Vol 41 # 3 September 2009 - Kma.org.kw

September 2009
KUWAIT MEDICAL JOURNAL 189
Table 3: Prevalence of commonly investigated genetic diseases in the GCC countries (% unless otherwise specified)
Disease
GCC country
Bahrain United Arab Kuwait Oman Qatar Saudi Arabia
Emirates
α-thalassemia 20.0 [54] 49.0 [55] 17.0 [56] 14.0–20.0 [57] 12.28 [58] 16.3–28.0 [59]
Data source PB HB HB HB HB PB
β-thalassemia trait (minor) 5.7 [60] 8.7 [51] 14.0 [61] 2.0 [62] 30.43* [58] 3.22 [63]
Data source PB PB HB PB HB PB
Congenital deafness 1.29 CM [64] 2.0 HN [65] 0.12 [66] 5.2 [67] 0.18 [68]
0.31NCM [64] 46.67 HR [65]
Data source HB HB PB HB PB
Congenital hypothyroidism 1/1963 [9] 1/1250 [6] 1/2750 [49] 1/3152 [24] 1/2279 [69]
Data source PB PB PB PB HB
Down’s syndrome 0.9/1000 [70] 2.63/1000 [71] 2.9/1000 [18] 0.5/1000 [72] 1.95/1000 [73] 1.8/1000 [74]
Data source Unclear PB PB PB PB PB
G6PD deficiency 18.0 M [45] 9.1 [51] 6.5 [75] 25.0 M [62] 2.0–4.0 [76,77]
10.0 F [45] 10.0 F [62]
Data source HB PB HB PB HB
Inborn error of metabolism 1/1000 [19] 1/1555 [78] 1/1327 [24] 1/1000 [79]
Data source HB HB PB PB
Major congenital anomalies 7.89/1000 [80] 12.5/1000 [18] 24.6/1000 [64] 12.23/1000 † [81] 25.8/1000 [83]
††† [82]
2.0 /1000
Data source PB HB HB HB HB
Phenylketonuria 0.7/10,000 [9] 3.8/10,000 †† [6] 0.4/10,000 [24] 1.23/10,000 [47]
Data source PB PB PB PB
Sickle cell disease 0.9 [45] 0.04 [84] 0.9 [61] 0.2 [62] 0.26 [63]
Data source HB PB HB PB PB
Sickle cell trait 16.3 [45] 0.9 [9] 6.0 [57] 6.0 [62] 14.63 [58] 4.2 [63]
Data source HB PB HB PB HB PB
HB = hospital based; PB = population based; M = male; F = female; HN = healthy newborn; HR = high risk; CM = consanguineous marriages;
NCM = non-consanguineous marriages
*For all types of β-thalassemia (minor, intermediate and major).
†
For congenital heart diseases. †† Might contain false positive results ††† For
hydrocephalus and meningomyelocele
stillbirth, congenital anomaly, and early childhood
death [17] . Furthermore, increases in the incidence of
common adult-onset diseases such as cancer, mental
disorders, heart diseases, gastrointestinal disorders,
and hypertension have been reported [22] .
Even though the prevalence of genetic diseases
in the GCC countries is high in comparison with
rates in Europe and North America ,[23–28] these
diseases are acknowledged in Europe and North
America as a major cause of morbidity and
mortality, [28,29] whereas their importance has been
underestimated for a long time in GCC countries.
This might be a result of the attention that has
been given to other public health problems in the
region, such as road traffic accidents, infections,
and chronic diseases [12,27,28,30–32] . An investigation
of cause-specific death rates for children 0 - 4
years of age found a notable reduction in the
number of reported causes for the period 1999
- 2000, except for perinatal causes in the Middle
East and North African area; perinatal diseases
are the leading determinant of disabilityadjusted
life years (DALYs). [33] Other factors,
such as cultural and social customs and religious
beliefs have made this topic a sensitive one to
investigate. [11,27,28,34–36]
THE ISLAMIC PERSPECTIVE
The implementation of preventive and
management services for genetic diseases is impeded
by several challenges [36] . A crucially important issue
for the GCC population is the Islamic view of genetic
disease. The question of how to extend the adoption
of new technologies related to the prevention of
genetic diseases in the context of Islamic regulations
has been discussed extensively in the last 10 to 15
years in the Arab world, and especially in the GCC
countries, through scientific meetings, conferences,
and workshops [30,34,37–39] . Despite these efforts, many
Arab people and even a number of researchers are
still unaware of Islamic views and regulations with
regard to genetic services [28,35] .
Islamic bioethics emphasize the importance of
respect for dignity and the rights of human beings.
At the same time, Islam has the flexibility to enable
the adoption of new and emerging technologies
intended to improve human health [34]. Islam aims
to encourage prevention of disease rather than
cure [40] . Islamic teaching discourages first-cousin
marriages [40] . Genetic counseling and premarital
counseling are encouraged in contemporary Islam,
provided that this is conducted by well-qualified and
experienced individuals who are knowledgeable