In Nigeria, Courting Couples Ask Each Other's Genotype — Epoche B1
In Nigeria, "what is your genotype?" is a question people ask each other early in a courtship, sometimes before a second meeting. The answer is a pair of letters — AA, AS or SS — describing which forms of haemoglobin, the substance that carries oxygen in the blood, a person carries. Churches and clinics ask engaged couples to be tested. The arithmetic is why. Someone with AS carries the sickle gene without being ill: this is the sickle cell trait. If two AS people have children, each pregnancy carries roughly a one-in-four chance of a child with SS — sickle cell disease, which brings episodes of severe pain, anaemia, infection and, without care, early death. The odds do not improve because the first child was healthy. The gene is common for a reason that is nobody's fault: one copy gives some protection against malaria, so where malaria has long been present the trait spread. Nigeria now has more births with sickle cell disease than any other country. Newborn screening changes that picture — a baby found early is given penicillin and vaccines from infancy, and grows up under care rather than being diagnosed in the middle of a crisis. A Yoruba proverb says that an elder should not sit in the market and let a child's head be carried crooked: those who know should speak before the harm is settled. That is the case for testing early, and for saying so plainly. But the other side should be said as plainly. Engagements have been broken over two letters, and some people hide their results. A test result is information, not a verdict; a couple who know what they face may weigh it differently, and the right to marry remains theirs. The task is to make sure nobody learns it too late to choose. References Allison, A. C. (1954). Protection afforded by sickle-cell trait against subtertian malarial infection. British Medical Journal, 1(4857), 290-294. Piel, F. B., Steinberg, M. H., & Rees, D. C. (2017). Sickle cell disease. New England Journal of Medicine, 376(16), 1561-1573. World Health Organization (2006). Sickle-cell anaemia: report by the Secretariat. Fifty-ninth World Health Assembly, document A59/9. Geneva: WHO.