Awareness, Attitude And Acceptance Of Premarital Genotype Counselling And Testing Among Students Of University Of Uyo, Akwa Ibom State.
Chapter One
Introduction
Background of the Study
Genetic testing and screening has become parts of the contemporary medicine and public health initiatives. These terms are usually used interchangeably, but the term “Testing” denotes a genetic test done on an adult on a voluntary basis, while ‘screening” implies large scale public health initiatives (Green, 2006). According to World Health Organization (WHO, 2010) Sickle cell disorder contributes to 5% of under five deaths on the continent more than 9% of such deaths occur in West Africa and up to 16% of under-five deaths in individual occur in West African Countries.
Sickle-Cell anaemia is an autosomal recessive disease and the person with disease must have inherited a copy of the defective haemoglobin gene from each parent. Sickle-cell anaemia is cause by a defective gene that produces an abnormal form of haemoglobin, the component of red blood cells responsible for transporting oxygen from the lungs to the tissues. The abnormal haemoglobin called Haemoglobin S (Hbs), is an example of a single point Mutation in the gene responsible for Haemoglobin Synthesis (Adekile & Adewuyi, 2011). Sickle Cell disorder (SCD) is one of the commonest but preventable inherited diseases it is a disease that affect the red blood cells and is a life long aliment which has been with man since the existence of man.
Sickle-cell affects all races of the world; its affects the people of Tropical Africa, Mediterranean sea, middle East and South India. It has contributed significantly to the high childhood mortality rate (Afolayan and Jolayemi, 2011).
Nigeria has an estimated population of 150 million with annual growth rate of 3.2% (Afolayan and Jolayemi, 2011). The current figure of individuals in Nigeria with this disorder is not known since the majority born in rural community do is poorly documented. (Afolayan and Jolayemi 2011). Anie (2010) was also of the view that SCD is a global health problem with psychosocial implications and Nigeria has the largest population of people with SCD with about 150,000 births annually.
Many religious organizations are currently requesting would-be-couples to conduct premarital gene type test. It is believed that marriage between two carriers of the sickle cell traits (Hb As) could only be described as an irrational plug into troubles and as such, the couple risks the tendency to produce children with sickle cell anaemia in every of four children/child that they bear. According to mendelian’s principles of inheritance, there is the tendency that two people who are carriers could give birth to a sickle-cell anaemia child/children. The couple could even have all their children with sickle anaemia irrespective of how many (Damilola, 2012).
The fact that the victim of this genetic disorder suffer as a result of the ignorance or selfishness of their parents makes it quite pathetic. According to Damilola (2012), anyone who has ever witnessed the great anguish that an individual with sickle cell anaemia goes through during a period of crisis will definitely not need the eloquence of a preacher before reconsidering taking genotype in compatibility as one of the numerous risk of Life. Awareness about premarital sickle cell screening can be gained through information from educational programmes. This in turn establishes a health awareness programme in order to explain the benefits of pre-marital sickle cell screening to the public and increase their awareness on the serious consequences of sickle cell disorder. Awareness gained about premarital sickle cell screening will help prevent SCD and the prevention will depend on the attitude of couples towards the screening, (Ferguson, 2010). Attitude to premarital sickle cell screening can be a dynamic element in human behaviour and it can be positive or negative. People who have positive attitude about the benefits associated with premarital sickle cell screening may like to accept the premarital screening.
Acceptance of premarital sickle cell screening is an of sticking to behaviour or the process of engaging in an activity for the purpose of mastering or improving on it. People may agree to comply to premarital sickle cell screening when they see that the behaviour will give positive results, like reducing the risk of having children with sickle cell disease.
On the other hand, individuals may fail to adhere to the sickle cell screening due to reasons such as fear of stigma, emotional or financial consequences and or reliability of the test result (Lockock & Joe, 2009).
The recognition of sickle cell anaemia is an important public health issue in necessary to ensure that young people are aware of sickle cell anaemia and how genotype test could assist them to avoid genotype incompatibility.
Statement of the Problem
Genotype testing has been a major problem for young intending couples in Nigeria. It is so crucial that many couples have called off their marriage plans owing to refusal or failure of a partner to undergo test prior to their marriage (George, 2011).
The likelihood exists that there are many young people who do not believe in genotype testing before marriage. However, this does not eliminate the need for young people to know the implications of lack of genotype testing to them especially to the child they intend to raise in future. (Okoro, 2010).
Poor attitude, low level of awareness and non-availability of resources to the public health and welfare sectors and economic inflation are severely curtailing access to appropriate medical and social services. This situation is frustrating to the families of a growing number of surviving victims in Urban or middle upper income groups. Efforts to create more awareness of SCD are paradoxically increasing frustration and stigmatization in the absence of a commensurate improvement of services (Akinyanju & Ibidapo, 2010).
According to Adekile and Adewuyi (2011), the level of awareness on genotype testing among young people is about 55.5% in Nigeria according to a research conducted in a hospital to assess the awareness of sickle cell as a tool for marriage like most hereditary diseases, sickle cell anaemia constitutes a burden to families when even a number suffers from it, especially as it affects the family’s finance and emotions.
Although over 300,000 babies are born worldwide with SCD, this is common mostly in low income countries. Since the discovery of sickle cell diseases by Herrick in 1904 as published in 1910 alot of new information has been made available about the disease. Studies have shown that the genetic basis of the disease in the substitution of Valine for glutamic acid in position 6 of the globin. Chains (Nussbaum, 2008). This results in the sickling in the red blood cells leading to the clinical features of the disease inheritance of the gene by the medellian law and couples with as will have 25% chance from each pregnancy to have Hb SS child, 50% chance of Hb AS and 25% chance of Hb AA (Alao, 2012).
During the researcher’s clinical experience at university of Uyo Teaching Hospital, she observed that many children suffered sickle cell disease as a result of many couples eagerness to have their own children. It is on this background that the researcher is motivated to carryout a research on the awareness, attitude and acceptance of premarital genotype counselling and testing among students of University of Uyo, Akwa Ibom State.
Thus the need to asses the awareness, attitudes and acceptance of selected young people despite that genotype testing is a appropriate and effective medical diagnostic tool for preventive measures against socio-economic and psychological burden that may result from marriage of genetically incompatible partner.
Objectives of the Study
To assess the level of awareness of premarital genotype counselling and testing among students of University of Uyo, Akwa Ibom State.
To determine the attitude of students towards premarital genotype counselling and testing in University of Uyo, Akwa Ibom State.
To assess the level of acceptance of premarital genotype counselling and testing among students of University of Uyo, Akwa Ibom State.
Research Questions
What is the level of awareness of premarital genotype counselling and testing among student of University of Uyo, Akwa Ibom State?
What is the attitude of students towards premarital genotype counselling and testing in University of Uyo, Akwa Ibom State?
What is the level of acceptance of premarital genotype counselling and testing among students of University of Uyo, Akwa Ibom State?
Significance of the Study
This research work will be of great benefit to the entire society because a positive approach towards premarital genotype counselling and testing will reduce the prevalence of genetic diseases, and this will improve manpower and productivity in our society.
Government will through the information institute policies guiding couples on premarital testing before marriage. However, if findings show high level of awareness, it will benefit the family and community health wise because adults students can be able to work wise selections before marriage.
The information provide will serve as a tools to health care providers in identifying areas of need, if findings show low level of awareness, appropriate measures will be devised to strengthen their enlightenment campaign in other to help educate them on the importance of the screening.
Findings from this study will be useful to health educators, counselors and policy maker as it will provide the relationship between awareness, attitude and acceptance to premarital genotype counselling and testing, such information will be used as a guide in health education campaigns and programs.
The future researchers through the findings of the study will be able to carry out more related researches thereby adding to existing body of knowledge.
Scope of the Study
This study is confined to unmarried undergraduate and post graduate students (males and females) at University of Uyo, Akwa Ibom State. The study also covered variables like awareness, attitude and how they relate to acceptance to premarital genotype counselling and testing.
Operational Definition of Terms
Awareness: Having knowledge about premarital genotype counselling and testing including what it entails and benefits.
Attitude: The positive or negative feelings and beliefs of adult students of University of Uyo towards premarital counselling and testing.
Acceptance: Agreement to undergo premarital counselling and testing.
Premarital Genotype Testing: Is a test done in order to know their status on the sickle cell and other genetic traits before going into marriage.
Premarital Genotype Counselling: This involves two or more individuals seeking help and other professional trained person helped solve genetic diseases problems that may be passed to children after marriage especially sickle cell disease.
Students: A student is a person who goes to school and is learning something or studying for a specific profession at the University of Uyo.
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