As Nigeria joins the rest of the world in observing the 2025 edition of World Sickle Cell Day on June 19, medical experts and pediatric specialists have once again emphasized the urgent need for premarital genetic screening and counselling to curb the growing spread of sickle cell disorder (SCD) in the country. With Nigeria recording one of the highest burdens of this genetic blood condition globally, stakeholders believe only a nationwide culture of genotype awareness and responsible partner selection can significantly reduce new cases.

This year’s global observance is themed “Global Action, Local Impact: Empowering Communities for Effective Self-Advocacy,” a message that resonates strongly in Nigeria, where an estimated 4 to 6 million people live with sickle cell disease, and about 150,000 babies are born annually with the condition — the highest figure worldwide, according to the World Health Organization (WHO).

Premarital Testing: A Powerful Preventive Weapon

At the forefront of this advocacy is Dr. Abdurrazzaq Alege, a Consultant Pediatrician at the Federal Teaching Hospital, Katsina, who described premarital counselling and genetic compatibility testing as “the most effective way” to prevent sickle cell disorder.

“If this is adhered to properly, the population of the ‘S’ gene in the environment will reduce significantly,” he said in a statement marking World Sickle Cell Day.

Dr. Alege warned that while stem cell transplants offer a potential cure, the procedure remains inaccessible and unaffordable for the vast majority of Nigerians due to its high cost and the absence of widespread medical infrastructure to support it.

“The disease is better prevented than managed. The definitive cure still remains stem cell transplant (replacing the abnormal stem cells in bone marrow with healthy ones), which is very costly and not readily available in Nigeria,” he added.

A Costly and Lifelong Medical Burden

Sickle cell disorder, which affects red blood cells and causes them to assume a rigid, sickle-like shape, leads to frequent pain crises, anemia, organ damage, and increased risk of infection. These symptoms require lifelong medical care, often involving:

• Daily hydration of at least three liters of water to improve blood circulation

• Avoidance of strenuous physical activity to reduce the risk of crisis

• A balanced diet excluding iron supplements

• Use of insecticide-treated mosquito nets and anti-malaria drugs like proguanil to prevent malaria triggers

• Preventive antibiotics such as Penicillin V to lower infection risks

• Folic acid supplements to support red blood cell production

In more severe cases, management may require:

• Chronic blood transfusion programmes every 6–8 weeks using hemoglobin AA blood to reduce the concentration of sickled cells

• Use of Hydroxyurea, a medication that boosts fetal hemoglobin levels and helps reduce painful crises

Dr. Alege, however, cautioned that such medications must be used strictly under medical supervision due to their potential side effects.

Voices from Academia: “Avoid Marrying Carriers”

Adding to the conversation, Professor Aminu Mohammad, a renowned Professor of Pediatric Surgery at Bayero University, Kano, and a specialist in congenital paediatric oncology, stressed the preventive power of informed partner choices.

“That is why premarital testing is important—to prevent the disease rather than treat it,” he told Frontpage Health.

According to him, if two carriers (AS genotype) avoid getting married or having children together, the risk of transmitting sickle cell disease can be completely eliminated.

“In some parts of the world, sickle cell disease has been nearly eliminated because people strictly follow genotype compatibility in marriage,” he said.

The professor urged Nigerian communities and religious organisations to normalize genotype testing before marriage as a moral and medical obligation, warning that failing to do so only continues the cycle of suffering for unborn generations.

Global and Local Burden of Sickle Cell Disease

The World Health Organization estimates that over 7.7 million people are currently living with SCD worldwide, marking a 40% increase since the year 2000. Each year, the condition contributes to more than 375,000 deaths globally.

Sub-Saharan Africa bears the brunt of the disease, accounting for 8 in 10 cases, alongside other malaria-endemic regions like parts of the Middle East, South Asia, and the Caribbean.

In Nigeria, the challenge is compounded by a low level of public awareness, cultural taboos, and inadequate access to genetic testing facilities, particularly in rural areas. Advocacy groups believe a massive public sensitization campaign—led by government, media, and religious institutions—is long overdue.

Stem Cell Transplant: A Distant Hope for Many

While stem cell transplant remains the only curative option for sickle cell disease, its price tag—which can run into tens of millions of naira—places it far beyond the reach of ordinary Nigerians.

Only a handful of hospitals in Nigeria and select centers abroad offer the treatment, and donor availability poses another major hurdle. Most patients rely on palliative care and regular crisis management, which can take a toll not only physically but financially and emotionally.

Community Advocacy: A Key to Progress

This year’s theme, “Empowering Communities for Effective Self-Advocacy,” captures the need for grassroots awareness and peer-led interventions. Many experts believe that community groups, civil society, and youth-led organizations must take charge of educating people on:

• The importance of genotype screening

• Access to free or subsidized testing centers

• Risks of ignoring medical advice during partner selection

• The long-term emotional and financial costs of raising children with sickle cell disorder

Conclusion: The Future Lies in Prevention

As Nigeria marks World Sickle Cell Day 2025, the consensus among medical experts is clear: Prevention remains the most effective, affordable, and realistic solution to reducing the burden of sickle cell disorder in Nigeria.

With millions of Nigerians still unaware of their genotype and cultural pressures pushing couples into incompatible marriages, genetic screening before marriage must become a public health priority. Only through coordinated government action, public education, and stronger community engagement can Nigeria turn the tide against one of its most enduring public health challenges.