Consanguinity in Qatar: Knowledge, Attitude and Practice in a Population Born Between 1946 and 1991

Abstract

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.

Indigenous Arabs are descendants of the earliest split from ancient Eurasian populations

“…These data, therefore, point to the ancestors of Q1 (Bedouin) and Q2 (Persian-South Asian) as having migrated out of Africa at the same time as the ancestors of other non-African populations (Henn et al 2012). Although PSMC estimates in the more recent past tend to have larger confidence intervals (Li and Durbin 2011), the Q1 (Bedouin) do appear to have a lower population size than the Q2 (Persian-South Asian) in the region <30,000 yr ago, consistent with high levels of inbreeding in the Q1 (Bedouin) (HunterZinck et al 2010;Sandridge et al 2010;Mezzavilla et al 2015). For the Q3 (African), the median effective population size was more similar to an African individual from the 1000 Genomes Project in the range 100,000 to 30,000 yr ago, consistent with SubSaharan African ancestry that is relatively recent (Omberg et al 2012).…”

“…The mtDNA haplogroups also included more worldwide geographic diversity overall, indicating a different male versus female pattern of intermarriage among these subpopulations (Sandridge et al 2010). Together the Chr Y and mtDNA haplogroups indicate that the Q1 (Bedouin), Q2 (Persian-South Asian), and Q3 (African) ancestry groups represent genetic subpopulations that not only reflect known migration history (HunterZinck et al 2010;Omberg et al 2012) but that also represent units defined by a patrilocal society with strong historical barriers to intermarriage (Esposito 2001;Cavalli-Sforza and Feldman 2003), in which gene flow has been dominated by female movement (i.e., admixture occurring through females marrying into the relatively isolated subpopulations), as well as female influxes from other geographic areas.…”

Consanguineous marriages, pearls and perils: Geneva International Consanguinity Workshop Report

“…Close kin marriage can be a strategy of conservation, with cousin marriage providing excellent opportunities for the transmission of cultural values and cultural continuity 17 . For these reasons consanguineous unions are generally thought to be more stable than marriages between non-relatives, although the data so far available on marital discord and divorce are small in number.…”

Consanguineous marriages

“…There is a general belief that marrying within the family reduces the possibilities of hidden uncertainties in health and financial issues. It is believed that consanguinity strengthens family ties and enforces family solidarity, with cousin marriage providing excellent opportunities for the transmission of cultural values and cultural continuity (Sandridge et al 2010). Premarital negotiations regarding financial matters of marriage are more easily conducted and sometimes less costly.…”