KNOWLEDGE, PERCEPTION AND ATTITUDE OF ABOUT-TO-WED COUPLES TOWARDS PREMARITAL SICKLE SELL GENETIC TESTING AND COUNSELLING IN IBADAN NORTH-EAST LOCAL GOVERNMENT REGISTRY, OYO STATE

Abstract

Sickle cell disease affects millions of people throughout the world and is particularly common among African descents. Earlier studies in Oyo State focused on attitude towards mandatory premarital testing with no information on knowledge, perception and attitude of about-to-wed couples towards premarital sickle cell counselling and testing. This study was therefore designed to investigate the level of knowledge, attitude and perception of about-to-wed couples towards Premarital Counselling and Testing (PSCCT) in lbadan North-East Local Government Area (LGA) of Oyo State. The study design was descriptive. A three-stage sampling technique was used to select LGA, registry, and 400 consenting respondents. A semi-structured, interviewer-administered questionnaire was used to obtain data on respondents' socio-demographic characteristics. Knowledge was measured on a 30-point scale on which scores of ≤10, 10 - 20 and > 20 were categorised as poor, fair and good, respectively. Perception towards PSCCT was measured on a 20-point scale; scores of ≤10 and >10 were classified as negative and positive, respectively. Attitude was measured on a 20-point scales on which scores of ≤10 and >10 were classified as negative and positive, respectively. Quantitative data were analysed using descriptive statistics, Chi-square test and logistic regression at p=0.05. Seven In-depth interview (IDs) were conducted on PSCCT and was analysed thematically. Age was 31.7±5.5 years, 55.0% were males, 98.0% had formal education, 52.0% were Christians and 62.0% were self employed. Majority (81.1%) had positive perception about PSCCT. Respondents' knowledge score was 11.4±5.0 with (63.0%) having a fair knowledge. Reported purposes of PSCCT were; making an informed marital choice (28.8%) and prevailing incidence of sickle cell disorder among offspring (24.0%). Majority (91.5%) wanted religious institutions to encourage PSCCT among intending couples. Respondents' attitude score was 7.1±1.8. Perception score was 12.4±3.8. Many (61.5%) had used PSCCT services most of whom used health facilities. Most, (58.0%) spent between N300 - N500 for the test and majority (91.5%) said marriage institutions should encourage their members to go for PSCCT. More respondents with formal education (98%) significantly utilised PSCCT compared to those that were not educated (2%). Respondents with formal education were more likely to utilise PSCCT compared to those that were not educated (OR 4.2; C=1.5-10.4), (61.5%) of respondents that utIlised PSCCT had good attitude towards PSCCT compared to those that did not utilise PSCCT. Utilisation of PSCCT was significantly associated with Knowledge of PSCCT. Respondents with fair knowledge were more likely to utilise the PSCCT compared to those with poor knowledge (OR: 2.5, CI=2.3-4.2). Respondents' perception score was 12.4±3.7. The IDIs revealed that majority used the hospital, School clinic and private laboratory for PSCCT. The good knowledge, attitude and perception of respondents towards PSCCT suggest the acceptability of the services among intending couples. Therefore promotion of premarital sickle cell counselling and testing at marriage registries and all government approved churches for weddings is therefore recommended.