A comparative study of sickle cell disease and rhesus factor comparability among couples in yenegoa and port harcourt

Project Abstract

<p> The study on a<br>comparative study of sickle cell disease and Rhesus factor comparability among<br>couples in Yenegoa and Port Harcourt aimed at evaluating the media campaign in creating awareness on sickle cell and<br>Rhesus factor among couples in Yenegoa and port Harcourt, to examine whether<br>counseling before marriage will help control the prevalence of sickle cell and<br>Rhesus factor among couples in Nigeria, to determine whether low standard of<br>living will increase the mortality rate among children with sickle cell<br>disease, to determine the effect of Rhesus factor and sickle cell on child<br>mortality rate in Yenegoa and port Harcourt and to determine the extent to<br>which availability of drugs and medical facilities controls sickle cell disease<br>and Rhesus factor in Yenegoa and Port Harcourt. The study made use<br>of primary data which are gotten from the distribution of the research<br>questionnaires; the sample size for the study is 101. The study made use of the<br>Pearson correlation method and paired sample t-test for the analysis. However there is a statistically<br>significantly <b>(0.00)</b>&nbsp;strong<br>relationship <b>(0.819)</b>&nbsp;between the<br>responses of the respondents that said that Rhesus factor and sickle<br>cell have significant effect on child mortality rate in Yenegoa and Port<br>Harcourt and those<br>that said that broadcast media reaches higher number of audience in creating<br>awareness for sickle cell and Rhesus.The study therefore concluded that there<br>is significant the difference in effectiveness of media campaign on sickle cell<br>and Rhesus factor. The<br>study also made useful recommendation to assist the federal government in<br>decision making. <br></p>

Project Overview

<p> <b><b><b><b></b></b></b></b></p><p><b><b><b><b>1.0 INTRODUCTION</b></b></b></b></p><p><b><b><b></b></b></b></p><b><b><b><p><b>1.1 BACKGROUND OF<br>STUDY</b></p><p><b></b></p><b><p>The prevalence<br>of sickle cell anemia and Rhesus factor comparability have increased overtime<br>time in Nigeria; thus causing an increase in mortality rate among children<br>especially those below twenty (20) years of age (Kulkarni, 2007). It is widely<br>believe that the causes of sickle cell anemia and Rhesus factor incompatibility<br>is due to a high level of ignorance on the dangers posed by these disease. The<br>federal government of Nigeria through the NGOs and the media has put in so much<br>effort on awareness campaign on how to control the occurrence of these diseases<br>especially for the young ones that are about the ages of getting married.</p><p>Sickle<br>cell disease (SCD) can simply be defined as a hereditary disorder in which an<br>individual has inherited two abnormal Hb genes, at least one of which is<br>responsible for the production of sickle Hb (HbS) (Creary et al., 2007). The<br>most common clinical phenotype is the homozygote, i.e. HbSS, also known as<br>sickle cell anaemia. Compound heterozygotes include HbSC, SD, SO-Arab and<br>Sbthal, which are all collectively (in addition to SS) referred to as SCD.</p><p>The<br>sickle-shaped red blood cells described by Herrick caused several<br>complications, including chronic anemia, vaso-occlusive pain episodes, ischemic<br>organ damage, infections, small stature, and delayed puberty (Barakat et al.,<br>2008). For many generations sickle cell disease has been a prevalent disorder<br>in Nigeria. Reports show that sickle cell disease was a well-known disorder in<br>most states in Nigeria and that the natives in Nigeria had several local names<br>for this disease before it was discovered in America (Reid &amp; Rodgers,<br>2007).</p><p>According<br>to Modell B, (2007) stated that the HbS gene became prevalent in different<br>parts of the world following selective pressure because the heterozygote (HbAS)<br>is protected against some of the deleterious effects of malaria. Therefore, SCD<br>is found at its highest frequencies in parts of the world where malaria is or<br>was endemic. In the same vein, Fleming AF, (2008) stated that because of slave<br>trade and recent migrations, it is now found even more widely including in<br>Europe and the USA. Nonetheless, the prevalence is highest in tropical Africa<br>and, indeed, the country with the highest burden is Nigeria where the trait<br>occurs in 25–30% and sickle cell anaemia occurs in approximately 2% of all<br>births</p><p>The<br>most common features of SCD are chronic haemolytic anaemia and recurrent<br>vaso-occlusion. The latter is responsible for the painful crises that<br>characterise the disease. There is also a chronic vasculopathy triggered by<br>free heme resulting in nitric oxide scavenging and upregulation of adhesion<br>molecules in reticulocytes, neutrophils and endothelial cells (Wood KC, 2008).<br>This is further complicated by a procoagulant state following the activation of<br>platelets. There is smooth muscle dystonia and eventual hyperplasia, which<br>contributes to vascular occlusions (Morris CR, 2009). This explains the<br>plethora of features and complications seen in SCD. The major cause of<br>mortality in childhood is overwhelming bacterial infections especially due to<br>encapsulated organisms, principally pneumococcus.</p><p>On<br>the other hand Rh is short for Rhesus blood group system. The Rh blood type<br>contains parts called antigens including the D antigen. If the D antigen is<br>present, a person is considered to be Rh positive. If the D antigen is absent,<br>the person is said to be Rh negative. About 85% of Nigerians have an Rh<br>positive blood type, while the remaining 15% are Rh negative. The Rhesus factor<br>is very important to the human body; however there might variation in<br>compatibility which results to Rhesus disease.</p><p>A<br>study of Rh disease deepens our understanding of historical infant mortality in<br>general and perinatal mortality in particular. The decline of infant mortality<br>in Nigeria started around 1800, which is earlier than in most other countries.<br>At that time, rates were very high even if the Nigerians as well as other<br>African countries levels were low in international comparison (Edvinsson et al.<br>2008). However there have been several awareness campaigns on the sickle cell<br>disease and Rhesus factor comparability among couples in Nigeria. The use of<br>mass media and other medium may help in the dissemination of information on<br>sickle cell and Rhesus factor among couples in Nigeria.</p><p><b>1.2 STATEMENT OF<br>PROBLEM</b></p><p><b></b></p><b><p>Sickle cell<br>disease and Rhesus factor issue has been prevalent in Nigeria for a very long<br>time now. Families and friends have lost lives to these ailments as a result of<br>lack of awareness on the preventive measures to be taken to control the<br>ailments. The federal government of Nigeria has channeled lots of funds to the<br>medical centers in Nigeria to help salvage the situation but the incidence is<br>still on the increase. Take yenegoa and portharcourt for example, there are<br>several factors that can lead to the increase in sickle cell disease and Rhesus<br>factor disease; Viz:</p><p>1. high<br>level of illiteracy</p><p>2. lack<br>of awareness campaign on the effect of sickle cell disease and Rhesus factor<br>among couples</p><p>3. low<br>standard of living &nbsp;</p><p>4. poor<br>medical facilities and</p><p>5. lack<br>of counseling before marriage</p><p>&nbsp;It is to this regard that the researcher<br>desire to carry out a comparative study on sickle cell disease and Rhesus<br>factor awareness campaign using mass media.</p><p><b>1.3 AIM AND OBJECTIVES<br>OF STUDY</b></p><p><b></b></p><b><p>The main aim of<br>the research work is to carry out a comparative study of sickle cell disease<br>and Rhesus factor comparability among couples in Yenegoa and Port Harcourt.<br>Other specific objectives of study are:</p><p>1. to<br>examine whether media campaign has a role to play in the level of awareness on<br>sickle cell and Rhesus factor among couples in Yenegoa and port Harcourt</p><p>2. to<br>examine whether counseling before marriage will help control the prevalence of<br>sickle cell and Rhesus factor among couples in Nigeria</p><p>3. to<br>determine whether low standard of living will increase the mortality rate among<br>children with sickle cell disease</p><p>4. to<br>determine the effect of Rhesus factor and sickle cell on child mortality rate<br>in Yenegoa and port Harcourt</p><p>5. to<br>determine the extent to which availability of drugs and medical facilities<br>controls sickle cell disease and Rhesus factor in Yenegoa and Port Harcourt</p><p><b>1.4 RESEARCH QUESTIONS</b></p><p><b></b></p><b><p>The study came<br>up with research questions so as to ascertain the above stated objectives. The<br>research questions for the study are:</p><p>1. What<br>is the difference in effectiveness of media campaign on sickle cell and Rhesus factor?</p><p>2. Does<br>media campaign play a role in the level of awareness on sickle cell and Rhesus<br>factor among couples in Yenegoa and Port Harcourt?</p><p>3. Does<br>counseling before marriage help control the prevalence of sickle cell and<br>Rhesus factor among couples in Nigeria?</p><p>4. What<br>is the effect of standard of living on mortality rate among children with<br>sickle cell disease?</p><p>5. to<br>determine the effect of Rhesus factor and sickle cell on child mortality rate<br>in Yenegoa and port Harcourt</p><p>6. To<br>what extent does availability of drugs and medical facilities controls sickle<br>cell disease and Rhesus factor in Yenegoa and Port Harcourt?</p><p><b>1.5 STATEMENT OF RESEARCH HYPOTHESIS</b></p><p><b></b></p><b><p><b>Hypothesis 1</b></p><p><b></b></p><b><p><b>H0:</b>&nbsp;there is no significant<br>the difference in effectiveness of media campaign on sickle cell and Rhesus<br>factor</p><p><b>H1:</b>&nbsp;there is significant the<br>difference in effectiveness of media campaign on sickle cell and Rhesus factor</p><p><b>Hypothesis 2</b></p><p><b></b></p><b><p><b>H0:</b>&nbsp;Rhesus factor and sickle<br>cell have no significant effect on child mortality rate in Yenegoa and port<br>harcourt</p><p><b>H1:</b>&nbsp;Rhesus factor and sickle<br>cell have significant effect on child mortality rate in Yenegoa and port<br>harcourt</p><p><b>1.6 SIGNIFICANCE OF STUDY</b></p><p><b></b></p><b><p>The study on a<br>comparative study of sickle cell disease and Rhesus factor comparability will<br>be of immense benefit to couples in Yenegoa and Port Harcourt and the media<br>because the study will compare the effectiveness of media campaign on sickle cell<br>and that of Rhesus factor. The study will also serve as a source of literature<br>for other researchers that desire to carry out similar research on the above<br>topic. Finally the<br>study will contribute to the body of existing literature and knowledge in this<br>field of study and provide a basis for further research</p><p><b>1.7 SCOPE OF STUDY</b></p><p><b></b></p><b><p>The study on a<br>comparative study of sickle cell disease and Rhesus factor comparability will<br>be limited to the media house and the couples in Yenegoa and Port Harcourt. The<br>study will cover for a period of seventeen years (2000-2017).</p><p><b>1.8 </b><b>LIMITATION OF<br>STUDY</b></p><p><b></b></p><b><p>The only problem the<br>researcher had in getting information from the respondents on sickle cell and<br>Rhesus factor was the unwillingness of the respondents to give information<br>about their health status. The might affect the information provided by the<br>respondents but the researchers however was able to get good information as<br>regard the research topic by making the respondents feel safe with whatever<br>information they provided to the researcher.</p><p><b>1.9 DEFINITION OF TERMS</b></p><p><b></b></p><b><p><b>Sickle cell:</b>&nbsp;A group of<br>disorders among couples in Yenegoa and Port Harcourt that cause red blood cells<br>to become misshapen and break down<b></b></p><p><b></b></p><b><p><b>Rhesus factor: </b>Rhesus factor in<br>accordance to the study isan<br>antigen occurring on the red blood cells of couples in Yenegoa and Port<br>Harcourt (around 85 per cent) and some other primates<b></b></p><b><p><b></b></p><b><p><b>Antigen:</b>&nbsp;a toxin or other<br>foreign substance which induces an immune response in the body, especially the<br>production of antibodies<b></b></p><b><p><b></b></p><b><p><b>Genetic counseling</b>:<br>Communication process between health care provider and client that emphasizes and<br>provides accurate and up-to-date information about a genetic disorder in a<br>sensitive and supportive, non-directive manner (SCDAA, 2005).</p><p><b>Hemoglobin</b>: Chemical substance<br>(an iron containing protein) of the red blood cell, which carries oxygen to the<br>tissues, and gives the cell its red color (SCDAA, 2005).</p><p><b>Hemoglobin A (HbA):</b>&nbsp;Hemoglobin<br>is composed of two alpha globins and two beta globins, normally produced by<br>children and adults (Jones, 2008, p. 119).</p><p><b>Hemoglobin C trait (AC):</b><br>Inheritance of one gene for the usual hemoglobin (A) and one gene for<br>hemoglobin (C). A person who has the hemoglobin C Trait (AC) is a carrier of<br>the hemoglobin C gene, and is not affected by the gene (SCDAA, 2005).</p><p><b>Hemoglobin C disease</b>: A person<br>has both HbS and HbC and is often referred to as “HbSC.” Hemoglobin C causes<br>red blood cells to develop. Having just some hemoglobin C and normal<br>hemoglobin, a person will not have any symptoms of anemia. However, if the<br>sickle hemoglobin S is combined with the target cell, some mild to moderate<br>anemia may occur (UMMC, 2010).</p><p><b>Hemoglobin E disease</b>: Similar to<br>sickle cell-C disease except that an element has been replaced in the<br>hemoglobin molecule under certain conditions, such as exhaustion, hypoxia,<br>severe infection, and/or iron deficiency</p><p><b>Sickle cell trait:</b>&nbsp;A person<br>carrying the defective gene, HbS, but also has some normal hemoglobin HbA.<br>Persons with the sickle cell trait are usually without symptoms of the disease,<br>but mild anemia may occur under intense, stressful conditions, exhaustion,<br>hypoxia (low oxygen), and/or severe infection. The sickling of the defective<br>hemoglobin may occur and result in some complications associated with sickle<br>cell disease</p></b></b></b></b></b></b></b></b></b></b></b></b></b></b></b></b></b></b></b> <br><p></p>