In-Text Answer 6

Although there is no way you could necessarily have known this, (b) is the correct answer. (a) is logically possible, but historically once colonialism became dominant in Africa, general health of the native populations deteriorated rapidly. However, data show that infant mortailty was considerably higher in West Africa at the time (1930s - 1950s) than in the U.S. In 1955 a study by J. and C. Lambotte-Legrand in Leopoldville (formerly Belgian Congo, then Zaire, now Congo) showed that of 300 infants found to be homozygous for sickle cell, 72 were dead before the age of 2, and 144 (almost half) by the age of 5 Furthermore, a 1970 study in Zambia showed that half the children with the disease died before the age of 3 and in Rhodesia only 1 in 10 children (3 out of 31 cases followed) lived beyond the age of 10. The ability to survive into adulthood with sickle cell disease is very much dependent on environmental factors such as nutrition, and availability of general health care, both of which were poor for native Africans under European (mostly British) colonial rule. This was demonstrated dramatically in 1971 when a nutritional program for sickle-cell patients, organized almost a decade earlier by the Sickle-Cell Hemoglobinopathy Clinic at the University of Ghana had increased survival rate beyond the age of 10 by 50%. In addition, nutritional factors appeared to play an important role, as considered by a study in Uganda which showed that those patients who survived into adolescence came from the higher socio-economic families than those who came from lower socio-economic families