Marriage is not just an emotional or cultural union, it is also a union of biological factors that can significantly impact the health of future generations. One of the most critical, yet often overlooked aspects of marital preparation is genotype compatibility.
In places like Nigeria, where sickle cell disease is prevalent, failing to conduct genotype verification before marriage has led to avoidable emotional, financial, and medical burdens to many.
Marriage is not just an emotional or cultural union, it is also a union of biological factors that can significantly impact the health of future generations.
Sickle cell disease (SCD) is a genetic blood disorder where red blood cells become rigid and sickle-shaped, while sickle cell anemia is the most common and severe type of SCD.
Both conditions result from an inherited mutation causing abnormal hemoglobin, which leads to the red blood cells distorting into a sickle or crescent shape. This abnormal shape prevents the cells from flowing smoothly through blood vessels, causing them to clump, block flow, and lead to pain, anemia, and organ damage.
Dr. Aisha Amal Galadanchi Akilu, a specialised consultant hematologist from Aminu Kano Teaching Hospital outlines five types of blood genotype which are as follows; AA, AS, AC, SC & SS. “ AA and AS are normal, while AC is rare, SC & SS are irregular and commonly cause sickle disease.
Marriage is not just an emotional or cultural union, it is also a union of biological factors that can significantly impact the health of future generations.
Hannah Ebun Oloyede, a 21 years old from hadejia describes how her health condition has become a financial burden for her family. “Sickle cell disease affects my family because it doesn’t have a specific time when a crisis starts . It can happen at anytime which sometimes lead to borrowing of money to pay up medical bills “
According to the World Health Organization (WHO) “SCD is a significant global health concern, especially in sub-Saharan Africa, the Middle East, the Caribbean, and South Asia, with severe forms often leading to early childhood death”.
In 2021, an estimated 7.74 million people were living with sickle-cell disease globally, with 515, 000 new births, primarily in sub-Saharan Africa, which accounts for nearly 80% of global cases.
Sickle-cell disease causes substantial under-5 mortality; 81,100 deaths in 2021, making it the 12th leading cause of death within the age category.
Fu’ad Lawal from Federal University Duste describes how excessive weather triggers the illness “Weather affects my health, and so also excessive cold and heat makes me weak”.
Dr. Amal listed some of the early signs and symptoms in children from 6 months of age that families should be cautious of : “dactylitis, jaundice ( yellowish eyes/skin), pale skin called ‘pallor’ and stunted growth due to chronic anemia. While in adulthood, pain in the joint ( due to blocked oxygen) which can last for hours or days, anemia (leading to fatigue, weakness and shortness of breath) and organ damage (like stroke or kidney problems).”
While some patient complain of mis clinical trials which leads to misdiagnosis in genotype results, Dr. Amal distinguished the various ways of carrying out the test, the most common and widely used in Nigeria due to low resource setting is : “Hemoglobin Electrophoresis, which is scan manually and is bound to have errors due to human nature, especially when reading the results.
HPLC ( high performance liquid chromatography) is a machine mainly designed for hemoglobin testing, which is accurate, expensive and very scarce, but available in Aminu Kano Teaching hospital.
Health professionals agreed that for a sickle cell patient to be healthy, he/she has to maintain a Healthy lifestyle which includes a balanced diet, adequate hydration, and avoiding extreme temperatures to reduce the risk of crises.
Marriage is not just an emotional or cultural union, it is also a union of biological factors that can significantly impact the health of future generations.
Dr. Musa Abdulkadir Magashi a senior consultant at Aminu kano teaching hospital spells out some of the treatment measures for sickle cell patients. Born marrow transplant, which he said “ is very expensive and only two states in Nigeria have started undergoing the measures, which are Lagos and Benin state”
He further emphasized that; the measures are not difficult but the aftercare. “ the main problem of born marrow transplant is the environment and facility for the aftercare, which leads to death if an individual don’t pass the stage well”
What people normally neglect is that, born Morrow doesn’t cure the disease completely but helps to reduce the production of ‘bi concave’ blood shape.
Marriage is not just an emotional or cultural union, it is also a union of biological factors that can significantly impact the health of future generations.
In a case when the patient marries SS, they will give birth to SS as well.
Gene therapy: is the advance treatment of sickle, Nigeria is yet to get there, even in high resource settings, is at the clinical trial.
Dr. Amal further emphasized that, in her years of working as a Hematologist, she noticed a key factor that contributes significantly to wide spread of Sickle cell anemia which is ‘education and lack of awareness’. She said “ many people, especially the rural dwellers , have no knowledge about SCD, some to the extent even believed that it’s witchcraft or co- wives doing.
She urged the government to recruit health extension workers, to go into these communities and sensitize them about the dangers and consequences associated with neglecting genotype testing before marriage.
By; Rahfat Zakar