e \u003cp\u003eThis study utilized a cross-sectional descriptive design to evaluate the Knowledge, Attitudes, and Practices (KAP) of Jahangirnagar University students who voluntarily consented to thalassemia carrier screening in our laboratory. Previously, we conducted a pre-KAP study among 911 students of the Biological Faculty of Jahangirnagar University, which generated a positive response among students to learn more about thalassemia, and we were able to encourage them to join our Thalassemia carrier screening campaign \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn 2021, due to a substantial positive response, 290 participants from various faculties, beyond the Biological Faculty included in our previous study, volunteered for thalassemia carrier screening. The study population comprised all students at Jahangirnagar University, estimated at 14,000 individuals. To determine a scientifically justified sample size, the standard formula for cross-sectional studies was used\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e : \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{n}_{\\theta\\:}=\\frac{{z}^{2}\\cdot\\:\\rho\\:\\cdot\\:\\left(1-P\\right)}{{e}^{2}}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003cp\u003ewhere \u003cb\u003eZ\u0026thinsp;=\u0026thinsp;1.96\u003c/b\u003e for 95% confidence, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.5\u003c/b\u003e (assumed proportion for maximum variability), and \u003cb\u003ee\u0026thinsp;=\u0026thinsp;0.05\u003c/b\u003e as the margin of error. This calculation yielded an initial sample size of 384 participants. Applying the finite population correction for N\u0026thinsp;=\u0026thinsp;14,000 resulted in an adjusted sample size of approximately 374 students\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. Due to voluntary participation in the screening campaign, the final sample comprised 290 students, corresponding to a margin of error of approximately \u003cb\u003e5.7%\u003c/b\u003e, which remains acceptable for a descriptive KAP study.\u003c/p\u003e \u003cp\u003eThe following inclusion and exclusion criteria were applied:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eInclusion Criteria\u003c/b\u003e: Individuals admitted to any department of Jahangirnagar University within the past 5\u0026ndash;6 years and aged 18 years or older.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eExclusion Criteria\u003c/b\u003e: Individuals unwilling to participate, those who did not provide written informed consent, or participants with incomplete questionnaire responses.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eAll participants provided written informed consent and completed a questionnaire covering demographic information, anthropometric variables, and hematological and biochemical parameters.\u003csup\u003e18 19\u003c/sup\u003eThey also completed a self-administered questionnaire concerning thalassemia under the supervision of qualified students, which consisted of five sections including personal information, knowledge, attitudes, practices, and awareness regarding thalassemia.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e The first section covered personal information such as age, sex, academic background, home district, marital status, religion, and family history of thalassemia\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. The knowledge section consisted of six multiple-choice questions covering the understanding of thalassemia. The attitudes section was assessed through three multiple-choice questions, evaluating beliefs about thalassemia screening and marriage. The practices section assessed participants' views on informing others about thalassemia and encouraging blood donations for patients through three multiple-choice questions\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e.The awareness section consisted of five multiple-choice questions, evaluating participants' knowledge about the causes and consequences of thalassemia\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003e \u003cb\u003eDescriptive statistics\u003c/b\u003e were used to summarize demographic data\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. \u003cb\u003eNormality testing\u003c/b\u003e was conducted using the \u003cb\u003eShapiro\u0026ndash;Wilk test\u003c/b\u003e and \u003cb\u003eKolmogorov\u0026ndash;Smirnov test\u003c/b\u003e, depending on sample size and data distribution\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Data were analyzed using SPSS version 19.0 (IBM Corporation, Armonk, New York, USA) and Microsoft Excel. Chi-square (\u003cb\u003eχ\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e)\u003c/b\u003e analyses were used to evaluate the statistical significance of differences in categorical data\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. Results were considered statistically significant with a \u003cem\u003ep\u003c/em\u003e-value less than 0.05\u003csup\u003e27\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e\n\u003ch2\u003eEthical Approval\u003c/h2\u003e\n\u003cp\u003eThe study protocol was approved by the Biosafety, Biosecurity and Ethical Committee of Jahangirnagar University, with the ethical approval reference number \u003cstrong\u003eBBEC, JU/M 2022 (3) 2\u003c/strong\u003e\u003csup\u003e18\u003c/sup\u003e.\u0026nbsp;All participants provided written informed consent, and their privacy was strictly maintained throughout the study\u003csup\u003e28\u003c/sup\u003e. Participation was entirely optional\u003csup\u003e18\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study involved a total of 290 participants, of which 289 responded and agreed to sign the consent form. One participant was excluded from the study due to incomplete responses. The study population consisted of 196 male participants (67.82%) and 93 female participants (32.17%) (Table 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of personal and family history of thalassemia, 1 participant (0.34%) gave a positive response, indicating that they had a personal and family history of Thalassemia.\u003c/p\u003e\n\u003cp\u003eIn this study, we explored the study population\u0026apos;s understanding of thalassemia. As shown in table 2, it was found that 82.69% of participants had heard of the term thalassemia before, with 79.59% of male participants and 89.25% of female participants having prior knowledge. 15.92% of participants were unaware of the disease. 76.47% of students answered that thalassemia is spread through blood, while 18.34% thought it was spread through semen. 84.08% of participants correctly identified a connection between the disease and marriage, while 14.88% gave incorrect answers. Over 50% of participants were not aware of the treatment for thalassemia, and 29.41% of students knew someone affected by the disease.\u0026nbsp;No significant differences in knowledge about thalassemia were evident between male and female participants (Table 2).\u003c/p\u003e\n\u003cp\u003eTo evaluate the study group\u0026apos;s attitudes toward thalassemia, the questionnaire included several questions on topics such as the necessity of thalassemia screening before marriage, the importance of parental screening before pregnancy, and the approach to take upon discovering that a newborn is affected by thalassemia. As shown in table 3, the majority of students (93.77%) believed that premarital screening was necessary to prevent thalassemia, while 5.88% did not support this idea. 92.38% of students supported prenatal screening of neonates if the parents were carriers of thalassemia, while 4.84% did not. 62.63% of participants thought they would give birth to an affected neonate after screening, while 27.68% believed that abortion was the best way to prevent thalassemia. There was no significant difference between the male and female participants\u0026apos; attitudes towards thalassemia (Table 3). Top of Form\u003c/p\u003e\n\u003cp\u003eThe questionnaire included several questions to assess the study population\u0026apos;s awareness of thalassemia, such as whether it is a blood disorder, if it can result from malnutrition, if it can be caused by marriage between blood relatives, the importance of raising social awareness for thalassemia, and whether patients require lifelong blood transfusions.71.28% of participants believed that thalassemia is only a blood disorder, while 27.33% did not. 79.93% of students responded negatively when asked if thalassemia was caused by malnutrition, while 15.22% responded positively. 77.16% of participants agreed that thalassemia can be caused by marrying between blood relatives, while 17.30% did not. 92.73% of students thought that raising social awareness for thalassemia is important, but 3.11% did not. 85.81% of students thought that thalassemia patients need blood transfusion throughout their life, while 8.99% responded \u0026lsquo;no\u0026rsquo;. No significant difference in awareness between male and female participants was evident (Table 4).Top of Form\u003c/p\u003e\n\u003cp\u003eWhile assessing the practice of the study population regarding thalassemia, most participants (77.85%) were willing to inform others about the consequences of thalassemia, while 1.73% were not. 75.43% of participants knew that blood transfusion was the main treatment for Thalassemia, while 18.68% did not. 89.96% of participants would encourage others to give blood to a thalassemia patient, and 5.88% would not. There was no significant difference in the responses related to the practice of thalassemia between male and female participants (Table 5).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study provides insights into the knowledge, attitudes, and practices of university students participating in a carrier screening program for thalassemia in Bangladesh. In February of 2021, we launched a comprehensive initiative that combined a carrier screening program with an awareness campaign targeting university students to enhance their understanding of thalassemia. The aim was to educate them about the genetic nature of the disease and its potential impact on their conjugal life and future generations if both partners are carriers. We encouraged student participation in the campaign and testing for carrier status. Blood samples were collected at our laboratory for screening.\u003c/p\u003e\n\u003cp\u003eOur study revealed that the majority of students (82.69%) were aware of thalassemia, and 84.08% believed it was related to marriage. However, 76.47% of students held the false belief that the disease spreads through blood. Only 50% of the students had adequate knowledge about the treatment of thalassemia. The results indicated that the overall understanding of thalassemia among university students was unclear. The study found that a higher percentage of female students (89.25%) compared to male students (79.59%) had heard about thalassemia, which is consistent with findings from studies conducted in Iran \u003csup\u003e29\u003c/sup\u003e and Bahrain \u003csup\u003e30\u003c/sup\u003e. Our study revealed a higher level of understanding about thalassemia among university students compared to a study conducted in Bahrain among university students, professionals, and married individuals \u003csup\u003e30\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn our study, 93.77% of students believed that premarital screening is necessary to reduce the incidence of thalassemia, and 92.38% felt that prenatal screening was important before pregnancy. However, a previous study in Bangladesh reported a poor understanding of thalassemia that led to negative attitudes \u003csup\u003e8\u003c/sup\u003e. In Oman, sociocultural factors such as fear of test results, embarrassment, marriage cancellations, and others contributed to the poor response to carrier screening \u003csup\u003e31,32\u003c/sup\u003e. Negative attitudes towards carrier screening in Pakistan were influenced by factors such as fear of rejection, a potential increase in abortion rates, and stress \u003csup\u003e33\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn our research, 77.85% of students showed a willingness to educate others about the consequences of thalassemia, and 89.96% said they would encourage others to donate blood to thalassemia patients. A previous study in Bangladesh found that 60.8% of college students were willing to donate blood to thalassemia patients, while 39% either declined or were uncertain about donating blood \u003csup\u003e34\u003c/sup\u003e. Our study aimed to increase awareness of thalassemia among university students so they could learn about the disease and its carrier form before entering into a safe relationship or marriage. A study by Hossain et al. focused on increasing awareness of this disease among college students \u003csup\u003e34\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eSince there is no appropriate treatment for thalassemia besides blood transfusion, carrier screening, and increased knowledge before marriage are the only protective actions to reduce its frequency across generations. Previous studies have shown that a significant proportion of respondents knew that thalassemia is a hereditary disease, such as 60.05% in a study conducted at Kolkata Tertiary Care Hospital \u003csup\u003e35\u003c/sup\u003e and 82.6% in a study in Pakistan \u003csup\u003e36\u003c/sup\u003e. However, our research found that 71.28% of participants believed that thalassemia is a blood disorder only. Our study also showed that 92.73% of students felt that raising awareness about thalassemia is important, which is similar to a study in Saudi Arabia where 92.9% of Taif University students agreed to contribute to raising awareness about the importance of premarital screening \u003csup\u003e37\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn 1975, Silverstroni and the team in Latium, Italy, started the first pre-marriage thalassemia screening as part of a school-based preventive initiative \u003csup\u003e38\u003c/sup\u003e. During the 1970s, screening programs were established across Canada, Cyprus, Greece, Italy, and the UK. However, due to low literacy rates and limited knowledge and awareness in Bangladesh, the success of thalassemia prevention is hindered. To address this, mandatory screening policies are necessary in Bangladesh.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations of the Study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of this study should be interpreted in light of certain limitations. their First, it relied on a convenience sample of students who voluntarily joined the carrier screening, which may not represent the wider student body or general population. \u0026nbsp;Their positive attitudes might be a consequence of their decision to participate\u003csup\u003e34\u003c/sup\u003e.\u0026nbsp;Second , the cross-sectional design captures a single point in time and does not allow for the establishment of causal relationships or the tracking of changes in KAP over time\u003csup\u003e39\u003c/sup\u003e. Finally, the use of a self-administered questionnaire may have introduced social desirability bias, potentially inflating favorable responses\u003csup\u003e40\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe findings of this study indicate that university students in Bangladesh lacked sufficient knowledge about thalassemia particularly regarding the hereditary nature of the disease, with many respondents incorrectly perceiving it as blood-borne. These gaps reflect limitations in existing public health communication and emphasize the importance of more personalized interventions. . However, university students demonstrated strong support for preventive measures, including premarital and prenatal screening which provide a unique opportunity to advance national strategies. To mitigate these challenges, it is recommended to implement targeted educational campaigns emphasizing the genetic nature of thalassemia, advocate for mandatory premarital screening policies,\u0026sup2;\u0026sup1;,\u0026sup2;\u0026sup2; and integrate accessible genetic counseling services for carriers and affected families. Through dispelling prevalent misconceptions and capitalizing on favorable attitudes, Bangladesh has the potential to achieve meaningful reductions in the future burden of thalassemia.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePre-KAP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePre-Knowledge, Attitude, Awareness and Practice\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by the Biosafety, Biosecurity and Ethical Committee of Jahangirnagar University and written informed consent was obtained from all participants. Privacy was ensured, and participation was made optional.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was funded by the GARE (Grant for Advanced Research in Education), Education Ministry, Bangladesh (Grant LS20191009), and the University Grant Commission research grant (2020-2021).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors gratefully acknowledge the support of the Department of Biochemistry and Molecular Biology Jahangirnagar University, Savar, Dhaka 1342, for the support to conduct this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eM A, S L, Thalassemias An Overview. 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Am J Epidemiol 161(4):389\u0026ndash;398. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/aje/kwi054\u003c/span\u003e\u003cspan address=\"10.1093/aje/kwi054\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"480\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1: \u0026nbsp;Gender distribution of participants in the pre-KAP study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.375%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55.625%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespondents (n%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.375%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55.625%;\"\u003e\n \u003cp\u003e93 (32.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.375%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55.625%;\"\u003e\n \u003cp\u003e196 (67.82)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.375%;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55.625%;\"\u003e\n \u003cp\u003e289 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"702\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"27\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2: Knowledge of participants in a carrier screening program about thalassemia (n=289)\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" rowspan=\"2\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge items\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"14\" valign=\"top\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" rowspan=\"2\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003cbr\u003e\u0026nbsp;p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003eTotal (n=289)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eMale (n=196)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eFemale (n=93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"25\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you heard the term thalassemia before?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e239 (82.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e156 (79.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e83 (89.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 2.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e46 (15.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e36 (18.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e10 (10.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"25\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you know how this disease spread?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eBlood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e221 (76.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e144 (73.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e77 (82.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e0.4128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.521\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eSemen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e53 (18.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e37 (18.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e16 (17.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"25\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs there any connection to this disease with marriage?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e243 (84.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e164 (83.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e79 (84.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; 3.812e-005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e43 (14.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e29 (14.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e14 (15.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"25\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you know the treatment of thalassemia?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e110 (38.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e78 (39.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e32 (34.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;1.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.297\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e174 (60.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e113 (57.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e61 (65.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"25\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you know any thalassemia patient(s)?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e85 (29.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e62 (31.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e23 (24.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; 1.324\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e203 (70.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e134 (68.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e69 (74.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"25\" valign=\"top\" style=\"width: 636px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat is your relationship with the patients?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3 (1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e2 (1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e1 (1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" rowspan=\"4\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;1.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003cbr\u003e\u0026nbsp;0.775\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003eCousins\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4 (1.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e2 (1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e2 (2.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 148px;\"\u003e\n \u003cp\u003eNeighbors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e7 (2.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e4 (2.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e3 (3.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003eNo relation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e224 (77.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"12\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e155 (79.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e69 (74.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eStatistical significance at a \u003cem\u003ep\u003c/em\u003e less than 0.05\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"690\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"14\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3: Attitude of participants in a carrier screening program towards thalassemia (n=289)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitudes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003cbr\u003e\u0026nbsp;p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003eTotal (n=289)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eMale (n=196)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eFemale (n=93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think that thalassemia screening is necessary before marriage?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e271 (93.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e186 (94.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e85 (91.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;0.7083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 0.400\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e17 (5.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e10 (5.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e7 (7.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think prenatal screening of neonatal is important before pregnancy,\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eif parents are thalassemia carriers?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e267 (92.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e184 (93.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e83(89.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u0026nbsp; 0.1325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 0.716\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e14 (4.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e9 (4.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e5 (5.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat should you do when you find that the neonatal is thalassemia-affected\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eafter screening?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eGive birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e181 (62.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e126 (64.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e55 (59.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.2223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.637\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003eAbortion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e80 (27.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e58 (29.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e22 (23.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eStatistical significance at a \u003cem\u003ep\u003c/em\u003e less than 0.05\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"738\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"20\" valign=\"top\" style=\"width: 684px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4: \u0026nbsp;Awareness of the participants in a carrier screening program about thalassemia (n=289)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" rowspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAwareness\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" rowspan=\"2\" valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003cbr\u003e\u0026nbsp;p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003eTotal (n=289)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eMale (n=196)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eFemale (n=93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\" style=\"width: 684px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs thalassemia only a blood disorder?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e206(71.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e137 (69.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e69 (74.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 1.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cbr\u003e\u0026nbsp; \u0026nbsp;0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e79 (27.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e58 (29.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e21 (22.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\" style=\"width: 684px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIs thalassemia caused by malnutrition?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e44 (15.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e32 (16.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e12 (12.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 0.3243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.569\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e231 (79.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e158 (80.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e73 (78.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\" style=\"width: 684px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan thalassemia be caused by marrying between blood relatives?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 146px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e223 (77.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e151 (77.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e72 (77.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp;1.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 146px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e50 (17.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e38 (19.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e12 (12.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\" style=\"width: 684px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRaising social awareness for thalassemia is important?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e268 (92.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e184 (93.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e84 (90.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 182px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; 0.3384\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.561\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e9 (3.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e7 (3.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2 (2.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\" style=\"width: 684px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think that thalassemia patients need blood transfusions throughout his/her life?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e248 (85.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e170 (86.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e78 (83.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" rowspan=\"2\" valign=\"top\" style=\"width: 183px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.005088\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e26 (8.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e18 (9.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (8.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eStatistical significance at a \u003cem\u003ep\u003c/em\u003e less than 0.05\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"732\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 648px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5: Practice of the participants in a carrier screening program about thalassemia (n=289)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge items\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e \u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u003cbr\u003e\u0026nbsp;p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003eTotal (n=289)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eMale (n=196)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eFemale (n=93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 648px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think you should inform other people about its consequences?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e225 (77.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e138 (70.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e87(93.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;0.7215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (1.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e4 (2.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e1 (1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 648px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you know blood transfusion is the main treatment for thalassemia?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e218 (75.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e149 (76.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e69 (74.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u0026nbsp; \u0026nbsp; 0.6691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.413\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e54 (18.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e40 (20.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e14 (15.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 648px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWill you encourage others to give blood to thalassemia patients?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e260 (89.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e179 (91.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e81 (87.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 0.1270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u0026nbsp;0.722\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e17 (5.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e11 (5.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e6 (6.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eStatistical significance at a \u003cem\u003ep\u003c/em\u003e less than 0.05\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"the University Grant Commission research grant (2020-2021).","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Thalassemia, pre-KAP study, attitudes, blood disorder, awareness, practices \u0026 university students","lastPublishedDoi":"10.21203/rs.3.rs-8496807/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8496807/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThalassemia is the most common inherited hemoglobin disorder in the world. A thalassemia carrier is a recessive condition carrying one of the faulty genes that cause thalassemia. There is a 25% probability in every pregnancy of having this life-threatening disorder in a child. This study aims to investigate university students' knowledge, attitudes, awareness and practices towards thalassemia by conducting a pre-KAP study in a thalassemia carrier screening campaign in Bangladesh.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional descriptive study was conducted at Jahangirnagar University, Bangladesh, from January 2021 to March 2021. The study involved 290 university students participating in a thalassemia carrier screening campaign, who completed a self-administered questionnaire about thalassemia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe pre-KAP study showed that 82.69% of students were familiar with thalassemia, but 76.47% of students answered incorrectly that thalassemia spreads through blood. More than 90% of the students (93.77%) believed that premarital screening is necessary to reduce the occurrence of thalassemia, and (92.73%) believed that raising social awareness for thalassemia is important. There were no notable distinctions between male and female participants in terms of their knowledge, attitudes, and practices regarding thalassemia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings indicate a critical deficit in accurate, specific knowledge despite general familiarity with the disease. his highlights the urgent need for targeted, evidence-based health education campaigns within academic institutions to correct misconceptions and empower future generations to make informed decisions about their health.\u003c/p\u003e","manuscriptTitle":"University students' knowledge, attitudes, awareness and practices (Pre-KAP) regarding thalassemia in a carrier screening campaign in Bangladesh","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-05 06:09:20","doi":"10.21203/rs.3.rs-8496807/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5e2466a0-e5fd-4b19-bbc2-442d627cf511","owner":[],"postedDate":"January 5th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-05T06:09:20+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-05 06:09:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8496807","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8496807","identity":"rs-8496807","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}