Bahrain comprises an archipelago of 36 islands, with an area of 717.5
, located in the Arabian Gulf. Saudi Arabia is situated to the west and Qatar to the east. The estimated population of Bahrain in 2010 was 1,039,297. The 2001 census data showed that the population of Bahrain was 646,551 in 2007, of which Bahraini nationals constituted 50.7% and non-Bahrainis constituted 49.3%. Most Bahraini Arabs are originally from the Arabian Peninsula. The crude birth rate was estimated to be 15.4/1000 individuals, whilst the infant mortality rate was 83/1000 live births in 2007 [3
Genetic blood diseases (GBDs) are common in Bahrain and in all Middle Eastern countries [4
]. Bahrain is the first country in the Middle East region to tackle this issue since 1984 when the Ministry of Health (MOH) of Bahrain recognized the importance of controlling these diseases. In 1984, the first genetics clinic was established, which began educational campaigns. Information booklets were prepared and distributed widely in an attempt to increase awareness about these diseases among the public.
The campaigns, which have been conducted since 1980, focused on public awareness, education, and screening pertaining to antenatal issues and premarital services (1993), students and premarital issues (1998), newborns (2007), and prenatal testing [6
In 1991, the Bahrain Hereditary Anemia Society was formed with the aim of promoting awareness among the people of Bahrain. Molecular laboratories have been established in the main hospitals to study genotype-phenotype correlations, and the mutations that cause GBDs have been characterized.
We obtained support from religious scholars, and the parliament. In 2004, the king of Bahrain issued a law of premarital counseling. In 2007, the ministerial cabinet approved the budget for the newborn screening (NBS) program.
Several teams were involved in the campaign, including clinical geneticists, primary health care workers, pediatricians, hematologists, molecular geneticists, school teachers, students, religious scholars, policymakers, nurses, and technicians.
The campaign continued for approximately 20 years. Various issues related to ethical, legal, and social implications (ELSI), such as informed consent, privacy, equity, confidentiality, and prevention of stigmatization and discrimination, were addressed during the screening programs.
The NBS program is a well-recognized health program aimed at early identification of infants who are affected by certain genetic, metabolic, or infectious conditions. Early identification of these conditions is particularly crucial as timely intervention can significantly reduce morbidity, mortality, and associated disabilities in affected infants and save thousands of babies from mental retardation, death, and other complications.
This paper describes the NBS program for sickle cell disease (SCD) and sickle cell thalassemia in Bahrain and analyzes the results of the last 3.5 years of screening service.