INTRODUCTION
Background of the study
Sickle cell disease is an inherited blood disorder characterized primarily by
chronic anemia and periodic episodes of pain. The underlying problems
involve hemoglobin a component of red blood cell which are defective in
sickle cell anemia which causes red blood cells to become stiff and assume
a sickle shape.
According to Irin and Scoff (2009) it is an incurable genetic disorder that is
widespread in sub-saharan Africa and among descendants of Africans
world-wide. It is widespread reaching its highest prevalence in West Africa
the Mediterranean basin and Saudi Arabia. In Africa the highest frequency
of sickle-cell disease in found in Nigeria.
The World Health Organization (WHO) in 2007 reported that around 2% of
new born in Nigeria were affected by sickle cell giving a total of 200000
babies born annually with the disease. Also four (4) million Nigerians are
estimated to suffer the disease while 25 million others carry the genes which
they pass on to their offspring. Nigeria presently accounts for 75% of infant
sickle cell death in the continent
The geographic distribution of sickle cell disease trait is very similar to that
of malaria because sickle cell trait has a partial protective effect against
malaria and this may explain why it has been maintained at such height of
prevalence levels in tropical Africa. Those who inherit the gene from both
parents suffer this disease and suffer from its severe effects and may die
before they reach reproductive age (SCORE 2010).
According to a UNICEF report in 2008 sickle cell disease affects millions
of people throughout the world. It is particularly common among people
whose ancestors come from sub-Saharan Africa. In Europe the highest
prevalence of the disease has been observed in France as a result of
population growth due to immigration from north and sub-Saharan Africa.
In the United States it affects about 72000 people most of whose ancestors
come from Africa. The disease occurs in one in every 500
Africa-Americans.
In the Middle East 6000 children are born annually with sickle-cell disease
at least 50% of these are in Saudi especially in Quatif city (Arab times.
Comm. 2009).
Verne Mason (1922) named the sickness sickle cell disease though earliest
records of the condition was reported in the 1870s among emancipated
slaves in the United States. It was known locally in the Nigerian western
tribes as “Ogbanje” meaning “Children who come and go” because of the
height of mortality of infants. Due to this condition individuals who are
carriers of the disease often live a healthy life but are able to transfer the
condition to their children.
The World Health Organization (WHO) in 1999 declared that sickle cell
disease was a public health priority as there were 300000 birth in a year and
over 75% of this number in Africa of this number 65% are from Nigeria
alone about 50-52% of this number die before adult hood and it is also
estimated that six (6) Million Africans will be living with sickle cell disease
by the year 2020.
Countries such as America and Britain have reduced sickle cell disease
mortality from 3 percent to 0.3 percent because of their expert intervention
such as genetic counseling new born screening prevention of infections and
comprehensive management. Such interventions in African countries are not
obtainable due to lack of locally appropriate information funding and
support
In Nigeria where sickle cell disease is a major public health concern control
programmes do not exist and there is no national coverage nor basic
facilities to manage patients. Systematic screening for sickle cell disease
using simple blood texts are not common practices and diagnosis is usually
made when a severe complication has occurred. (Abdulrasheed Abolaji)
(2008).
Oniyangi O. (2006) in his report states that counseling and prevention of
cause of infections are simple measures that are not readily available nor
accessible to most people. As a result the majority of children with the most
severe from of sickle cell disease die before the age of five usually from an
infection or severe anemia. Other survivors remain vulnerable to
exacerbations of the disease and its complications. He also reports that the
recurrent pain and its implications can interfere with many aspects of the
patients’ life including education employment and psychosocial
development.
The National Institute & Health (NIH) in 2009 stated that there is no known
perfect cure for sickle cell however cost effective treatments exist for pain
management and other aspects of the disease. It also stated that the most
important components of this treatment are early intervention with
analgesics antibiotics rest good nutrition folic acid supplementation
liberal fluids intake and sometimes invasive procedures such as blood
transfusion exchange blood transfusion and surgery as the case may be.
The Sickle Cell Cohort Study (SCORE 2009 - 2011) a non-government
mental organization stated that there is sufficient evidence that neonatal
screening for sickle-cell disease when linked with timely diagnostic testing
parental education and comprehensive care markedly reduces morbidity and
mortality in infancy and early childhood. It also noted that the way forward
in the management of sickle-cell disease is through the creation and
strengthening of sickle-cell control programmers within the frame work of
national programmes on the prevention of infant morbidity and mortality
rate which is the fourth millennium development goals
Also the group advised that prevention involves setting up of sickle-cell
screening and genetic counseling centers where couples are advised on the
possibility of transferring defective genes to their offsprings should they
decide to have children. Couples are also informed of the complication and
suffering such victims undergo so that the individual are able to make
informed choices and decisions
It also advocated for early pre-natal period screening which should be
available alongside the counseling and health education services since
diagnosis raises serious ethical and cultural issues which differs from one
individual to the other
Sickle cell disease management at different levels of health care systems
should conduct programmes that use simple affordable technology that is
accessible to a large proportion of the community such programmes are
performed instead of a parallel system which may be too expensive and
unsustainable. It should also include training of health personnel in the
prevention diagnosis and case management also the health care system
should be able to provide the basic requirements of these services.
Partnerships should be fostered between health professionals parents
patients relevant community interest groups and the medics where
appropriate to create awareness for Public education and enlightenment.
This will make more people to identify risks in the community through
family history genetic counseling and screening encouraging active
participation in prevention and health care programmes.
Surveillance and research are also very important components in the
management and prevention of sickle cell. Report from Science Daily 2011
highlighted the recent issues and development in the disease management
which includes stem-cell transplants gene therapy and modern blood testing
techniques to determine blood types in seconds. Others include
Trans-Cranial scans (TCD) boosting fetal hemoglobin levels through the
use of hydroxyurea though its long-term effect on children is unknown
Any information generated from such research should be disseminated and
used as evidence in policy making as well as day-to-day decision making
although the possibility of making the aforementioned management
modalities available in Nigeria is still unrealistic because of poverty
corruption and governments failure to bring health close and affordable to
the common man.
Statement of the Problem
It is a known fact that human existence is really subject to the forces of
nature. However through the course of human history humanity has labored
so much to master these forces of nature and bring them to submission. To
some extent this has been achieved through science and technology but the
situation may not be quiet the same in most countries of the world especially
in Nigeria and Africa in general
The lack of modern medical facilities used in the management of sickle-cell
disease has left many families devastated as a result of the rise in the death
toll.
Available statistics have shown that an estimate of 45000 babies born
annually in Nigeria between 2-3% are born with sickle cell disease while
about 25-30% are born with the sickle cell trait. On the whole it is estimated
that a total of 37 million Nigeria (Children and adults) suffer from this
disease (WHO 2008)
Being a genetic disease the complete cure for sickle cell has not yet been
found by orthodox and traditional system of health care. However the hope
of seeing that the disease in completely eradicated can only be realized
through the adoption and application of preventive measures.
Therefore this means that a perfect knowledge of individuals genotype that
of an intended spouse and what possible outcomes should they decide to
have children is the best approach to the prevention of sickle cell disease.
Thus whichever combination would lead to the birth of a child with sickle
cell disease should be discouraged by so doing the disease will be prevented
(Sagoe 1998)
Unfortunately a great proportion of people in Africa especially in Nigeria
are still in ignorance concerning what genotype is and the relevance of its
knowledge. Besides this the nature of the disease is still covered in mystery
and misguided speculations hence the reason for assessing the knowledge of
the students of college of science and Technology (CST) Kaduna
Polytechnic towards pre-marital genotype counseling
Objectives of the Study
This study is being conducted for the reasons highlighted below:-
- To determine students knowledge about the cause of sickle-cell
disease
- To determine students awareness about the various diagnostic
investigations that are available for sickle cell disease
- To identify socio-cultural practices and beliefs of students about sickle
cell disease
- To suggest measures that can be taken to reduce the occurrence of the
disease.
Research Question
1. What are the of causes sickle-cell disease?
2. What are the laboratory investigations necessary to detect sickle cell
disease?
3. What are the socio cultural beliefs about sickle cell disease?
4. What measures can be taken to prevent the occurrence of sickle cell
disease?
Significance of the Study
Nigeria today with its ever-increasing size in population and insufficient
basic necessities has the largest population of people with sickle cell
disorders with about 150000 births annually.
Therefore the significance of this study is to promote and protect the total
well being of students with this disorder which can be achieved through
public enlightenment campaigns on the ways the disorder can be prevented.
Organized workshops can be conducted to provide correct information and
to dispel negative impression about the disease. Research programs will be
carried out to enhance human development through education of the students
and health personnel on the recent developments and trends in managing this
disorder
Cohesive strategies could be suggested to the College’s management in the
formulation of policies that will prevent sickle-cell occurrence through
student orientation and education.
Establishment of genetic counselling units with the College’s clinic to
provide students with correct information.
In conclusion there will be fostering of collaboration between government
and non-governmental organizations college management and student union
body to facilitate exchange of information sponsorship and expert
intervention
Scope of Study
This study will be limited to finding out the knowledge of the student of the
College of Science and Technology (CST) Kaduna Polytechnic about
premarital genotype counseling and testing as a means of reducing the
occurrence of sickle cell disease
Due to the nature of the study the research will cover all the schools in the
college which is made up of different departments and different categories of
students.
Project Information
Price
NGN 3,000Pages
69Chapters
1 - 5Program type
national diploma (nd)
Additionnal content
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