The fate of a 26-year-old pregnant woman, Olamide Azeez (not her real name), and her unborn baby remains uncertain due to her ignorance of genotype compatibility before pregnancy. Compounding her situation, Azeez, because of financial constraints, is relying on herbal concoctions provided by a traditional birth attendant. This has raised further concerns about her health and that of her unborn child.

There are hundreds of people like Azeez across the country whose lack of knowledge about genotype compatibility remains a major factor in the rising number of children born with sickle cell disorder. According to the World Health Organisation (WHO), sickle cell disease is a serious inherited blood disorder caused by a mutation in the HBB gene. The organisation said the disease also accounts for substantial mortality among children under five years, making it the 12th leading cause of death in that age group.

Mr Martins Agu, a local trader, recounts his painful experience with sickle cell disease. Agu recalls that before their wedding 18 years ago, a marriage counsellor at their church had advised him and his wife to undergo genotype testing. According to him, the test results showed they were genetically compatible, with one partner having the AA genotype and the other having the AS genotype. However, it was discovered that the last two of their five children had the SS genotype.

A family member encouraged them to repeat the genotype test, and the new result showed that they were both AS, not AA and AS as they had been told before marriage. Agu's experience reflects that of many families across the country grappling with the challenge of caring for children living with sickle cell disease.

Dr Casimir Ifeanyi, President of the Association of Medical Laboratory Scientists of Nigeria (AMLSN), worries about the prevalence of substandard equipment and testing procedures in many laboratories across the country. He said the persistent challenge was significantly contributing to frequent genotype testing errors nationwide. According to him, such inaccuracies pose serious risks to patients who rely on laboratory results for critical health decisions.

Dr Lucky Okpetu, a Consultant Haematologist, stresses the importance of genotype testing before marriage. He describes it as one of the most effective ways of reducing the burden of sickle cell disease in Nigeria. Okpetu explains that SCD occurs when a child inherits abnormal haemoglobin genes from both parents.

### Key Facts

  • An estimated 150,000 infants are born annually with sickle cell disorder.
  • Sickle cell disease accounts for substantial mortality among children under five years, making it the 12th leading cause of death in that age group.
  • Only 10% of more than 30,000 laboratories operating in Nigeria are regulated by the Medical Laboratory Science Council of Nigeria (MLSCN).
  • Dr Casimir Ifeanyi is the President of the Association of Medical Laboratory Scientists of Nigeria (AMLSN).
  • Dr Lucky Okpetu is a Consultant Haematologist at the Federal Medical Centre, Ebute Meta.