Knowledge and Attitude of Intending Couple Towards Genotype Screening
Chapter One
Objectives of the study
The general objective of this study was to determine the level of awareness, attitude towards sickle cell anaemia and genotype test and future intention to undergo test among the intending couple in Ibadan in Oyo State in order to obtain and provide important baseline data, and make recommendations that could be useful in promoting the important of genotype screening. The specific objectives that guided the study were as follows:
To:
- Determine the respondents‘ awareness on sickle cell anaemia /genotype screening.
- Determine the attitudes of the respondents on sickle cell anaemia and genotype screening.
- Determine the respondents‘ practices on genotype screening.
- Assess the future intention (willingness) to undertake genotype test before marriage.
CHAPTER TWO
LITERATURE REVIEW
Concept of Genotype and Mendelian Inheritance
Sickle cell anaemia has been known in Africa before the twentient century and the inhabitance have given it several names based on their understanding (Onwubalili 1983). Since sickle cell anaemia was discovered by DR J.B. Herrick in 1904, from the blood of an anaemic West ldian medical student, a lot of information have been made available about the disease. It was inferred that the gene has a variable expression which is more pronounced in some individuals producing sickle cell aneamia and weaker in others, resulting in what is now referred to as sickle cell trait (Nussbaum 2001).
Genetics is concerned with some inherited characteristics. Long DNA molecules are carried on structures called chromosomes in the nucleus of each cell. Human chromosomes occur in pairs; one derived from the mother and one from the father in sexual reproduction. Humans have twenty- three pairs of chromosomes, of which twenty-two are similar in males and females. These are numbered 1 through 22; according to chromosome size. One chromosome pair is different between the females and males: XX in females, and XY in males (Nussbaum 2001).
Several key concepts put forward by Mendel have been expanded, as the science of genetics has grown. It is now known that genetic information is passed on as a series of discrete units known as Genes, each of which is associated with specific traits. Furthermore, most organisms (including humans) get two copies of their genetic information, one from each parent. This means that most living things have two copies of each gene, and that these two copies are not necessarily the same since they came from different parents (Sturtevant, 2001).
The distinction between Genotype and Phenotype is commonly experienced when studying family patterns for certain hereditary diseases or conditions. Due to the diploid of humans there are two alleles for any given gene. These alleles can be the same (homozygous) or different (heterozygous), depending on the individual. With a dominant allele, the offspring is guaranteed to inherit the trait in question irrespective of the second allele. With a recessive allele, the phenotype depends upon the other allele. This person has a normal phenotype but runs a 50-50 risk of passing his or her abnormal gene on to offspring. A homozygous dominant individual has a normal phenotype and no risk of abnormal offspring (Holtzman and Watson, 1998). A homozygous recessive individual has an abnormal phenotype and is guaranteed to pass the abnormal gene onto offspring.
CHAPTER THREE
METHODOLOGY
Study design
The study design for this research is a descriptive design to determine the attitude and intention towards genotype screening among intending couple of The Polytechnics, Ibadan. It was design to identify characteristics of the study population that is associated with their awareness and attitude about genotype testing and practices before marriage. Independent variables are demographic characteristics example sex, age, religion and awareness towards sickle cell aneamia and genotype test and the future intention to undertake the test as a diagnostic measure.
Study Population
The study focuses on intended couples in Ibadan, Oyo state Nigeria. Eligible respondents were unmarried male and female students between the ages of 18-35 years.
Sampling size and sampling techniques
Based on the sample size determination, the minimal sample size needed was obtained using Epi- info package. The total Population was 1,946, expected frequency was 50%, and worst precision is 55%. At 95% confidence interval, the sample size is 321. For attrition and non – response the sample size was increased to 400 for authentication of findings.
CHAPTER FOUR
RESULTS
The findings of this study are presented in this chapter. It consists of demographic characteristics, awareness on sickle cell anaemia and genotype testing, practices of genotype testing, attitude towards genotype screeninging and future intention to undertake genotype test.
CHAPTER FIVE
DISCUSSION, CONCLUSION AND RECOMMENDATIONS
The finding from this study were discussed in this section and covers the following areas: Socio- demographic characteristics; level of awareness of sickle cell anaemia and genotype testing; attitude towards genotype testing; practice of genotype testing; and intention to undertake the test among some selected intending couples. The chapter also includes conclusion, and recommendations for further research.
Socio-demographic characteristics of respondents
Most of the respondents were between 18-30 years with a mean age of 21.6 (SD 3.1) years and a range of 18-35 years. This age range was expected as they were still undergraduates. Previous studies among undergraduates‘ students have shown age range by the following authors; Chukwuma et al., (2007); Jumana Al-Aama, (2010); Omolase et al., (2010); Alao, (2008); and Moran et‘al., (2007). This is expected as young adults pursuing tertiary education and most are still unmarried as this age.
Awareness on sickle cell anaemia and genotype testing
The level of awareness on Sickle cell aneamia and genotype testing was high among respondents. Secondary school was the first source of information for the respondents since majority heard about it from this point in life. This might be due to the fact that they were taught or learnt about the disease while they were in secondary school. This is in consonance with the study reported by Adeyemi and Adekanle (2007), on a study on knowledge amongst senior secondary school students in Nigeria about sickle cell disease, suggesting the need for some legislation about premarital screening and the education of the citizens which should begin at the secondary school level. This was also similar to a study conducted among undergraduate student in a Nigeria university by Agbanusi et al., 2006 to determine the extent of awareness of sickle cell disease and its heterozygous state and it shows that more than half of the students knew about sickle cell anaemia. This is also similar with the study reported by Alao (2008), on the study conducted to determine the attitude towards marriage in the face of haemoglobin genotype incompatibility and it shows that about half of the students knew their genotype status.
Conclusion
The finding from the study shows that there was high awareness rate among respondents about sickle cell anaemia and genotype testing and this should be maintained. The major source of information among these groups is the media (television) and this enable the respondents know the importance of genotype test before marriage. Orientation programme during admission as students into the school should be encouraged.
Respondent partner results contributed to the decision of respondents thereby enabling them make informed decision concerning the safety of their future.
Health implication of findings
The finding of this study is high awareness and practice of genotype testing. Given this recent strategy to sustain and surpass the implication of couples doing genotype testing need to be implemented. These include awareness and the use of community based campaign programme.
The use of mass media, text messages to intending couples, use of E-mails and electronic bill boards. Use of faith based organizations to disseminate genotype testing information to their congregation at least on a monthly basis.
Others include the use of youth based organizations to include it as part of their outreach programme regularly.
Recommendation
- More awareness programmes should be created by the stakeholders during fresher‘s orientation programme by educating the students on premarital genotype test and the consequences of actions guiding their choice of
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