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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 3,000
  • Pages

    69
  • Chapters

    1 - 5
  • Program type

    national diploma (nd)

Additionnal content

Abstract
Table of content
References
Cover page
Questionnaire
Appendix

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