Prevalence of sickle cell gene among apparently healthy under-two south-east Nigerian children: what is the role of parental premarital counselling and socio-demographic characteristics? A pilot study

Abstract

Objective: This cross-sectional descriptive study examined the role of parental premarital counselling and socio-demographic characteristics on the prevalence of sickle cell gene among 82 apparently healthy under-two children.

Methods: Subjects were recruited from under-two children attending child welfare clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East, Nigeria.

Results: More than half of their mothers were aware of their hemoglobin phenotype (64.6%) and that of their husbands (53.6%). In about half of the families (52.4%), the parents had a premarital counselling intervention against sickle cell disease (SCD). Among the 44 families where parents were aware of their phenotype before marriage, only one couple (2.3%) was at risk of having an offspring with SCD. None of the subjects had SCD and the prevalence of sickle cell trait (SCT) among them was 22%. Premarital counselling intervention in families seemed to increase the prevalence of SCT when compared to those not counselled but this was not statistically significant (p = 0.30). The lower prevalence of SCT among children of more educated women suggests that educational status may affect the distribution of the sickle cell gene in the population.

Conclusion/Recommendation: Premarital counselling and screening may be effective in reducing the prevalence of SCD but the higher prevalence of SCT among the population where this intervention occurred portends an ominous sign for the future. Integration of malaria eradication and competent genetic counselling, with avoidance of discrimination against people with SCT or SCD, into screening programmes are essential for reducing the burden and impact of SCD.

Keywords: Sickle cell gene, sickle cell disease, prevalence, premarital screening, counselling