Monday, August 25, 2008

Inbreeding in Oman - a health warning

A nice SQU study shows how the social preference for inbreeding in Oman is probably related to many of the health problems, including diabetes and birth defects. Although the headline blames 'The modern lifestyle', of course in-breeding is anything but a modern phenomena in the Sultanate.

In-breeding, know scientifically as Consanguineous Marriage, is a demonstrable health problem all over the world. And we all know how common it is in Oman for marriages to be between first cousins.

Modern lifestyle 'brings new challenges'
Published: August 24, 2008, 23:28
Muscat: A study conducted among patients with coronary heart disease in Muscat suggests that people with hypertension, diabetes mellitus, and a family history of coronary heart disease, consanguinity and sedentary occupations are to be considered at high risk of developing the disease.
...

In addition to lifestyle, the study points out that the tradition and custom of marrying close relatives also contributes to this emerging problem. Consanguinity is quite common with 34 per cent of women married to first cousins and 20 per cent married to other relations.

Inbreeding can, and has, been measured. Here's a map.
Oman rates relatively high globally at around 35% on this map, although not at the top. However, Dr. S Joshi, Senior Consultant at SQU Hospital in a presentation given in Morocco in 2006 stated Oman's rate is a shocking 52%, with 38% 'first degree' - ie first cousins.
Given the inexorable rise in diabetes in Oman, and the cultural preferences for inbreeding, perhaps it time for Oman Health authorities to boost the resources and advertising associated with their programme of genetic counseling (and testing) for prospective spouses? (this service is supposedly available...
Premarital counseling clinics are available in all regional hospitals in the Sultanate. Doctors in primary health care institutions can organize the referral.

And perhaps the Government should also be far more active to encourage marriage between people who are, well, not related? (and not just leave it to the Omani girls and boys currently meeting in the Sultanate's shopping malls and fast food joints on the quiet!).

Not only would it improve the genetic health of the population, it would also act to break down many of the tribal barriers that remain very strong here and act to divide the loyalities of people between nation and tribe.

8 comments:

  1. Apparently the leading plastic surgery procedure in the Gulf is having the ears pinned back.

    I guess that makes sense then.

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  2. Hey angry!

    Welcome, first comment an all... Really love your blog Angry. You're my people.

    I was shocked that some 40% (memory and can't be bothered to chase the source) of all infant mortalities in Oman are now birth defects.

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  3. Yeah, it's a funny blog to read! :)

    With regards to in-breeding, and AIO's comment regarding ear pinning... I wonder if someone should mention that procedure to Prince Charles?! :P

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  4. Yep, I always got into strong discussion with people who prefer to marry from their close relatives. No matter how you explain that it is not recommended (Even by the prophet, correct me if I am wrong) they still insist in relatives marriages and their excuse is: "If I don't marry her, who will?" or "I have priority in marrying her over an outsider" or crap like that.
    LOL, it is so bad here in the country to an extent that girls are hardly any more beautiful than boys. Crazy as it sounds, you can hear that comment a lot. Oh and by the way, the parents have a huge role here. They give discounts for marrying their daughters to relatives, seriously.

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  5. Thanks for the warm welcome UD.

    And thanks too Lurkey, I'm blushing.

    A friend of mine who used to work in a clinic here had used a code when inbred children would be coming in, just to warn the nurses that the child would be different or odd looking, "FLK" funny looking kid. You have to prepare people for that.

    I think in general that culture and custom should be respected until people start endangering themselves, even then though, it's their own choice.

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  6. Dragon, would appreciate it if you could find the source of that 40% infant mortality statistic. If anything, would be a good point of discussion with my fellow Omanis. Cheers.

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  7. mnb4800 - thats for the comment. You also see kids in some of the villages that all have a very 'same same' look about them...

    Angry
    LOL. A friend told me once in Norfolk, UK, the nurses would write NFN on some kids charts - Normal for Norwich.

    Anon
    Can't.

    But here's a couple of other studies that should do:
    1/ A Tunisian study: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2205975 showing marrying your cousin basically doubles your chances of a child dying at or soon after birth. (note these are rate per thousand, not %)

    Quote: Mortality increased with the degree of inbreeding; the rate of neonatal and post-neonatal deaths, and deaths of children younger than 5 years was 39.12‰, 34.23‰, and 18.34‰, respectively, in first cousins, in comparison with 20.54‰, 23.69‰, and 6.42‰, respectively, in non-consanguineous couples.
    end quote

    and a Nizwa study http://www3.interscience.wiley.com/journal/118739795/abstract supporting the same ratio: that Omani had a twice as high rate of fatal deformities


    Quote
    Although the consanguinity rate of 53.1% among Omani births almost matched with the regional average of 52.7%, it was 76% among those with major malformations. Also, there was an increased clustering of multiple abnormalities and rare recessive disorders in cases with closely related parents and grandparents. The birth prevalence of major malformations was 14.6 per 1000 in non-Omani births as compared to 25.2 in Omani births (P < 0.05). Genetic factors could be implicated in 343 (63.4%) cases and 130 (37.9%) of these were potentially preventable.
    end quote

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  8. Thanks for the Nizwa study! Quite an enterprising dragon you are.

    ReplyDelete

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