Abstract
BACKGROUND: Genetic disorders like sickle cell disease (SCD), Thalassemia, and Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency significantly impact social, health, financial, and healthcare systems, affecting 2%-5% of live births, 30% of pediatric hospitalisations, and 50% of juvenile deaths. Premarital carrier screening (PMCS) is a critical preventive measure, yet it remains unexplored in Ghana's Ahafo Region. This study examined young adults' knowledge and factors influencing willingness or unwillingness to undergo PMCS for genetic blood disorders. METHODS: A cross-sectional study was conducted among 460 young adults (18-35 years) in health facilities in the Ahafo Region, Ghana, from January to March 2024. Data was collected using a validated and translated questionnaire to capture socio-demographic characteristics, knowledge of genetic disorders, and factors influencing willingness to undergo PMCS. Data analysis was performed using Stata v14, with statistical significance set at p < 0.05. Chi-square tests were used to assess associations between socio-demographic factors and willingness to undergo PMCS. Logistic regression analysis was conducted to identify predictors of willingness, presenting results as odds ratios (OR) with corresponding p-values. RESULTS: Among the 460 respondents, most (n = 294; 63.9%) knew their SCD status, but fewer were aware of their G6PD (n = 418; 90.9%) and Thalassemia (n = 441; 95.9%) statuses. A significant number had not tested for SCD (n = 303; 65.9%), G6PD (n = 421; 91.5%), or Thalassemia (n = 446; 97.0%). Among the 460 respondents, 88.5% expressed willingness to undergo PMCS. A chi-square test revealed that sex (χ² = 11.481, p = 0.0032)., education level (χ² = 8.428, p = 0.0379), and parental consanguinity (χ² = 14.336, p = 0.0136) were significantly associated with willingness to undergo PMCS. Logistic regression analysis revealed higher willingness among females [OR = 4.3, p = 0.002], cohabiting individuals [OR = 0.3, p = 0.021], married individuals [OR = 0.1, p = 0.001], self-employed [OR = 0.2, p = 0.047], unemployed [OR = 0.2, p = 0.037], and those informed through school subjects [OR = 0.2, p = 0.036]. CONCLUSION: Despite low awareness of genetic disorders, willingness to undergo PMCS is high among young adults in the Ahafo Region, highlighting the need for integrated, culturally tailored public health strategies, particularly through school-based education to improve uptake and reduce the burden of hereditary conditions.