Distribution of Haemoglobin Genotypes, Awareness, Motivators, and Barriers to Genotype Testing Among Health Science Students at Maflekumen Higher Institute Tiko, South West Region of Cameroon

Abstract

Background:Haemoglobin genotype testing is a crucial preventive measure against sickle cell disease (SCD) which encompasses all conditions associated with sickling of the red blood cells including sickle cell anemia, sickle cell trait and compound heterozygous. While students enrolled in health science programs are expected to be aware of genotype testing, various factors influence their decision to undergo screening. This study aimed to determine the distribution of haemoglobin genotypes, assess awareness of genotype testing and identify motivators and barriers to early genotype testing among health science students at Maflekumen Higher Institute, Tiko.

Materials and methods: A cross sectional study was conducted among health science students from December 2024 to January 2025. Haemoglobin genotype screening was performed using the sickle SCAN and data on their awareness, motivators, and barriers to testing were collected using a semi-structured questionnaire.  The data was analyzed using the Statistical Package for Social Sciences version 25.0 software application. The Chi square statistical test was employed to assess the association between variables. A p value <0.05 was considered statistically significant. 

Results:The majority (81.3%) of the 134 participants were females and 57.5% were in their second year of studies. Haemoglobin genotype distribution showed that 84.3% of participants had normal adult human haemoglobin (HbAA) and 15.7% had the sickle cell trait (HbAS), with no cases of sickle haemoglobin S (HbSS), sickle haemoglobin C (HbSC) and sickle haemoglobin C trait (HbAC) detected. The distribution of haemoglobin genotypes was not influenced by socio-demographic factors such as gender (p=0.06), age group (p=0.71), level of study (p=0.62) or marital status (p=0.46). The awareness of haemoglobin genotype testing was high (95.5%), with significant differences by level of study (p=0.009) as students in their first year of study had the lowest awareness (66.7%). The primary motivators for undergoing testing were personal curiosity (51.5%) and relationship or marriage considerations (43.3%). Other motivators to genotype testing identified were affordable cost of testing (14.2%), family history of sickle cell disease (13.4%), institution requirement (12.7%) and peer influence (3.0%). The key barriers identified were high cost of the testing (48.1%), lack of awareness (35.1%), and limited access to testing services (20.9%). Other barriers to testing were no perceived need to know genotype (6.7%), fear of results (2.2%) and religious/cultural beliefs (1.5%). 

Conclusion: The study demonstrates that while awareness of haemoglobin genotype testing is high among health science students, barriers to testing such as cost of testing and lack of accessibility persist. This study underscores the need of policies that integrate haemoglobin genotype screening into students’ health programs, subsidize cost of testing and establish on campus screening facilities.