This topic reminds me of a novel I read long ago where a guy was drenched in the middle of a rainy night, trying to woo a lady who for reasons I cannot recall was not interested in the relationship. The guy remarked that anybody in love is a fool, and he, at that moment, was the biggest fool of them all. I have seen sickle cell carriers in crisis; it is heart wrenching and frustrating. Just wondering aloud now, why will two people see potential pains and dangers ahead and still want to get married?

Parent should not bring a child into this world to experience such torture; you do not want to see a loved one in such agony, if it is avoidable. It is okay that our forebears married out of ignorance. Why will you do it now knowing full well the implications? That for me is a heinous crime against humanity, especially the unborn.

Nigerians seem to be aware of the existence of genotypes, in rural populations, there appears to be widespread ignorance about the consequences of not paying attention to genotype compatibility. Many people don’t know that for each pregnancy in which both parents are AS, there is a 25% chance of them giving birth to a child with the sickle cell genotype. The implication of this statistic is that each pregnancy is a mutually exclusive event and the chances of having a sickle cell baby does not reduce with successive pregnancies. Every pregnancy has a 1 in 4 chance of producing a baby with this disorder.

While 70% of the world’s population are carriers, Nigeria has the highest prevalence of sickle cell trait in the world, with 25% of adults being carriers of the trait. Nigeria also accounts for 50% of sickle cell disease (SCD) births worldwide, and of every 1,000 babies born in Nigeria, 20 are born with Sickle Cell Disease, which means that they carry the SS genotype.

Sickle cell disease is a life-long illness. The severity of the disease varies widely from person to person.  In high-income countries, the life expectancy of a person with SCD is 40–60 years, thanks to advances in the diagnosis and care of SCD. However, in Nigeria, the life expectancy of children born with SCD was found to be as low as 23 years. During this projected lifespan, people with SCD are subjected to unpredictable bouts of intense pain and regular hospitalization. Over a lifetime, SCD can harm a person’s spleen, brain, eyes, lungs, liver, heart, kidneys, joints, bones or skin.

There is not yet a cure for Sickle Cell Disease and that is why prevention is highly needed and it is advisable for intending couples starting a family to get a genotype test. A couple who both carry the AS genotype are advised not to start a family. They can choose to adopt children rather than take the risk of giving birth to children with sickle cell disease.

A genotype is the entire genetic constitution of an individual. The genetic makeup of an organism or group of organisms with reference to a single trait, set of traits, or an entire complex of traits. In a nutshell: your genotype is your complete heritable genetic identity; the sum total of genes transmitted from parent to offspring.

There are four hemoglobin genotypes (hemoglobin pairs/formations) in humans: AA, AS, SS and AC (uncommon). SS and AC are the abnormal genotypes or the sickle cells. We all have a specific pair of this hemoglobin in our blood which we inherited from both parents. AA can marry anybody, AS is better off with AA and AS and AS, AS and AC are too risky

It is imperative to know your spouse genotype. This is to prevent serious health issues for the children which can affect the marriage. Also, it is not suitable for sickle cell patient (SS) to get married to a carrier of the sickle cell gene (AS) because of the 50% chance of having babies with the sickle cell gene in each pregnancy. However, a sickle cell patient (SS) can marry an individual with no trait of the Sickle Cell gene (AA).

Courting parties need lot of sensitization on this topic and also prayers, intervention (not interference), good counsel and emotional support because  many of their decisions flow from the heart rather than the head. They are susceptible to manipulation and emotional accidents.