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Love or Lies?: Fake genotype results fuel rise in sickle cell births, broken homes

sickle-cell


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Despite growing awareness and legislation mandating genotype testing before marriages, fake genotype results is on the rise. Investigations by The PUNCH duo UMAR SANI and VICTOR AYENI reveal that some prospective couples, desperate to marry despite incompatible genotypes, are forging medical results — often with the help of unscrupulous laboratories or unqualified personnel

Yearly, the wedding committee of the Gwallaga Jumma’at Mosque, Bauchi, conducts about 500 weddings. On several occasions, it has declined approving some marriages due to presentation of fake genotype results.

Chairman of the committee, Hassan Ladan, says genotype tests are usually re-conducted in the mosque’s hospital when any result is doubtful.

“Being that the committee has its designated rules and guidelines for conducting weddings. A prospective couple has to obtain forms from us, filled and summit not less than two days to the marriage. After summiting the forms we take our time to scrutinise it.

“We have turned down many weddings with whom results we are suspicious of. Most of those results come from the privately owned health facilities including independent laboratories,” Ladan, Head of the Committee told The Punch.

The test results are  confirmed through two important ways such as stamps, date and signature of the incharge who conducted the test.

Ladan declined naming the Laboratories whose results have been rejected.

In many Nigerian churches and mosques, the leadership and marriage committees often mandate that intending couples go for genotype, among other tests.

The genotype result is often sent to the church or mosque clerics who ascertain the couple’s compatibility to prevent instances of sickle cell disease in their offspring.

Medical research has indicated that certain genotype combinations can either increase or reduce the risk of sickle cell disease. This has led to increased advocacy for genotype screening before marriage to determine blood compatibility between prospective couples. The advocacy has gained widespread acceptance, prompting legislation in several states across the country.

The Bauchi State, the State House of Assembly enacted the Bauchi State Compulsory Genotype, HIV Test, and Anti-Discrimination Law, 2017, which mandates genotype and HIV screening before marriage. The law which was also obtained by The PUNCH has been implemented with the involvement of key stakeholders, including medical personnel, religious leaders, and traditional rulers.

Anambra state also a law mandating genotype test as a condition for approval of marriage.

In November last year, the House of Representatives introduced a bill that will mandate intending couples to undergo compulsory genotype screening before they are issued marriage certificates.

The proposed legislation sponsored by the spokesmen of the House of Representatives spokesman, Akin Rotimi (Ekiti, APC), scaled a first reading on October 30.

Clause 3 (1 and 2) of the bill states that no registry shall issue a “marriage certificate unless both parties have undergone genotype screening.The results of the genotype screening shall be submitted to the marriage registry before the issuance of the marriage certificate.”

The bill also stipulates penalties in clause 7(1), which read that, “Any person or entity that issues a marriage certificate without complying with the provisions of this Act commits an offence and shall be liable on conviction to a fine not exceeding N500,000 or imprisonment for a term not exceeding one year, or both.

“Any health facility that provides false genotype results or engages in fraudulent practices related to genotype screening commits an offence and shall be liable on conviction to a fine not exceeding N1,000,000 or imprisonment for a term not exceeding two years, or both.”

A similar bill introduced in the Ninth Assembly was not passed into law.

However, strict enforcement of the law in Bauchi State and the demand for the test results by marriage committees across the country has led some prospective couples, who find themselves incompatible, to resort to forging genotype test results to proceed with marriage.

Our investigation revealed that some hospitals and private laboratories are involved in producing and selling altered results. The ease of obtaining these forged results often depends on personal connections or a willingness to pay a fee.

The PUNCH was told of a case of a forged result involving a couple who, after years of courtship, discovered they both had the AS genotype, indicating incompatibility.

The young man, from Dass Local Government Area in Bauchi State, reportedly made multiple attempts to obtain a different test result from various laboratories, but all confirmed his AS genotype.

An eyewitness, who was involved in the process, told The PUNCH that he eventually forged his genotype result at a hospital in the local government.

“I won’t mention the hospital, but I know how it happened. His cousin, who was studying biochemistry and was an industrial training student in the hospital laboratory at the time, helped him obtain a falsified AA result, making it appear compatible with his girlfriend’s AS genotype. That was how they got married.”

An online medical resource, Medbury Medicals explained that the genotype “is the biological coding that ensures this specificity, uniqueness, and individuality. The DNA (Deoxyribonucleic Acid) contains the instruction manual that guides the formation of our genetic as well as physical traits.”

Typically, there are five distinct types of blood genotype. They are  AA, AS, AC, SS, and SC.

“While AA and AS are normal, AC is rare and SS and SC are irregular and anomalous and commonly cause sickle cell disease,” a medical doctor, Samuel Iyke, told our correspondent.

“Sickle cell disease occurs when an individual’s blood cells are shaped in a deformed and abnormal manner, potentially blocking blood flow, causing pain and damage to vital organs.

“This is why intending couples are expected to know and share information about each other’s blood genotype and blood. It provides insight into their offspring’s genotype and overall health.”

According to Synlab, a Nigerian medical laboratory company, genotype testing examines an individual’s genetic makeup by “looking for changes called variations/mutations in the DNA of an individual.”

The report stated that though it may take “two to a few weeks to get the results of a genotype test from the day the test was carried out,” genotype testing results “may not always come out to be true which can be a result of interpretation errors or the testing techniques.”

The Punch investigation revealed cases of manipulation and variation of the results with some intending couples deliberately seeking to manipulate their test results to falsely show an AA genotype when they have an AS genotype., where there are cases of errors.

This alteration, it was gathered, was often sought by intending spouses who desperately wish to marry someone with AS genotype which would result in a 25 per cent possibility of having a child with sickle cell disease.

Our correspondent learnt that such individuals seeking to manipulate the medical result allegedly liaise with some laboratory technicians towards this end.

A medical lab technologist in a private facility who pleaded anonymity told our correspondent that she had an experience where a lady requested that the result she be presented was AA.

“She and her fiance had come for the test earlier, then she returned here and asked if I could present an AA genotype result for her because she loved the man and was certain he was God’s will and would love to proceed with the marriage. Of course, I turned her down,” she recounted.

Sharing a similar experience he heard, an X user, Ezekiel Mshelia, wrote, “A church supported this lady to hide her genotype status from the man after the test, noting that God will heal them. They are both AS.

“The man didn’t know his wife’s real genotype. But after the wedding, the first child came and his genotype was SS. Now, the man is confused, and the church is begging him to keep quiet.”

A nurse in a public hospital in a state in the southwest, who preferred to be called Omolara, confided in our correspondent that she had once treated a child whose genotype did not match either of his parents.

“The boy’s genotype showed he is SS, but his father was AS and the mother was AA and the mother insisted that he was their biological child and she presented proof of this.

“My take is, there must have been a genotype manipulation at some point or there was a wrong result given to either of the couple or it was a case of paternity fraud. Something was not right,” she stated.

A Lagos-based technician, Kingsley Chidi, who married his wife in 2014 in a Pentecostal church said when he was still single, he did a genotype test and it showed that he was AA.  “But when I was to marry my wife, we conducted a mandatory test at a medical facility our church took us to. This time around the result said my genotype was AS and my wife’s was AA.”

The father of four noted that a genotype test which was early conducted on his wife at a teaching hospital indicated that her genotype was AS.

With the disparity in result, the 34-year-old was thrown into confusion regarding his real genotype, a situation which he said would necessitate another test in a teaching hospital.

“Now, I can’t say if I am AA or AS. Yes, In both yes the blood group came out the same. The disparity was in the genotype,” he added.

An Ibadan-based father of two, Mayowa Adekunle, had a similar experience when he conducted a genotype test in a private hospital in the city before he got married in 2020.

“The result said I was AS. To be honest, I found it amusing because I knew it must be an error on their part. I’ve always known I am AA. I quietly went to another hospital and they confirmed that my genotype is AA.

“Thinking of it, I don’t know what would have happened if I had believed the first result before I got married. My wife is AS and that result falsely stated that mine too was AS. We could have cancelled the wedding on that basis, thinking there could be a risk of having a sickle cell child,” Adekunle said.

Variance in results

An X influencer, Serah Ibrahim, in a February 8, 2025 post seen by our correspondent, shared an account of a scenario she claimed to have witnessed in a hospital.

“I was outside making a phone call when they drove in,” she wrote. “The way the lady jumped out of the car while the guy went to park his car, she entered like ‘someone must die here today.’

“The guy parked and walked in like he had a lot in his mind. Before I got back in, madam was already scattering the place. She seems very much angrier than the guy. He was still calm in the midst of it all.

“This lady was shouting at the front desk that her man’s result had an error, that it came out as AS instead of AA and she’s already AS. The man was also saying he’s AA, so why did the test come as AS?”

Ibrahim narrated that someone in the hospital attended to them and explained that if the test indicated it was AS, then it was AS.

“You can see the blood group and all other medical records, so why are you disputing only the genotype? The result was sent to the mosque or their imam and they have told them they can’t get married. Well, I wish them luck,” she added.

In her replies, several netizens also shared similar experiences which included instances where they were given what they insist were erroneous genotype results.

“They should go run it somewhere else,” an X user, Richard Ukuevo, advised. “This genotype thing is somehow. My elder brother’s result showed he was AA as a child, and also in secondary school. But a day before his marriage, it showed he was AS. After marriage, his genotype showed it was AA. Since then I have been sceptical about the genotype results.”

“I visited a hospital for a genotype test,” another X user, Obinna Okoron said, “from my school days result showed I’m AA, but this hospital gave me AS with blood group B. They still advised me to check with another hospital. The next hospital gave me AA and blood group B+. How do you expect me to act?

“My school days documents show my genotype is AA and B- which is the one I have been using. For the sake of marriage, I went to run another genotype again. The first hospital said AS and B- and told me to go to another hospital. I went to another hospital, and they gave me AA but this time B+ result. I reacted, and they went in and came back and gave me a B-.”

“For me, I already conducted three (genotype) tests in three different states just to be sure of the outcome. This is before even getting into any relationship. It’s wrong to be deep in relationships before you know your genotype, especially for guys with AS,” Steve Oshomah, another X user, said.

An X user named Ebe Ogidi, advised, “They should just do a confirmatory test, if possible in another hospital. In fact, it is advised that they do a confirmatory test after the initial one. Before my cousin and his wife got married, knowing she’s AS, and my cousin was AS, they went to the lab to pay and change the result. Today they’re suffering.”

Efforts made by our correspondent to contact Ogidi to share his cousin’s experience was not successful as he could not be reached via direct message.

Reactions to allegations of faking

When our correspondent inquired from clerics of two Pentecostal churches and a mosque, they countered the possibility of intending couples manipulating genotype results.

“The chances of such a thing happening are very odd because first of all, we have an accredited laboratory which we send couples to whenever we want to conduct the tests. Besides, we handle such matters confidentially such that even the couples themselves are not the ones who handle or deliver the results,” Pastor Muyiwa Uyi, said.

Pastor of Multiply Christian Network, Lagos, Daniel Okunoye, explained that it is the church, rather than the intending couples, who decide where genotype test will be conducted.

“They (the couples) have very limited control over the result. Theirs is to present themselves for the test and the lab will send us the result. And we don’t use just any lab for our tests, so there is no way the results would be manipulated.”

Reiterating a similar stance, an Ogun State-based Muslim cleric, Saheed Olagoke, noted that such tests emerged out of a necessity to determine the truth and hence are often strictly confidential.

While commenting on cases of forged result or variations, the Senior registrar in the department of hematology of the Abubakar Tafawa Balewa University Teaching Hospital, ATBUTH, Dr. Salis Mukhtar said  sometimes it resulted from the literacy level of Nigerians which is low and even among those that are literate.

He believes the problem stems from proliferation of unqualified or untrained personnel operating in the laboratories. Salis stated that those unqualified personnel due issue out wrong results or fake results mostly at private independent laboratories where they operate.

He said that, testing genotype has varieties of methods to validate one’s result.

“The method that is most common in our environments is called haemoglobin electro paresis. This requires highly trained personnel to prove it. And those that are trained to do these genotype tests are those with a minimum of bachelor of medical laboratory science, “he stated.

Salis expressed worries noting that “But you will find out that many laboratory technicians or laboratory assistants who do not even understand the process are the one’s conducting it.”

The hematologist insisted that some of the personnel as against professional, read science courses like: chemistry, bio-chemistry saying “Some personnel did not even go to any medical training institutions. They just open a laboratory and place their fellow untrained individual to be conducting tests thereby issuing fake results that are not authenticated/genuine.”

“Some even went ahead to sell results or dash it out to their associates not know the implications.”

He stated that any trained personnel in the discipline must have sworn an oath and as a result don’t joke with the work.

Salis also revealed that to put an end to the trends, authorities have to swing into action to provide private laboratories with guidelines of operations.

According to him, no laboratory should be allowed to operate without a trained personnel awarded of degree in that regard.

A staff of M.Y.A Medical Diagnostic Laboratory and Clinical Service, Dass in Bauchi State, Sadiq Ibrahim did not totally reject the accusation against private medical labs in Bauchi.

He explained that the forging of genotype results happens depending on the standard of the laboratory and honesty of the personnel.

“I have been approached by some prospective couples whose genotype results weren’t compatible.

Some come offering money, but I have never fallen for that,” Ibrahim said,

He said there are several cases of  prospective couples faking the results by themselves.

“Some who knew their genotype long before settling to marry, approach you seeking other premarital screening such as the hypothesis, HIV and excluding the genotype. After the screening was conducted signed/stamped and issued to them, they move ahead to write the genotype results themselves in available spaces in the laboratory form, “Sadiq added.

“It also happens at local Primary Healthcare Centers with which don’t even have the genotype testing machine. After conducting the test for other premarital screenings such as hypothesis and HIV, they fill the genotype result asking from the individuals.”

Sadiq said individuals personal integrity and the standard of health facility in question play a vital role in the faking and otherwise of genotype results.

 ‘Genotype results don’t change’

Speaking with our correspondent, a biotechnologist, Benson Okorie, explained that the human genotype does not change is associated with the gene, a genetic inheritance, which only be altered by mutations or environmental factors in humans.

“But this is a low record, like one out of a million,” he said. “Genotype doesn’t change. If the genotype test is properly done in laboratory A, the same results should be detected in laboratory B and another laboratory, so it doesn’t change.

“Now, regarding genotype fraud, yes, it does happen. Some of this could happen as a result of a laboratory manipulating results for monetary gain or couples telling each other fake genotype statuses before getting married. Additionally, incompetent personnel handling the tests can result in variants, confusing or untrue genotype results.”

Highlighting an example in his career, Okorie said some couples, during their talking stages, deceive each other about their true genotype and or they went to a lab that was not competent enough to provide an accurate result.

“In one case I know of, it later came to light that the man was AS whereas he had been claiming AA before they got married. When the wife had their first child, he was SS.

“There is a test we do called Non-invasive Genotyping Test, that is done to know the genotype of the unborn child. If we get to know the child is SS, we let the parents deliberate on the options provided.

“People doing fake genotype tests can also cause this confusion. The Non-invasive Genotype test is also very expensive and is not affordable by many people,” he added.

Highlighting some of the consequences of genotype fraud, the biotechnologist identified a high rate of sickle cell children within the community, broken homes/families, loss of trust among couples and deliberate abortion of unborn child once detected through the Noninvasive Genotyping Test.

“The government as well as medical agencies need to make a move against fake laboratories across the country. There should also be widespread sensitisation for people to be wary of genotype fraud.

“Churches and families must give more attention to couples genotype profile before accepting marriage proposals and it’s essential for people who have done the test need to repeat them in two or three laboratories,” Okorie added.

A medical laboratory scientist, Chima Obi, also advised intending couples to ensure that they go to teaching hospitals and laboratories that are well-equipped for their tests.

“There are lots of people going around with wrong genotype results. As a medical laboratory scientist, I usually recommend that an adult checks his or her genotype in more than two top places to be double sure. I can’t tell you the number of genotype disputes I have settled,” he said.

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