Anemia · 2026
Factors Associated With Knowledge of Sickle Cell Disease and Haemoglobin Genotype Awareness Among Pregnant Women in Three Health Centres in Libreville and Owendo, Gabon.
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Igala Marielle, Ewendje Rick Farel, Ledaga Nathalie Ambounda, Lentombo Léonie Esther Ledaga, Moussounda Paule Marcelle Bamba, Ondo Graziella Dolores Helley, Mensah Sarah Ikhogou, Ebozogo Axel Dany Ollo, Boguikouma Jean Bruno
Аннотация
INTRODUCTION: In Gabon, screening for sickle cell disease, a hereditary disorder that causes haemolytic anaemia due to the sickling of red blood cells, is systematic during pregnancy and mandatory before marriage. Several years after the implementation of these measures, this study aimed to identify the factors associated with knowledge of sickle cell disease and awareness of haemoglobin genotype among pregnant women.
PATIENTS AND METHODS: This was a multicentre, cross-sectional, descriptive and analytical study conducted from May to December 2024 in three health centres in Greater Libreville. Pregnant women of any age, regardless of gestational age, who agreed to participate by giving written consent were included. Statistical analysis was performed using Epi-Info software, version 7.2.3.1. Multivariable logistic regression was additionally performed to identify independent determinants of haemoglobin genotype awareness and of general knowledge of sickle cell disease.
RESULTS: A total of 300 women with a mean age of 26.6 ± 5.9 years were included. They were mostly single (56%), in training or apprenticeship (42%), with a secondary education level (54%). Haemoglobin genotype was known to 128 (42.7%) participants. Awareness of one's own genotype was independently associated with age (aOR = 1.12, 95% CI 1.07-1.18), number of antenatal visits (aOR = 1.46, 95% CI 1.26-1.69), and tertiary education (aOR = 5.61, 95% CI 1.66-19.02), whereas marital status, significant in bivariate analysis, was not an independent determinant after adjustment.
CONCLUSION: Mandatory screening policies alone are insufficient to ensure adequate awareness of sickle cell disease and haemoglobin genotype. Antenatal care visits represent a concrete, currently underused opportunity for structured counselling; integrating progressive, education-adapted genetic counselling into routine antenatal care should be prioritised to strengthen the public health impact of Gabon's existing screening programmes.
PATIENTS AND METHODS: This was a multicentre, cross-sectional, descriptive and analytical study conducted from May to December 2024 in three health centres in Greater Libreville. Pregnant women of any age, regardless of gestational age, who agreed to participate by giving written consent were included. Statistical analysis was performed using Epi-Info software, version 7.2.3.1. Multivariable logistic regression was additionally performed to identify independent determinants of haemoglobin genotype awareness and of general knowledge of sickle cell disease.
RESULTS: A total of 300 women with a mean age of 26.6 ± 5.9 years were included. They were mostly single (56%), in training or apprenticeship (42%), with a secondary education level (54%). Haemoglobin genotype was known to 128 (42.7%) participants. Awareness of one's own genotype was independently associated with age (aOR = 1.12, 95% CI 1.07-1.18), number of antenatal visits (aOR = 1.46, 95% CI 1.26-1.69), and tertiary education (aOR = 5.61, 95% CI 1.66-19.02), whereas marital status, significant in bivariate analysis, was not an independent determinant after adjustment.
CONCLUSION: Mandatory screening policies alone are insufficient to ensure adequate awareness of sickle cell disease and haemoglobin genotype. Antenatal care visits represent a concrete, currently underused opportunity for structured counselling; integrating progressive, education-adapted genetic counselling into routine antenatal care should be prioritised to strengthen the public health impact of Gabon's existing screening programmes.