Effectiveness of Pre-Marital Genetic Screening Programmes in Reducing Sickle Cell Disease Births in Kano State

Pre-marital genetic screening combined with genetic counselling represents one of the most cost-effective strategies for preventing sickle cell disease (SCD) births in high-prevalence settings. Kano State in North West Nigeria has implemented pre-marital screening programmes through teaching hospitals, but their effectiveness in changing reproductive behaviour and reducing SCD birth incidence has not been rigorously evaluated. This retrospective cohort study tracked 500 couples who underwent pre-marital SCD screening and counselling at Aminu Kano Teaching Hospital between 2019 and 2022. Couples were stratified by genotype combination (AS x AS, AS x SS, etc.) and followed up for reproductive outcome data through hospital antenatal records and telephone interviews. The proportion of at-risk couples (both AS or one SS) who proceeded to marriage and subsequent SCD-affected births was compared with a historical control cohort from 2015 to 2017. Post-counselling, a significant proportion of high-risk couples reported changing or delaying marriage plans. The incidence of SCD-affected births among counselled couples was significantly lower than the historical control. Religious influence was identified as both a facilitating and complicating factor. These findings validate the effectiveness of pre-marital SCD screening in Kano State. Keywords: pre-marital screening, sickle cell disease, genetic counselling, Kano State, reproductive behaviour