ACCEPTABILITY OF PRENATAL DIAGNOSIS OF SICKLE CELL DISEASE AMONGST ADULTS IN UVWEI LOCAL GOVERNMENT AREA, DELTA STATE, NIGERIA

Abstract

Sickle cell disease (SCD) is a serious disease with debilitating effects that cause a lot of pains, discomfort and also leads to short life expectancy. The burden of SCD still remains a serious public health issue globally and also in Nigeria. It is a disease that can be prevented through genetic counselling, prenatal diagnosis (PND) and selective abortion. However little is known about attitudes towards PND and acceptability of PND in Nigeria. Therefore this study aims to determine the acceptability of prenatal diagnosis of sickle cell disease and termination of affected pregnancy (TAP). This study was a descriptive and cross sectional community based survey among consenting adults. A total number of 422 respondents were selected and interviewed through a five stage cluster sampling. Data collection was done using a structured questionnaire which was interviewer administered and it provided information on respondents knowledge about SCD, attitude towards SCD, acceptability of PND of SCD and TAP and reasons for acceptability of PND and TAP. Management and analysis of data was carried out using SPSS. Descriptive statistics was used to describe the general characteristics of the study sample. Knowledge score was computed by adding up the scores for all questions on knowledge of SCD and the mean score was used as the cut off for good versus poor knowledge. Similarly, attitude score was computed by adding up the scores of all questions on attitude on a Likert scale and the mean score was used as cut-off for positive versus negative attitude. Chi-square test was used to determine the association between the independent and dependent variables. The mean age of respondents was 29.82 (SD=± 11.36 years). There were 192 males (45.5%) and 230 females (54.5%). There were 352 urban dwellers (83.6%) and 69 rural dwellers (16.4%). About 227 respondents had tertiary level of education (54.0%) where 162 (38.6%), 23 (5 .5%) and 8 (1.9%) of the respondents had secondary, primary and no formal level of education respectively. The mean score of the knowledge of SCD was 14±2.22 and mean score for attitude towards SCD was 34±4.83. Respondents with good knowledge of SCD were 169 (50.1%) and those with positive attitude were 192 (45.5%). The number of respondents who have ever heard of PND was 114 (27.9%) while acceptability of PND and TAP was 48% and 13.2% respectively. Multivariate analysis showed Christians were four more times likely than Muslims to accept PND (OR- 4.53, 95%CI- 1.27 - 16.17) and urban dwellers were about two times less likely than rural dwellers to accept PND (OR- 0.55, 95%CI- 0.31 - 0.99). Findings from this study have shown that less than half of respondents' accepted PND and TAP. Efforts should be made to enlighten the public if this procedure is to be accepted by the public.