Benefits of premarital genotype, HIV screening
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.