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dc.contributor.authorDyson, Simon
dc.contributor.authorChambers, Keith
dc.contributor.authorGawler, Sue
dc.contributor.authorHubbard, Stephanie
dc.contributor.authorJivanji, Vanita
dc.contributor.authorSutton, Faye
dc.contributor.authorSquire, Patricia
dc.identifier.citationDyson, S. et al. (2007) Lessons for intermediate and low prevalence areas in England from the Ethnicity Questions and Antenatal Screening for sickle cell / thalassaemia [EQUANS] study. Diversity in health and social care, 4 (2), pp. 123-35.en
dc.description.abstractThis study evaluates a temporary research-based intervention of universal ante-natal screening for sickle cell/thalassaemia in two areas of England of intermediate (1.29 per 10,000) and low (0.18 per 10,0000) expected foetal prevalence for sickle cell disease (SCD). It also assesses the comprehensiveness of coverage in levels of laboratory tests requested of risk groups for SCD identified by an ethnicity screening question. The design was a ten month (Sept 2002-June 2003) questionnaire study with random allocation to two ethnicity screening questions and comparison with: (1) laboratory results (2) numbers of laboratory screens requested (3) numbers of laboratory screens undertaken (4) an equivalent period before intervention and (5) ethnic monitoring data. 2,922 pregnant women were recruited at their first booking with midwife (of 3,255 recorded as invited, from a possible 12,424 women recorded as booking). In a move from a selective screening programme to a temporary, research-based universal screening programme, the intermediate prevalence area increased screening coverage from 20.7% to 42.6% of the ante-natal population. Carriers of sickle cell, thalassaemia and other haemoglobinopathies identified during the study period increased from 86 to 118, representing a proportional increase of 0.36% (95% CI: 0.01% to 0.71%, p= 0.045). In the low prevalence area, with a selective screening programme, the proportion identified as at risk using specifically-designed ethnicity screening questions (as opposed to generic ethnic monitoring using locally-devised categories) increased from 2.2% to 13.0% (p<0.001). Only 10% of those identified as at-risk by the ethnicity-screening questions were offered a laboratory haemoglobinopathy screen. In a low prevalence area, use of evidence-based ethnicity screening questions increases the proportion of clients identified as at risk of carrying genes associated with sickle cell or thalassaemia. In order to minimise the rates of failing to offer laboratory screening in a low prevalence area, midwives require specific training on the screening process, and which risk groups to offer a laboratory screen.en
dc.description.sponsorshipNHS Sickle Cell and Thalassaemia Screening Programme, Department of Health, and Unit for the Social Study of Thalassaemia and Sickle Cellen
dc.subjectsickle cellen
dc.subjecthealth policyen
dc.subjectlow prevalenceen
dc.titleLessons for intermediate and low prevalence areas in England from the Ethnicity Questions and Antenatal Screening for sickle cell / thalassaemia [EQUANS] studyen
dc.researchgroupUnit for the Social Study of Thalassaemia and Sickle Cell
dc.researchgroupMary Seacole Research Centre
dc.researchinstituteInstitute for Allied Health Sciences Researchen

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