International Journal of Academic Research ISSN: 2348-7666; Vol.4, Issue-12(1), December, 2017 Impact Factor: 6.023; Email: [email protected]
Total Page:16
File Type:pdf, Size:1020Kb
International Journal of Academic Research ISSN: 2348-7666; Vol.4, Issue-12(1), December, 2017 Impact Factor: 6.023; Email: [email protected] Mohamed Yehia El Awady, Professor of Community Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Nehal Mohamed El Raggal, Professor of Pediatrics-Neonatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt Amany Mohammed Sayed, Assistant professor of Community Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Amira Rabee Mahdy, General Practitioner, Ministry of Health, Egypt. International Journal of Academic Research ISSN: 2348-7666; Vol.4, Issue-12(1), December, 2017 Impact Factor: 6.023; Email: [email protected] reported in rural areas, among individuals with low educational levels, A consanguineous marriage is and among the poorest defined as a union between two individuals who are related as second cousins or closer, with the inbreeding There are many adverse health coefficient equal or higher than 0.0156 effects of consanguineous marriage, it has a greater risk not only of producing offspring which are homozygous for a The study of consanguinity is a deleterious recessive gene, but also subject of interest for both social individuals with increased susceptibility scientists and human biologists. for polygenic or multifactorial disease, Understanding the pattern of sterility, still births, spontaneous consanguinity is not only helpful in abortions, child death, infant mortality. getting an insight into the socio-biological There is no association of consanguinity structure of populations, but is also with autosomal dominant, X-linked, or pertinent to the health and disease chromosomal disorders (such as Down variables of the populations. syndrome). Consanguinity increases the risk of expression of autosomal recessive The rate of consanguineous conditions in the offspring marriage, varies in different countries The current study was conducted and is usually associated with some to identify the magnitude of demographic features, as religion, consanguineous marriage and to educational level, socio-economic status, determine some child health effects location and size of the area, isolation of associated with consanguineous population, consanguinity in parents’ marriage. marriages, responders’ attitude towards consanguineous marriage, and living in To determine the rural or urban area prevalence of consanguine marriage in Abu Raqabah village, Al Minufiyah Governorates and to identify the Consanguineous marriage is frequencies of various birth outcomes and associated with lower age at marriage, child health-related problems associated lower age at first birth, higher preference with consanguineous marriage in for larger family size and lower level of children e.g. abortion, stillbirths, husband–wife communication about use congenital malformations, genetic of family planning methods and lower disorders, diseases with autosomal rate of contraceptive use recessive inheritance, developmental disorders, congenital heart diseases, Consanguinity is less common in hearing problems. North African Arab countries where it was reported to be 29% in Egypt. However in another study on the Nubian A cross sectional study with internal population in southern Egypt the figures comparison was conducted in the family ranged between 41.5-45.5%.The highest health unit of Abu-Raqabah village in Al rates of such marriages have been Minufiyah, Egypt. All families that have International Journal of Academic Research ISSN: 2348-7666; Vol.4, Issue-12(1), December, 2017 Impact Factor: 6.023; Email: [email protected] health records in Abu Raqabah Family 920 file. There were about 270 family Health Unit were included in the study to health files excluded from the study due calculate the frequency of to incomplete data. consanguineous marriages. Administrative All families recorded as having approval for conducting this research was consanguineous marriage and the similar obtained from the authorities of the number of families having no family health unit. Subjects were consanguineous marriage was met by an informed about the study objectives and interview questionnaire in the family verbal anonymous consents were health center to obtain data about all obtained from all participants. Assuring health problems due to consanguineous confidentiality of information and the marriage and to compare frequency of data collected was used only for the each health related problem between stated research purpose. both groups. The questionnaire was constructed of questions about many items as the sociodemographic data, All family positive medical history for some chronic health records were included; data diseases of parents. Parents have been regarding sociodemographic asked for more details about child health characters and consanguineous related problems like congenital heart marriage were obtained to calculate diseases, mental retardation, blood the prevalence of consanguineous diseases, neurological diseases, hearing marriage in Abu Raqaba village. Data diseases, visual diseases, endocrinal obtained from the family health diseases, renal and psychiatric diseases. records included: Sociodemographic It was important to report the frequency characters, state of consanguine of abortion, stillbirth, infant death and marriage with degree of child death aged less than 5 years old in consanguinity if present, both consanguineous and non- reproductive history, recorded child consanguineous groups. health-related problems e.g. genetic diseases, congenital heart diseases, renal diseases, hearing problem and Quantitative data were summarized other diseases. using means and standard deviations or medians and ranges. Categorical data According to the governmental reports of were summarized as percentages. For population census done by the central numerical variables multivariate analysis agency for the public mobilization and was done using logistic regression to statistics (CAPMAS), the total number of detect if consanguinity is an independent families that were living in Abu Raqabah variable for having child health problems. village was 1370 family during the study For categorical variables, differences period. The actual population records in were analyzed with 2 (chi square) tests in the Family Health Unit of Abu- and Fisher’s exact test when appropriate. Raqabah were 1190 record while the active files with complete data were only International Journal of Academic Research ISSN: 2348-7666; Vol.4, Issue-12(1), December, 2017 Impact Factor: 6.023; Email: [email protected] The prevalence of consanguineous marriages in the studied population was 19.02% (175 families out of 920) according to family records reported in the Family Medicine Unit. (Figure 1) Yes, 175, 19.02% No, 745, 80.98% Prevalence of consanguineous marriages in the studied population This result was less than the prevalence about the risk of child health problems, calculated in previous Egyptian study in Sohag and Assuit both populations (from 22.9% to 39.9%) by were familiar with consanguineous and that difference may be due to marriage while the present study was increase the human awareness about the conducted in a village in Al Minufiyah health hazards of consanguineous governrate (Lower Egypt with a marriage. population nature different than that of Upper Egypt. Similar study was carried out by Using a cross-sectional The present study revealed that the first approach of 10,000 unselected couples cousin marriages occurred more often taken from three governorates Sohag, than other types of consanguinity (89%). Assuit and Cairo in Egypt to reflect Similar results were also reported in properly the prevalence of consanguinity. other Arab countries like Saudi Arabia That study showed that the overall It was also frequency of consanguinity in Egypt was detected that first cousin unions were the (35.3%), however this frequency varies by most prevalent type among the region. It was significantly higher in consanguineous marriages as well as in Sohag (42.2%) and great Cairo (36.1%) the total marriages in a recent study than in Assuit (21.7%).That higher conducted in Pakistan frequency of consanguinity was due to less cultural awareness of population International Journal of Academic Research ISSN: 2348-7666; Vol.4, Issue-12(1), December, 2017 Impact Factor: 6.023; Email: [email protected] On the other hand, a high workers of both groups while mothers are frequency of unions among second almost not working in both groups. There cousins was reported in the Parrish of was no statistical significant difference Dota and Costa Rica populations. Among between both groups regarding parents' Arabs it constitutes 20-52% of all age, education level and occupation. marriages and first cousin marriages There was significant association constitute almost one third of all between number of children and marriages consanguinity of the parents (P value It has been a long-standing social <0.05) that means higher number of habit among Egyptians. The etiology of offspring in consanguineous families than this high degree of consanguinity is in non-consanguineous families (Table1) nearly the same in all Arab countries. It In the current study, a significant includes maintenance of family structure, association between number of children stability, durability as well as keeping and consanguinity of the parents was property. It has financial advantages recorded (P value<0.05). This may be relating to dowry or bride wealth