Medical Corner: "Pre – Marital Screenings: “To Do Or Not To Do?”

"Marriage is honourable in all and the bed undefiled "Heb. 13:4 KJV. An institution ordained by God, established on a covenant binding a man and a woman in holy matrimony. The marital relationship is designed to be of much benefit.

 SOME BENEFITS OF MARRIAGE INCLUDE:

1.      Companionship: This is one of the most important reasons why God established marriage. “And the Lord God said, it is not good that the man should be alone; I will make him a help meet for him." Gen 2:18, KJV.

2.      Procreation: The first commandment given to the first couple was "Be fruitful and multiply, replenish the earth and subdue it" Gen 1; 28a. Children are a gift from the Lord and the fruit of the womb His reward.

3.      Profitability:Two are always better than one as they have a greater reward for their labour.

4.      Benefits to the children: The marriage institution creates a conducive social, economic and spiritual environment for effective child upbringing and parenting.

5.      Benefits to the parents: Children especially when properly brought up can also take care of their parents in old age.

 However these and other benefits of marriage never be actualized or may only be partially actualized if marriage is contracted in ignorance and falsehood or if both partners are totally unaware of each partners health status .It is also true that some partners may also be completely aware of the each other’s health status and have possibly been counselled on some areas of biological incompatibility yet they decide to take the risk by getting married. Yet a few others have become victims conflicting or totally erroneous laboratory results. Some also have decided to keep away some vital information on the state of their health from their partners.These have left a lot of marriages either in the eye of the storm or to have caused them to finally hit the rocks.

 Pre-marital screening involves all the screening or test that should be undertaken by intending couples before progressing with their marital relationship. This in my opinion should be done immediately after saying yes to a marriage proposal. This will help the couple not to have become too emotionally or even in some cases physically involved with each other should there be any health reasons not to continue with the marriage plans. A lot of couples have found out about their health problems too late at such a time that calling off the relationship becomes almost impossible.

Pre-marital tests if done early and adequate counsel is received, will save the unborn children from avoidable, unnecessary and seemingly unending health challenges. Some of these children would always be in and out of the hospital while the unfortunate ones end up with early childhood or adult deaths. The partners themselves are not spared from the dangers of contracting sexually transmitted diseases from their partners.

 Pre marital test include

        i.            HIV 1 $ 2 tests

      ii.            Hepatitis B screening

    iii.            VDRL test

    iv.            Genotype

      v.            Blood group

Others include

o        Tuberculosis test

o        HCV

o        Hypertension screening

o        Diabetes Screening

 HIV TEST

Intending couples are advised to go for voluntary counselling and testing TOGETHER IN AN APPROVED HOSPITAL. The issue discordant couples where one is positive and the other negative will be handled by well trained counsellors. If both are positive there is also need for proper counselling to stay healthy and possibly have HIV free babies.

 

HEPATITIS TEST

Hepatitis means the inflammation of the liver. It can be caused by the Hepatitis virus. There are many strains of Hepatitis virus including Hepatitis A, B, C, Dand E. The most common types are A, B, C and can be tested for.

 Hepatitis A Virus INFECTION

This is transmitted through the ingestion of food and water contaminated by human waste containing hepatitis A virus. It can also be spread among household members and close contact through contact with oral secretions or stool and poor hand washing.  Hepatitis A virus seldom causes permanent liver damage that can lead to liver failure.

Hepatitis B virus INFECTION

The virus can be can be transmitted by contact with body fluid, secretions or blood of affected individuals. Hence it can be transmitted sexually, transferred from mother to child. Tattooing, sharing razor blades, needles and other sharps and tooth brushes with infected persons can enhance spread. Carriers of this virus are at a risk of developing cirrhosis, liver failure and liver cancer.

Hepatitis C virus infection

This is spread by the same route as hepatitis B virus although rate of transmission sexually is lower. Chronic hepatitis B can lead to cirrhosis, liver failure and cancer.

 PREVENTION OF Hepatitis virus infection

1.      Avoiding exposure to another individual's blood, semen, vomit etc. especially if the person is Hepatitis positive.

2.      Proper hand washing and practicing proper food hygiene.

3.      Immunoglobulin can be given to prevent infection in individuals exposed to the hepatitis virus. It is safe and works immediately lasting up to 6 months when injected but very expensive.

4.      Vaccination for Hepatitis A & B vaccines are available and recommended for all babies, adolescents under 18 years who did not receive the vaccination at birth ,occupationally exposed people, household contacts and sexual partners of infected people infected with chronic hepatitis B infection. All pregnant women should be screened for hepatitis B virus and their babies immunized before breast feeding commences. There are no vacancies for hepatitis C and D.

VDRLTEST

An acronym for Veneral Disease Research Laboratory test for syphilis. Syphilis is transmitted by the same route as hepatitis B and C virus. It can cause paralysis, blindness, deafness, dementia etc. if not treated.

Prevention is same as hepatitis A and B.

 Genotype TEST

A person's genotype is the genetic composition of that individual that results in some of the physical characteristics. It can be determined by specific tests not just by physical appearance. Geno-type can either be AA, AS, SS, AC and CC. It is transmitted from parents to offspring. Transmission of the S or C gene is by random selection. In the union of two carriers AS and AS or AC and AC, there is 25% chance that each pregnancy will result in a baby with sickle cell disease (SS or CC).

 Sickle cell anaemia is characterised by a chronic destruction of the red blood cells resulting in intermittent events referred to as crisis which may be associated with excruciating pains and frequent blood transfusions. Other major problems include increased rate of infections e.g. meningitis, sepsis, Osteomyelitis, stroke and early infant adolescent or adult death. Most affected children spend a good part of their lives on admission in the hospital each episode lasting about 8 days thus greatly reducing the quality of the lives of affected children. This puts intense pressure on the family resources and often drains the affected family both emotionally and spiritually.

The only prevention for Sickle cell disease is to completely stop the breeding of children with this disease. This can be achieved by proper genetic counselling. Intending couples should endeavour to check their genotypes together in at least 3 different standard laboratories to avoid issues of conflicting results.

It is therefore very expedient to put the welfare of even the yet unborn babies far above any feeling of attraction or love no matter how genuine.

Blood group TEST

This is also very important since some neonatal diseases can be associated with incompatibility between the baby's inherited blood group and the mother's blood group if they are different. This can result in severe neonatal illnesses, still births and even early infant death as in Rhesus incompatibility.  Again proper genetic counselling is of optimum benefit.

The other tests like hypertension screening may not be mandatory but are also advisable if only for knowledge sake and possible commencement of early treatment.

Finally the importance of pre-marital tests can never be over emphasized. It is advice able that prior to the wedding the bride and groom to be, should have an honest discussion about their respective personal and families medical histories.

Premarital test if properly done with adequate genetic counselling instructions adhered to, will help the intending couples to have a healthy start as they begin a new chapter of their lives together. It will also ensure that they enjoy their God given relationship and family afterwards. John 3:2 "I wish above all things that you prosper and be in health even as your soul prospereth." KJV.

Prophetic Declarations from our Pastors

     1. I decree and declare that your case is settled today and tomorrow

     2. I decree and declare that all your outstanding blessings for 2018 shall not be carried over but shall be fulfilled this month

.    3. I decree that no evil shall befall you nor any plague come near your dwelling place.

     4God settled Abraham, he settled Isaac and settled Jacob. He will settle you this month.

     5. I declare celebration in your home, marriage, business, job, family in Jesus name.

                     Welcome to your month of “Multiple Blessing”

Bible Quote

Come unto me, all you that labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn of me; for I am meek and lowly in heart: and you shall find rest unto your souls.

Matt 11: 28