Will genetic counselling be effective in controlling sickle cell disease in Ghana?

ABSTRACT

The knowledge; attitude and practices regarding birth control were studied in 183 adults with sickle cell disease and 61 parents of affected children in Accra. Knowledge of the aetiology of sickle cell disease was poor. Only 30 per cent of respondents volunteered that it is hereditary while 74 per cent attributed it to environmental causes or disease. When prompted; 75 per cent agreed it was hereditary but 20 per cent thought it came from relatives other than parents. Thirty-three per cent (33 per cent) of parents did not know their genotype; while 36 per cent of married patients and 51 per cent of parents did not know the genotype of their spouses. Only 10 per cent of patients knew their spouses' genotype before marriage. The possibility of transmitting the disease had limited the desired family size in half of married patients; and in 18 per cent of parents. However; 37 and 46 per cent respectively already had 4 or more children. A third of married respondents were using birth control methods. Fifty-eight per cent of unmarried patients were worried about transmitting the disease; and 48 per cent would test a prospective spouse and not marry a carrier. However; 22 per cent stated that the partner's genotype would not alter the decision to marry. While 38 per cent of married patients and 27.8 per cent of parents would consider changing their spouses because of the disease; 3.8 per cent of the married patients and none of the parents had actually done so. It is suggested that better education of the general public and patients about sickle cell disease is necessary for genetic counselling to have an impact on the control of the disease