Awareness and Attitude Towards Premarital Genotype Counseling in Nigeria

1.0 Introduction

1.1 Background of Study

Premarital genotype counseling is a critical healthcare service in Nigeria, aimed at educating individuals and couples about their genetic compatibility before marriage. This counseling is especially important due to the high prevalence of sickle cell trait and other genetic disorders in the Nigerian population. Studies show that sickle cell disease (SCD) is one of the most common genetic disorders in Nigeria, with an estimated 25% of the population being carriers of the sickle cell trait (Ola et al., 2019). As a result, couples who are both carriers of the sickle cell trait have a 25% chance of having a child with sickle cell anemia, a life-threatening condition that significantly impacts the quality of life. In response to this, premarital genotype counseling has been introduced as a preventive measure to help couples make informed decisions regarding their reproductive health. Despite its importance, the level of awareness about premarital genotype counseling remains low in many parts of Nigeria.

In the early stages of the movement according to Akinmoladun et al. (2017), there was limited awareness and knowledge about the significance of genotype counseling among the general public, particularly in rural areas. Many individuals were unaware of the genetic risks associated with marriage between carriers of the sickle cell trait, and cultural norms often overshadowed the importance of premarital genotype screening (Akinmoladun et al., 2017). As a result, the incidence of children born with sickle cell disease remained high, despite the availability of preventive measures.

Over time, premarital genotype counseling became more integrated into the healthcare system, particularly in urban areas. However, the uptake of counseling services remained uneven across different regions of Nigeria. In many rural areas, misconceptions about the counseling process and cultural resistance to genetic testing persisted, limiting the effectiveness of the program (Akinmoladun et al., 2017). Studies have shown that while there is an increasing level of awareness among young people, attitudes toward counseling are still mixed, with some individuals viewing it as unnecessary or invasive (Oyekale, 2016).

A study by Oyekale (2016) highlighted that many individuals are unaware of the implications of their genotype, and those who are aware may lack a positive attitude toward seeking counseling. Furthermore, misconceptions about the counseling process and a lack of accessible healthcare services contribute to the low uptake of premarital genotype counseling (Akinmoladun et al., 2017). Premarital genotype counseling plays a significant role in addressing the challenges associated with genetic disorders in Nigeria, particularly those related to sickle cell disease (SCD). As a country with a high prevalence of sickle cell traits, Nigeria faces significant health burdens associated with genetic disorders. The introduction of premarital genotype counseling serves as an essential strategy to mitigate these risks by educating couples about the genetic compatibility of their traits before marriage, thus preventing the birth of children with severe genetic conditions like sickle cell anemia.

According to Akinmoladun et al. (2017), genotype counseling offers individuals and couples the opportunity to make informed decisions regarding marriage, reducing the incidence of genetic diseases within the population. Despite its importance, studies have shown that awareness and attitudes toward premarital genotype counseling in Nigeria remain inconsistent, with many individuals either unaware of the need for counseling or holding misconceptions about the process (Ola et al., 2019). This gap in awareness and negative attitudes toward counseling hinder the effectiveness of the counseling process and its potential to reduce genetic disorders. Therefore, this study aims to explore the current level of awareness and the prevailing attitudes towards premarital genotype counseling in Nigeria.

1.2 Statement of Problems

Investigation revealed that the awareness and attitude towards premarital genotype counseling in Nigeria is a critical issue due to the country's high prevalence of sickle cell disease (SCD). Despite the availability of genotype counseling services, many individuals remain unaware of the importance of knowing their genotype status before marriage, leading to the continuation of preventable genetic disorders. Research indicates that a significant number of Nigerians, particularly in rural areas, lack basic knowledge about the risks of sickle cell disease and the benefits of premarital counseling (Akinmoladun et al., 2017). This lack of awareness often results in the high incidence of SCD among children born to parents who are carriers of the sickle cell trait.

Additionally, cultural beliefs and misconceptions about genotype counseling significantly influence attitudes towards it. Many individuals view genotype screening as unnecessary or invasive, often due to a lack of understanding or fear of social stigma (Oyekale, 2016). This negative attitude towards premarital genotype counseling persists despite ongoing public health efforts to raise awareness and educate the population about the benefits of counseling in reducing the incidence of sickle cell disease. The challenge of addressing these misconceptions is compounded by the limited availability of counseling services, especially in rural and underserved regions, where healthcare access is restricted (Ola et al., 2019). The problem of inadequate awareness and negative attitudes towards premarital genotype counseling is further exacerbated by a lack of comprehensive educational programs targeting young adults, who are the primary beneficiaries of such services. Therefore it is against this backdrop that this study will aim to assess the level of awareness and attitude towards premarital genotype counseling in Nigeria.

1.3 Aim and Objectives of Study

The aim of this study is to investigate the awareness and attitudes towards premarital genotype counseling among Nigerians. The specific objectives of the study are:

1. To evaluate the level of awareness about premarital genotype counseling among individuals in Nigeria.
2. To examine the attitudes of Nigerians towards premarital genotype counseling, including factors that influence their decisions to undergo genotype screening.
3. To identify the factors that contribute to misconceptions and negative attitudes regarding premarital genotype counseling in Nigeria.
4. To assess the role of education and public health initiatives in shaping awareness and attitude towards premarital genotype counseling.
5. To provide recommendations for improving awareness programs and strategies aimed at promoting the adoption of premarital genotype counseling as a preventive health measure.

1.4 Research Questions

Based on the stated objectives, this study seeks to answer the following research questions:

• What is the level of awareness regarding premarital genotype counseling among Nigerians?
• What are the attitudes of Nigerians towards premarital genotype counseling, and what factors influence these attitudes?
• How do educational campaigns, healthcare professionals, and the media influence the awareness and attitudes of Nigerians towards premarital genotype counseling?
• What misconceptions or negative beliefs exist about premarital genotype counseling that may prevent individuals from undergoing screening?
• What public health policies and programs can be developed to enhance awareness and encourage the use of premarital genotype counseling in Nigeria?

1.5 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

• H₀1: Public health campaigns and media coverage does not significantly influence attitudes towards premarital genotype counseling in Nigeria.
• H₀2: There is a significant relationship between the level of education and the awareness of premarital genotype counseling in Nigeria.
• H₀3: There is a significant positive attitude towards premarital genotype counseling among individuals who have received adequate information about its benefits.

1.6 Significance of Study

The outcome of this research will inform policymakers about the development of targeted health policies and strategies to promote premarital counseling as a preventive health measure. The study will contribute to the promotion of informed decision-making, which is essential for reducing the incidence of genetic diseases in Nigeria.

Additionally, the research will encourage increased advocacy for premarital genotype counseling as a tool for improving public health and reducing the social and economic burden of genetic disorders in the country.

For couples and individuals, the study will provide vital information to help them make informed decisions about their health and the potential risks of genetic disorders.

Finally, the research will be important for advocacy groups, as it will help them in raising awareness and sensitizing the public about the benefits of premarital genotype counseling, potentially leading to broader societal acceptance and action.

1.7 Scope of the Study

The scope of this study will focus on the awareness and attitudes towards premarital genotype counseling among individuals in Lagos State, Nigeria. The study will specifically target young adults within the age group of 18 to 35, as this is the primary demographic affected by premarital genotype counseling. The research will involve selected universities, health clinics, and community centers in Lagos State to gather diverse perspectives on the subject.

1.8 Limitations of the Study

The research study on the awareness and attitude towards premarital genotype counseling in Nigeria was limited by several factors.

1. First, the sample size was limited to individuals within Lagos State, which may not fully represent the attitudes and awareness of individuals in other parts of Nigeria.
2. Second, there was a potential for bias in responses, as participants might have given socially desirable answers rather than their true opinions.
3. Additionally, insufficient funding was a constraint, which limited the resources available for a more extensive data collection process. There was also a limitation in terms of time, as the study had to be completed within a set timeframe, which might not have allowed for deeper exploration into some areas of the research.
4. Lastly, there were challenges in accessing some target participants due to a lack of cooperation or delays in responding to survey requests, affecting the overall data collection process.

1.9 Definition of Terms

Awareness: Awareness refers to the knowledge and understanding that individuals have about a particular issue or subject. In the context of premarital genotype counseling, awareness pertains to how much people know about the importance of genotype screening before marriage, its potential implications, and the health risks associated with genetic disorders (Oluyede, 2020).

Attitude: Attitude is the way individuals feel or think about a particular subject, which can influence their behavior. In this study, attitude refers to the perceptions, beliefs, and behavioral intentions of individuals towards premarital genotype counseling. A positive attitude may reflect the willingness to engage in counseling, while a negative attitude may involve resistance or indifference (Akinmoladun & Dada, 2019).

Premarital Genotype Counseling: Premarital genotype counseling is a process where individuals or couples are educated and tested for their genetic makeup before marriage. This counseling aims to identify the likelihood of genetic disorders, particularly sickle cell disease, that may arise in offspring if both partners carry similar genetic traits (Sule & Akande, 2018).

Genotype: Genotype refers to the genetic constitution of an individual, specifically the alleles inherited from their parents. Genotype testing is a medical procedure that helps identify whether an individual carries genes for certain inherited conditions, such as sickle cell anemia (Oluyede, 2020).

Sickle Cell Disease: Sickle cell disease is a genetic blood disorder characterized by abnormal hemoglobin, which leads to the formation of sickle-shaped red blood cells. Individuals with sickle cell disease experience various health complications, including pain, anemia, and organ damage. This condition is particularly relevant in premarital genotype counseling in Nigeria, where the disease is prevalent due to genetic traits in the population (Akinmoladun & Dada, 2019).