KNOWLEDGE AND PRACTICE OF PREMARITAL GENETIC COUNSELLING AS A PREVENTIVE MEASURE AGAINST HAVING CHILDREN WITH SICKLE CELL DISEASE AMONG WOMEN IN LAGOS NIGERIA

Abstract

Nigeria currently has the highest incidence and prevalence of sickle cell disease (SCD) among all countries of the world and this continues to cause high morbidity and early death. SCD and other Haemoglobinopathies are a major public health concern among the black race. The aim of this study was to determine if women would still go ahead to have children with SCD after knowing they and their partners have sickle cell trait through blood genotype test. This study was a descriptive hospital based study carried out in eight primary health care facilities across six Local Government Areas in Lagos state, Nigeria on 407 women. The main tools for this study were self and interviewed administered questionnaires containing both open-ended and closed-ended questions. The numbers of completed questionnaires were 407 out of the 420 administered, giving a response rate of 96.9%. Data were analysed by frequency counts, percentages, chi-square test and bivariate analysis at 5% level of significance. The mean age of the women was 38.6±7.2, while for the children with SCD, it was 9.3±5.1 The study showed that 92.6% of the study participants accepted that it was important for unmarried individuals to meet a Counsellor before they plan a marriage. About 81.0% accepted that having a higher level of formal education increased the knowledge of SCD. The chi square test analysis showed a significant association between study participants' highest level of education and knowledge and practices related to genetic counselling (p=0.02), and between ethnic group and practices related to SCD genetic counselling (p=0.01). Study participants who had secondary school education as the highest level of education had an odds ratio of 0.90 and 95% confidence interval of 0.48-1.71 which was not significant for the bivariate analysis. While tertiary and above had an odds ratio of 0.66 and a 95% confidence interval of 0.33-1.30, which also was not significant. About ninety percent of the study participants accepted that their life would have been different, better and stable if they had known about PGC and practiced it. About 83.0% of the women accepted that SCD is a serious disease and expressed that having children with SCD gave them a lot of psychological trauma. Forty two percent rejected that there was no reincarnation of a child that dies from SCD, 39.6% rejected that saying prayers daily could cure a child from SCD; while 81.3 % rejected that it was the destiny of a child with SCD to have the disease. This study showed good knowledge across employment status and marital status as 89.7% and 87.5% of the study participants responded correctly to questions asked on PGC. These results showed that the women would not go ahead with pregnancy or marriage if they had known that they and their partners were carriers of the sickle cell gene. Public health education programmes on PGC should start right from the secondary schools as this will go a long way in making vital information available to the youths especially the females who are more vulnerable, in the future to make informed choices about pregnancy and marriage if they have sickle cell trait.