Ben­e­fits of pre­mar­i­tal geno­type, HIV screen­ing

Daily Trust - - HEALTH - From Balarabe Alka­s­sim (Bauchi), Ma­gaji Isa(Jalingo), Lami Sadiq (Jos), Halima Musa(Kano)& Olayemi John-Men­sah (Abuja)

Geno­type and HIV screen­ing be­fore mar­riage has a lot of ben­e­fits for both part­ners and the chil­dren they plan to have. Not only are they vi­tal tests for pre­vent­ing HIV/AIDs in­fec­tion, they also save cou­ples and their off­spring the stress that comes with the man­age­ment of sickle cell dis­ease.

A per­son’s geno­type refers to the types of genes he or she has which is re­spon­si­ble for a par­tic­u­lar in­her­i­ta­ble trait. Geno­type screen­ing helps cou­ples to know if they are both car­ri­ers of the sickle cell genes.

Some ex­perts say that while screen­ing be­fore mar­riage is not aimed at stop­ping peo­ple with AS, SS geno­types or who are HIV pos­i­tive from get­ting part­ners to marry, it at least af­fords the in­tend­ing cou­ple the op­por­tu­nity to be aware of their ge­netic com­pat­i­bil­ity, and to make the choice of agree­ing to go ahead de­spite of the odds as well as be pre­pared to han­dle the out­come.

How­ever, apart from the im­por­tance of this, mar­riages are con­tracted in cities and ru­ral ar­eas, amongst ed­u­cated and un­e­d­u­cated peo­ple daily with­out car­ry­ing out th­ese vi­tal tests.

Dr Ezeokeke Chikao­d­i­naka a med­i­cal of­fi­cer at the Wuse District Hos­pi­tal said a mother and fa­ther con­trib­ute each of the genes that com­bine to give the geno­type that ex­presses the sick­ling trait.

“If a mother is AA and the fa­ther is AA the sick­ling gene will not be ex­pressed, so the chil­dren will all be AA. But if an AS mar­ries AA, there is 25 per­cent chance of hav­ing a child with AS in ev­ery child­birth. Look­ing at AS + AS we will have 25% chance AA, 25% SS, 50% AS in ev­ery child­birth,” he said.

A gy­nae­col­o­gist with the Na­tional Hos­pi­tal, Abuja, Dr Ako­rede Duro­jaiye, said: “There are dif­fer­ent types of the haemoglobin geno­type and they have been clas­si­fied as AA, AS, SS, AC, SC, and the rare form CC. The other forms are the tha­lassemia.”

He added that a size­able num­ber of peo­ple car­ried the S or the C trait as AS, AC, SS or SC.

“The baby in­her­its one of the al­lele genes from ei­ther par­ent. For ex­am­ple if the fa­ther is AS and the mother is AS. The baby could take ei­ther A or S from the fa­ther or the mother. If the baby takes S from the fa­ther and also S from the mother, the re­sult is SS which is a sickle cell child,” Dr Duro­jaiye said.

He ad­vised that peo­ple do the geno­type test be­fore mar­riage and cou­ples who carry trait of ab­nor­mal geno­type should be dis­cour­aged from the mar­riage so that their off­spring will not be a sick­ler.

In Taraba State, it is now manda­tory for in­tend­ing cou­ples to present cer­tifi­cate of HIV screen­ing be­fore the wed­ding is con­ducted in any Mus­lim com­mu­nity across the state.

Daily Trust checks re­vealed that hun­dreds of men and women who got mar­ried with­out sub­ject­ing them­selves to HIV screen­ing died of the dis­ease across the 16 lo­cal govern­ment ar­eas of the state within the last decade.

Also, some men who knew that they were HIV pos­i­tive took ad­van­tage of the ig­no­rance and poverty of par­ents in ru­ral com­mu­ni­ties and in some cases ur­ban ar­eas, to marry in­no­cent girls, di­vorced or wid­owed women with­out the tests.

A one time mem­ber of the state House of As­sem­bly (names with­held),Daily Trust learnt, who had tested pos­i­tive, gave a huge sum of money to the poor par­ents of his beau­ti­ful bride only for her to dis­cover a few months af­ter the mar­riage, that he had in­fected her with the deadly virus. To the dis­may of many, the leg­is­la­tor di­vorced the young wo­man.

The en­light­en­ment cam­paigns at the ward, vil­lage and lo­cal govern­ment lev­els car­ried out by the state’s Agency for the Con­trol of AIDS (SACA) for the past 15 years has im­proved aware­ness among Mus­lim com­mu­ni­ties hence the in­tro­duc­tion of com­pul­sory HIV screen­ing for in­tend­ing cou­ples.

Garba Yusuf, a res­i­dent of Mu­tum-Biyu said, “You don’t need to be told that it is ab­so­lutely nec­es­sary for a cou­ple to be screened for HIV, hep­ati­tis and geno­type be­fore mar­riage.”

He said his friend died of HIV/ AIDS few years af­ter mar­ry­ing a di­vorced wo­man, adding that his late friend and his wife were not screened be­fore the mar­riage.

Sim­i­larly, a com­mu­nity leader in Bali Lo­cal Govern­ment Area, Malam Dauda Sa­maila, told Daily Trust that the in­tro­duc­tion of com­pul­sory HIV test for cou­ples be­fore mar­riage had saved the lives of many in­tend­ing cou­ples in his com­mu­nity.

Malam Dauda dis­closed a case where the rep­re­sen­ta­tive of a groom brought the re­sult of a health screen­ing which showed he was neg­a­tive but a Good Sa­mar­i­tan raised an alarm that it was a fake re­sult, a fresh screen­ing was done at another cen­tre and it was dis­cov­ered that the groom was pos­i­tive.

An Is­lamic cleric in Sunkani, Ardo-Kola Lo­cal Govern­ment Area, Malam Ibrahim Yakubu, ex­plained that it was a res­o­lu­tion by the Taraba State Mus­lim Coun­cil that no mar­riage will take place within any Mus­lim com­mu­nity with­out prior pre­sen­ta­tion of an au­then­tic HIV-AIDS screen­ing cer­tifi­cate from a govern­ment ap­proved hos­pi­tal.

He said, how­ever, that where both groom and bride-to-be test pos­i­tive, mar­riage was al­lowed to be con­tracted if they both agreed to go ahead.

The Di­rec­tor-Gen­eral of Taraba State Agency for Con­trol of AIDS (TACA) Al­haji Abba Sale Ibrahim, said the com­pul­sory screen­ing had helped in re­duc­ing the rate of HIV-AIDS in­fec­tion in the state to be­tween 3 to 4 per cent.

Sim­i­larly in Bauchi State, pre-mar­i­tal HIV and geno­type screen­ing has been on the in­crease.

Ac­cord­ing to the Head of Lab­o­ra­tory Ser­vices, Bauchi State Spe­cial­ist Hos­pi­tal, Ab­dur­rah­man Dan­juma, in the past, peo­ple came to the hos­pi­tal to be screened mainly for HIV but be­cause of the aware­ness cam­paigns be­ing car­ried out by var­i­ous stake­hold­ers, in­clud­ing Mus­lim and Chris­tian cler­ics and the tra­di­tional in­sti­tu­tions, peo­ple were be­com­ing more en­light­ened and this has led to high rate of screen­ing amongst in­tend­ing cou­ples.

To give clout to the var­i­ous ef­forts, a bill has been pre­sented at the Bauchi State House of As­sem­bly to make it manda­tory for in­tend­ing cou­ples to un­dergo HIV and geno­type screen­ing be­fore mar­riage.

Re­li­gious and faith-based or­gan­i­sa­tions have been play­ing tremen­dous roles in cre­at­ing aware­ness and en­sur­ing pre­mar­i­tal HIV, geno­type tests are car­ried out in Plateau State.

Losam Yon­nie, who is en­gaged to be mar­ried and at­tends Mar­velous Chapel in Tudun Wada, Jos, told our correspondent that the church en­forced tests in­clud­ing blood group (Pheno­type), geno­type and HIV/AIDS.

Hav­ing com­menced coun­sel­ing about a month ago, he and his fi­ancé were re­quired to visit a hos­pi­tal his church rec­om­mended to con­duct the test three months into coun­sel­ing, af­ter which the re­sults would be sub­mit­ted to the church.

“We will be re­quired to go for a sec­ond test two weeks to the wed­ding,” he said.

Sarah Pam who is a mem­ber of the Re­deemed Chris­tian Church of God, head­quar­ters, Je­sus House in Jos said, “Some churches have spe­cific hospi­tals where such tests are car­ried out but for us in Re­deemed, the church owns a hos­pi­tal which in­tend­ing cou­ples visit to be tested for HIV/AIDS, geno­type and preg­nancy. This is be­cause we dis­cov­ered over the years that cou­ples some­times li­aised with some doc­tors to de­ceive the church, es­pe­cially as it re­lates to preg­nancy.”

Our correspondent gath­ered that there is no in­sti­tu­tional com­pul­sion for such tests be­fore mar­riage among the Mus­lim Hausa com­mu­nity of Jos but cou­ples who are aware about their im­por­tance do them.

The Pub­lic­ity Sec­re­tary of Jama’atu Nas­ril Is­lam (JNI) for Jos North, Umar Faruk Musa, said, “We en­cour­age in­tend­ing cou­ples to see the need to go for blood group or geno­type tests as well as HIV/ AIDS tests. This is nor­mally achieved through coun­sel­ing di­a­logues.”

In Kano, in­ves­ti­ga­tion by Daily Trust showed that only a few ed­u­cated peo­ple do the tests be­fore mar­riage.

“Few ed­u­cated youth are com­ing for the tests but the bulk of those com­ing, go for HIV test only,” said a source at one of the hospi­tals in Kano.

A Kano-based Is­lamic cleric, Sheikh Ibrahim Khalil said, “there is a gen­eral con­sen­sus among Is­lamic schol­ars that un­der­go­ing such a test is oblig­a­tory by Is­lamic in­junc­tion,” he said.

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