Hostname: page-component-77c89778f8-5wvtr Total loading time: 0 Render date: 2024-07-16T10:28:29.420Z Has data issue: false hasContentIssue false
  • English
  • Français

CONSANGUINITY IN QATAR: KNOWLEDGE, ATTITUDE AND PRACTICE IN A POPULATION BORN BETWEEN 1946 AND 1991

Published online by Cambridge University Press:  09 November 2009

A. L. SANDRIDGE ,
J. TAKEDDIN ,
E. AL-KAABI  and
Y. FRANCES
A. L. SANDRIDGE
Affiliation:
Shafallah Medical Genetics Center, Doha, Qatar Department of Public Health, Weill Cornell Medical College, NY, USA
J. TAKEDDIN
Affiliation:
Weill Cornell Medical College, NY, USA
E. AL-KAABI
Affiliation:
Weill Cornell Medical College, NY, USA
Y. FRANCES
Affiliation:
Weill Cornell Medical College, NY, USA
Get access Rights & Permissions [Opens in a new window]

Summary

From March 2007 to March 2008 a cross-sectional study was conducted in Qatar to estimate the prevalence of consanguinity among Qataris and to assess their knowledge of the risks and their attitudes towards the practice. A secondary objective was to test the acceptability of sixteen Likert-style questions within the Qatari population. Face-to-face interviews using a 70-item structured questionnaire were conducted by three native Arabic-speaking medical students with 362 Qatari employees. Where consanguinity existed between the employee's parents, a diagram of the consanguinal relationship (phylogram) was completed. The response rate was 93%. By phylogram, 22% of participants reported a cousin relationship between their parents (consanguinal relationship) and another 15% reported that their parents were from the same tribe (affinal relationship). With respect to their own marital decision, 68% of the respondents had been married at least once. By phylogram, 35% of these reported a consanguineous relationship (first marriage), 9% reported only an affinal relationship and 56% reported that they were not married to a blood relative. Results on the sixteen Likert-style attitude questions were stratified by consanguinity status of parents and of self. In the stratification by consanguinity status of parents the top five attitudes differed by group but there appeared to be more similarity between the consanguinal and only tribal groups. Attitudinal results were stratified by sex. Results showed that the males had a stronger belief in several of the attitudes than females with the exception of causation of genetic abnormalities and health problems. The phylogram was shown to collect more detailed and explicit data than hard-coding. With respect to knowledge, the results showed that knowledge was imperfect with high proportions of participants not knowing that consanguinity has been implicated in autosomal recessive diseases such as thalassaemia, inborn errors of metabolism, deafness, anomalies of the extremities and specific congenital heart defects. Additionally, a sizeable proportion of the participants did not know that a more distant cousin marriage (e.g. third cousin) theoretically could be a less genetically risky choice to potential offspring than a closer cousin marriage (half-first cousin). These results indicate that more effort needs to be made in developing public health strategies to improve the population's understanding of the cost-benefit analysis involved in contracting consanguineous marriages given the goal of healthy offspring.

Type
Research Article
Information
Journal of Biosocial Science , Volume 42 , Issue 1 , January 2010 , pp. 59 - 82
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdulrazzaq, Y. M., Bener, A., Al-Gazali, L. I., Al-Khayat, A. I., Micallef, R. & Gaber, T. (1997) A study of possible deleterious effects of consanguinity. Clinical Genetics 51, 167–173.CrossRefGoogle ScholarPubMed
Abu-Rabia, S. & Maroun, L. (2005) The effect of consanguineous marriage on reading disability in the Arab community. Dyslexia 11, 1–21.CrossRefGoogle ScholarPubMed
Abu-Rezq, H. A. S., Al-Tarkait, A. A. H., Husien, N. I. K., Qasrawi, B. & Radovanovic, Z. (1995) Multi handicap and consanguinity in Kuwait: a case-control study (letter). Annals of Saudi Medicine 15(2), 189–191.CrossRefGoogle Scholar
Afzal, M. (1988) Consequences of consanguinity on cognitive behavior. Behavior Genetics 18(5), 583–594.CrossRefGoogle ScholarPubMed
Al-Abdulkareem, A. A. & Ballal, S. (1998) Consanguineous marriage in an urban area of Saudi Arabia: rates and adverse health effects on the offspring. Journal of Community Health 23(1), 75–83.CrossRefGoogle Scholar
Al-Ansari, A. (1993) Etiology of mild mental retardation among Bahrani children: a community-based case control study. Mental Retardation 31(3), 140–143.Google Scholar
Al-Awadi, S. A., Naguib, K. K., Moussa, M. A., Farag, T. I., Teebi, A. S. & El-Khalifa, M. Y. (1986) The effect of consanguineous marriages on reproductive wastage. Clinical Genetics 29, 384–388.CrossRefGoogle ScholarPubMed
Alfi, O. S., Chang, R. & Azen, S. P. (1980) Evidence for genetic control of nondisjunction in man. American Journal of Human Genetics 32, 477–483.Google ScholarPubMed
Al-Fuzae, L., Aboolbacker, K. C. & Al-Saleh, Q. (1998) Beta-Thalassaemia major in Kuwait. Journal of Tropical Pediatrics 44(5), 311–312.CrossRefGoogle ScholarPubMed
Al-Gazali, L. I., Dawodu, H. A., Sabarinathan, K. & Varghese, M. (1995) The profile of major congenital abnormalities in the United Arab Emirates (UAE) population. Journal of Medical Genetics 32, 7–13.CrossRefGoogle ScholarPubMed
Al-Husain, M. & Al-Bunyan, M. (1997) Consanguineous marriages in a Saudi population and the effect of inbreeding on prenatal and postnatal mortality. Annals of Tropical Paediatrics 17, 155–160.CrossRefGoogle Scholar
Al-Jaber, K. A. & Farid, S. M. (2000) Qatar Family Health Survey 1998. Principal Report. Ministry of Health, Doha.Google Scholar
Al Khabori, M. (2004) Causes of severe to profound deafness in Omani paediatric population. Journal of Paediatric Otorhinolaryngology 68, 1307–1313.CrossRefGoogle ScholarPubMed
Assaf, S. & Khawaja, M. (2009) Consanguinity trends and correlates in the Palestinian Territories. Journal of Biosocial Science 41, 107–124.CrossRefGoogle ScholarPubMed
BadaruddozaAfzal, M. Afzal, M. & Akhtaruzzaman, (1994) Inbreeding and congenital heart diseases in a North Indian population. Clinical Genetics 45, 288–291.CrossRefGoogle Scholar
Barth, F. (1953) Principles of Social Organization in Southern Kurdistan. Universitetets Etnografiske Museum Bulletin No. 7. Brodrene Jorgensen A/S–Boktrykkeri, Oslo.Google Scholar
Basaran, N., Hassa, H., Basaran, A., Artan, S., Stevenson, J. D. & Sayli, B. S. (1989) The effect of consanguinity on the reproductive wastage in the Turkish population. Clinical Genetics 36, 168–173.CrossRefGoogle ScholarPubMed
Bashi, J. (1977) Effects of inbreeding on cognitive performance. Nature 266, 440–442.CrossRefGoogle ScholarPubMed
Bassili, A., Mokhtar, S. A., Dabous, N. I., Zaher, S. R., Mokhtar, M. M. & Zaki, A. (2000) Risk factors for congenital heart diseases in Alexandria, Egypt. European Journal of Epidemiology 16, 805–814.CrossRefGoogle ScholarPubMed
Ben Arab, S., Masmoudi, S., Beltaief, N., Hachicha, S. & Ayadi, H. (2004) Consanguinity and endogamy in Northern Tunisia and its impact on non-syndromic deafness. Genetic Epidemiology 27, 74–79.CrossRefGoogle ScholarPubMed
Bener, A., Abdulrazzaq, Y. M., Al-Gazali, L. I., Micallef, R., al-Khayat, A. I. & Gaber, T. (1996) Consanguinity and associated socio-demographic factors in the United Arab Emirates. Human Heredity 46, 256–264.CrossRefGoogle ScholarPubMed
Bener, A. & Alali, K. A. (2006) Consanguineous marriage in a newly developed country: the Qatari population. Journal of Biosocial Science 38, 239–246.CrossRefGoogle Scholar
Bener, A., El Hakeem, A. A. M. & Abdulhadi, K. (2005) Is there any association between consanguinity and hearing loss? International Journal of Pediatric Otorhinolaryngology 69, 327–333.CrossRefGoogle ScholarPubMed
Bittles, A. H. (1994) The role and significance of consanguinity as a demographic variable. Population and Development Review 20(3), 561–584.CrossRefGoogle Scholar
Bittles, A. H., Grant, J. C. & Shami, S. A. (1993) Consanguinity as a determinant of reproductive behaviour and mortality in Pakistan. International Journal of Epidemiology 22(3), 463–467.CrossRefGoogle ScholarPubMed
Bundey, S. & Alam, H. (1993) A five-year prospective study of the health of children in different ethnic groups, with particular reference to the effect of inbreeding. European Journal of Human Genetics 1, 206–219.CrossRefGoogle Scholar
Chaleby, K. & Tuma, T. A. (1987) Cousin marriages and schizophrenia in Saudi Arabia. Journal of Psychiatry 150, 547–549.CrossRefGoogle ScholarPubMed
Chitty, L. S. & Winter, R. M. (1989) Perinatal mortality in different ethnic groups. Archives of Disease in Children 64, 1036–1041.CrossRefGoogle ScholarPubMed
Denic, S., Bener, A., Sabri, S., Khatib, F. & Milenkovic, J. (2005) Parental consanguinity and risk of breast cancer: a population-based case-control study. Medical Science Monitor 11, CR415–419. Epub 2005 August 26th.Google ScholarPubMed
Dorsten, L. E., Hotchkiss, L. & King, T. M. (1999) The effect of inbreeding on early childhood mortality: twelve generations of an Amish settlement. Demography 36(2), 263–271.CrossRefGoogle ScholarPubMed
Durkin, M. S., Khan, N. Z., Davidson, L. L., Huq, S., Munir, S., Rasul, E. & Zaman, S. S. (2000) Prenatal and postnatal risk factors for mental retardation among children in Bangladesh. American Journal of Epidemiology 152(11), 1024–1033.CrossRefGoogle ScholarPubMed
El-Shanti, H., Saoud, A., Sadoon, A. A., Leal, S. M., Chen, S., Lee, K. & Spiegel, R. (2006) A distinct autosomal recessive ataxia maps to chromosome 12 in an inbred family from Jordan. Brain Development 28(6), 353–357.CrossRefGoogle Scholar
Gev, D., Roguin, N. & Freundlich, E. (1986) Consanguinity and congenital heart disease in the rural Arab population in Northern Israel. Human Heredity 36, 213–217.CrossRefGoogle ScholarPubMed
Govinda Reddy, P. (1983) Effects of consanguineous marriages on fertility among three endogamous groups of Andhra Pradesh. Social Biology 34, 68–77.Google Scholar
Gunaid, A. A., Hummad, N. A. & Tamim, K. A. (2004) Consanguineous marriage in the capital city Sana'a, Yemen. Journal of Biosocial Science 36, 111–121.CrossRefGoogle ScholarPubMed
Hassan, I., Haleem, A. A. & Bhutta, Z. A. (1997) Profile and risk factors for congenital heart disease. Journal of the Pakistan Medical Association 47(3), 78–81.Google ScholarPubMed
Hegab, S. M. & Al-Mutawa, S. A. (1996) Congenital hereditary autosomal recessive alacrima. Ophthalmic Genetics 17(1), 35–38.CrossRefGoogle ScholarPubMed
Hussain, R., Bittles, A. H. & Sullivan, S. (2001) Consanguinity and early mortality in the Muslim populations of India and Pakistan. American Journal of Human Biology 13, 777–787.CrossRefGoogle ScholarPubMed
Jaber, L., Merlob, P., Bu, X., Rotter, J. I. & Shohat, M. (1992) Marked parental consanguinity as a cause for increased major malformations in an Israeli Arab Community. American Journal of Medical Genetics 44, 1–6.CrossRefGoogle Scholar
Jain, V. K., Nalini, P., Chandra, R. & Srinivasan, S. (1993) Congenital malformations, reproductive wastage and consanguineous mating. Australian and New Zealand Journal of Obstetrics and Gynaecology 33(1), 33–36.CrossRefGoogle ScholarPubMed
Kir, T., Gulec, M., Bakir, B., Hosgonul, E. & Tumerdem, N. (2005) The frequency and effecting factors of consanguineous marriage in a group of soldiers in Ankara. Journal of Biosocial Science 37, 519–523.CrossRefGoogle Scholar
Khlat, M. (1997) Endogamy in the Arab World. In Teebi, A. S. & Farag, T. I. (eds) Genetic Disorders among Arab Populations. Oxford Monographs on Medical Genetics No. 30. Oxford University Press, Oxford, UK.Google Scholar
Khlat, M., Halabi, S., Khudr, A. & Der Kaloustian, V. M. (1986) Perception of consanguineous marriages and their genetic effects among a sample of couples from Beirut. American Journal of Medical Genetics 25, 299–306.CrossRefGoogle ScholarPubMed
Khoury, M. J., Beaty, T. H. & Cohen, B. H. (1993) Fundamentals of Genetic Epidemiology. Oxford University Press, New York.CrossRefGoogle Scholar
Khoury, M. J., Cohen, B. H., Diamond, E. L., Chase, G. A. & McKusick, V. A. (1987) Inbreeding and pre-reproductive mortality in the old order Amish. III. Direct and indirect effects of inbreeding. American Journal of Epidemiology 125(3), 473–483.CrossRefGoogle Scholar
Khoury, S. A. & Massad, D. F. (2000) Consanguinity, fertility, reproductive wastage, infant mortality and congenital malformations in Jordan. Saudi Medical Journal 21(2), 150–154.Google ScholarPubMed
Khoury, S. A. & Massad, D. (1992) Consanguineous marriage in Jordan. American Journal of Medical Genetics 43, 769–775.CrossRefGoogle ScholarPubMed
Machin, D., Campbell, M. J., Fayers, P. M. & Pinol, A. P. Y. (1987) Sample Size Tables for Clinical Studies. Sampsize V2.0. Copyright 1987–1997. Blackwell Science Ltd.Google Scholar
Mokhtar, M. M. & Abdel-Fattah, M. M. (2001) Consanguinity and advanced maternal age as risk factors for reproductive losses in Alexandria, Egypt. European Journal of Epidemiology 17, 559–565.CrossRefGoogle ScholarPubMed
Murphy, R. F. & Kasdan, L. (1959) The structure of parallel cousin marriage. American Anthropologist 61, 17–29.CrossRefGoogle Scholar
Nabulsi, M. M., Tamim, H., Sabbagh, M., Obeid, M. Y., Yunis, K. A. & Bitar, F. F. (2003) Parental consanguinity and congenital heart malformations in a developing country. American Journal of Medical Genetics 116A, 342–347.CrossRefGoogle ScholarPubMed
Nagy, S. (2005) Making room for migrants, making sense of difference: spatial and ideological expressions of social diversity in urban Qatar. Urban Studies 43(1), 119–137.CrossRefGoogle Scholar
Narchi, H. & Kulaylat, N. (1997) Congenital malformations: are they more prevalent in populations with a high incidence of consanguineous marriages? Annals of Saudi Medicine 17, 254–256.CrossRefGoogle ScholarPubMed
Nyrop, R. F. (1984) Persian Gulf States. Area Handbook. Department of the US Army.Google Scholar
Nyrop, R. F., Benderly, B. L., Carter, L. N., Eglin, D. R. & Kirchner, R. A. (1977) Area Handbook for Saudi Arabia. American University, Washington, DC.Google Scholar
Ober, C., Hyslop, T. & Hauck, W. W. (1999) Inbreeding effects on fertility in humans: evidence for reproductive compensation. American Journal of Human Genetics 64, 225–231.CrossRefGoogle ScholarPubMed
Ottenheimer, M. (1996) Forbidden Relatives. The American Myth of Cousin Marriage. University of Illinois, Urbana and Chicago.Google Scholar
Parkin, R. (1997) Kinship, An Introduction to the Basic Concepts. Blackwell, UK.Google Scholar
Patterson, D. F. (1991) Genes and the heart; congenital heart disease. Academy of Veterinary Cardiology Proceedings, 58th Annual Meeting of the AAHA and the Ontario Veterinary Medical Association Meeting,Toronto, Ontario, Canada.Google Scholar
Pyle, R. L., Paterson, D. F. & Chacko, S. (1976) The genetics and pathology of discrete subaortic stenosis in the Newfoundland Dog. American Heart Journal 92(3), 324–334.CrossRefGoogle ScholarPubMed
Queisser-Luft, A., Stolz, G., Wiesel, A., Schlaefer, K. & Spranger, J. (2002) Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990–1998). Archives of Gynecology and Obstetrics 266, 163–167.CrossRefGoogle Scholar
Rittler, M., Liascovich, R., Lobez-Camelo, J. & Castilla, E. E. (2001) Parental consanguinity in specific types of congenital anomalies. American Journal of Medical Genetics 102, 36–43.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Roodpeyma, S., Kamali, Z., Afshar, F. & Naraghi, S. (2002) Risk factors in congenital heart disease. Clinical Pediatrics 41(9), 653–658.CrossRefGoogle ScholarPubMed
Sailer, S. (2003) Cousin marriage conundrum. American Conservative, 20–22.Google Scholar
Sandridge, A. L. (2000) Collecting pedigree information in an epidemiological context. Statistica – Anno LX – 2000 4, 745–751.Google Scholar
Sandridge, A. L. (2006) Risk factors for congenital heart defects in Saudi Arabian infants. PhD thesis, London School of Hygiene and Tropical Medicine.CrossRefGoogle Scholar
Sawardekar, K. P. (2005) Profile of major congenital malformations at Nizwa Hospital, Oman: 10-year review. Journal of Paediatric Child Health 41, 323–330.CrossRefGoogle Scholar
Scott, H., Mason, K. & Marshall, M. (1946) Western Arabia and the Red Sea. Naval Intelligence Division, Oxford.Google Scholar
Schull, W. J. & Neel, J. V. (1972) The effects of parental consanguinity and inbreeding in Hirado, Japan. V. Summary and interpretation. American Journal of Human Genetics 24, 425–453.Google ScholarPubMed
Shafi, T., Khan, M. R. & Atiq, M. (2003) Congenital heart disease and associated malformations in children with cleft lip and palate in Pakistan. British Journal of Plastic Surgery 56, 106–109.CrossRefGoogle ScholarPubMed
Shami, S. A., Qaisar, R. & Bittles, A. H. (1991) Consanguinity and adult morbidity in Pakistan. Lancet 338, 954.CrossRefGoogle ScholarPubMed
Shami, S. A., Schmitt, L. H. & Bittles, A. H. (1989) Consanguinity related prenatal and postnatal mortality of the populations of seven Pakistani Punjab cities. Journal of Medical Genetics 26, 267–271.CrossRefGoogle ScholarPubMed
Sheiner, E., Shoham-Vardi, I., Sheiner, E. K., Mazor, M., Katz, M. & Carmi, R. (1999) Maternal factors associated with severity of birth defects. International Journal of Gynecology and Obstetrics 64, 227–232.CrossRefGoogle ScholarPubMed
Stein, Z., Belmont, L. & Durkin, M. (1987) Mild mental retardation and severe mental retardation compared, experiences in eight less developed countries. Upsala Journal of Medical Sciences (Supplement) 44, 89–96.Google ScholarPubMed
Stoll, C., Alembik, Y., Dott, B. & Roth, M. P. (1998) Study of Down syndrome in 238,942 consecutive births. Annales de genetique 41(1), 44–51.Google Scholar
Stoll, C., Alembik, Y., Roth, M. P. & Dott, B. (1999) Parental consanguinity as a cause for increased incidence of births defects in a study of 238,942 consecutive births. Annales de genetique 42(3), 133–139.Google Scholar
Stoll, C., Alembik, Y., Roth, M. P., Dott, B. & De Geeter, B. (1989) Risk factors in congenital heart disease. European Journal of Epidemiology 5(3), 382–391.CrossRefGoogle ScholarPubMed
Stoltenberg, C., Magnus, P., Lie, R. T., Daltveit, A. K. & Irgens, L. M. (1997) Birth defects and parental consanguinity in Norway. American Journal of Epidemiology 145(5), 439–448.CrossRefGoogle ScholarPubMed
Stoltenberg, C., Magnus, P., Skrondal, A. & Lie, R. T. (1999) Consanguinity and recurrence risk of stillbirth and infant death. American Journal of Public Health 89(4), 517–523.CrossRefGoogle ScholarPubMed
Tamim, H., Khogali, M., Beydoun, H., Melki, I., Yunis, K. & The National Collaborative Perinatal Neonatal Network (2003) Consanguinity and apnea of prematurity. American Journal of Epidemiology 158(10), 942–946.CrossRefGoogle ScholarPubMed
Teebi, A. S. (1994) Autosomal recessive disorders among Arabs, an overview from Kuwait. Journal of Medical Genetics 31(3), 224–233.CrossRefGoogle ScholarPubMed
Wahab, A., Ahmad, M. & Akram Shah, S. (2005) Migration as a determinant of marriage pattern: preliminary report on consanguinity among Afghans. Journal of Biosocial Science 38, 315–325.CrossRefGoogle Scholar
Zakzouk, S. (2002) Consanguinity and hearing impairment in developing countries: a custom to be discouraged. Journal of Laryngology and Otology 116, 811–816.CrossRefGoogle ScholarPubMed
Zakzouk, S., El-Sayed, Y. & Bafaqeeh, S. A. (1993) Consanguinity and hereditary hearing impairment among Saudi population. Annals of Saudi Medicine 13, 447–450.CrossRefGoogle ScholarPubMed
Zlotogora, J. (1997) Genetic disorders among Palestinian Arabs: 1. Effects of consanguinity. American Journal of Medical Genetics 68, 472–475.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Zahlan, R. S. (1979) The Creation of Qatar. Croom Helm, London.Google Scholar