Carrying out a genotype test shortly after a recent blood transfusion can produce inconsistent results compared to previous tests, laboratory scientists have warned. They advise giving sufficient time, which can be as long as six months from the time of the blood transfusion. This warning is in response to growing complaints of inconsistent genotype test results on social media platforms. Recently, some individuals took to X, formerly Twitter, to express their surprise and confusion over receiving different genotype results from what they had previously had.
One individual, Efe Johnson, tweeted, “How many times did you all say we need to take the genotype/blood group tests, again? I just got the shock of my life. Has my whole life been a lie? I got a different result from what I’ve always thought, and I’m wondering what the rationale behind taking different tests is. “Doesn’t that just complicate things further? Someone just said they took three tests and all were different?” Johnson wondered how she could ascertain which is the right one and expressed concern over the discrepancies. Another individual with the handle, Ibadan Baker (Nike), shared her surprise and dismay after discovering discrepancies in her genotype results.
Despite believing her genotype to be AS for several years based on a previous test, a recent test conducted on March 19, 2024, revealed her genotype to be AA. “I’m AA. So what happened to the guys I had let go because of genotype?” she queried. A British scientific journal, Nature.com, defines genotype as the genetic makeup of an organism, describing an organism’s complete set of genes. Additionally, the Stanford Encyclopedia of Philosophy states that genotype is the relevant part of the Deoxyribonucleic acid (DNA), the molecule carrying genetic information for the development and functioning of an organism, passed to the organism by its parents.
Generally, there are five distinct genotypes: AA, AS, SS, AC, and SC. Medical scientists note that AA and AS are the normal genotypes, while SS and SC are responsible for sickle cell disease. According to the Sickle Cell Disorder Registry Nigeria, SCD is a major genetic condition in the country, with a disease burden of over 40 million people, forming the largest burden of the disorder in the world.
The registry noted that about 150,000 babies are born every year with sickle cell, and 100,000 of them die before their fifth birthday. Meanwhile, the World Health Organization estimates that over 300,000 babies with severe forms of Sickle Cell Disease are born each year, WHO, In a concerted effort to combat sickle cell anaemia, genotype testing has become mandatory for prospective couples in Nigeria following a decision by the House of Representatives in 2019. The legislation mandates religious organisations and government registries to ensure that intending couples undergo compulsory genotype tests.
Furthermore, the Anambra State House of Assembly passed a law in 2019 prohibiting marriages between individuals affected by sickle cell anaemia. However, it is disconcerting for intending couples to receive different genotype test results from what they had previously been given. Medical scientists attribute this concerning trend to the proliferation of labs lacking accreditation and the involvement of unqualified personnel in conducting tests.
Commenting on the matter, the National Publicity Secretary of the Association of Medical Laboratory Scientists of Nigeria, Adeyinka Adedire, stated that individuals undergoing a genotype test shortly after receiving a blood transfusion may experience inconsistent results. He explained that genetic material from the blood donor could persist in the recipient’s bloodstream, potentially impacting the outcome of the genotype test. “If someone has recently received a blood transfusion, remnants of the transfused blood may remain in their system for a few days or up to three months. Consequently, undergoing a genotype test in a laboratory lacking qualified lab scientists may yield inaccurate results. “There is a risk that some of the donor’s genotypes could still be detectable in the patient. However, if a qualified medical laboratory scientist handles such samples, specific procedures must be undertaken on the blood before conducting the genotype testing,” Adedire said. He stated that while various techniques exist for genotype testing, the majority of labs in Nigeria rely on manual procedures, which demand highly skilled expertise.
Adedire attributed the proliferation of unqualified and unlicensed medical lab scientists to the employment of graduates in fields such as biochemistry, science laboratory technology, biology, and anatomy to carry out tests, instead of registered and licensed medical laboratory scientists. He clarified that science laboratory technicians are solely licensed to work in research institutes, not in medical diagnostic labs. Adedire further blamed the situation on the proliferation of non-qualified and licensed medical lab scientists carrying out medical tests.
He stated that some labs engage the services of graduates of biochemistry, science laboratory technology, biology, and anatomy to carry out tests against registered and licensed medical laboratory scientists, leading to concerns about the accuracy and reliability of test results. Adedire emphasized that science laboratory technicians are only licensed to work in research institutes and not in medical diagnostic labs.
He added that the Association of Medical Laboratory Scientists of Nigeria has been conducting awareness campaigns to educate citizens about the risks associated with visiting unregulated and unregistered labs manned by unqualified personnel for lab diagnosis. Adedire urged the government to ensure that only bodies empowered by the law to carry out medical laboratory diagnosis are allowed to operate.
Furthermore, he advised citizens to verify the credentials of healthcare facilities they visit by looking for their Corporate Affairs Commission certificates and the license of the Medical Lab Scientist displayed at the reception of the laboratory. He said, “Always request for the license of whoever is practising there. As a citizen, you have a right to request evidence that shows that the person is licensed by the Association of Medical Laboratory Scientists of Nigeria to render such services.” He advised persons with conflicting genotype results to “visit a federal or state government hospital, make an introduction and give them all the genotype test results to run the test independently. According to him, by the time they are aware of the two or three conflicting results, there are special considerations they will give those samples and ensure that the best results come out. I urge them not to lose hope.”
