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Background: Thalassemia major is amongst the most common genetic disorders in developing countries like Pakistan. This research project aims to assess the level of knowledge among people related to thalassemia and the number of thalassemia cases linked to consanguineous marriages.Materials and Methods: A cross-sectional study was conducted among parents (n=272) of thalassemia patients registered with Rawalpindi thalassemia welfare society, from June 2019 to September 2019. Parents of thalassemia major patients aged 1 to 16 years were included. Parents who were health care professionals or community workers, and with children who had some other genetic disorders along with thalassemia major were excluded. Non-probability consecutive sampling was used. Data were collected using a self-designed questionnaire that assessed the prevalence of thalassemia in relation to consanguineous marriages and awareness of thalassemia in parents of affected ones. Data were analyzed using Statistical Package for Social Sciences (SPSS), version 22, by applying descriptive statistics.Results: About 72% of the parents (n=214) had consanguineous marriages. None of them had a thalassemia screening test before their marriage. 98.5% of the parents said no awareness campaign had ever been conducted for thalassemia in their area. 50% of families believed that thalassemia had affected their children's interaction with other children of their age.Conclusion: This study reveals that parents of thalassemia-affected children are not aware of the high link between thalassemia and cousin marriages and the prevalence of premarital testing is almost none.

BackgroundThe Center for Disease Control and Prevention recommends strict contact isolation precautions (CP) that include hand hygiene (HH) and barrier (gloves and gown) precautions upon entering and leaving the rooms of patients diagnosed with multidrug-resistant organism or Clostridium difficile infections. Although this policy has been in place for several years, compliance rate among HCW is rarely studied. The aim of our study was to covertly monitor, analyze, and compare the overall bundle compliance (OBC) and individual (HH, glove and gown) component compliance (ICC) among HCWs during routine patient care.MethodsA prospective observational study was done in six Detroit Medical Centers (July 2017 to February 2018). Trained observers audited both inpatient and intensive care units on random days and time. Components audited (1) HH before donning and after doffing (2) gowning and gloving techniques before entering and after existing the patient room. A mobile application (speedy audit) was used to record all data. A pilot targeted education program (TEP) was also conducted in one of the hospitals where education was focused only on strict HH practice before donning.ResultsA total of 6,274 observations were collected. The OBC was 38%. Common HCWs observed included nurses (registered nurse and nursing student) 47%; physicians (attending’s, residents, fellows) 28%; service workers including Environmental Service, Food service, Patient transporter, Social worker, Pastoral care- 14%; Allied Health Professions including Dietician, Blood Collection, Physiotherapist, Radiology Tech, Respiratory Therapist 4%; The OBC among all HCW were below 50%. For the ICC, HH (49%) was way below the gloving (80%,) and gowning (62%) compliance. HH compliance before donning was strikingly lower (40%) than the compliance after doffing (62%). This trend was similar in all HCW. Within a month of TEP, a drastic increase in both HH [↑ to 75% from 26% (P < 0.001)] and OBC [↑ to 68% from 16% (P < 0.001)] was seen.ConclusionCommon misconception that gloves are substitute to HH could explain the low HH rates before donning. Recognition of this gap and focused education on HH before donning has led to improved compliance in all HCW.Disclosures All authors: No reported disclosures.

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