If there is one health question Nigerians have become very comfortable asking, it is: “What’s your genotype?”
It can come up during premarital counselling, while discussing relationships, or even as a random question among friends. Most of us have heard about sickle cell disease, but knowing the word “genotype” is not the same as actually understanding sickle cell.
Over the years, facts and family advice have become mixed together, leaving plenty of myths floating around.
Since September is Sickle Cell Awareness Month, here are five things we should probably stop believing about sickle cell.
Myth 1: Sickle cell is caused by a curse or something supernatural
This one may sound surprising, but beliefs connecting sickle cell disease to supernatural causes have been documented in Nigeria.
The truth is much less mysterious: sickle cell disease is an inherited genetic condition. It happens when a child inherits certain abnormal haemoglobin genes from their parents. It is present from birth; it is not caused by a curse, witchcraft, bad behaviour or something a parent did during pregnancy.
So if someone in your family has sickle cell, perhaps the first step isn’t finding out who offended whom. It is understanding genetics.
Myth 2: Someone with sickle cell is always sick
This is one of those assumptions that can make life unnecessarily difficult for people living with sickle cell.
Yes, sickle cell disease can cause serious complications, including severe pain, anemia, infections and other health problems but that doesn’t mean someone with sickle cell spends every day in a hospital bed.
People living with the condition can go to school, work, have relationships, pursue careers and live full lives. Their health may require more planning and medical care, but having sickle cell does not automatically mean being incapable of having a normal life.
A person can have sickle cell and still be the colleague who never misses a deadline, the friend who is always making plans or the person who complains about Lagos traffic like everybody else.
Myth 3: AS is just a mild version of SS
This is a big one. In Nigeria, people sometimes talk about “AS” as though it means someone has a less severe form of sickle cell disease. It doesn’t.
Sickle cell trait (AS) is different from sickle cell disease (such as SS). Someone with sickle cell trait has inherited one sickle cell gene and one normal haemoglobin gene. People with the trait usually don’t have the symptoms associated with sickle cell disease.
Having AS is therefore not the same as having a “small” version of SS.
However, sickle cell trait still matters because a person can pass the sickle cell gene to their children. That’s why knowing your genotype is useful information, not just when marriage enters the conversation.
Myth 4: Sickle cell is basically a marriage problem
Ask many Nigerians about sickle cell and the conversation will eventually arrive at marriage.
“Know your genotype before you marry.”
“Don’t marry someone with this genotype.”
“Check before you fall in love.”
The concern behind these warnings is understandable. When two people carry certain haemoglobin variants, there can be a risk of having a child with sickle cell disease. For example, when two people with sickle cell trait (AS) have a child, there is a 25% chance in each pregnancy that the child will have sickle cell disease but sickle cell is not a marriage problem. It is a genetic and health issue.
Knowing your genotype shouldn’t begin when you meet someone you want to marry. It is useful information to know about yourself regardless of your relationship status and perhaps we should replace the fear-based “never marry this person” approach with better education about genetics and informed reproductive choices.
Myth 5: People with sickle cell shouldn’t exercise or do anything strenuous
This one needs some nuance.
People with sickle cell disease may need to take precautions around activities and situations that could trigger complications but the idea that anyone with sickle cell must avoid all physical activity is an oversimplification.
Even people with sickle cell trait, who generally do not have symptoms of sickle cell disease, can participate in physical activity. The CDC recommends sensible precautions such as staying hydrated, gradually increasing exercise intensity and taking breaks, particularly during intense exercise or in hot conditions.
The point isn’t that everyone should exercise the same way. It is that a diagnosis shouldn’t automatically become a lifetime ban on doing things.
So, what should we actually know?
Sickle cell disease is serious and the right knowledge ensures that we can provide the right support too anyone who needs it.
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