Knowledge, Attitude, and Practice Toward Thalassemia Carrier Screening in Asia: A Systematic Review and Meta-Analysis
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2023-07-13
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Abstract
Introduction: We conducted a systematic review and meta-analysis to estimate the proportion of good or positive level of knowledge, attitude, and practice (KAP) for thalassemia carrier screening in Asia population and estimate the proportions of participants whose answered indicated satisfactory level of KAP in selected item questions.
Methods: Electronic databases (PubMed, Google Scholar, and Scopus) and relevant journals published up to 31 January 2023 were systematically searched. A cross-sectional survey and observational or interventional studies on KAP were included and critically appraised using the Risk of Bias Tool. A random-effects model was used to estimate the pooled proportion of good or positive level of KAP with 95% confidence interval (CI).
Results: Thrity-one studies representing 22.038 participants were included (26 evaluated knowledge, 23 evaluated attitude, and 6 evaluated practice). The pooled estimates of good knowledge and positive attitudes were found to be 37% (95% CI: 18-56%, I2=99.4%, n=6) and 67% (95% CI: 40-94%, I2=99.8%, n=4), respectively. In knowledge item questions, “thalassemia carrier’s partner should undergo blood tests” and “test is available for detecting thalassemia carrier” presented highest (90%) and lowest (64%) proportion of correct answers, respectively. In attitude item questions, “thalassemia screening for both partners is necessary” and “willing to change the decision to marry in case of positive result” presented highest (90%) and lowest (64%) proportion of positive response, respectively. In practice item questions, “planning to get tested” and “had undergone thalassemia screening” presented highest (76%) and lowest (16%) proportion of good practice, respectively.
Conclusion: The findings revealed low proportions of good knowledge and positive attitude toward carrier screening in Asia. These findings indicate the need to revise plans and policies to improve KAP level. Using standard definition or cut-off scores for good or positive level of KAP can help better evaluate these components and compare them.
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Thalassemia Carrier, Screening, Knowledge