CHAPTER ONE

INTRODUCTION

1.1 Background

Sickle cell disease or anemia (SCD) is an inherited autosomal recessive blood disorder that causes red blood cells to become rigid and crescent-shape (Adewoyin et al.,2015). This leads to several complications, including hand-foot syndrome, recurrent infection delay growth, vision problems, vaso-oclusion, chronic hemolysis, acute and chronic kidney disease and eventually progressive multiorgan damage (Adewoyin et al.,2015) and  (Stroke Jama et al.,2009). Sufferers also have decrease life expectancy and low quality of life [Ahmed et al., 2016).

Sickle cell disease or anemia is one of the most widespread monogenic diseases in the World; with over 300000 babies born with SCD every year (Piel, 2015).It commonly affects many African and Asian Countries, with the Middle East being one of the most permanently affected regions. In Cameroon studies have shown that SCD is a relatively common genetic disorder. Up to 27% of the population have the trait, with 2.6%- 4.2%of which being manifested as SCD, (homozygous, SS) and the rest being heterozygotes AS (Alotaibi, 2017). The Eastern province has the highest prevalence(145cases/10000 population)followed by Southwestern province (24cases/10000 population) the high prevalence in Saudi Arabia is due to high occurrence of consanguinity between first cousins (>50%of total marriage) and the population is due lack of awareness of inherited hematological disease and in Cameroon is due to lack of awareness, knowledge, attitude and practice of the SCD homozygous genetic inheritance (Farsi at al.,2014). Additionally, SCD carriers are resistant to Falciparum malaria which is endemic in the region. The heterozygote advantage also contributes to the increase prevalence of SCD in Arabia countries (Jastaniah, 2011). Recent studies shows no significant changes in SCD prevalence (Alswaidi et al.,2012) previous  studies have proven that, despite the legal implementation of compulsory premarital genetic counseling (PMGC), The  incidence of SCD in Cameroon has not changed significantly over the last 15 years(Ahmed et al., 2015). The lack of knowledge, attitude and practice regarding SCD causes an increase in the disease incidence and a decrease in the quality of life among the disease sufferers (Alotaibi, 2017). SCD still remains one of the biggest unspoken issues in Cameroon faces today, with one of the highest prevalence worldwide (Vicky Jocelyne Ama moor, 2016). Studies shows that due to lack of the awareness of the causes, signs and symptoms, diagnosis, mode of transmission, treatment, complication and prevention have let to infant and maternal morbidity and mortality rate in Cameroon. Unlike most other disease, cultural stigma proved to be direct cause of high SCD incidence rate. This is a unique aspect of SCD knowledge, attitude and practice studies that requires further exploration so that suitable and effective preventive measures can be taken.

1.2 Problem Statement

With regards to SCD in the World, Africa is known to be the region with the highest incidence of SCD. Most babies are born with SCD due to the fact that mother’s get into sexual intercourse without knowing their SCD status. Inaddition to this, they don’t even know their partners status with regards to SCD. It been reported that children turn to manifest the signs and symptoms of the disease at 1year old of age. To limit the incidence and prevalence there is need for community awareness on SCD. All these prompted the researcher to assess the knowledge, attitude and practices among women   of reproductive age towards sickle cell anemia

1.3 Rationale

The rationales for this study are as follows

• To improve on the level of awareness of sickle anemia / sickle cell disease among women of reproductive age in the Muea community.
• To limit morbidity and mortality cause by sickle cell anemia.
• To limit discrimination and stereotyping in the community with respect to sickle cell disease patients.

 1.4 Research Questions

         Research questions of this study are as follows:

• What is the level of awareness of women of reproductive age towards sickle cell anemia?
• What is the attitude of women of reproductive age towards sickle cell anemia?
• What is the level of practice of women of reproductive age towards sickle cell anemia?

1.5 Research Objective

The objectives of this study include the following:

1.5.1 General objective

The general objective of this study was to assess the knowledge, attitude and practices of women of reproductive age towards sickle cell anemia in the Muea community.

1.5.2 Specific objectives

The specific objectives of this study were

• To assess the level of awareness of women of reproductive age towards sickle cell anemia.
• To determine the attitude of women of reproductive age towards sickle cell anemia.
• To evaluate the practice of women of reproductive age towards sickle cell anemia.