The Sickle Cell Trait and Reproductive Decisions Among Youths in the Fako Division of Cameroon

Background: Sickle cell disease is a major inherited condition in sub-Saharan Africa, and the sickle cell trait continues to shape reproductive choices among young adults. This study assessed the prevalence of the sickle cell trait among youths in the Fako Division and identified factors influencing knowledge and reproductive decisions. Methods: A hospital cross-sectional study was carried out from January to April 2020 among 300 youths aged 18–40 years in Buea, Limbe, and Tiko. Data were collected using a structured questionnaire that captured sociodemographic characteristics, knowledge of sickle cell disease and trait, behaviour, attitude and reproductive intentions. Haemoglobin electrophoresis was performed to determine genotype status. Descriptive statistics were computed, and logistic regression analyses were used to identify factors independently associated with good knowledge and marriage decisions based on genotype with statistical significance at p<0.05. Results: Among 640 participants who were screened for sickle cell trait, 300 consented to respond to the structured questionnaire. The prevalence of sickle cell trait (AS) was 12.3% (79/640). From the 300 participants who responded, 83.0% (249/300) demonstrated good knowledge of sickle cell disease, only 42.7% (128/300) were aware of their genotype, and 18.7% (56/300) knew their partner's. A significant 76.3% (229/300) indicated that a partner's genotype would affect their marriage decision, while 68.3% (205/300) reported it would influence childbearing choices. Predictors of good knowledge were female sex (aOR: 2.39; 95% CI: 1.17–4.86), residence in Buea (aOR: 7.24; 95% CI: 2.27–23.16), Christian faith (aOR: 10.57; 95% CI: 1.22–91.83), and not having children (aOR: 2.44; 95% CI: 1.09–5.47). Decisions to marry based on genotype were significantly more likely among Christians (aOR: 11.44; 95% CI: 1.01–19.95) and among individuals reporting more than one sexual partner (aOR: 2.04; 95% CI: 1.09–3.81). Conclusion: One in ten youths in Fako carries the sickle cell trait. Despite high awareness, many lacked personal or partner genotype knowledge. Partner genotype influenced reproductive decisions, highlighting the need for improved screening initiatives, premarital counselling, and timely education for sickle cell disease prevention.