In many Ghanaian and Nigerian churches, a couple cannot fix a wedding date until they bring medical test results to the pastor. The most important result is often a two-letter code: the genotype.
Why genotype matters
Sickle cell disease is a serious inherited blood disorder that is common in West Africa. A person’s genotype shows which haemoglobin genes they carry. Most people are AA. People with AS carry one sickle gene; they are usually healthy but are carriers, often called sickle cell trait. People with SS have sickle cell disease, which causes pain crises, anaemia, infections and organ damage.
If both partners are AS, each pregnancy has a one in four chance of producing a child with SS. Other combinations, such as AS and SC, also carry risks.
The test
Genotype testing is a simple blood test available at hospitals and laboratories. Couples should use reputable labs, and some take the test twice at different labs to be sure, because errors can have lifelong consequences.
Other common tests
HIV and hepatitis B. Knowing each other’s status allows couples to protect each other and plan for healthy pregnancies. Treatment and prevention options are effective.
Blood group and rhesus factor. If the woman is rhesus negative and the man rhesus positive, doctors can manage the pregnancy with injections to prevent complications.
Other screenings. Some couples also test for sexually transmitted infections and general health markers.
When results are difficult
Some couples discover that both are AS after they are already in love or engaged. This is painful. Couples should speak with a doctor or genetic counsellor about the real risks and options, which may include prenatal testing, in vitro fertilisation with embryo testing, adoption or deciding not to marry.
No one should be forced into a decision. Pastors and families can support couples with compassion.
Test early
The best time to know your genotype is before a relationship becomes serious. Many young people now ask about genotype early in dating, and some state it on social media or dating profiles.
Sickle cell today
Treatment for sickle cell disease has improved, and people with SS can live long lives with good care. But the condition remains a major health burden in West Africa, and prevention through awareness remains important.
A two-minute conversation about genotype before the engagement can prevent years of heartbreak. It is one of the most loving questions a couple can ask each other.
