1
|
Khayat AM, Alshareef BG, Alharbi SF, AlZahrani MM, Alshangity BA, Tashkandi NF. Consanguineous Marriage and Its Association With Genetic Disorders in Saudi Arabia: A Review. Cureus 2024; 16:e53888. [PMID: 38465157 PMCID: PMC10924896 DOI: 10.7759/cureus.53888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Consanguineous marriages, where spouses are related by blood, have been a longstanding practice in human history. The primary medical concern with consanguineous marriages is the increased risk of genetic disorders. When closely related individuals reproduce, there is a higher probability that both parents carry the same genetic mutation. In Arab countries, especially Saudi Arabia, the rate of consanguineous marriage is high compared with Western European and Asian countries. This high rate is directly proportionate with elevated risk of genetic disorders, including congenital heart diseases, renal diseases, and rare blood disorders. Additionally, it was noted that the rate of negative postnatal outcomes is higher in consanguineous marriages compared with the general population. These observations indicate the necessity of tackling this area and highlighting the consequences of this practice. In this review, we aim to discuss the current evidence regarding the association between consanguineous marriages and genetic disorders in Saudi Arabia.
Collapse
Affiliation(s)
| | | | - Sara F Alharbi
- Biotechnology, College of Science, Taif University, Taif, SAU
| | | | | | - Noha Farouk Tashkandi
- Medical Research, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| |
Collapse
|
2
|
Ghanim M, Mosleh R, Hamdan A, Amer J, Alqub M, Jarrar Y, Dwikat M. Assessment of Perceptions and Predictors Towards Consanguinity: A Cross-Sectional Study from Palestine. J Multidiscip Healthc 2023; 16:3443-3453. [PMID: 38024133 PMCID: PMC10656848 DOI: 10.2147/jmdh.s433506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background/Aim Consanguinity represents a biological relationship between two individuals. In clinical genetics, it specifically refers to the marriage between individuals who are second cousins or closer. The aim of the study is to assess perceptions and their predictors among the Palestinian population towards consanguinity. Methods A survey-based cross-sectional study was conducted. The sample was collected using convenience and snowball sampling methods, yielding a sample of 1008 participants. The perceptions towards consanguinity and its predictors were assessed using Chi-square test. Results The prevalence of consanguinity among married participants was 18.7% (N = 81/432), while it was 28.8% among their parents. Consanguinity rate was significantly low among the young age group (ie, <47 years old) and among participants whose mothers have undergraduate educational levels (P < 0.05). Other factors like parental consanguinity, educational level of participants, their father's educational level, and residency place showed no significant associations (P > 0.05). Rejection of consanguinity was significantly noted among young age participants, absence of parental consanguinity, the presence of children or family members with genetic disorders and female gender (P < 0.001). Furthermore, participants who indicated that they are governmental employees, those with 2000-5000 ILS monthly income, those who are married (P < 0.01), and those who indicated that their mothers are holders of postgraduate degree were significantly more likely to reject the idea of consanguinity (P < 0.05). Also, medical and/or scientific reasons were significantly associated with rejecting the idea of consanguinity (P < 0.001). Conclusion Consanguinity prevalence has decreased among recent generations in Palestine, but it remains a significant challenge in Palestine. Therefore, educational and awareness programs about consanguinity and its health effects are effective strategies for reducing the consanguinity rate, especially for persons who are at the age of marriage.
Collapse
Affiliation(s)
- Mustafa Ghanim
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rami Mosleh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Anas Hamdan
- Department of Anesthesia and Resuscitation Technology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Johnny Amer
- Department of Allied and Applied Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Malik Alqub
- Department of Allied and Applied Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Yazun Jarrar
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Majdi Dwikat
- Department of Allied and Applied Medical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
3
|
Rahma AT, Abdullahi AS, Graziano G, Elbarazi I. The attitude and behaviors of the different spheres of the community of the United Arab Emirates toward the clinical utility and bioethics of secondary genetic findings: a cross-sectional study. Hum Genomics 2023; 17:98. [PMID: 37932866 PMCID: PMC10626730 DOI: 10.1186/s40246-023-00548-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
INTRODUCTION Genome sequencing has utility, however, it may reveal secondary findings. While Western bioethicists have been occupied with managing secondary findings, specialists' attention in the Arabic countries has not yet been captured. We aim to explore the attitude of the United Arab Emirates (UAE) population toward secondary findings. METHOD We conducted a cross-sectional study between July and December 2022. The validated questionnaire was administered in English. The questionnaire consists of six sections addressing topics such as demographics, reactions to hypothetical genetic test results, disclosure of mutations to family members, willingness to seek genetic testing, and attitudes toward consanguinity. Chi-squared and Fisher's exact tests were used to investigate associations between categorical variables. RESULTS We had 343 participants of which the majority were female (67%). About four-fifths (82%) were willing to know the secondary findings, whether the condition has treatment or not. The most likely action to take among the participants was to know the secondary findings, so they can make life choices (61%). CONCLUSION These results can construct the framework of the bioethics of disclosing secondary findings in the Arab regions.
Collapse
Affiliation(s)
- Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, UAE.
| | - Aminu S Abdullahi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, UAE
| | | | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, UAE
| |
Collapse
|
4
|
Saunders-Pullman R, Raymond D, Ortega RA, Shalash A, Gatto E, Salari M, Markgraf M, Alcalay RN, Mascalzoni D, Mencacci NE, Bonifati V, Merello M, Chung SJ, Novakovic I, Bardien S, Pal G, Hall A, Hattori N, Lynch T, Thaler A, Sue CM, Foroud T, Verbrugge J, Schulze J, Cook L, Marder K, Suchowersky O, Klein C, Simuni T. International Genetic Testing and Counseling Practices for Parkinson's Disease. Mov Disord 2023; 38:1527-1535. [PMID: 37310233 PMCID: PMC10461455 DOI: 10.1002/mds.29442] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND There is growing clinical and research utilization of genetic testing in Parkinson's disease (PD), including direct-to-consumer testing. OBJECTIVES The aim is to determine the international landscape of genetic testing in PD to inform future worldwide recommendations. METHODS A web-based survey assessing current practices, concerns, and barriers to genetic testing and counseling was administered to the International Parkinson and Movement Disorders Society membership. RESULTS Common hurdles across sites included cost and access to genetic testing, and counseling, as well as education on genetic counseling. Region-dependent differences in access to and availability of testing and counseling were most notable in Africa. High-income countries also demonstrated heterogeneity, with European nations more likely to have genetic testing covered through insurance than Pan-American and Asian countries. CONCLUSIONS This survey highlights not only diversity of barriers in different regions but also the shared and highly actionable needs for improved education and access to genetic counseling and testing for PD worldwide. © 2023 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Deborah Raymond
- Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Roberto A Ortega
- Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Emilia Gatto
- Instituto de Neurociencias Buenos Aires, Affiliated University of Buenos Aires, Argentina
| | - Mehri Salari
- Functional Neurosurgery Research Center, Shohada-e Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maggie Markgraf
- Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Roy N. Alcalay
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA; and Movement Disorders Division, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Deborah Mascalzoni
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy; and Center for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Niccolò E. Mencacci
- Ken and Ruth Davee Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Vincenzo Bonifati
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marcelo Merello
- Movement Disorders Section, Neuroscience Department Fleni, Buenos Aires, Argentina, and National Research Council (CONICET), Buenos Aires, Argentina, and Pontifical Catholic University of Argentina, Buenos Aires, Argentina
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ivana Novakovic
- Faculty of Medicine, Institute of Human Genetics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Soraya Bardien
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council/ Stellenbosch University Genomics of Brain Disorders Research Unit, Cape Town, South Africa
| | - Gian Pal
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Anne Hall
- Research Advocate, Parkinson’s Foundation, New York, NY, USA
| | - Nobutaka Hattori
- Department of Neurology, Faculty of Medicine, Juntendo University Tokyo, Japan; Research Institute of Disease of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan; Neurodegenerative Disorders Collaborative Laboratory, RIKEN Center for Brain Science, Saitama, Japan
| | - Timothy Lynch
- The Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland; and Health Affairs & School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Avner Thaler
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; and Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Carolyn M. Sue
- Department of Neurogenetics, Kolling Institute, Royal North Shore Hospital and University of Sydney, Sydney, Australia
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jennifer Verbrugge
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeanine Schulze
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lola Cook
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Karen Marder
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Oksana Suchowersky
- Departments of Medicine (Neurology), Medical Genetics and Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Tatyana Simuni
- Ken and Ruth Davee Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
5
|
Grant M, Kabakian-Khasholian T, Yazbek S. Interventions addressing genetic disease burdens within selected countries in the MENA region: a scoping review. J Community Genet 2023; 14:29-39. [PMID: 36692811 PMCID: PMC9947218 DOI: 10.1007/s12687-023-00633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The MENA region is disproportionately affected by genetic disease. The aim of this research is to scope the region for evidence of genetic services and public health interventions to identify geographic gaps, and to provide a descriptive overview of interventions to identify knowledge gaps. METHODS This study is conducted as a scoping review and follows the Arksey & O'Malley scoping review framework. RESULTS Seventy-six articles spanning 16 MENA nations met inclusion criteria. Studies included interventions in the form of genetic service provision (n=28), as well as comprehensive programs including pilot programs (n=7), community-based genetics programs (n=6) national-level prevention programs (n=18), and national-level mandatory programs (n=17). CONCLUSIONS There is an imbalanced response to genetic disease burdens across the MENA region. More research is warranted where interventions are scarce, particularly to inform development of pilot community-based programs. There is also a need for better monitoring and evaluation of existing nation-wide programs.
Collapse
Affiliation(s)
- Madison Grant
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Soha Yazbek
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| |
Collapse
|
6
|
Saad M, Mokrab Y, Halabi N, Shan J, Razali R, Kunji K, Syed N, Temanni R, Subramanian M, Ceccarelli M, Rafii Tabrizi A, Bedognetti D, Chouchane L. Genetic predisposition to cancer across people of different ancestries in Qatar: a population-based, cohort study. Lancet Oncol 2022; 23:341-352. [DOI: 10.1016/s1470-2045(21)00752-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/12/2021] [Accepted: 12/15/2021] [Indexed: 12/22/2022]
|
7
|
Rodriguez-Flores JL, Messai-Badji R, Robay A, Temanni R, Syed N, Markovic M, Al-Khayat E, Qafoud F, Nawaz Z, Badii R, Al-Sarraj Y, Mbarek H, Al-Muftah W, Alvi M, Rostami MR, Cruzado JCM, Mezey JG, Shakaki AA, Malek JA, Greenblatt MB, Fakhro KA, Machaca K, Al-Nabet A, Afifi N, Brooks A, Ismail SI, Althani A, Crystal RG. The QChip1 knowledgebase and microarray for precision medicine in Qatar. NPJ Genom Med 2022; 7:3. [PMID: 35046417 PMCID: PMC8770564 DOI: 10.1038/s41525-021-00270-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/04/2021] [Indexed: 12/28/2022] Open
Abstract
Risk genes for Mendelian (single-gene) disorders (SGDs) are consistent across populations, but pathogenic risk variants that cause SGDs are typically population-private. The goal was to develop "QChip1," an inexpensive genotyping microarray to comprehensively screen newborns, couples, and patients for SGD risk variants in Qatar, a small nation on the Arabian Peninsula with a high degree of consanguinity. Over 108 variants in 8445 Qatari were identified for inclusion in a genotyping array containing 165,695 probes for 83,542 known and potentially pathogenic variants in 3438 SGDs. QChip1 had a concordance with whole-genome sequencing of 99.1%. Testing of QChip1 with 2707 Qatari genomes identified 32,674 risk variants, an average of 134 pathogenic alleles per Qatari genome. The most common pathogenic variants were those causing homocystinuria (1.12% risk allele frequency), and Stargardt disease (2.07%). The majority (85%) of Qatari SGD pathogenic variants were not present in Western populations such as European American, South Asian American, and African American in New York City and European and Afro-Caribbean in Puerto Rico; and only 50% were observed in a broad collection of data across the Greater Middle East including Kuwait, Iran, and United Arab Emirates. This study demonstrates the feasibility of developing accurate screening tools to identify SGD risk variants in understudied populations, and the need for ancestry-specific SGD screening tools.
Collapse
Affiliation(s)
- Juan L Rodriguez-Flores
- Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA
- Regeneron Genetics Center, Tarrytown, NY, USA
| | | | | | - Ramzi Temanni
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
| | - Najeeb Syed
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
| | - Monika Markovic
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Eiman Al-Khayat
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Fatima Qafoud
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Zafar Nawaz
- Diagnostic Genomic Division, Hamad Medical Corporation, Doha, Qatar
| | - Ramin Badii
- Weill Cornell Medicine, Doha, Qatar
- Diagnostic Genomic Division, Hamad Medical Corporation, Doha, Qatar
| | | | - Hamdi Mbarek
- Qatar Genome Program, Qatar Foundation, Doha, Qatar
| | | | | | | | | | - Jason G Mezey
- Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Computational Biology, Cornell University, Ithaca, NY, USA
| | | | | | - Matthew B Greenblatt
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Khalid A Fakhro
- Weill Cornell Medicine, Doha, Qatar
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
| | | | - Ajayeb Al-Nabet
- Diagnostic Genomic Division, Hamad Medical Corporation, Doha, Qatar
| | - Nahla Afifi
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Andrew Brooks
- RUCDR Infinite Biologics, Piscataway, NJ, USA
- Department of Genetics, Rutgers University, New Brunswick, NJ, USA
| | | | - Asmaa Althani
- Qatar Genome Program, Qatar Foundation, Doha, Qatar
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Ronald G Crystal
- Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA.
| |
Collapse
|
8
|
The Special Features of Prenatal and Preimplantation Genetic Counseling in Arab Countries. Genes (Basel) 2022; 13:genes13020167. [PMID: 35205212 PMCID: PMC8872395 DOI: 10.3390/genes13020167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/02/2022] [Accepted: 01/12/2022] [Indexed: 12/04/2022] Open
Abstract
Genetic counseling services have only recently been introduced in most Arab countries, and their utilization is increasing. Prenatal genetic counseling is essential, particularly in the Arab context, which is characterized by high rates of consanguinity. Nevertheless, little is known about the decisions faced by parents and the factors underlying the complex decision making that must occur when accessing these services in Arab countries. Herein, we performed a narrative review to discuss the reported experiences of parents accessing genetic counseling in the prenatal setting in the 22 Arab countries. We also highlight the different types of decisions encountered and the factors influencing them. We report that: (i) utilization of genetic counseling services varies across different Arab countries; (ii) many factors affect decision making and service utilization, especially religion; and (iii) parents are faced with an array of decisions in the prenatal setting, partly driven by increased utilization of prenatal diagnosis and preimplantation genetic testing in some countries. Our work is the first to highlight the different factors and decisions influencing genetic counseling in Arab countries. Understanding these factors is essential for improving genetic counseling services in the region and helping counselors facilitate informed decision making.
Collapse
|
9
|
Masri AT, Nasir A, Irshaid F, Alomari F, Irshaid A, Al-Qudah A, Nafi O, Almomani M. Genetic evaluation of children with autism spectrum disorders in developing and low-resource areas. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1491-1498. [PMID: 34781785 DOI: 10.1177/13623613211055535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autism is the most common neurodevelopmental disorder in children worldwide. Genetic factors play an important role in the risk of developing autism. Determining the genetic cause of autism is key to understanding the biological processes that lead to the clinical manifestations of autism, and can inform the management and even prevention of this condition. Establishing genetic causes of autism requires collection of genetic data on a global scale. Limited research on genetic testing for individuals with autism is available from developing countries in low-resource regions. In this study, we explored the types of investigations ordered for Jordanian children with autism by their physicians. A representative sample of parents of children with autism in Jordan was questioned about the studies that their children received. We found that the recommended genetic testing was only performed in a small number of children with autism. In contrast, most children in the sample received non-genetic testing, which is not routinely recommended. We also explored the sociocultural factors that may influence the decision to perform genetic testing in this population. We discuss our findings in light of the data available from other developing and developed countries.
Collapse
Affiliation(s)
| | - Arwa Nasir
- University of Nebraska Medical Center, USA
| | | | | | | | | | | | | |
Collapse
|
10
|
DInur-Schejter Y, Stepensky P. Social determinants of health and primary immunodeficiency. Ann Allergy Asthma Immunol 2021; 128:12-18. [PMID: 34628007 DOI: 10.1016/j.anai.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Inborn errors of immunity (IEI) are rare genetic conditions affecting the immune system. The rate of IEI and their presentation, course, and treatment are all affected by a multitude of social determinants, eventually affecting prognosis. This review summarizes the current knowledge of the social determinants affecting infectious susceptibility, genetic predisposition, diagnosis, and treatment of IEI. DATA SOURCES PubMed. STUDY SELECTIONS Search terms included "consanguinity," "social determinants," and "founder effect." Further studies were selected based on relevant citations. RESULTS Changes in climate and human behavior have modulated the spread of disease vectors and infectious organisms. Consanguinity increases the rate of autosomal recessive conditions, changes the distribution, and affects the severity of IEI. Access to sophisticated genetic and immunologic diagnostic modalities affects genetic counseling and timely diagnosis. Effective genetic counseling should address to the patient's genetic background and ethical code. Access to appropriate and timely treatment of immunodeficiencies is scarce in some regions of the world. CONCLUSION High consanguinity rate and reduced access to prophylactic measures increase the burden of immunodeficiencies in many low- and medium-income countries. Furthermore, poor access to diagnostic and treatment modalities in these regions adversely affects patients' prognosis. Increased awareness among health care professionals and the public and increased collaboration with Western countries aid in diagnosis of these conditions. Further advancements require improved public funding to the prevention, diagnosis, and treatment of IEI.
Collapse
Affiliation(s)
- Yael DInur-Schejter
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Ein Kerem Medical Center, Jerusalem, Israel.
| | - Polina Stepensky
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| |
Collapse
|
11
|
Hosen MJ, Anwar S, Taslem Mourosi J, Chakraborty S, Miah MF, Vanakker OM. Genetic counseling in the context of Bangladesh: current scenario, challenges, and a framework for genetic service implementation. Orphanet J Rare Dis 2021; 16:168. [PMID: 33836792 PMCID: PMC8034097 DOI: 10.1186/s13023-021-01804-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/30/2021] [Indexed: 11/26/2022] Open
Abstract
With the advancements in genetics and genomics in the twenty-first century, genetic services have become an integral part of medical practices in high-income and upper-middle-income countries. However, people living in low and lower-middle-income countries (LICs and LIMCs), including Bangladesh, are rather underprivileged in receiving genetic services. Consequently, genetic disorders are emerging as a significant public health concern in these countries. Lack of expertise, high expense, the dearth of epidemiological data, insufficiently updated medical education system, poor infrastructure, and the absence of comprehensive health policies are the main factors causing people living in these countries not having access to genetic services. In this article, the authors took benefit from their professional experience of practicing medical genetics in the area and reviewed existing literature to provide their opinions. Particularly, it reviews the current knowledge of genetic disorders' burden and their causative factors in Bangladesh. It focuses on why providing genetic services is challenging in the context of the country's cultural and religious sentiment. Finally, it proposes a physician-academician collaborative framework within the existing facility that aims to tackle the challenges. Such a framework could also be useful for other LICs and LMICs to address the challenges associated with providing genetic services.
Collapse
Affiliation(s)
- Mohammad Jakir Hosen
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Saeed Anwar
- Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Edmonton, AB T6G 2R7 Canada
| | - Jarin Taslem Mourosi
- Department of Biology, The Catholic University of America, 620 Michigan Avenue NE, Washington, DC 20064 USA
| | - Sourav Chakraborty
- Research and Development Laboratory, Globe Biotech Limited, Tejgaon, Dhaka, 1208 Bangladesh
| | - Md. Faruque Miah
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Olivier M. Vanakker
- Center for Medical Genetics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| |
Collapse
|
12
|
Knowledge and Attitudes of Medical and Health Science Students in the United Arab Emirates toward Genomic Medicine and Pharmacogenomics: A Cross-Sectional Study. J Pers Med 2020; 10:jpm10040191. [PMID: 33114420 PMCID: PMC7711592 DOI: 10.3390/jpm10040191] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/17/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023] Open
Abstract
Medical and health science students represent future health professionals, and their perceptions are essential to increasing awareness on genomic medicine and pharmacogenomics. Lack of education is one of the significant barriers that may affect health professional’s ability to interpret and communicate pharmacogenomics information and results to their clients. Our aim was to assess medical and health science students’ knowledge, attitudes and perception for a better genomic medicine and pharmacogenomics practice in the United Arab Emirates (UAE). A cross-sectional study was conducted using a validated questionnaire distributed electronically to students recruited using random and snowball sampling methods. A total of 510 students consented and completed the questionnaire between December 2018 and October 2019. The mean knowledge score (SD) for students was 5.4 (±2.7). There were significant differences in the levels of knowledge by the year of study of bachelor’s degree students, the completion status of training or education in pharmacogenomics (PGX) or pharmacogenetics and the completion of an internship or study abroad program (p-values < 0.05. The top two barriers that students identified in the implementation of genomic medicine and pharmacogenomics were lack of training or education (59.7%) and lack of clinical guidelines (58.7%). Concerns regarding confidentiality and discrimination were stated. The majority of medical and health science students had positive attitudes but only had a fair level of knowledge. Stakeholders in the UAE must strive to acquaint their students with up-to-date knowledge of genomic medicine and pharmacogenomics.
Collapse
|
13
|
Abdul Rahim HF, Ismail SI, Hassan A, Fadl T, Khaled SM, Shockley B, Nasrallah C, Qutteina Y, Elmaghraby E, Yasin H, Darwish D, Fakhro KA, Badji R, Al-Muftah W, Afifi N, Althani A. Willingness to participate in genome testing: a survey of public attitudes from Qatar. J Hum Genet 2020; 65:1067-1073. [PMID: 32724056 PMCID: PMC7605429 DOI: 10.1038/s10038-020-0806-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/29/2022]
Abstract
Genomics has the potential to revolutionize medical approaches to disease prevention, diagnosis, and treatment, but it does not come without challenges. The success of a national population-based genome program, like the Qatar Genome Program (QGP), depends on the willingness of citizens to donate samples and take up genomic testing services. This study explores public attitudes of the Qatari population toward genetic testing and toward participating in the QGP. A representative sample of 837 adult Qataris was surveyed in May 2016. Approximately 71% of respondents surveyed reported that they were willing to participate in the activities of the QGP. Willingness to participate was significantly associated with basic literacy in genetics, a family history of genetic diseases, and previous experience with genetic testing through premarital screening. Respondents cited the desire to know more about their health status as the principle motivation for participating, while lack of time and information were reported as the most important barriers. With QGP plans to ramp up the scale of its national operation toward more integration into clinical care settings, it is critical to understand public attitudes and their determinants. The results demonstrate public support but also identify the need for more education and individual counseling that not only provide information on the process, challenges, and benefits of genomic testing, but that also address concerns about information security.
Collapse
Affiliation(s)
| | - Said I Ismail
- Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar
| | - Amel Hassan
- Department of Pediatrics, Sidra Medicine, Doha, Qatar
| | - Tasnim Fadl
- Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar
| | - Salma M Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Bethany Shockley
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Catherine Nasrallah
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Yara Qutteina
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Engi Elmaghraby
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Heba Yasin
- Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar
| | - Dima Darwish
- Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar
| | - Khalid A Fakhro
- Department of Human Genetics, Sidra Medicine, Doha, Qatar.,Department of Genetic Medicine, Weill Cornell Medical College, Doha, Qatar.,College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Radja Badji
- Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar
| | - Wadha Al-Muftah
- Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar.,Department of Genetic Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Nahla Afifi
- Qatar Biobank, Qatar Foundation, Doha, Qatar
| | - Asmaa Althani
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar.,Qatar Genome Program, Qatar Foundation, Qatar Science and Technology Park, Innovation Center, Doha, Qatar.,Qatar Biobank, Qatar Foundation, Doha, Qatar
| |
Collapse
|
14
|
AlHarthi FS, Qari A, Edress A, Abedalthagafi M. Familial/inherited cancer syndrome: a focus on the highly consanguineous Arab population. NPJ Genom Med 2020; 5:3. [PMID: 32025336 PMCID: PMC6997177 DOI: 10.1038/s41525-019-0110-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/11/2019] [Indexed: 12/18/2022] Open
Abstract
The study of hereditary cancer, which accounts for ~10% of cancer cases worldwide is an important subfield of oncology. Our understanding of hereditary cancers has greatly advanced with recent advances in sequencing technology, but as with any genetic trait, gene frequencies of cancer-associated mutations vary across populations, and most studies that have located hereditary cancer genes have been conducted on European or Asian populations. There is an urgent need to trace hereditary cancer genes across the Arab world. Hereditary disease is particularly prevalent among members of consanguineous populations, and consanguineous marriages are particularly common in the Arab world. There are also cultural and educational idiosyncrasies that differentiate Arab populations from other more thoroughly studied groups with respect to cancer awareness and treatment. Therefore, a review of the literature on hereditary cancers in this understudied population was undertaken. We report that BRCA mutations are not as prevalent among Arab breast cancer patients as they are among other ethnic groups, and therefore, other genes may play a more important role. A wide variety of germline inherited mutations that are associated with cancer are discussed, with particular attention to breast, ovarian, colorectal, prostate, and brain cancers. Finally, we describe the state of the profession of familial cancer genetic counselling in the Arab world, and the clinics and societies dedicated to its advances. We describe the complexities of genetic counselling that are specific to the Arab world. Understanding hereditary cancer is heavily dependent on understanding population-specific variations in cancer-associated gene frequencies.
Collapse
Affiliation(s)
- Fawz S AlHarthi
- 1Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,2Genetics Counselling Division, Saudi Diagnostic Laboratory, King Faisal Specialist Hospital International Company, Riyadh, Saudi Arabia
| | - Alya Qari
- 3Medical Genetic Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Alaa Edress
- 1Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,2Genetics Counselling Division, Saudi Diagnostic Laboratory, King Faisal Specialist Hospital International Company, Riyadh, Saudi Arabia
| | - Malak Abedalthagafi
- 1Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| |
Collapse
|
15
|
Global perspectives on primary immune deficiency diseases. STIEHM'S IMMUNE DEFICIENCIES 2020. [PMCID: PMC7258797 DOI: 10.1016/b978-0-12-816768-7.00054-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
16
|
Altaany Z, Khabour OF, Al-Taani G. Knowledge, Beliefs, and Attitudes Concerning Genetic Testing Among Young Jordanians. J Multidiscip Healthc 2019; 12:1043-1048. [PMID: 31849479 PMCID: PMC6912010 DOI: 10.2147/jmdh.s233614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/15/2019] [Indexed: 12/19/2022] Open
Abstract
Background Medical genetic testing is an evolving side of clinical care that helps people to make informed medical and lifestyle decisions. The source of knowledge, personal beliefs, and attitude towards genetic testing are the main determinative factors of getting optimal utilization of such technology in reducing/prevention of diseases. Methods A structured survey was used to assess the knowledge, beliefs, and attitude regarding genetic testing among 463 young adults aged 18 years or older living in the North of Jordan. Results More than three-quarters (77.1%) of the respondents were familiar with the term genetic testing. The most common sources of knowledge were: education they received (44.8%), the internet (37.5%), and social media (17.2%). Most (93.9%) of the respondents believed that genetic testing is a useful tool to diagnose and prevent genetic diseases. Almost three-quarters (72.7%) of the respondents believed that the health care system provides advice or genetic counseling to those with a genetic disease. A total of 9.6% of the respondents thought that genetic testing might cause a physical risk to their lives. In addition, 11.3% of the respondents believed that genetic testing is forbidden and not permissible and about 6.3% did not agree in performing genetic testing in the future. Finally, about half (53.4%) of the respondents consider genetic testing affordable and the remainder consider it costly. Conclusion Our findings emphasize the importance of acquiring knowledge about genetic testing among young individuals, Issues related to knowledge were identified and should be further improved, such as cost prediction, safety, and the legitimacy of genetic testing to get better outcomes in the Jordanian community.
Collapse
Affiliation(s)
- Zaid Altaany
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ghaith Al-Taani
- Department of Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| |
Collapse
|
17
|
Almomani BA, Al-Keilani MS, Al-Sawalha NA. Knowledge and views about genetics: a public-based cross-sectional study. Eur J Hum Genet 2019; 28:417-423. [PMID: 31659251 DOI: 10.1038/s41431-019-0532-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/26/2019] [Accepted: 10/13/2019] [Indexed: 11/09/2022] Open
Abstract
This study aimed to explore the knowledge, factors affecting knowledge, and views of the Jordanian population on genetics-related issues. A cross-sectional questionnaire study was conducted in Jordan. The questionnaire was administered by face-to-face interview to the participants who were recruited from different public places. In total, 5000 questionnaires were collected from public population in Jordan and 43.4% (2171/5000) of them were knowledgeable. The public's knowledge was found to be associated with female gender (OR = 1.493, 95% CI = 1.280-1.741, p < 0.001), bachelor degree (OR = 1.853, 95% CI = 1.592-2.157, p < 0.001), having children (OR = 1.433, 95% CI = 1.162-1.768, p = 0.001), and having first-degree relatives with comorbid conditions (OR = 1.669, 95% CI = 1.431-1.946, p < 0.001). Although public in Jordan had positive genetic attitudes, they raised several concerns about the applications of genetics in clinical practice. Genetic knowledge was significantly associated with all positive public attitudes and most of their concerns (p < 0.001). These findings suggested that female gender, educational level, having children, and having first-degree relatives with comorbid conditions were good predictors for public's knowledge about genetics-related issues. Public education about the value of participation in genetic research as well as educational and training programs for healthcare professionals are recommended to assist in establishing genetics-related services in Jordan.
Collapse
Affiliation(s)
- Basima A Almomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
| | - Maha S Al-Keilani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour A Al-Sawalha
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
18
|
Riaz M, Tiller J, Ajmal M, Azam M, Qamar R, Lacaze P. Implementation of public health genomics in Pakistan. Eur J Hum Genet 2019; 27:1485-1492. [PMID: 31101884 PMCID: PMC6777461 DOI: 10.1038/s41431-019-0428-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/10/2019] [Accepted: 04/30/2019] [Indexed: 02/06/2023] Open
Abstract
There has been considerable recent progress in the implementation of public health genomics policy throughout the developed world. However, in the developing world, genetic services still remain limited, or unavailable to most. Here, we discuss challenges and opportunities related to the implementation of public health genomics in developing countries. We focus on Pakistan, a country with one of the world's highest rates of inter-family marriages and prevalence of inherited genetic conditions. Pakistan still lacks a national newborn screening programme, clinical genetic testing services, or public health genomics framework. The medical infrastructure in Pakistan, characterized by limited publicly-funded health services and a significant burden of infectious disease, may contribute to de-prioritization of genetic health services. In addition, there are a number of societal, cultural and religious factors to consider. Recently a number of large research studies have been conducted in populations of Pakistani descent, mostly in collaboration with major US, UK and European institutions. Some of these have yielded high-impact scientific findings, but have yet to translate into public health outcomes in Pakistan. Before the benefits of genomics can be realized in developing countries, the first initial steps towards strategic prioritization, resourcing, and long-term goal setting are required. We propose some practical recommendations and possible first steps forward.
Collapse
Affiliation(s)
- Moeen Riaz
- Public Health Genomics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Jane Tiller
- Public Health Genomics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Muhammad Ajmal
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Maleeha Azam
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Raheel Qamar
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
- Pakistan Academy of Sciences, Islamabad, Pakistan
| | - Paul Lacaze
- Public Health Genomics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
19
|
Bhinder MA, Sadia H, Mahmood N, Qasim M, Hussain Z, Rashid MM, Zahoor MY, Bhatti R, Shehzad W, Waryah AM, Jahan S. Consanguinity: A blessing or menace at population level? Ann Hum Genet 2019; 83:214-219. [PMID: 30891741 DOI: 10.1111/ahg.12308] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 02/15/2019] [Accepted: 03/01/2019] [Indexed: 12/18/2022]
Abstract
Consanguinity has highly complex and multifaceted aspects with sociocultural as well as biological debates on its pros and cons. The biological upshot of consanguinity includes the increased homozygosity, which results in manifold increased risk of genetic disorders at family and population levels. On the other hand, in addition to social, cultural, political, and economic benefits, consanguineous marriages have biological advantages at the population level. The consequence of consanguineous marriages is an upsurge in the number of homozygous diseased individuals with fewer chances of mating and reduced chances of survival, therefore evolutionarily confining the transmission of disease alleles to future generations and encouraging its elimination from a population. Protective effects of consanguinity have also been observed in a few diseases in different populations. Although attractive for many reasons, nonconsanguineous marriages will cause risk alleles to spread throughout the population, making most individuals carriers, and ultimately will resume the production of recessive diseases in subsequent generations. Although consanguinity, from an evolutionary point of view, is beneficial at the population level, it increases the risk of diseases in the very next generation. Presently, there is no treatment for most of the genetic disorders; we cannot opt for consanguinity for long-term benefits. Nonconsanguineous marriages are a better strategy by which we may delay disease manifestation for some generations until science offers a viable solution.
Collapse
Affiliation(s)
- Munir Ahmad Bhinder
- Department of Human Genetics & Molecular Biology, University of Health Sciences, Lahore, 54600, Pakistan
| | - Haleema Sadia
- Balochistan University of Information Technology, Engineering and Management Sciences, Takatu Campus, Quetta, Pakistan
| | - Nasir Mahmood
- University of Health Sciences, Lahore, 54600, Pakistan
| | - Muhammad Qasim
- Department of Bioinformatics and Biotechnology, Govt. College University, Faisalabad, Pakistan
| | - Zawar Hussain
- Department of Zoology, University of Education, Lahore, Pakistan
| | - Muhammad Mudassar Rashid
- Department of Human Genetics & Molecular Biology, University of Health Sciences, Lahore, 54600, Pakistan
| | - Muhammad Yasir Zahoor
- Institute of Biochemistry & Biotechnology, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - Rashid Bhatti
- National Centre of Excellence in Molecular Biology, Lahore, Pakistan
| | - Wasim Shehzad
- Institute of Biochemistry & Biotechnology, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - Ali Muhammad Waryah
- Molecular Biology & Genetics Department, Medical Research Center, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan
| | - Shah Jahan
- University of Health Sciences, Lahore, 54600, Pakistan
| |
Collapse
|
20
|
Zayed H, Ouhtit A. Accredited genetic testing in the Arab Gulf region: reinventing the wheel. J Hum Genet 2016; 61:673-4. [DOI: 10.1038/jhg.2016.22] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|