By now, it’s a common practice in Malaysia to have a premarital checkup before uniting the bride and groom on their wedding day. This screening usually involves blood tests that look for a multitude of health indicators from general wellbeing, infectious diseases to hereditary diseases. The prices of these tests may also differ from one healthcare centre to another. Therefore, it is important to know which one is compulsory and why it is so.
Results for general wellbeing
One of the most looked at results of blood tests in healthcare settings are for individuals’ wellbeing. These results usually entails:
- Full blood count
It is a clinical test to look at your blood constituents. There are many proteins and cells that make up human blood. These include red blood cells, white blood cells and platelets just to name a few. This reading can tell whether the individual is within normal range or not. If so, it can help doctors to look for what is causing the deranged reading and what treatment is appropriate to correct it. Most commonly found during these tests is anaemia, due to low red blood cells which are treatable.
- Peripheral blood film
This test is commonly done in government and private hospitals. It is a helpful diagnostic tool especially to look for blood related pathology. Peripheral blood film allows healthcare workers to visualise changes in patient’s blood cell sizes, shapes, ratios and infections such as malaria.
- Blood grouping with or without Rhesus study
As the name suggests, it is to identify your blood group. While Rhesus study will determine whether you are Rhesus positive or negative. Hence you will hear people describe their blood group as B +ve and such. Rhesus study is so important especially for women who clearly want to become mothers. This is because a Rhesus negative mother with a Rhesus positive partner can have a Rhesus positive baby. If not detected early, a lot of complications can arise from the pregnancy as the mother is not Rhesus compatible with the child in her womb.
These tests for general wellbeing are commonly done both in government and private clinics. It is necessary and would really help if you know this information about yourself mainly if you require emergency blood transfusion.
Screening for infectious diseases
Infectious disease screening ranges from STDs to any blood-borne diseases. Tests that can be offered includes:
- HIV screening
A compulsory premarital checkup component in Malaysia is HIV tests. The initial method done is the rapid test method, looking for HIV antigen or antibody with 92% sensitivity. Only when the test is positive or reactive, another blood sample will be sent to confirm in a Hospital Laboratory. Due to the stigma and serious implication of being diagnosed HIV positive, these tests are usually done with patient counselling by the doctor. It is to reassure patients that whatever the result may be, HIV is not a death sentence and manageable.
- VDRL tests for Syphilis
It stands for venereal disease research laboratory tests. Blood will be taken from your veins and antibodies against Treponema Pallidum, a bacteria that causes syphilis will be measured. If it turns out to be positive, further confirmation will be done with the FTA-ABS test which is much more sensitive for syphilis. This test is not compulsory but commonly done in tandem with HIV tests. It is very important because babies of untreated syphilis positive mothers can be stillborn or die quickly after birth because of the infection.
- Hepatitis B screening
It’s a blood test to look for antibodies against Hepatitis B virus. Hepatitis B is transmitted via bodily fluids, semen and blood. Most adults with hepatitis tend to be asymptomatic. This test facilitates doctors to know whether the individual is currently infected, has a history of past exposure or has developed immunity towards it. Undetected hepatitis B can be transmitted during childbirth from mother to child. When a newborn is exposed to this infection, the complications can be fatal, not to mention the child can also actively spread the disease.
Other types of infectious disease screening are also available. Nonetheless, these three clinical tests are of utmost importance and routinely done. It is also commonly done for pregnant mothers. Therefore, it is logical to be taken during premarital checkup.
Genetic disease tests
Genetic and hereditary diseases is a wide topic in medical professions. The best approach for this test is geographical and ancestral based. That being said, the commonest hereditary disease screened in Malaysia is Thalassaemia. Especially among the Chinese and Malay community.
Thalassaemia is an inherited blood-related disease. It is a condition of the patient’s body not producing enough normal and healthy red blood cells. Current estimation shows that 1 in 20 Malaysians carries Thalassaemia genes.
It is an autosomal recessive disease. Which means, Thalassaemia carriers would not have any symptoms. The problem occurs when a carrier father and carrier mother have childrens. Their children have 50% chance of being a carrier and 25% of living with symptomatic Thalassaemia. Symptomatic Thalassemia patients almost often than not will end up requiring regular blood transfusion which affects quality of life, increases costs of healthcare and makes them susceptible to other diseases.
The latest guideline stated that Malaysians who are diagnosed with Thalassaemia should have all family members checked. If you are a known carrier it is also advisable for you to have your soon to be spouse checked as well. This is to help couples decide their future of having children.
Blood tests in premarital checkup are not limited to the lists above. There are many more infectious diseases and genetic disorders that can be tested for if needed. For some, these tests may seem pointless but most of it is to ensure your future children can live a full and healthy life disease-free.
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