Determinants of Sickle Cell Disease Premarital Screening Utilization among Youth Corps Members in Iwo Local Government Area, Osun State, Nigeria

Determinants of Sickle Cell Disease Premarital Screening Utilization among Youth Corps Members in Iwo Local Government Area, Osun State, Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Determinants of Sickle Cell Disease Premarital Screening Utilization among Youth Corps Members in Iwo Local Government Area, Osun State, Nigeria Oludamola Victoria Adeleke, Ngozi Anthonia Okafor, Oluwatosin Ope-Babadele, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6542064/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Sickle cell disease (SCD) is the most common genetic condition in the world. Nigeria has the highest burden of Sickle cell disease in the world with the prevalence of sickle cell trait and the homozygous form as 25% and 2%, respectively. Prevention of SCD is crucial among unmarried adults. Premarital screening is an important strategy for the prevention of SCD. Yet, the prevalence of SCD is still rising as a result of a lack of knowledge, accessibility, affordability of health care services, cultural and religious beliefs about the disease and an unwillingness to participate in premarital screening The study assessed the determinants of SCD premarital screening utilization among youth corps members in Iwo Local Government areas, Osun State, Nigeria. Methods : .A descriptive cross-sectional design was adopted for the study. Population consists of 365 youth corps members, Sample size of 297 participants was determined using the Leslie Kish formula A stratified random sampling technique was utilized to select 297 participants in Iwo Local Government Area, Osun State. A structured and validated questionnaire was used for data collection with reliability coefficient scoring from 0.731(α)-0.85(α) Response rate was 99%. Data were analyzed using descriptive and inferential statistics, at significance level of 0.05. Results : Findings showed that the majority (91.2%) had adequate knowledge of sickle cell disease. Regarding premarital screening, the majority (88.8%) demonstrated adequate knowledge. All participants showed willingness to undergo premarital screening. Utilization of premarital screening was reported by the majority (73.8%). Emotional preparedness to handle any results from premarital screening and history of premarital genetic counselling were significantly associated with utilization of genotype premarital screening. Knowledge and utilization of sickle cell disease premarital screening, willingness and utilization of sickle cell disease premarital screening were not statistically significant with the p-value > 0.05 Conclusion : The findings of this study highlight the importance of addressing sociocultural perceptions misconception, enhancing public awareness, and ensuring accessibility to foster greater adoption of premarital screening. Determinants Premarital Screening Sickle Cell Disease Utilization Youth Introduction The burden of sickle cell disease (SCD) is immense. Globally, early 100 million people are affected. About 300,000 SCD affected babies on each year. Sub-Saharan Africa is the region where the majority of SCD births occur, with high rates of under-five mortality and over 50% of deaths from SCD complications (1). In Nigeria, there are about 20 cases of sickle cell anemia for every 1000 people due to the high prevalence of sickle cell trait, which is 23.7%. Approximately, 150,000 newborns with the disease are born each year as a result of these births. Based on this data, Nigeria has the highest incidence of sickle cell disease (Hb SS and Hb SC) worldwide, affecting 2.69–5% of the population (2), The quality of life for people living with sickle cell disease (SCD) is negatively impacted by a variety of clinical manifestations that can be chronic and debilitating. The most frequent SCD manifestations include stroke, leg ulcers, priapism, acute painful crises, acute chest syndrome, and severe bacterial infections (2). Premarital screening helps in the prevention of SCD. There is a need to increase its awareness which in turn improves its uptake disease(3). Thousands of babies and children are dying because premarital sickle cell screening which would have allowed intending couples to know their hemoglobin genotype before marriage is not being carried out, despite significant advancements in the knowledge of the molecular pathology, pathophysiology, and causes of inheritable disorders(4). Typically, spouses are discouraged from taking these tests out of concern that their incompatibility may negatively impact their marital arrangement (5). Prevention of SCD is crucial among adults who are single in urban areas, particularly with the rise in premarital sex and delay of marriage, considering the relatively high prevalence of SCD in Nigeria and its potential to rise. Yet, the prevalence of SCD is still rising as a result of a lack of knowledge, accessibility and affordability of health care services, cultural and religious beliefs about the disease and an unwillingness to participate in a premarital screening (6). Therefore, this study is aimed to assess the determinants of sickle cell disease premarital screening utilization among youth corps member in Iwo local government area, Osun State imbibing the theory of planned behaviour. Methodology Study Design and Setting This study utilized a cross-sectional survey design to assess the determinants of sickle cell disease premarital screening utilization among youth corps members in Iwo local government area, Osun State. The study was conducted at the weekly community development service at the secretariat in Iwo local government area Participants and Procedure The study included 365 youth corps members at Iwo local government in Osun state selected through stratified random sampling based on their batches. Inclusion criteria include Youth corps members who are not married. Data were collected using a self-structured questionnaire, distributed at the weekly community development service. Informed consent was obtained from all participants before distribution of the questionnaire, and the data collection period spanned three weeks. Study Instrument A self-structured questionnaire was used to assess participants' knowledge, willingness, utilization and determinants of sickle cell disease premarital screening utilization. It was developed based on a review of existing literature (Adeyemo et al 2022: Moustafa et al, 2022; Al-shafai et al, 2022; Adegbite et al, 2021: Miagoro et al, 2024) and pre-tested. The questionnaire contained six sections: sociodemographic characteristics, knowledge of sickle cell disease (10 items), knowledge of premarital screening for sickle cell disease (10), willingness towards sickle cell disease premarital screening (11 items), utilization level of sickle cell disease premarital screening (13), determinants of utilization of sickle cell disease premarital screening (15). Furthermore, the respondent’s level of knowledge regarding SCD was measured based on up of ten (10) questions. The measurable mean of knowledge in the identification of the knowledge level of sickle-cell disease was based on 10 items. It was answered by True or False questions. The Participants’ overall knowledge of sickle cell disease was determined based on their responses to 10 knowledge-based questions with correct responses scored 1, incorrect zero; participants with total scores between (7-10) and (0-6) were adjudged to have good and poor knowledge of sickle cell disease respectively. In addition, the respondent’s willingness towards sickle cell disease premarital screening was also measured. It was determined by their responses to eleven (11) willingness-based Likert questions of yes -3, undecided -2, and no -1 for positive statements and reversed coded for negative statements. This was further categorized into three. Those who scored less than equal to 10, were regarded as having poor willingness, those who scored greater than 11 to 22 were regarded as having moderate willingness while those who score 22 to 33 were regarded as having high willingness. The respondents sickle cell disease premarital screening utilization was also measured. It was made up of thirteen (13) questions that assessed the level of utilization of sickle-cell disease premarital screening among youth corps members. Those who scored less than equal to 5, were regarded as having poor utilization, those who scored greater than 6 to 9 were regarded as having moderate utilization while those who score 10 to 13 were regarded as having high utilization. Furthermore, the respondents determinants of utilization of sickle cell disease premarital screening It consists of fifteen (15) questions that expose the influence of cultural belief, religious belief, healthcare cost, and access on utilization of sickle-cell premarital screening Likert scale of 4 was used to answer the questions. Those who scored less than equal to 20, were regarded as having poor willingness, those who scored greater than 21 to 42 were regarded as having moderate willingness while those who score 42 to 60 were regarded as having high willingness. Statistical Analysis Data were analyzed using IBM SPSS Statistics version 28.0. Descriptive statistics such as frequencies, percentages, means, and standard deviations were computed for sociodemographic variables. Chi-square tests were used to assess associations between categorical variables, with a significance level set at p < 0.05. Ethical Consideration Permission and ethical clearance were taken from the Babcock University Health Research Ethic Committee with approval number BUHREC 107/24. Permission was obtained from the Communication Liaison Officer (CLO), who coordinate the youth corps member on schedule data collection day and time. Before data collection, participants were provided with the study objectives and informed consent was obtained. Confidentiality of their responses was guaranteed and emphasized their freedom to withdraw from the study at any stage. All questions and concerns were addressed with sincerity, fostering transparent. Results Table 1: Sociodemographic Characteristics Variables Categories n (%) Age (in years) (Mean±SD=25.02±2.728) ≤ 20 10 (3.4) 21-25 168 (57.1) 26-30 111 (37.8) ≥ 31 5 (1.7) Gender Male 123 (41.8) Female 171 (58.2) Religion Christian 175 (59.5) Islam 107 (36.4) Traditional 12 (4.1) Marital Status Single 232 (78.9) Engaged 62 (21.1) Tribe Yoruba 233 (79.3) Igbo 32 (10.9) Hausa 5 (1.7) Ijaw 24 (8.2) Level of Education HND 105 (35.7) Bachelors’ Degree 174 (59.2) Postgraduate Degrees 15 (5.1) Course of Study Business and Management 68 (23.1) Social Sciences and Humanities 100 (34.0) Health and Biological Sciences 44 (15.0) Science and Technology 82 (27.9) Premarital Counselling History Yes 79 (26.9) No 215 (73.1) Table 1 revealed that the mean age of the respondents was 25.02±2.728 years, indicating a predominantly youthful population. In terms of gender, females accounted for more than half 171(58.2%) of the sample, religious affiliation, Christianity was the majority175(59.5%), marital status distribution revealed that most respondents were single 232(78.9%), tribal affiliation indicated that the Yoruba tribe was dominant,233(79.3%). Regarding education, more than half 74(59.2%) held a Bachelor's degree; in terms of courses studied, over one-third 100(34.0%) had a background in Social Sciences and Humanities, 82(27.9%) in Science and Technology, 68(23.1%) in Business and Management, and 44(15.0%) in Health and Biological Sciences; on premarital counselling for sickle-cell disease history, about three-quarter 215(73.1%) of respondents reported that they had not undergone such screening. Table 2 :Knowledge of Sickle Cell Disease Variables Yes n(%) No n(%) SCD is a genetic blood disorder 293 (99.7) 1 (0.3) SCD is inherited from parents through genes 277 (94.2) 17 (5.8) Individuals with genotype SS or SC have SCD 272 (92.5) 22 (7.5) Premarital genetic screening can detect the sickle cell trait 275 (93.5) 19 (6.5) A child can inherit SCD if both parents carry the trait 282 (95.9) 12 (4.1) SCD can be diagnosed through a blood test 274 (93.2) 20 (6.8) SCD can be transmitted through blood transfusions 137 (46.6) 157 (53.4) SCD is contagious and can spread through casual contact 50 (17.0) 244 (83.0) Stem cell transplantation is currently the potential cure for SCD 203 (69.0) 91 (31.0) People with sickle cell trait always develop SCD 249 (84.7) 45 (15.3) Mean±SD 7.90±1.17 Median 8.00 Table 2 revealed that majority 293(99.7%), correctly identified sickle cell disease as a genetic blood disorder, majority 277(94.2%) were aware that sickle cell disease is inherited from parents through genes, similarly, majority 272(92.5%) recognized that individuals with genotype SS or SC have sickle cell disease; furthermore, role of premarital genetic screening in detecting the sickle cell trait was understood by majority 275(93.5%); also majority, 282(95.9%), understood that a child could inherit sickle cell disease if both parents carry the trait; furthermore, majority 274(93.2%) correctly acknowledged that sickle cell disease could be diagnosed through a blood test; the understanding of disease transmission through blood transfusions showed a mixed response, with about half 137(46.6%) incorrectly believing it could be transmitted in this way; majority 244(83.0%), correctly denied that sickle cell disease is contagious or can spread through casual contact; regarding treatment, few over two-third 203(69.0%) identified stem cell transplantation as a potential cure for sickle cell disease, while majority 249(84.7%), incorrectly believed that people with sickle cell trait always develop the disease. Table 3: Knowledge of Premarital Screening for Sickle Cell Disease (n=294) Variables Yes n (%) No n (%) Heard of premarital genotype screening 213 (72.4) 81 (27.6) Premarital genotype screening is a test done to identify the risk of having a child with SCD 275 (93.5) 19 (6.5) Premarital genotype screening should be done during courtship or before marriage 275 (93.5) 19 (6.5) Premarital genotype screening can prevent having a child with SCD 274 (93.2) 20 (6.8) Not adhering to premarital genotype screening recommendations can have significant consequences 274 (93.2) 20 (6.8) Premarital genotype screening is only necessary if there's a family history of SCD 98 (33.3) 196 (66.7) Both partners need to undergo premarital screening for it to be effective 281 (95.6) 13 (4.4) Premarital genotype screening is a one-time test that doesn't need to be repeated 171 (58.2) 123 (41.8) Counselling is an important part of the premarital genotype screening process 270 (91.8) 24 (8.2) If both partners have the sickle cell trait (AS), they are guaranteed to have a child with SCD 217 (73.8) 77 (26.2) Mean±SD 7.84±1.14 Median 8.00 Table 3 revealed that about three-quarters 213(72.4%), had heard of premarital genotype screening; The understanding of its purpose was strong, with majority 275(93.5%) recognizing that premarital genotype screening identifies the risk of having a child with sickle cell disease; similarly, majority 275(93.5%) agreed that it should be conducted during courtship or before marriage; majority 274(93.2%) acknowledged that premarital genotype screening can prevent the occurrence of sickle cell disease in children; furthermore, majority 274(93.2%), believed that failing to adhere to recommendations from premarital screening could have significant consequences; however, one-third 98(33.3%) thought screening was necessary only in cases of a family history of sickle cell disease, while the majority, 196(66.7%), rejected this notion; overwhelming majority 281(95.6%), agreed that both partners need to undergo screening for it to be effective; however, more than half 171(58.2%) incorrectly believed that premarital genotype screening is a one-time test that does not need to be repeated; counselling was widely recognized as an important component of premarital screening, with majority 270(91.8%) affirming its necessity; lastly, about three-quarters 217(73.8%) mistakenly believed that if both partners carry the sickle cell trait (AS), they are guaranteed to have a child with sickle cell disease. Table 4: Willingness towards Sickle Cell Disease Premarital Screening Variables Responses (n=294) Yes f(%) No f(%) Undecided (f%) Mean±SD Willing to undergo premarital screening for SCD before marriage 268 (91.2) 8 (2.7) 18 (6.1) 2.88±0.400 Willing to undergo premarital screening for SCD even if there is a cost involved 255 (86.7) 32 (10.9) 7 (2.4) 2.76±0.634 Would encourage others to participate in premarital screening for SCD 282 (95.9) 12 (4.1) 0(0) 2.92±0.396 Would recommend premarital screening as a way to reduce the burden of SCD on families 276 (93.9) 12 (4.1) 6 (2.0) 2.90±0.417 If found out to have sickle cell trait, would insist on screening for partner 281 (95.6) 13 (4.4) 0(0) 2.91±0.412 Would undergo premarital genotype screening even if it might disclose genetic status to others 263 (89.5) 31 (10.5) 0(0) 2.79±0.615 Believes individuals in intimate relationships should know their sickle cell trait status 272 (92.5) 22 (7.5) 0(0) 2.85±0.527 If the screening were voluntary, would still choose to do it 281 (95.6) 7 (2.4) 6 (2.0) 2.93±0.334 Would improved procedures for SCD premarital screening make you more likely to undergo the screening 257 (87.4) 31 (10.5) 6 (2.0) 2.77±0.625 Would assurance of accurate results make you more willing to undergo the screening 269 (91.5) 19 (6.5) 6 (2.0) 2.85±0.507 Would make time for sickle cell premarital screening even if having a busy schedule 279 (94.9) 9 (3.1) 6 (2.0) 2.92±0.370 Mean±SD 31.48±2.64 Median 33.00 Proportion with scores equal to the median/total obtainable score 198(67.3%) Proportion with scores < median 96(32.7%) Table 4 revealed that the majority, 268(91.2%), expressed willingness to undergo premarital screening for SCD before marriage, while only 8(2.7%) were unwilling and 18(6.1%) remained undecided, with a mean score of 2.88±0.400. Even when considering screening with associated costs, 255(86.7%) were still willing to proceed, while 32(10.9%) were unwilling and 7(2.4%) remained undecided, resulting in a mean score of 2.76±0.634. Encouraging others to participate in premarital screening for SCD was strongly supported by 282(95.9%), while only 12(4.1%) opposed it, leading to a mean score of 2.92±0.396. Similarly, 276(93.9%) stated that they would recommend premarital screening as a strategy to reduce the burden of SCD in families, whereas 12(4.1%) were against it and 6(2.0%) remained undecided, yielding a mean score of 2.90±0.417. If diagnosed with the sickle cell trait, 281(95.6%) would insist on screening their partner, while only 13(4.4%) opposed the idea, leading to a mean score of 2.91±0.412. Regarding willingness to undergo screening despite the risk of genetic status disclosure, 263(89.5%) expressed willingness, while 31(10.5%) did not, resulting in a mean score of 2.79±0.615. Additionally, 272(92.5%) agreed that individuals in intimate relationships should know their sickle cell trait status, whereas 22(7.5%) disagreed, leading to a mean score of 2.85±0.527. Even if screening were voluntary, 281(95.6%) stated they would still undergo the test, while 7(2.4%) were unwilling and 6(2.0%) were undecided, resulting in a mean score of 2.93±0.334. The likelihood of undergoing screening increased with improved procedures, as indicated by 257(87.4%), while 31(10.5%) remained unwilling and 6(2.0%) were undecided, leading to a mean score of 2.77±0.625. Assurance of accurate results would also enhance willingness, as expressed by 269(91.5%), while 19(6.5%) disagreed and 6(2.0%) remained undecided, with a mean score of 2.85±0.507. Despite a busy schedule, 279(94.9%) affirmed they would make time for premarital screening, while 9(3.1%) were unwilling and 6(2.0%) were undecided, yielding a mean score of 2.92±0.370. Overall, the mean willingness score among respondents was 31.48±2.64, indicating a strong positive disposition towards premarital screening for SCD. Table 5: Utilization of Sickle Cell Disease Premarital Screening Variables Categories n (%) Ever undergone a genotype test for SCD Yes 217(73.8) No 77(26.2) If yes, was the genotype testing easily accessible (n=217) Yes 189(87.1) No 28(12.9) Frequency of undergoing a genotype test for SCD (n=217) Once 74(34.1) Twice 91(41.9) Three times 44(20.3) Four or more times 8(3.7) If more than once, did you use different health facilities for the tests? (n=143) Yes 114(79.7) No 29(20.3) Genotype (n=217) AA 141(48.0) SS 8(2.7) SC 2(0.7) AC 2(0.7) AS 64(21.8) Who primarily decided that you should have a genotype test done? (n=217) Self 104(47.9) Partner 18(8.3) Religious Authority 5(2.3) Parent 57(26.3) Health worker 31(14.3) School 2(0.9) Purpose of carrying out genotype test** Premarital screening 44(20.3) Prenatal testing 40(18.4) General health check-up 77(35.5) Family planning 23(10.6) Requirement for school/work 37(17.1) Curiosity about genetic makeup 21(9.7) Doctors’ recommendation 8(3.7) Family history of SCD 217(100.0) Received counselling before the test (n=217) Yes 96(44.2) No 121(55.8) If not had a genotype test, what is the main reason (n=77) Lack of awareness 14(18.2) Cost 10(13.0) Fear of result 17(22.1) Not considered necessary 19(24.7) Limited access to testing facilities 17(22.1) Has partner also had a genotype test for SCD Yes 147(50.0) No 58(19.7) Unsure 48(16.3) Don't have a partner or girlfriend 41(13.9) Aware of any local facilities offering genotype testing Yes 184(62.6) No 110(37.4) Ever discussed genotype testing with your partner or potential partner? Yes 213(72.4) No 38(12.9) Not applicable 43(14.6) If premarital screening revealed you and your partner were at risk of having a child with SCD, would it affect your relationship decisions? Yes 221(75.2) No 73(24.8) Table 5 revealed that the majority 217(73.8%) had undergone a genotype test for SCD; among those who underwent testing, the majority 189(87.1%) reported that the genotype testing was easily accessible; based on the frequency of testing, few over one-third 74(34.1%) had undergone the test once, 91(41.9%) twice, and 44(20.3%) three times; among those tested more than once, majority 114(79.7%) had used different health facilities; the distribution of genotypes revealed participants were AA 141(48.0%), AS 64(21.8%), SS 8(2.7%), SC 2(0.7%) and AC 2(0.7%); the decision to undertake genotype testing was primarily self-initiated by about half 104(47.9%), followed by parental influence in 57(26.3%) cases. Health workers influenced 31(14.3%) participants, while partners, religious authorities and schools accounted for 18(8.3%), 5(2.3%), and 2(0.9%) decisions, respectively Table 6 : Determinants of Utilization of Premarital Screening for Sickle Cell Disease Variables Strongly agree f(%) Agree f(%) Disagree f(%) Strongly disagree f (%) Mean±SD SCD is a medical condition, not a curse or punishment from God. 219(74.5) 64(21.8) 0(0) 11(3.7) 3.67±0.669 Premarital screening for SCD aligns with cultural and religious beliefs. 175(59.5) 81(27.6) 33(11.2) 5(1.7) 3.45±0.759 Family and community support undergoing premarital screening for SCD. 180(61.2) 75(25.5) 33(11.2) 6(2.0) 3.46±0.773 Action and choices play a significant role in determining future children's health status. 213(72.4) 68(23.1) 8(2.7) 5(1.7) 3.66±0.617 Premarital screening for SCD is a responsible health choice, even for those who believe in God's will or fate. 210(71.4) 64(21.8) 15(5.1) 5(1.7) 3.63±0.662 Seeking religious guidance or counselling regarding premarital screening for SCD is beneficial. 154(52.4) 105(35.7) 24(8.2) 11(3.7) 3.37±0.784 Healthcare services that offer premarital screening for SCD are easily accessible to me. 131(44.6) 100(34.0) 51(17.3) 12(4.1) 3.19±0.865 The cost of premarital screening for SCD is reasonable and not a significant barrier. 107(36.4) 139(47.3) 37(12.6) 11(3.7) 3.16±0.784 Have adequate knowledge about SCD and the importance of premarital screening. 157(53.4) 93(31.6) 38(12.9) 6(2.0) 3.36±0.784 Premarital screening for SCD should be mandatory for those planning to marry. 228(77.6) 54(18.4) 12(4.1) 0(0) 3.73±0.527 The results of premarital screening would influence decisions about marriage or having children. 202(68.7) 75(25.5) 17(5.8) 0(0) 3.63±0.592 Society should be more accepting of individuals with SCD. 183(62.2) 94(32.0) 17(5.8) 0(0) 3.56±0.602 Would be afraid to undergo premarital screening for fear of what others might think of me. 64(21.8) 55(18.7) 107(36.4) 68(23.1) 2.39±1.068 Feels emotionally prepared to handle any results from premarital screening. 111(37.8) 138(46.9) 34(11.6) 11(3.7) 3.19±0.781 Trusts the healthcare system to provide accurate and reliable results for SCD premarital screening. 140(47.6) 129(43.9) 20(6.8) 5(1.7) 3.37±0.688 Table 6 indicated that undergoing premarital screening for sickle cell disease was significantly associated with higher odds of utilizing premarital services (p=0.026). Individuals who had participated in counselling were more than twice as likely (AOR = 2.23, 95% CI: 1.10–4.50) to use these services compared to those who had not undergone counselling. Emotional preparedness to handle the results of premarital screening was marginally significant (p=0.051), suggesting that individuals who felt prepared were 2.74 times more likely to utilize premarital services (AOR = 2.74, 95% CI: 0.99–7.53). Although this variable approached statistical significance, further research may be required to confirm its role. In contrast, other factors such as the perceived cost of screening, the belief that screening should be mandatory, societal acceptance of individuals with sickle cell disease, and the influence of screening results on marital or reproductive decisions were not significantly associated with service utilization (p>0.05). Table 7:Relationship between Respondents’ Knowledge of Sickle Cell Disease (SCD) and Level of Utilization of Sickle Cell Disease Premarital Screening Variables Utilization of SCD Premarital Screening x 2 df p Yes No Knowledge SCD Good Knowledge 196(73.1%) 72(26.9%) 0.715 1 0.398 Poor Knowledge 21(80.8%) 5(19.2%) Total 217(73.8%) 77(26.2%) The table 7 indicated that respondents’ knowledge of SCD was not significantly related to their utilization of sickle cell disease premarital screening as p > .050. Table 8:Relationship between Respondents’ Willingness Towards Sickle Cell Disease (SCD) Premarital Screening and Level of Utilization of Sickle Cell Disease Premarital Screening Variables Utilization of SCD Premarital Screening x 2 df p Yes No Willingness Towards SCD Premarital Screening based on total willingness scores Fully willing 148(74.7%) 50(25.3%) 0.276 1 0.599 Partly willing 69(71.9%) 27(28.1%) Total 217(73.8%) 77(26.2%) The table 8 indicated that the respondents’ willingness towards SCD premarital screening was not significantly related to their utilization of sickle cell disease premarital screening as P > .050. Discussion The socio-demographic findings highlight a youthful and predominantly single population, with more than half aged 21-25 years. This suggests the respondents are in their early adulthood, a critical period for reproductive health decision-making. Females constituted a larger proportion, reflecting a possible gender interest or accessibility in the study topic. Christianity was more than half of the population, and the Yoruba tribe was dominant, indicating the cultural and regional context of the study which is also linked to the geographical location of the setting. Educationally, more than half held a Bachelor's degree, suggesting a relatively educated sample capable of understanding health interventions. However, the low rate of premarital counselling for sickle cell disease, more than half indicates a significant gap in awareness and sensitization efforts about sickle cell disease prevention, despite the respondents' educational background. These findings highlight the need for further initiatives to educate the public about PMS through social media and educational campaigns in colleges and universities as recommended in previous literature (7). Similarly,(8) in Makkah, Saudi Arabia also indicate the need for more work to be done to educate the public about PMS through educational campaigns in universities and schools as well as social media. The findings of this study revealed an overall good level of knowledge about sickle cell disease, with about 9 out of 10 respondents demonstrating good knowledge. Specifically, almost all respondents correctly identified SCD as a genetic blood disorder, almost all respondents also recognized its inheritance through parental genes. Additionally, almost all understood that individuals with genotype SS or SC have SCD. These results align with the study by (9), which reported high awareness levels among almost all the respondent’s university lecturers in Sokoto, Nigeria, indicating that knowledge about SCD may be improving among educated populations. Despite the high awareness, gaps in knowledge persist, approximately half of respondents incorrectly believed that SCD could be transmitted through blood transfusion, and the more than half assumed that individuals with sickle cell traits always develop the disease. This finding suggests that while general knowledge is strong, misconceptions remain prevalent. These gaps mirror the findings of (4) in Kano, where students at the Federal College of Education demonstrated poor knowledge of SCD, and misconceptions about transmission persisted. Such misunderstandings may stem from inadequate health education or a lack of targeted public awareness campaigns. The findings of this study revealed that most respondents had good knowledge of premarital screening for sickle cell disease. Specifically, more than half of youth corps members in Iwo Local Government Area, Osun State, had heard of premarital genotype screening. Furthermore,9 out of 10 of respondents recognized that premarital screening identifies the risk of having a child with SCD, and almost all agreed that it can prevent the occurrence of SCD in children. This high level of awareness is encouraging, as it suggests that public health messages regarding the importance of premarital screening are resonating among young populations. The strong understanding of the purpose of premarital screening and its timing before marriage reflects progress in knowledge dissemination. This finding is consistent with the study by (10) in south-western Nigeria, where the more than half of respondents demonstrated good knowledge of premarital screening. Similarly, (11) reported high awareness among university students in Oman, highlighting that educational access and exposure to health programs can positively impact knowledge. The findings of this study reveal a significant willingness among participants to undergo premarital sickle cell screening, with all the respondents expressing a high level of readiness to participate in the screening process. This overwhelming support for premarital screening is aligned with global trends, as several studies, such as those by (12) and. (10) in Nigeria, have similarly demonstrated a high willingness toward premarital screening. Furthermore,(11) among 400 Omani study participants from different majors at a national governmental university, premarital screening was viewed favourably by study participants, who also recognized the value of premarital screening exams, according to the study findings. Also, keeping in view with the findings of this current study by (1) among young people in the Youth Service Corps in Ibadan found out that 9 of 10 of the respondents reported willingness to undergo genotype screening. Likewise,(13) among non-healthcare students in Central Java revealed the more than half had a positive attitude. The findings of this study revealed that while all the participants had a high level of willingness to be screened, more than half had actual utilization of the screenings. This slight discrepancy between willingness and actual utilization being a recurring theme in the literature warrants further investigation. The finding that 8 out of 10 found genotype testing easily accessible suggests that logistical barriers may not be a significant obstacle for those who chose to undergo testing. However, the breakdown of the frequency of testing, with more than one-third having undergone it only once, and 7 out of 10 seeking testing across different health facilities, may point to underlying issues related to consistency, and validation of the test results. When compared to the existing literature, the study aligns with some findings while also diverging in others. For instance, (1) found that 8 out of 10 of young people in the Youth Service Corps in Ibadan had undergone genotype screening, This mirrors the relatively high uptake in the present study, but 7 out of 10 who reported having undergone screening in this current study is still notable, especially considering the relatively small discrepancy between those who have and have not undergone screening. This comparison indicates that while uptake rates may vary by context, the desire to screen is mostly high, although the actual participation rates can be more variable The results of this study indicate that several factors are associated with the utilization of premarital sickle cell disease (SCD) genotype screening, with particular emphasis on emotional and informational barriers. Chi-square analysis revealed that the belief that screening results would influence marriage, societal acceptance of individuals with SCD, and emotional preparedness to handle the results were found to significantly affect the likelihood of engaging in premarital screening. These findings reflect the work of (14), who identified similar factors to premarital screening in Northern Nigeria, including disease-related knowledge, and stigma. The significant influence of emotional unpreparedness observed in this study suggests that psychological factors play a crucial role in decisions regarding genetic screening. Interestingly, individuals who reported emotional preparedness were more likely to engage with the screening, possibly driven by a sense of responsibility or a need for clarity about potential risks for their future children. This aligns with (15), who also noted that fear of results or emotional unease might push individuals to confront potential health risks within relationships, even if it initially creates psychological discomfort. The findings of this study reveals that respondents possess commendable knowledge and high willingness regarding sickle cell disease and premarital genotype screening. Despite this, the actual utilization of premarital screening services remains influenced by factors such as accessibility, cost, emotional preparedness, and the role of premarital counselling. While willingness and knowledge did not significantly predict service utilization, the findings highlight the importance of addressing sociocultural perceptions, enhancing public awareness, and ensuring accessibility to foster greater adoption of these vital services. Declarations Ethics approval and consent to participate This study adhered to the Helsinki Declaration's principle of conducting studies among human participants. Formal ethical approval was obtained from Babcock University Health Research Ethic Committee with approval number BUHREC 107/24, and written informed consent was obtained from the study participants. Consent for publication All authors gave consent for publication of the work under the Creative Commons Attribution-Non-Commercial 4.0 license. Availability of Data and Materials The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. Competing Interest The authors declare that they have no conflict of interest Funding The authors declare that this study was self-funded Authors’ contribution Conceptualization: O.V and N.A conceptualized the study. O.V wrote the initial manuscript. O.V, D.E and A.T collected data while O.V and D.E wrote the methodology. D.E analyzed the data. N.A and O.O supervised the work. All authors reviewed the manuscript Acknowledgement The authors would like to appreciate all the youth corps members that participated in this study. References Adegbite OA. Young people’s knowledge of sickle cell disease and willingness for genotype screening in Ibadan, Nigeria. African Journal of Biomedical Research. 2021 May 31;24(2):211-7. Ojewunmi OO, Adeyemo TA, Ayinde OC, Iwalokun B, Adekile A. Current perspectives of sickle cell disease in Nigeria: changing the narratives. Expert Review of Hematology. 2019 Aug 3;12(8):609-20. Hariharan N, Brunson A, Mahajan A, Keegan TH, Wun T. Bleeding in patients with sickle cell disease: a population-based study. Blood Advances. 2020 Mar 10;4(5):793-802. Hussaini MA, Durbunde AA, Jobbi YD, Muhammad IY, Mansur AU, Umar M, Isaac OT, Ummulkulthum K, Bolanle AA, Kambai J. Assessment of experience, perception and attitude towards premarital sickle cell disease screening among students attending federal college of education, Kano, Nigeria. Niger Int J Res Rep Hematol. 2019 Feb;2(1):1-2. .Oludare GO, Ogili MC. Knowledge, attitude and practice of premarital counseling for sickle cell disease among youth in Yaba, Nigeria. African journal of reproductive health. 2021 Dec 9;17(4). Oluwole EO, Okoye CD, Ogunyemi AO, Olowoselu OF, Oyedeji OA. Knowledge, attitude and premarital screening practices for sickle cell disease among young unmarried adults in an urban community in Lagos, Nigeria. Pan African Medical Journal. 2022;42(1). Moustafa AZ, Hafiz AA, Abdulhalim AM, Aljehani AD, Aldajani BM, Bokhari GY, Alqurashi HM, Alturki YM. Knowledge, awareness and attitude of premarital screening sickle cell disease and thalassemia, Makkah, Saudi Arabia. International Journal of Medicine in Developing Countries. 2022 Apr 11;6(5):711-. .Bindhani BK, Devi NK, Nayak JK. Knowledge, awareness, and attitude of premarital screening with special focus on sickle cell disease: a study from Odisha. Journal of community genetics. 2020 Oct;11:445-9. .Isa H, Adegoke S, Madu A, Hassan AA, Ohiaeri C, Chianumba R, Brown B, Okocha E, Ugwu N, Diaku-Akinwumi I, Adeyemo T. Sickle cell disease clinical phenotypes in Nigeria: a preliminary analysis of the Sickle Pan Africa Research Consortium Nigeria database. Blood Cells, Molecules, and Diseases. 2020 Sep 1;84:102438. Adesina OA, Ogamba CF, Osibogun A. Premarital genotype screening for sickle cell disease: knowledge gaps, perception and determinants of uptake among final year undergraduates of a tertiary institution in South-west Nigeria. Nigerian Medical Journal. 2022;63(1):50-8. Alkalbani A, Alharrasi M, Achura S, Al Badi A, Al Rumhi A, Alqassabi K, Almamari R, Alomari O. Factors Affecting the willingness to undertake premarital screening test among prospective marital individuals. SAGE open nursing. 2022 Feb;8:23779608221078156. Adigwe OP, Onavbavba G, Onoja SO. Attitudes and practices of unmarried adults towards sickle cell disease: emergent factors from a cross sectional study in Nigeria’s capital. Hematology. 2022 Dec 31;27(1):488-93. Baihaqi BS, Hidayah AN, Rujito L. Awareness of non-health students about premarital genetic screening; A study in Indonesia. Health Education and Health Promotion. 2023 Apr 10;11(2):189-94. Galadanci AA, Estepp JH, Khan H, Farouk ZL, Caroll Y, Hodges J, Yarima S, Ibrahim UA, Idris IM, Gambo A, Hussaini N. Barriers and facilitators of premarital genetic counseling for sickle cell disease in northern Nigeria. Journal of Pediatric Hematology/Oncology. 2023 Aug 1;45(6):e716-22. Reed-Weston AE, Espinal A, Hasar B, Chiuzan C, Lazarin G, Weng C, Appelbaum PS, Chung WK, Wynn J. Choices, attitudes, and experiences of genetic screening in Latino/a and Ashkenazi Jewish individuals. Journal of Community Genetics. 2020 Oct;11:391-403. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6542064","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":463291970,"identity":"8d138d6c-8a84-4af8-b773-88bac1ff083f","order_by":0,"name":"Oludamola Victoria Adeleke","email":"data:image/png;base64,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","orcid":"","institution":"Babcock University","correspondingAuthor":true,"prefix":"","firstName":"Oludamola","middleName":"Victoria","lastName":"Adeleke","suffix":""},{"id":463291971,"identity":"56ec1a08-b359-4b63-98df-9e0d7300ada0","order_by":1,"name":"Ngozi Anthonia Okafor","email":"","orcid":"","institution":"Babcock University","correspondingAuthor":false,"prefix":"","firstName":"Ngozi","middleName":"Anthonia","lastName":"Okafor","suffix":""},{"id":463291972,"identity":"35e23d5b-b061-461d-9825-5558160c2207","order_by":2,"name":"Oluwatosin Ope-Babadele","email":"","orcid":"","institution":"Babcock University","correspondingAuthor":false,"prefix":"","firstName":"Oluwatosin","middleName":"","lastName":"Ope-Babadele","suffix":""},{"id":463291973,"identity":"6a3a807e-21c6-48b4-a8bb-8941dd72b7ce","order_by":3,"name":"Dolapo Emmanuel Ajala","email":"","orcid":"","institution":"Bowen University Hospital, Bowen University","correspondingAuthor":false,"prefix":"","firstName":"Dolapo","middleName":"Emmanuel","lastName":"Ajala","suffix":""},{"id":463291974,"identity":"c0f32bfb-72d0-4367-91a4-da00c06ac001","order_by":4,"name":"Olumide Thomas Adeleke","email":"","orcid":"","institution":"Bowen University","correspondingAuthor":false,"prefix":"","firstName":"Olumide","middleName":"Thomas","lastName":"Adeleke","suffix":""}],"badges":[],"createdAt":"2025-04-27 18:53:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6542064/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6542064/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101730663,"identity":"198df828-0420-4f83-9de1-137253f104f2","added_by":"auto","created_at":"2026-02-03 05:56:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2415230,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6542064/v1/d15ef6c2-0835-46b3-b11e-09600147b8a4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Determinants of Sickle Cell Disease Premarital Screening Utilization among Youth Corps Members in Iwo Local Government Area, Osun State, Nigeria","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe burden of sickle cell disease (SCD) is immense. Globally, early 100 million people are affected. About 300,000 SCD affected babies on each year. Sub-Saharan Africa is the region where the majority of SCD births occur, with high rates of under-five mortality and over 50% of deaths from SCD complications (1). In Nigeria, there are about 20 cases of sickle cell anemia for every 1000 people due to the high prevalence\u0026nbsp;of\u0026nbsp;sickle\u0026nbsp;cell\u0026nbsp;trait,\u0026nbsp;which\u0026nbsp;is\u0026nbsp;23.7%.\u0026nbsp;Approximately, 150,000 newborns with the disease are born each year as a result of these births. Based on this data, Nigeria has the highest incidence of sickle cell disease (Hb SS and Hb SC) worldwide, affecting 2.69\u0026ndash;5% of the population (2), The quality of life for people living with sickle cell disease (SCD) is negatively impacted by a variety of clinical manifestations that can be chronic and debilitating. The most frequent SCD manifestations include stroke, leg ulcers, priapism, acute painful crises, acute chest syndrome, and severe bacterial infections (2).\u003c/p\u003e\n\u003cp\u003ePremarital screening helps in the prevention of SCD. There is a need to increase its awareness which in turn improves its uptake disease(3). Thousands of babies and children are dying because premarital sickle cell screening which would have allowed intending couples to know their hemoglobin genotype before marriage is not being carried out, despite significant advancements in the knowledge of the molecular pathology, pathophysiology, and causes of inheritable disorders(4).\u003c/p\u003e\n\u003cp\u003eTypically, spouses are discouraged from taking these tests out of concern that their incompatibility may negatively impact their marital arrangement (5). Prevention of SCD is crucial among adults who are single in urban areas, particularly with the rise in premarital sex and delay of marriage, considering the relatively high prevalence of SCD in Nigeria and its potential to rise. Yet, the prevalence of SCD is still rising as a result of a lack of knowledge, accessibility and affordability of health care services, cultural and religious beliefs about the disease and an unwillingness to participate in a premarital screening (6). Therefore, this study is aimed to assess the determinants of sickle cell disease premarital screening utilization among youth corps member in Iwo local government area, Osun State imbibing the theory of planned behaviour.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study utilized a cross-sectional survey design to assess the determinants of sickle cell disease premarital screening utilization among youth corps members in Iwo local government area, Osun State. The study was conducted at the weekly community development service at the secretariat in Iwo local government area\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants and Procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study included 365 youth corps members at Iwo local government in Osun state selected through stratified random sampling based on their batches. Inclusion criteria include Youth corps members who are not married. Data were collected using a self-structured questionnaire, distributed at the weekly community development service. Informed consent was obtained from all participants before distribution of the questionnaire, and the data collection period spanned three weeks.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Instrument\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA self-structured questionnaire was used to assess participants' knowledge, willingness, utilization and determinants of sickle cell disease premarital screening utilization. It was developed based on a review of existing literature (Adeyemo et al 2022: Moustafa et al, 2022; Al-shafai et al, 2022; Adegbite et al, 2021: Miagoro et al, 2024) and pre-tested. The questionnaire contained six sections: sociodemographic characteristics, knowledge of sickle cell disease (10 items), knowledge of premarital screening for sickle cell disease (10), willingness towards sickle cell disease premarital screening (11 items), utilization level of sickle cell disease premarital screening (13), determinants of utilization of sickle cell disease premarital screening (15).\u003c/p\u003e\n\u003cp\u003eFurthermore, the respondent’s level of knowledge regarding SCD was measured based on up of ten (10) questions. The measurable mean of knowledge in the identification of the knowledge level of sickle-cell disease was based on 10 items. It was answered by True or False questions. The Participants’ overall knowledge of sickle cell disease was determined based on their responses to 10 knowledge-based questions with correct responses scored 1, incorrect zero; participants with total scores between (7-10) and (0-6) were adjudged to have good and poor knowledge of sickle cell disease respectively.\u003c/p\u003e\n\u003cp\u003eIn addition, the respondent’s willingness towards sickle cell disease premarital screening was also measured. It was determined by their responses to eleven (11) willingness-based Likert questions of yes -3, undecided -2, and no -1 for positive statements and reversed coded for negative statements. This was further categorized into three. Those who scored less than equal to 10, were regarded as having poor willingness, those who scored greater than 11 to 22 were regarded as having moderate willingness while those who score 22 to 33 were regarded as having high willingness.\u003c/p\u003e\n\u003cp\u003eThe respondents sickle cell disease premarital screening utilization was also measured. It was made up of thirteen (13) questions that assessed the level of utilization of sickle-cell disease premarital screening among youth corps members. Those who scored less than equal to 5, were regarded as having poor utilization, those who scored greater than 6 to 9 were regarded as having moderate utilization while those who score 10 to 13 were regarded as having high utilization.\u003c/p\u003e\n\u003cp\u003eFurthermore, the respondents determinants of utilization of sickle cell disease premarital screening It consists of fifteen (15) questions that expose the influence of cultural belief, religious belief, healthcare cost, and access on utilization of sickle-cell premarital screening Likert scale of 4 was used to answer the questions. Those who scored less than equal to 20, were regarded as having poor willingness, those who scored greater than 21 to 42 were regarded as having moderate willingness while those who score 42 to 60 were regarded as having high willingness.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using IBM SPSS Statistics version 28.0. Descriptive statistics such as frequencies, percentages, means, and standard deviations were computed for sociodemographic variables. Chi-square tests were used to assess associations between categorical variables, with a significance level set at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePermission and ethical clearance were taken from the Babcock University Health Research Ethic Committee with approval number BUHREC 107/24. Permission was obtained from the Communication Liaison Officer (CLO), who coordinate the youth corps member on schedule data collection day and time. Before data collection, participants were provided with the study objectives and informed consent was obtained. Confidentiality of their responses was guaranteed and emphasized their freedom to withdraw from the study at any stage. All questions and concerns were addressed with sincerity, fostering transparent.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Sociodemographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (in years)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(Mean\u0026plusmn;SD=25.02\u0026plusmn;2.728)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u0026le; 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e10 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e21-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e168 (57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e26-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e111 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u0026ge; 31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e5 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e123 (41.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e171 (58.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e175 (59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e107 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eTraditional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e12 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e232 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eEngaged\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e62 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTribe\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eYoruba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e233 (79.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eIgbo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e32 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e5 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eIjaw\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e24 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of Education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eHND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e105 (35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eBachelors\u0026rsquo; Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e174 (59.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003ePostgraduate Degrees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e15 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCourse of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eBusiness and Management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e68 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eSocial Sciences and Humanities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e100 (34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eHealth and Biological Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e44 (15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eScience and Technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e82 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital Counselling History\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e79 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 223px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e215 (73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 revealed that the mean age of the respondents was 25.02\u0026plusmn;2.728 years, indicating a predominantly youthful population. In terms of gender, females accounted for more than half 171(58.2%) of the sample, religious affiliation, Christianity was the majority175(59.5%), marital status distribution revealed that most respondents were single 232(78.9%), tribal affiliation indicated that the Yoruba tribe was dominant,233(79.3%). Regarding education, more than half \u0026nbsp; 74(59.2%) held a Bachelor\u0026apos;s degree; in terms of courses studied, \u0026nbsp;over one-third 100(34.0%) had a background in Social Sciences and Humanities, 82(27.9%) in Science and Technology, 68(23.1%) in Business and Management, and 44(15.0%) in Health and Biological Sciences; on premarital counselling for sickle-cell disease history, about three-quarter 215(73.1%) of respondents reported that they had not undergone such screening.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 :Knowledge of Sickle Cell Disease\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eSCD is a genetic blood disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e293 (99.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eSCD is inherited from parents through genes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e277 (94.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e17 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eIndividuals with genotype SS or SC have SCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e272 (92.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e22 (7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003ePremarital genetic screening can detect the sickle cell trait\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e275 (93.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e19 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eA child can inherit SCD if both parents carry the trait\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e282 (95.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e12 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eSCD can be diagnosed through a blood test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e274 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e20 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eSCD can be transmitted through blood transfusions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e137 (46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e157 (53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eSCD is contagious and can spread through casual contact\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e50 (17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e244 (83.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003eStem cell transplantation is currently the potential cure for SCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e203 (69.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e91 (31.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61.6234%;\"\u003e\n \u003cp\u003ePeople with sickle cell trait always develop SCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 7.4567%;\"\u003e\n \u003cp\u003e249 (84.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8182%;\"\u003e\n \u003cp\u003e45 (15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 65.9848%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Mean\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 16.039%;\"\u003e\n \u003cp\u003e7.90\u0026plusmn;1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 65.9848%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Median\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 16.039%;\"\u003e\n \u003cp\u003e8.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 revealed that majority 293(99.7%), correctly identified sickle cell disease as a genetic blood disorder, majority 277(94.2%) were aware that sickle cell disease is inherited from parents through genes, similarly, majority 272(92.5%) recognized that individuals with genotype SS or SC have sickle cell disease; furthermore, role of premarital genetic screening in detecting the sickle cell trait was understood by majority 275(93.5%); also majority, 282(95.9%), understood that a child could inherit sickle cell disease if both parents carry the trait; furthermore, majority 274(93.2%) correctly acknowledged that sickle cell disease could be diagnosed through a blood test; the understanding of disease transmission through blood transfusions showed a mixed response, with about half 137(46.6%) incorrectly believing it could be transmitted in this way; majority 244(83.0%), correctly denied that sickle cell disease is contagious or can spread through casual contact; regarding treatment, few over two-third 203(69.0%) identified stem cell transplantation as a potential cure for sickle cell disease, while majority 249(84.7%), incorrectly believed that people with sickle cell trait always develop the disease.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Knowledge of Premarital Screening for Sickle Cell Disease (n=294)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003eYes n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003eNo n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeard of premarital genotype screening\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e213 (72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e81 (27.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital genotype screening is a test done to identify the risk of having a child with SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e275 (93.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e19 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital genotype screening should be done during courtship or before marriage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e275 (93.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e19 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital genotype screening can prevent having a child with SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e274 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e20 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot adhering to premarital genotype screening recommendations can have significant consequences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e274 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e20 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital genotype screening is only necessary if there\u0026apos;s a family history of SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e98 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e196 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBoth partners need to undergo premarital screening for it to be effective\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e281 (95.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e13 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital genotype screening is a one-time test that doesn\u0026apos;t need to be repeated\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e171 (58.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e123 (41.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCounselling is an important part of the premarital genotype screening process\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e270 (91.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e24 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf both partners have the sickle cell trait (AS), they are guaranteed to have a child with SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e217 (73.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e77 (26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e7.84\u0026plusmn;1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 439px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e8.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 3 \u0026nbsp;revealed that about three-quarters 213(72.4%), had heard of premarital genotype screening; The understanding of its purpose was strong, with majority 275(93.5%) recognizing that premarital genotype screening identifies the risk of having a child with sickle cell disease; similarly, majority 275(93.5%) agreed that it should be conducted during courtship or before marriage; majority 274(93.2%) acknowledged that premarital genotype screening can prevent the occurrence of sickle cell disease in children; furthermore, majority 274(93.2%), believed that failing to adhere to recommendations from premarital screening could have significant consequences; however, one-third 98(33.3%) thought screening was necessary only in cases of a family history of sickle cell disease, while the majority, 196(66.7%), rejected this notion; overwhelming majority 281(95.6%), agreed that both partners need to undergo screening for it to be effective; however, more than half 171(58.2%) incorrectly believed that premarital genotype screening is a one-time test that does not need to be repeated; counselling was widely recognized as an important component of premarital screening, with majority 270(91.8%) affirming its necessity; lastly, about three-quarters 217(73.8%) mistakenly believed that if both partners carry the sickle cell trait (AS), they are guaranteed to have a child with sickle cell disease.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Willingness towards Sickle Cell Disease Premarital Screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.0121%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponses (n=294)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003eYes f(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003eNo f(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003eUndecided (f%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWilling to undergo premarital screening for SCD before marriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e268 (91.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e8 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e18 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.88\u0026plusmn;0.400\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWilling to undergo premarital screening for SCD even if there is a cost involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e255 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e32 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e7 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.76\u0026plusmn;0.634\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWould encourage others to participate in premarital screening for SCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e282 (95.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e12 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.92\u0026plusmn;0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWould recommend premarital screening as a way to reduce the burden of SCD on families\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e276 (93.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e12 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e6 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.90\u0026plusmn;0.417\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eIf found out to have sickle cell trait, would insist on screening for partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e281 (95.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e13 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.91\u0026plusmn;0.412\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWould undergo premarital genotype screening even if it might disclose genetic status to others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e263 (89.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e31 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.79\u0026plusmn;0.615\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eBelieves individuals in intimate relationships should know their sickle cell trait status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e272 (92.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e22 (7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.85\u0026plusmn;0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eIf the screening were voluntary, would still choose to do it\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e281 (95.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e7 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e6 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.93\u0026plusmn;0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWould improved procedures for SCD premarital screening make you more likely to undergo the screening\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e257 (87.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e31 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e6 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.77\u0026plusmn;0.625\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWould assurance of accurate results make you more willing to undergo the screening\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e269 (91.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e19 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e6 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.85\u0026plusmn;0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eWould make time for sickle cell premarital screening even if having a busy schedule\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9038%;\"\u003e\n \u003cp\u003e279 (94.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.0629%;\"\u003e\n \u003cp\u003e9 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.0454%;\"\u003e\n \u003cp\u003e6 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e2.92\u0026plusmn;0.370\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.0121%;\"\u003e\n \u003cp\u003e31.48\u0026plusmn;2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.0121%;\"\u003e\n \u003cp\u003e33.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38.5173%;\"\u003e\n \u003cp\u003eProportion with scores equal to the median/total obtainable score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.0121%;\"\u003e\n \u003cp\u003e198(67.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.3669%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Proportion with scores \u0026lt; median\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 31.0121%;\"\u003e\n \u003cp\u003e96(32.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1783%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4 revealed that the majority, 268(91.2%), expressed willingness to undergo premarital screening for SCD before marriage, while only 8(2.7%) were unwilling and 18(6.1%) remained undecided, with a mean score of 2.88\u0026plusmn;0.400. Even when considering screening with associated costs, 255(86.7%) were still willing to proceed, while 32(10.9%) were unwilling and 7(2.4%) remained undecided, resulting in a mean score of 2.76\u0026plusmn;0.634. Encouraging others to participate in premarital screening for SCD was strongly supported by 282(95.9%), while only 12(4.1%) opposed it, leading to a mean score of 2.92\u0026plusmn;0.396. Similarly, 276(93.9%) stated that they would recommend premarital screening as a strategy to reduce the burden of SCD in families, whereas 12(4.1%) were against it and 6(2.0%) remained undecided, yielding a mean score of 2.90\u0026plusmn;0.417. If diagnosed with the sickle cell trait, 281(95.6%) would insist on screening their partner, while only 13(4.4%) opposed the idea, leading to a mean score of 2.91\u0026plusmn;0.412. Regarding willingness to undergo screening despite the risk of genetic status disclosure, 263(89.5%) expressed willingness, while 31(10.5%) did not, resulting in a mean score of 2.79\u0026plusmn;0.615. Additionally, 272(92.5%) agreed that individuals in intimate relationships should know their sickle cell trait status, whereas 22(7.5%) disagreed, leading to a mean score of 2.85\u0026plusmn;0.527. Even if screening were voluntary, 281(95.6%) stated they would still undergo the test, while 7(2.4%) were unwilling and 6(2.0%) were undecided, resulting in a mean score of 2.93\u0026plusmn;0.334. The likelihood of undergoing screening increased with improved procedures, as indicated by 257(87.4%), while 31(10.5%) remained unwilling and 6(2.0%) were undecided, leading to a mean score of 2.77\u0026plusmn;0.625. Assurance of accurate results would also enhance willingness, as expressed by 269(91.5%), while 19(6.5%) disagreed and 6(2.0%) remained undecided, with a mean score of 2.85\u0026plusmn;0.507. Despite a busy schedule, 279(94.9%) affirmed they would make time for premarital screening, while 9(3.1%) were unwilling and 6(2.0%) were undecided, yielding a mean score of 2.92\u0026plusmn;0.370. \u0026nbsp;Overall, the mean willingness score among respondents was 31.48\u0026plusmn;2.64, indicating a strong positive disposition towards premarital screening for SCD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: Utilization of Sickle Cell Disease Premarital Screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver undergone a genotype test for SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e217(73.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e77(26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf yes, was the genotype testing easily accessible (n=217)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e189(87.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e28(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of undergoing a genotype test for SCD (n=217)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eOnce\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e74(34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eTwice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e91(41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eThree times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e44(20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eFour or more times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e8(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf more than once, did you use different health facilities for the tests? (n=143)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e114(79.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e29(20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGenotype (n=217)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eAA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e141(48.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e8(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eSC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e2(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eAC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e2(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e64(21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWho primarily decided that you should have a genotype test done? (n=217)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eSelf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e104(47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003ePartner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e18(8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eReligious Authority\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e5(2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eParent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e57(26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eHealth worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e31(14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eSchool\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e2(0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePurpose of carrying out genotype test**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003ePremarital screening\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e44(20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003ePrenatal testing\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e40(18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eGeneral health check-up\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e77(35.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eFamily planning\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e23(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eRequirement for school/work\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e37(17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eCuriosity about genetic makeup\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e21(9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eDoctors\u0026rsquo; recommendation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e8(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eFamily history of SCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e217(100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReceived counselling before the test (n=217)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e96(44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e121(55.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf not had a genotype test, what is the main reason (n=77)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eLack of awareness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e14(18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eCost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e10(13.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eFear of result\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e17(22.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNot considered necessary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e19(24.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eLimited access to testing facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e17(22.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHas partner also had a genotype test for SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e147(50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e58(19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eUnsure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e48(16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eDon\u0026apos;t have a partner or girlfriend\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e41(13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAware of any local facilities offering genotype testing\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e184(62.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e110(37.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver discussed genotype testing with your partner or potential partner?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e213(72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e38(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNot applicable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e43(14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf premarital screening revealed you and your partner were at risk of having a child with SCD, would it affect your relationship decisions?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e221(75.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e73(24.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5 revealed that the majority 217(73.8%) had undergone a genotype test for SCD; among those who underwent testing, the majority 189(87.1%) reported that the genotype testing was easily accessible; based on the frequency of testing, few over one-third 74(34.1%) had undergone the test once, 91(41.9%) twice, and 44(20.3%) three times; among those tested more than once, majority 114(79.7%) had used different health facilities; the distribution of genotypes revealed participants were AA 141(48.0%), AS 64(21.8%), SS 8(2.7%), SC 2(0.7%) and AC 2(0.7%); the decision to undertake genotype testing was primarily self-initiated by about half 104(47.9%), followed by parental influence in 57(26.3%) cases. Health workers influenced 31(14.3%) participants, while partners, religious authorities and schools accounted for 18(8.3%), 5(2.3%), and 2(0.9%) decisions, respectively\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6 : Determinants of Utilization of Premarital Screening for Sickle Cell Disease\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly agree \u0026nbsp; f(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree f(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree f(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly disagree f (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u0026plusmn;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSCD is a medical condition, not a curse or punishment from God.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e219(74.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e64(21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.67\u0026plusmn;0.669\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital screening for SCD aligns with cultural and religious beliefs.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e175(59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e81(27.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e33(11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5(1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.45\u0026plusmn;0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily and community support undergoing premarital screening for SCD.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e180(61.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e75(25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e33(11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.46\u0026plusmn;0.773\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAction and choices play a significant role in determining future children\u0026apos;s health status.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e213(72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e68(23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e8(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5(1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.66\u0026plusmn;0.617\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital screening for SCD is a responsible health choice, even for those who believe in God\u0026apos;s will or fate.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e210(71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e64(21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e15(5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5(1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.63\u0026plusmn;0.662\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeeking religious guidance or counselling regarding premarital screening for SCD is beneficial.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e154(52.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e105(35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e24(8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.37\u0026plusmn;0.784\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealthcare services that offer premarital screening for SCD are easily accessible to me.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e131(44.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e100(34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e51(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e12(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.19\u0026plusmn;0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe cost of premarital screening for SCD is reasonable and not a significant barrier.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e107(36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e139(47.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e37(12.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.16\u0026plusmn;0.784\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave adequate knowledge about SCD and the importance of premarital screening.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e157(53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e93(31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e38(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e6(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.36\u0026plusmn;0.784\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePremarital screening for SCD should be mandatory for those planning to marry.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e228(77.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e54(18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e12(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.73\u0026plusmn;0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe results of premarital screening would influence decisions about marriage or having children.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e202(68.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e75(25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e17(5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.63\u0026plusmn;0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSociety should be more accepting of individuals with SCD.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e183(62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e94(32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e17(5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.56\u0026plusmn;0.602\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWould be afraid to undergo premarital screening for fear of what others might think of me.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e64(21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e55(18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e107(36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e68(23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e2.39\u0026plusmn;1.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFeels emotionally prepared to handle any results from premarital screening.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e111(37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e138(46.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e34(11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e11(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.19\u0026plusmn;0.781\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 272px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrusts the healthcare system to provide accurate and reliable results for SCD premarital screening.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e140(47.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e129(43.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e20(6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5(1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.37\u0026plusmn;0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 6 \u0026nbsp; indicated that undergoing premarital screening for sickle cell disease was significantly associated with higher odds of utilizing premarital services (p=0.026). Individuals who had participated in counselling were more than twice as likely (AOR = 2.23, 95% CI: 1.10\u0026ndash;4.50) to use these services compared to those who had not undergone counselling. Emotional preparedness to handle the results of premarital screening was marginally significant (p=0.051), suggesting that individuals who felt prepared were 2.74 times more likely to utilize premarital services (AOR = 2.74, 95% CI: 0.99\u0026ndash;7.53). Although this variable approached statistical significance, further research may be required to confirm its role. In contrast, other factors such as the perceived cost of screening, the belief that screening should be mandatory, societal acceptance of individuals with sickle cell disease, and the influence of screening results on marital or reproductive decisions were not significantly associated with service utilization (p\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7:Relationship between Respondents\u0026rsquo; Knowledge of Sickle Cell Disease (SCD) and Level of Utilization of Sickle Cell Disease Premarital Screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUtilization of SCD Premarital Screening\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ex\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003edf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge SCD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eGood Knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e196(73.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e72(26.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.715\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.398\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003ePoor Knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e21(80.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e5(19.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e217(73.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e77(26.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe table 7 indicated \u0026nbsp;that respondents\u0026rsquo; knowledge of SCD was not significantly related to their utilization of sickle cell disease premarital screening as \u003cem\u003ep\u003c/em\u003e\u0026gt; .050.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8:Relationship between Respondents\u0026rsquo; Willingness Towards Sickle Cell Disease (SCD) Premarital Screening and Level of Utilization of Sickle Cell Disease Premarital Screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 286px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUtilization of SCD Premarital Screening\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ex\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003edf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWillingness Towards SCD Premarital Screening\u003c/strong\u003e based on total willingness scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eFully willing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e148(74.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e50(25.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.599\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003ePartly willing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e69(71.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e27(28.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e217(73.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e77(26.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eThe \u0026nbsp;table 8 indicated that the respondents\u0026rsquo; willingness towards SCD premarital screening was not significantly related to their utilization of sickle cell disease premarital screening as \u003cem\u003eP\u003c/em\u003e\u0026gt; .050.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe socio-demographic findings highlight a youthful and predominantly single population, with more than half aged 21-25 years. This suggests the respondents are in their early adulthood, a critical period for reproductive health decision-making. Females constituted a larger proportion, reflecting a possible gender interest or accessibility in the study topic. Christianity was more than half of the population, and the Yoruba tribe was dominant, indicating the cultural and regional context of the study which is also linked to the geographical location of the setting. Educationally, more than half held a Bachelor\u0026apos;s degree, suggesting a relatively educated sample capable of understanding health interventions. However, the low rate of premarital counselling for sickle cell disease, more than half indicates a significant gap in awareness and sensitization efforts about sickle cell disease prevention, despite the respondents\u0026apos; educational background. These findings highlight the need for further initiatives to educate the public about PMS through social media and educational campaigns in colleges and universities as recommended in previous literature (7). Similarly,(8) in Makkah, Saudi Arabia also indicate the need for more work to be done to educate the public about PMS through educational campaigns in universities and schools as well as social media.\u003c/p\u003e\n\u003cp\u003eThe findings of this study revealed an overall good level of knowledge about sickle cell disease, with about 9 out of 10 respondents demonstrating good knowledge. Specifically, almost all respondents correctly identified SCD as a genetic blood disorder, almost all respondents also recognized its inheritance through parental genes. Additionally, almost all understood that individuals with genotype SS or SC have SCD. These results align with the study by (9), which reported high awareness levels among almost all the respondent\u0026rsquo;s university lecturers in Sokoto, Nigeria, indicating that knowledge about SCD may be improving among educated populations. Despite the high awareness, gaps in knowledge persist, approximately half of respondents incorrectly believed that SCD could be transmitted through blood transfusion, and the more than half assumed that individuals with sickle cell traits always develop the disease. This finding suggests that while general knowledge is strong, misconceptions remain prevalent. These gaps mirror the findings of (4) in Kano, where students at the Federal College of Education demonstrated poor knowledge of SCD, and misconceptions about transmission persisted. Such misunderstandings may stem from inadequate health education or a lack of targeted public awareness campaigns.\u003c/p\u003e\n\u003cp\u003eThe findings of this study revealed that most respondents had good knowledge of premarital screening for sickle cell disease. Specifically, more than half of youth corps members in Iwo Local Government Area, Osun State, had heard of premarital genotype screening. Furthermore,9 out of 10 of respondents recognized that premarital screening identifies the risk of having a child with SCD, and almost all agreed that it can prevent the occurrence of SCD in children. This high level of awareness is encouraging, as it suggests that public health messages regarding the importance of premarital screening are resonating among young populations. The strong understanding of the purpose of premarital screening and its timing before marriage reflects progress in knowledge dissemination. This finding is consistent with the study by (10) in south-western Nigeria, where the more than half of respondents demonstrated good knowledge of premarital screening. Similarly, (11) reported high awareness among university students in Oman, highlighting that educational access and exposure to health programs can positively impact knowledge.\u003c/p\u003e\n\u003cp\u003eThe findings of this study reveal a significant willingness among participants to undergo premarital sickle cell screening, with all the respondents expressing a high level of readiness to participate in the screening process. This overwhelming support for premarital screening is aligned with global trends, as several studies, such as those by (12) and. (10) in Nigeria, have similarly demonstrated a high willingness toward premarital screening. Furthermore,(11) among 400 Omani study participants from different majors at a national governmental university, premarital screening was viewed favourably by study participants, who also recognized the value of premarital screening exams, according to the study findings. Also, keeping in view with the findings of this current study by (1) among young people in the Youth Service Corps in Ibadan found out that 9 of 10 of the respondents reported willingness to undergo genotype screening. Likewise,(13) among non-healthcare students in Central Java revealed the more than half had a positive attitude.\u003c/p\u003e\n\u003cp\u003eThe findings of this study revealed that while all the participants had a high level of willingness to be screened, more than half had actual utilization of the screenings. This slight discrepancy between willingness and actual utilization being a recurring theme in the literature warrants further investigation. The finding that 8 out of 10 found genotype testing easily accessible suggests that logistical barriers may not be a significant obstacle for those who chose to undergo testing. However, the breakdown of the frequency of testing, with more than one-third having undergone it only once, and 7 out of 10 seeking testing across different health facilities, may point to underlying issues related to consistency, and validation of the test results.\u003c/p\u003e\n\u003cp\u003eWhen compared to the existing literature, the study aligns with some findings while also diverging in others. For instance, (1) found that 8 out of 10 of young people in the Youth Service Corps in Ibadan had undergone genotype screening, This mirrors the relatively high uptake in the present study, but 7 out of 10 who reported having undergone screening in this current study is still notable, especially considering the relatively small discrepancy between those who have and have not undergone screening. This comparison indicates that while uptake rates may vary by context, the desire to screen is mostly high, although the actual participation rates can be more variable\u003c/p\u003e\n\u003cp\u003eThe results of this study indicate that several factors are associated with the utilization of premarital sickle cell disease (SCD) genotype screening, with particular emphasis on emotional and informational barriers. Chi-square analysis revealed that the belief that screening results would influence marriage, societal acceptance of individuals with SCD, and emotional preparedness to handle the results were found to significantly affect the likelihood of engaging in premarital screening. These findings reflect the work of \u0026nbsp;(14), who identified similar factors to premarital screening in Northern Nigeria, including disease-related knowledge, and stigma. The significant influence of emotional unpreparedness observed in this study suggests that psychological factors play a crucial role in decisions regarding genetic screening. Interestingly, individuals who reported emotional preparedness were more likely to engage with the screening, possibly driven by a sense of responsibility or a need for clarity about potential risks for their future children. This aligns with (15), who also noted that fear of results or emotional unease might push individuals to confront potential health risks within relationships, even if it initially creates psychological discomfort.\u003c/p\u003e\n\u003cp\u003eThe findings of this study reveals that respondents possess commendable knowledge and high willingness regarding sickle cell disease and premarital genotype screening. Despite this, the actual utilization of premarital screening services remains influenced by factors such as accessibility, cost, emotional preparedness, and the role of premarital counselling. While willingness and knowledge did not significantly predict service utilization, the findings highlight the importance of addressing sociocultural perceptions, enhancing public awareness, and ensuring accessibility to foster greater adoption of these vital services.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study adhered to the Helsinki Declaration\u0026apos;s principle of conducting studies among human participants. Formal ethical approval was obtained from Babcock University Health Research Ethic Committee with approval number BUHREC 107/24, and written informed consent was obtained from the study participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors gave consent for publication of the work under \u0026nbsp; the \u0026nbsp; Creative \u0026nbsp; \u0026nbsp;Commons \u0026nbsp; Attribution-Non-Commercial 4.0 license.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that this study was self-funded\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: O.V and N.A conceptualized the study. O.V wrote the initial manuscript. O.V, D.E and A.T collected data while O.V and D.E wrote the methodology. D.E analyzed the data. N.A and O.O supervised the work. All authors reviewed the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to appreciate all the youth corps members that participated in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAdegbite OA. Young people\u0026rsquo;s knowledge of sickle cell disease and willingness for genotype screening in Ibadan, Nigeria. African Journal of Biomedical Research. 2021 May 31;24(2):211-7.\u003c/li\u003e\n\u003cli\u003eOjewunmi OO, Adeyemo TA, Ayinde OC, Iwalokun B, Adekile A. Current perspectives of sickle cell disease in Nigeria: changing the narratives. Expert Review of Hematology. 2019 Aug 3;12(8):609-20.\u003c/li\u003e\n\u003cli\u003eHariharan N, Brunson A, Mahajan A, Keegan TH, Wun T. Bleeding in patients with sickle cell disease: a population-based study. Blood Advances. 2020 Mar 10;4(5):793-802.\u003c/li\u003e\n\u003cli\u003eHussaini MA, Durbunde AA, Jobbi YD, Muhammad IY, Mansur AU, Umar M, Isaac OT, Ummulkulthum K, Bolanle AA, Kambai J. Assessment of experience, perception and attitude towards premarital sickle cell disease screening among students attending federal college of education, Kano, Nigeria. Niger Int J Res Rep Hematol. 2019 Feb;2(1):1-2.\u003c/li\u003e\n\u003cli\u003e.Oludare GO, Ogili MC. Knowledge, attitude and practice of premarital counseling for sickle cell disease among youth in Yaba, Nigeria. African journal of reproductive health. 2021 Dec 9;17(4).\u003c/li\u003e\n\u003cli\u003eOluwole EO, Okoye CD, Ogunyemi AO, Olowoselu OF, Oyedeji OA. Knowledge, attitude and premarital screening practices for sickle cell disease among young unmarried adults in an urban community in Lagos, Nigeria. Pan African Medical Journal. 2022;42(1).\u003c/li\u003e\n\u003cli\u003eMoustafa AZ, Hafiz AA, Abdulhalim AM, Aljehani AD, Aldajani BM, Bokhari GY, Alqurashi HM, Alturki YM. Knowledge, awareness and attitude of premarital screening sickle cell disease and thalassemia, Makkah, Saudi Arabia. International Journal of Medicine in Developing Countries. 2022 Apr 11;6(5):711-.\u003c/li\u003e\n\u003cli\u003e.Bindhani BK, Devi NK, Nayak JK. Knowledge, awareness, and attitude of premarital screening with special focus on sickle cell disease: a study from Odisha. Journal of community genetics. 2020 Oct;11:445-9.\u003c/li\u003e\n\u003cli\u003e.Isa H, Adegoke S, Madu A, Hassan AA, Ohiaeri C, Chianumba R, Brown B, Okocha E, Ugwu N, Diaku-Akinwumi I, Adeyemo T. Sickle cell disease clinical phenotypes in Nigeria: a preliminary analysis of the Sickle Pan Africa Research Consortium Nigeria database. Blood Cells, Molecules, and Diseases. 2020 Sep 1;84:102438.\u003c/li\u003e\n\u003cli\u003eAdesina OA, Ogamba CF, Osibogun A. Premarital genotype screening for sickle cell disease: knowledge gaps, perception and determinants of uptake among final year undergraduates of a tertiary institution in South-west Nigeria. Nigerian Medical Journal. 2022;63(1):50-8.\u003c/li\u003e\n\u003cli\u003eAlkalbani A, Alharrasi M, Achura S, Al Badi A, Al Rumhi A, Alqassabi K, Almamari R, Alomari O. Factors Affecting the willingness to undertake premarital screening test among prospective marital individuals. SAGE open nursing. 2022 Feb;8:23779608221078156.\u003c/li\u003e\n\u003cli\u003eAdigwe OP, Onavbavba G, Onoja SO. Attitudes and practices of unmarried adults towards sickle cell disease: emergent factors from a cross sectional study in Nigeria\u0026rsquo;s capital. Hematology. 2022 Dec 31;27(1):488-93.\u003c/li\u003e\n\u003cli\u003eBaihaqi BS, Hidayah AN, Rujito L. Awareness of non-health students about premarital genetic screening; A study in Indonesia. Health Education and Health Promotion. 2023 Apr 10;11(2):189-94.\u003c/li\u003e\n\u003cli\u003eGaladanci AA, Estepp JH, Khan H, Farouk ZL, Caroll Y, Hodges J, Yarima S, Ibrahim UA, Idris IM, Gambo A, Hussaini N. Barriers and facilitators of premarital genetic counseling for sickle cell disease in northern Nigeria. Journal of Pediatric Hematology/Oncology. 2023 Aug 1;45(6):e716-22.\u003c/li\u003e\n\u003cli\u003eReed-Weston AE, Espinal A, Hasar B, Chiuzan C, Lazarin G, Weng C, Appelbaum PS, Chung WK, Wynn J. Choices, attitudes, and experiences of genetic screening in Latino/a and Ashkenazi Jewish individuals. Journal of Community Genetics. 2020 Oct;11:391-403.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Determinants, Premarital Screening, Sickle Cell Disease, Utilization, Youth","lastPublishedDoi":"10.21203/rs.3.rs-6542064/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6542064/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Sickle cell disease (SCD) is the most common genetic condition in the world. Nigeria has the highest burden of Sickle cell disease in the world with the prevalence of sickle cell trait and the homozygous form as 25% and 2%, respectively. Prevention of SCD is crucial among unmarried adults. Premarital screening is an important strategy for the prevention of SCD. Yet, the prevalence of SCD is still rising as a result of a lack of knowledge, accessibility, affordability of health care services, cultural and religious beliefs about the disease and an unwillingness to participate in premarital screening The study assessed the determinants of SCD premarital screening utilization among youth corps members in Iwo Local Government areas, Osun State, Nigeria.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: .A descriptive cross-sectional design was adopted for the study. Population consists of 365 youth corps members, Sample size of 297 participants was determined using the Leslie Kish formula A stratified random sampling technique was utilized to select 297 participants in Iwo Local Government Area, Osun State. A structured and validated questionnaire was used for data collection with reliability coefficient scoring from 0.731(α)-0.85(α) Response rate was 99%. Data were analyzed using descriptive and inferential statistics, at significance level of 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Findings showed that the majority (91.2%) had adequate knowledge of sickle cell disease. Regarding premarital screening, the majority (88.8%) demonstrated adequate knowledge. All participants showed willingness to undergo premarital screening. Utilization of premarital screening was reported by the majority (73.8%). Emotional preparedness to handle any results from premarital screening and history of premarital genetic counselling were significantly associated with utilization of genotype premarital screening. Knowledge and utilization of sickle cell disease premarital screening, willingness and utilization of sickle cell disease premarital screening were not statistically significant with the p-value \u0026gt; 0.05\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The findings of this study highlight the importance of addressing sociocultural perceptions misconception, enhancing public awareness, and ensuring accessibility to foster greater adoption of premarital screening.\u003c/p\u003e","manuscriptTitle":"Determinants of Sickle Cell Disease Premarital Screening Utilization among Youth Corps Members in Iwo Local Government Area, Osun State, Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-30 12:12:43","doi":"10.21203/rs.3.rs-6542064/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"72950bba-2a0c-454a-9890-2635071a0d63","owner":[],"postedDate":"May 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-19T09:55:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-30 12:12:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6542064","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6542064","identity":"rs-6542064","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}