# Awareness and Acceptability of Prenatal Diagnosis of Sickle Cell Disease among Mothers of Affected Children in a Northern Nigerian Teaching Hospital

## TL;DR

This study explores how aware and willing mothers of children with sickle cell disease in Northern Nigeria are to use prenatal diagnosis to prevent future cases.

## Contribution

The study provides insights into PND awareness and acceptability among SCD-affected mothers in Northern Nigeria, highlighting education and religious beliefs as key factors.

## Key findings

- Only 22.2% of mothers had heard of prenatal diagnosis, and 93.3% expressed willingness to accept it after being informed.
- Higher education and child disease severity were associated with greater PND acceptability.
- Religious beliefs were the main reason for PND refusal among those who declined.

## Abstract

Nigeria has the highest global prevalence of sickle cell disease (SCD), necessitating effective preventive measures to control the disease. Prenatal diagnosis (PND) is a key early intervention for SCD, yet there is a shortage of studies in Northern Nigeria focusing on mothers of children with SCD. These mothers not only carry the burden of the disease but also face the risk of having more affected children, making them vital stakeholders in managing and controlling SCD. This study assessed the awareness and acceptability of prenatal diagnosis PND for SCD among mothers of children with the disease.

A cross-sectional study was conducted involving 297 mothers of children with SCD attending the Paediatric Haematology clinic at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Data were collected via an interviewer-administered questionnaire addressing the characteristics of the children and mothers, as well as their awareness, attitudes, and acceptability of PND. SPSS version 23 was used for data analysis, with a p-value < 0.05 considered statistically significant.

Most participants (90.9%) were of Hausa ethnicity and 97.0% were of Islamic faith. A majority (77.8%) had less than tertiary education, and 57.9% lacked personal income. Nearly 41% had more than one child affected by SCD, and about one-fifth had lost a child to SCD complications. Only 22.2% of mothers had heard of PND, mostly from healthcare workers, and just 0.3% had undergone the procedure. After receiving information about PND, 93.3% were willing to accept it, though 45% of those who declined cited religious beliefs. Factors associated with PND acceptance included the mother's education and the child’s SCD severity.

Awareness of PND among at-risk mothers is low, yet most expressed willingness to accept it. Educational level and disease severity were associated with PND acceptability.

Nigeria has the highest number of people with sickle cell disease (SCD) in the world. To help prevent more children from being born with the disease, prenatal diagnosis (PND) allows parents to know whether their baby will have SCD before birth. However, there is little research in Northern Nigeria focusing on mothers who already have children with SCD. These mothers carry the heavy burden of caring for sick children and face the possibility of having more children with the disease. Understanding how much these mothers know about PND and whether they would be willing to use it is important for controlling the spread of SCD. In this study, 297 mothers of children with SCD attending a hospital in Zaria, Nigeria, were surveyed. The mothers answered questions about their children, personal background, and knowledge of and willingness to accept PND. The data were analyzed to identify factors that influenced awareness and acceptability of PND. The majority of the mothers were Hausa and Muslim, and most had low levels of education. Over half of the mothers had no personal income. Nearly 41% of the mothers had more than one child with SCD, and about 20% had lost a child due to the disease. Only 22.2% of the mothers had heard of PND, mostly from healthcare workers, and just 0.3% had undergone the procedure. After learning more about PND, 93.3% of the mothers said they would be willing to use it. However, religious belief was the main reason for refusal among those who declined. Mothers with higher education levels and those whose children had more severe disease manifestation were more likely to accept PND. In conclusion, awareness of PND among these mothers is low, but most are open to it once informed. Educational efforts could improve acceptance of PND in Northern Nigeria.