THE GENETIC BACKGROUND OF SOUTHERN IRANIAN COUPLES BEFORE MARRIAGE
Nariman A, Sobhan MR, Savaei M, Aref-Eshghi E, Nourinejad R, Manoochehri M, Ghahremani S, Daliri F, Daliri K,*
*Corresponding Author: Dr. Karim Daliri, Department of Human Genetics, Behbahan Faculty of Medical Sciences, Bashir Boulevard, Behbahan, Iran. Tel: +98-9374140937. Fax: +98-9374140937. E-mail: karimdaliri@ gmail.com
page: 71

DISCUSSION

To the best of our knowledge, this is the first study in Khuzestan Province, Iran (Behbahan City) to investigate the genetic background of couples before marriage. We found that most respondents (97.0%) had never been referred for genetic counseling, and their health care providers had only referred a few of them for genetic testing (98.6%) despite the high rate of consanguinity. These findings suggest that most health service providers in our setting were not aware of or underestimated the importance of genetic services. Our respondents were also mostly unaware of the type of tests they had undergone. These suggest that both health care providers and the public would benefit from training in the general concepts of genetics and their importance before marriage. This cannot be achieved without increasing the collaboration between genetic counseling centers, genetic testing laboratories and health service providers. DNA copy number variants (microdeletions and duplications), single gene and complex disorders, chromosomal aberrations and epigenetic disorders are the main categories of potential causes of genetic problems. With the progress in molecular genetics of diseases, each year about 10 to 15 new tests become available for clinical genetic testing [10]. As more genes are discovered and the etiology of more genetic disorders is understood, the role of genetic counseling in health care systems is expected to increase. Genetic counseling is the process of helping people to understand the medical, psychological and familial implications of genetic contributions to disease. Counseling should include assessing the chances of occurrence or recurrence of a disease, management and prevention. In our study, the main reason for genetic counseling was consanguinity, whereas other forms of assessments were mainly ignored. These results are comparable to those by Fathzadeh et al. [11] who reported consanguinity as the primary reason for referrals for genetic counseling. In populations with high rates of consanguineous marriages, an improvement in the public health genetic service as well as the education of the public about the risks of consanguineous marriages is strongly suggested to reduce the risks. Apart from this, the integration of the genetics service to the local Primary Health Care facility that is currently performed at the rural and metropolitan levels in the province, would be the first step to improve clinical genetic services in this region. In addition, a number of reports have noted that health care providers may be inconsistent in the counseling they provide for consanguinity, so in this area, they need to increase their awareness of genetic issues, possibly through self-learning and official education, in order to make appropriate referrals [12]. Conclusions. The implications of our findings are useful from both theoretical and practical standpoints. Despite the key role of genes in the etiology of different human diseases, some medical professionals may underestimate their actual value in the process of prevention, diagnosis and treatment. All couples who plan to marry, especially those who are related by consanguinity, should be informed of the risks, benefits, and possible outcomes of pregnancy and parenthood through genetic counseling and public education via the media. Furthermore, we strongly recommend closer collaboration between clinical genetic counseling centers, genetic testing laboratories and health service providers at marital counseling centers, as well as regular training for health service providers such as physicians and nurses in basic and applied concepts in human and medical genetics. Declaration of Interest. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.



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