DR ALFRED MURAGE
Almost all couples in advanced stages of tying the knot attend several sessions of pre-marital counselling. There are even pre-nuptial legal agreements tied to material possessions pre-dating the marriage for some. But how many engage in pre-marital health screening? This should be considered of equal importance to all other pre-marital rituals, and should never be missed.
Many people are usually unaware of their state of health, as many conditions have no significant symptoms. Pre-marital health screening should have some bare minimum health checks, but may also be stretched to a detailed comprehensive health check, albeit at great expense. At a minimum, the intending couples should be screened for sexually transmitted infections (STIs), hereditary conditions and potential fertility related issues. Other general health screening tests should be incorporated in the existing and recommended screening intervals.
Ideally, the intending couple should attend the health screening visits together. They should already have agreed on matters related to confidentiality of their results, especially if either party turned positive. Screening for STIs should include chlamydia, gonorrhoea, syphilis and HIV. Hepatitis B and C should also be tested for. If either party is infected, treatment options and other precautions are available to prevent transmission to the uninfected partner. And if a pregnancy is planned, several precautions can be put in place to reduce risks of disease transmission to the unborn baby as well. A detailed medical history from either party, combined with pre-pregnancy advice is necessary, especially if planning to have children. Specific fertility tests may be hard to justify, unless a problem is obviously apparent.
Hereditary conditions are uncommon, but have the potential of being transmitted to offspring if present. Screening for hereditary conditions should be guided by a detailed family history and known predisposition of certain communities to some genetic conditions. An example in Kenya is sickle cell disease, a genetically inherited condition affecting the blood cells. If the intending couple both carry the sickle cell gene, they would have a significant chance of bearing a child with the disease, and potential for lifelong ill health. If such information is known beforehand, certain medical interventions may be applicable prior to or during pregnancy, in attempts to maximise better outcomes.
Couples can chose to visit a general practitioner for their pre-marital health check or even a gynaecologist. Be wary of taking it too far because not every potential condition can be screened for or predicted. You must draw a line on the barest minimum and practical screening tests. Even though the pre-marital tests may indicate a clear coast and give the couple the confidence to tie the knot, it is important to be vigilant after the honeymoon, as it’s easy to get STIs with extra-marital flings.