Genetic disorders in the Arab world
BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38982.704931.AE (Published 19 October 2006) Cite this as: BMJ 2006;333:831
- Lihadh Al-Gazali (algazali@hotmail.com), professor in clinical genetics1,
- Hanan Hamamy, professor in human genetics2,
- Shaikha Al-Arrayad, consultant geneticist3
- 1 Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- 2National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
- 3Salmaniya Medical Complex, Ministry of Health, Bahrain, Kingdom of Bahrain
- Correspondence to: L Al-Gazali
- Accepted 7 September 2006
Available evidence suggests that congenital and genetic disorders are responsible for a major proportion of infant mortality, morbidity, and handicap in Arab countries.1–3 The population of the region is characterised by large family size, high maternal and paternal age, and a high level of inbreeding with consanguinity rates in the range of 25-60%.1 2 4 w1 Certain disorders are common throughout the Arab world, including haemoglobinopathies, glucose-6-phosphate dehydrogenase deficiency, different congenital malformations caused by recessive genes, and several metabolic disorders.1 2 Other recessive disorders cluster in certain groups and subpopulations.1 2 5 Genetic services vary in extent and coverage in different Arab countries, but mostly they remain patchy, selective, and inadequate.2 5 6
We present the magnitude of the problem and the currently available genetic services in Arab countries, together with recommendations for developing strategies for prevention. In view of the good coverage of primary healthcare systems in most Arab countries, community genetic services that include screening programmes could be strengthened by the efficient training of primary healthcare personnel.2
Why are genetic disorders common in the Arab world?
Available data suggest that genetic and congenital disorders are more common in Arab countries than in industrialised countries; recessively inherited disorders account for a substantial proportion of physical and mental handicap.1–3 6 Several factors may contribute to the high prevalence of genetically determined disorders:
High consanguinity rates—25-60% of all marriages are consanguineous, and the rate of first cousin marriages is high (figs 1 and 2; table A on bmj.com).4 w1 In addition, isolated subpopulations with a high level of inbreeding exist. Furthermore, in many parts of the Arab world the society is still tribal.5 6 w1 This has made the epidemiology of genetic disorders complicated, as many families and tribal groups are descended from a limited …