Claim: A social media user alleged that marrying people from regions outside West Africa where sickle cell is less prevalent can solve genetic problems.
Verdict: Misleading! Marrying someone from outside West Africa does not cure or solve genetic problems because sickle cell is transmitted through genes, and the disease is not limited to Africa. There are several reports of cases in the US, India, Asia, etc.
Full Text
Sickle Cell Disease (SCD), also known as sickle cell anaemia, is a group of inherited blood disorders characterised by the production of abnormal haemoglobin. This leads to misshapen red blood cells that can cause various health complications.
The World Health Organisation (WHO) approximates that 5% of the world’s population carries trait genes for haemoglobin disorders, which are mainly sickle-cell disease and thalassaemia.
Even though sickle cell disease is more prominent in countries where malaria is present, like some African countries (Nigeria, the Republic of Congo, Cameroon, Ghana, and Uganda), it also affects millions globally, including populations in the United States, the Caribbean, and parts of India and the Middle East.
This highlights that marrying outside one’s region does not eliminate the risk of sickle cell disease, and international marriages, if approached without proper genetic screening, can still contribute to its spread unless both partners have compatible genotypes.
Recently, Charles Awuzie claimed on Facebook that international marriages can solve the genetic issue of sickle cell disease. The claimant explained that people from West Africa who have AS/SS blood groups can marry people from outside West Africa, where sickle cell is less prevalent, to solve genetic problems.
According to the claimant, the sickle cell gene is absent from most people outside Nigeria.
“This is the global distribution of the sickle cell gene. Find a country with normal haemoglobin and get married. There’s no law that says you must marry a Nigerian,” the post caption reads.
With the post, they infer that Nigerians marrying non-Nigerians from countries with less prevalence of sickle cell would reduce its prevalence.
As of May 19, 2025, the post had garnered over 7,000 reactions, over 2,000 comments, and 899 shares.
Since this is a public health issue, DUBAWA investigated the claim.
Verification
The WHO classifies Sickle Cell disease as a haemoglobin disorder characterised by a modification in the shape of the red blood cell. In this case, the red blood cell changes from a smooth, doughnut-shaped shape into a crescent or half-moon shape.
The misshapen cells lack plasticity and can block small blood vessels, impairing blood flow.
This condition leads to shortened red blood cell survival and subsequent anaemia, often called sickle-cell anaemia.
Poor blood oxygen levels and blood vessel blockages in people with sickle-cell disease can lead to chronic acute pain syndromes, severe bacterial infections, and necrosis (tissue death).
Sickle Cell disease is inherited and passed down through genes from parents to their children. For a child to have sickle cell disease, there are three factors involved, which are;
- Both parents carry the sickle cell trait (AS): If both parents are AS, they are both carriers of the sickle cell disease. So if both parents pass the sickle cell gene to their child, the child will have sickle cell disease.
- One parent has sickle cell disease while the other has the trait: If one parent has sickle cell disease (SS) and the other has the sickle cell trait (AS), each child has a 50% chance of inheriting sickle cell disease. Which simply means that if a child inherits the sickle cell gene from both parents who are SS and AS, the child will have sickle cell disease.
- Both parents have sickle cell disease: If both parents have sickle cell disease, all their children will inherit sickle cell disease since both parents are SS.
For instance, if someone from Africa who already has Sickle Cell disease or possesses its trait marries someone from Asia or Europe or any other part of the world who also has Sickle Cell disease or possesses its trait, their child will have Sickle Cell disease or be a carrier of the trait depending on the three factors stated above.
Perhaps having people marry non-sickle cell carriers outside their region could potentially reduce the spread, as the post author implies. However, such a decision is not blanket, as some of their followers believed. Marrying just anyone would not reduce the spread.
Below is a simple image showing how sickle cell disease is inherited.
Photo credit: National Heart, Lung, and Blood Institute.
Experts Opinion
Alao Opemipo, a medical doctor at the University of Abuja Teaching Hospital (UATH), Gwagwalada, Abuja, Nigeria, said Sickle cell disease (SCD) is a genetic disorder due to a single base-pair point mutation in the β-globin gene, resulting in the substitution of the amino acid valine for glutamic acid in the β-globin chain. It is a genetic disease deeply rooted in an individual’s genes. As long as this disease is present in an individual, inter racial or intermarriage is not sufficient to override this, except, of course, the individual residing outside of Nigeria or Africa is of a different genotype like AA. Sickle cell inheritance is not determined by race but by the individual’s genetic makeup. An article from Healthline also confirms that sickle cell is not determined by race.
Eniola Soyinka, a medical doctor of Federal Medical Center, Ebute metta Lagos, also stated that anyone who is a carrier of sickle cell (AS) or anyone with sickle cell (SS) should still double check the haemoglobin genotype of their partner regardless of their country of residence because not everyone living outside Africa has a genotype of AA. People who have a genotype of AA are the only ones who don’t have to worry about anything because, regardless, they can never give birth to a child with sickle cell. This assertion is further backed by a 2024 article by Fidson Healthcare Plc stating that,
“There are three main genotypes: AA, AS, and SS. An individual with an AA genotype does not carry the sickle cell trait, while an AS carries one normal and one sickle cell gene, and SS denotes sickle cell disease. For a child to be born with SCD, both parents must carry the sickle cell trait (AS or SS).”
The malaria hypothesis
The claimant attached a map stating that Haemoglobin S is nearly absent outside malaria endemic zones to support his claim. We investigated it and discovered that the map is linked to a 2010 Nature Communications study shared by Europe PubMed Central. According to this study, this map showing the global distribution of the sickle cell gene confirms the malaria hypothesis.
The malaria hypothesis theory claims that the Haemoglobin S gene has been naturally selected in populations where malaria was historically common, because it offers some protection against the disease. This 2013 study, published in the New England Journal of Medicine, highlights the complex genetic origins, diverse geographic distribution, and age-dependent clinical manifestations of sickle cell disease, underscoring the need for tailored management strategies to reduce morbidity and mortality globally.
In contrast to what the claimant insinuates, this 2014 study published in The Lancet Global Health also notes that migration has led to an increase in the occurrence of sickle-cell disease in countries with previously low incidence of the disorder.
A 2021 study published in The Lancet Haematology revealed that over half a million babies were born with sickle cell disease in 2021, with more than three-quarters of this number in countries of sub-Saharan Africa.
While these show a dominance of the disease in Africa, it does not mean people outside Africa do not suffer from this. There are also studies on sickle cell disease issues in Europe, Asia,
This 2024 article, “Sickle cell disease: a comparative perspective on global and national initiatives,” published in Frontiers in Haematology, reveals that although the disease’s burden is mainly in sub-Saharan Africa, India, and the Middle East, it is also present in the United States.
So, while the map shows where sickle cell traits are common due to the historical prevalence of malaria, it does not support the claim that marrying someone outside the African region where the disease is absent stops genetic inheritance since the disease is not limited to one region; it is spread by gene, not location.
Conclusion
The statement that West Africans with AS/SS blood groups can marry others from regions outside West Africa, where sickle cell is less prevalent, to solve genetic problems is false. This is because sickle cell disease is passed through the genes, not the location. It is strongly advised that everyone should ensure to check their genotype at a trusted hospital, especially couples who want to get married, to prevent the spread of sickle cell disease.