Distribution of Haemoglobin S and C in Ghana – The Role of Ethnic Barriers to Intermarriages

  • Bernice Ameyaw Ghana Ports and Harbours’ Authority (GPHA) Hospital, Takoradi-Ghana
  • Emmanuel Ameyaw Graduate School of Economics and Management, Tohoku University
  • Prince Kenneth Homiah Ghana Ports and Harbours’ Authority (GPHA) Hospital, Takoradi-Ghana
  • Akwasi Asamoah University of Energy and Natural Resources
Keywords: haemoglobin distribution, haemoglobin s, haemoglobin c, intermarriages


Using repeated cross-sectional data from the Ghana Ports and Harbours’ Authority (GPHA) hospital and cross-sectional household data from the Ghana Living Standards Survey 7, this paper exploits intermarriages between the northern part and southern part of Ghana as a potential underlying factor partly explaining the distribution of haemoglobin S (Hb S) and haemoglobin C (Hb C) in the country. Similar to other studies, we find evidence for a higher prevalence of Hb S and a lower prevalence of Hb C in the southern part of Ghana. We also find that the rate of intermarriage between northern ethnic groups and southern ethnic groups is just about 2.6 per cent, largely leading to the confinement of Hb S to the southern part of Ghana and Hb C to the northern part of Ghana.

Author Biographies

Prince Kenneth Homiah, Ghana Ports and Harbours’ Authority (GPHA) Hospital, Takoradi-Ghana
Msc Quality Management
Akwasi Asamoah, University of Energy and Natural Resources
BSc Medical Laboratory Science


. Acquaye, C., Oldham, J. et al. “Variants of haemoglobin and glucose-6phosphate dehydrogenase. ii. distribution in northern Ghana.” Ghana Medical Journal, vol. 14(1), pp. 5–10. 1975.

. Akhigbe, R., Ige, S., Afolabi, A., Azeez, O., Adegunlola, G., Bamidele, J., et al. “Prevalence of haemoglobin variants, abo and rhesus blood groups in Ladoke Akintola university of technology, Ogbomosho, Nigeria.” Trends Med Res, vol. 4, pp. 24–29. 2009.

. Amoako, N., Asante, K. P., Adjei, G., Awandare, G. A., Bimi, L., & Owusu-Agyei, S. “Associations between red cell polymorphisms and plasmodium falciparum infection in the middle belt of Ghana.” PloS one, vol. 9(12). 2004.

. El-Beshlawy, A., & Youssry, I. “Prevention of hemoglobinopathies in Egypt.” Hemoglobin, vol. 33(sup1), pp. S14–S20. 2009.

. Desai, D. V., & Dhanani, H. “Sickle cell disease: History and origin.” The internet journal of hematology, vol. 1(2), pp. 1540. 2004.

. Edington, G., & Laing, W. “Relationship between haemoglobins c and s and malaria in Ghana.” British Medical Journal, vol. 2(5037), pp. 143. 1957.

. Edington, G., & Lehmann, H. “Expression of the sickle-cell gene in Africa.” British Medical Journal, vol. 1(4925), pp. 1308. 1955.

. Fleming, A., Storey, J., Molineaux, L., Iroko, E., & Attai, E. “Abnormal haemoglobins in the Sudan savanna of Nigeria: I. prevalence of haemoglobins and relationships between sickle cell trait, malaria and survival.” Annals of Tropical Medicine & Parasitology, vol. 73(2), pp. 161–172. 1979.

. El-Hazmi, M. A., Al-Hazmi, A. M., & Warsy, A. S. “Sickle cell disease in middle east Arab countries.” The Indian journal of medical research, vol. 134(5), pp. 597. 2011.

. Kreuels, B., Kreuzberg, C., Kobbe, R., Ayim-Akonor, M., Apiah-Thompson, P., Thompson, B., ... Adjei, O., et al. “Differing effects of hbs and hbc traits on uncomplicated falciparum malaria, anemia, and child growth. Blood.” The Journal of the American Society of Hematology, vol. 115(22), pp. 4551–4558. 2010.

. Mockenhaupt, F. P., Ehrhardt, S., Cramer, J. P., Otchwemah, R. N., Anemana, S. D., Goltz, K., ... Bienzle, U. “Hemoglobin c and resistance to severe malaria in ghanaian children.” Journal of Infectious Diseases, vol. 190(5), pp. 1006– 1009. 2004.

. Modell, B. “Haemoglobin disorders-a point of entry for community genetics services in India? “Springer. 2019.

. Modell, B., & Darlison, M. “Global epidemiology of haemoglobin disorders and derived service indicators.” Bulletin of the World Health Organization, vol. 86, pp. 480–487. 2008.

. Nubila, T., Ukaejiofo, E. O., Nubila, N. I., Azeez, R., et al. “Frequency distribution of hemoglobin variants among yorubas in Ibadan, southwestern Nigeria: A pilot study.” Nigerian Journal of Experimental and Clinical Biosciences, vol. 1(1), pp. 39. 2013.

. Nwafor, A., & Banigo, B. “A comparison of measured and predicted haemoglobin genotype in a nigerian population in bonny, rivers state, Nigeria.” Journal of Applied Sciences and Environmental Management, vol. 5(1). 2001.

. Piel, F. B., Howes, R. E., Patil, A. P., Nyangiri, O. A., Gething, P. W., Bhatt, S., ... Hay, S. I. “The distribution of haemoglobin c and its prevalence in newborns in Africa.” Scientific reports, vol. 3, pp. 1671. 2013.

. Sinou, M. “Antenatal screening of sickle cell disease.” 8th postgraduate course for training in reproductive medicine and reproductive biology. Cameroon. 2003.

. Thompson, G. “Significance of haemoglobins s and c in Ghana.” British Medical Journal, vol. 1(5279), pp. 682. 1962.

. Uzoegwu, P. N., & Onwurah, A. “Prevalence of haemoglobinopathy and malaria diseases in the population of old aguata division, Anambra state, Nigeria.” Biokemistri, vol. 15(2), pp. 57–66. 2003.