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Marriage patterns in Sri Lanka and the prevalence of parental consanguinity in patients with β-thalassaemia: a cross-sectional descriptive analysis

Published online by Cambridge University Press:  25 October 2019

Anuja P. Premawardhena ,
Shamila T. De Silva Open the ORCID record for Shamila T. De Silva [Opens in a new window] ,
M. D. Dilith C. Goonatilleke ,
Dileepa S. Ediriweera ,
Sachith Mettananda ,
B. K. Rexan P. Rodrigo ,
Angela Allen  and
David J. Weatherall
Anuja P. Premawardhena*
Affiliation:
Faculty of Medicine, University of Kelaniya, Sri Lanka
Shamila T. De Silva
Affiliation:
Faculty of Medicine, University of Kelaniya, Sri Lanka
M. D. Dilith C. Goonatilleke
Affiliation:
Faculty of Medicine, University of Kelaniya, Sri Lanka
Dileepa S. Ediriweera
Affiliation:
Faculty of Medicine, University of Kelaniya, Sri Lanka
Sachith Mettananda
Affiliation:
Faculty of Medicine, University of Kelaniya, Sri Lanka
B. K. Rexan P. Rodrigo
Affiliation:
Faculty of Medicine, University of Kelaniya, Sri Lanka
Angela Allen
Affiliation:
Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
David J. Weatherall
Affiliation:
Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
*
*Corresponding author. Email: premawa@hotmail.com
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Abstract

Consanguineous marriages potentially play an important role in the transmission of β-thalassaemia in many communities. This study aimed to determine the rate and socio-demographic associations of consanguineous marriages and to assess the influence on the prevalence of β-thalassaemia in Sri Lanka. Three marriage registrars from each district of Sri Lanka were randomly selected to prospectively collect data on all couples who registered their marriage during a 6-month period starting 1st July 2009. Separately, the parents of patients with β-thalassaemia were interviewed to identify consanguinity. A total of 5255 marriages were recorded from 22 districts. The average age at marriage was 27.3 (±6.1) years for males and 24.1 (±5.7) years for females. A majority (71%) of marriages were ‘love’ marriages, except in the Moor community where 84% were ‘arranged’ marriages. Overall, the national consanguinity rate was 7.4%. It was significantly higher among ethnic Tamils (22.4%) compared with Sinhalese (3.8%) and Moors (3.2%) (p < 0.001). Consanguinity rates were also higher in ‘arranged’ as opposed to ‘love’ marriages (11.7% vs 5.6%, p < 0.001). In patients with β-thalassaemia, the overall consanguinity rate was 14.5%; it was highest among Tamils (44%) and lowest among Sinhalese (12%). Parental consanguinity among patients with β-thalassaemia was double the national average. Although consanguinity is not the major factor in the transmission of the disease in the country, emphasis should be given to this significant practice when conducting β-thalassaemia prevention and awareness campaigns, especially in high-prevalence communities.

Keywords

Sri LankaConsanguinityThalassaemia
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 4 , July 2020 , pp. 573 - 584
Copyright
© Cambridge University Press 2019

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References

Bhagya, B, Sucharitha, S and Avadhani, R (2013) Prevalence and pattern of consanguineous marriages among different communities in Mangalore. Online Journal of Health & Allied Sciences 11(4), 1–3.Google Scholar
Bhatta, DN and Haque, A (2015) Health problems, complex life, and consanguinity among ethnic minority Muslim women in Nepal. Ethnic Health 20(6), 633–649.CrossRefGoogle ScholarPubMed
Bittles, AH (2001) Consanguinity and its relevance to clinical genetics. Clinical Genetics 60, 89–98.CrossRefGoogle Scholar
Bittles, AH and Black, ML (2010) Evolution and health and medicine Sackler colloquium: consanguinity, human evolution and complex diseases. Proceedings of the National Academy of Sciences of the USA 107, 1779–1786.CrossRefGoogle Scholar
Black, ML, Sinha, S, Agarwal, S, Colah, R, Das, R, Bellgard, M and Bittles, AH (2010) A descriptive profile of β-thalassaemia mutations in India, Pakistan and Sri Lanka. Journal of Community Genetics 1, 149–157.CrossRefGoogle ScholarPubMed
Caldwell, B (1996) The family and demographic change in Sri Lanka. Health Transition Review 6, 45–60.Google ScholarPubMed
Caldwell, BK (2005) Factors affecting female age at marriage in South Asia. Asian Population Studies 1(3), 283–301.CrossRefGoogle Scholar
Demographic and Health Survey Report (2006) Department of Census and Statistics, Sri Lanka. URL: http://www.statistics.gov.lk (accessed 7th June 2019).Google Scholar
De Silva, WI (1990) Age at marriage in Sri Lanka: stabilizing or declining? Journal of Biosocial Science 22(4), 395–404.CrossRefGoogle ScholarPubMed
De Silva, WI (1997) The Ireland of Asia: trends in marriage timing in Sri Lanka. Asia-Pacific Population Journal 12(2), 3–24.CrossRefGoogle ScholarPubMed
De Silva, WI (2014) Still the “Ireland of Asia”? Declining female age at marriage in Sri Lanka. Journal of Family Issues 35(12), 1605–1623.CrossRefGoogle Scholar
Fareed, M and Afzal, M (2017) Genetics of consanguinity and inbreeding in health and disease. Annals of Human Biology 44(2), 99–107.CrossRefGoogle ScholarPubMed
Fernando, DFS (1975) Changing nuptiality patterns in Sri Lanka 1901–1971. Population Studies 29(2), 179–190.Google Scholar
Gamage, S (1982) The marriage pattern of Sri Lanka. Economic Review 02 25–26.Google Scholar
Geiger, W and Bode, MH (1912) The Mahavamsa or the Great Chronicle of Ceylon. Oxford University Press, London.Google Scholar
Hussain, R and Bittles, AH (1998) The prevalence and demographic characteteristics of consanguineous marriages in Pakistan. Journal of Biosocial Science 30, 261–275.CrossRefGoogle ScholarPubMed
Jones, GW and Yeung, W (2014) Marriage in Asia. Journal of Family Issues 35(12), 1567–1583.CrossRefGoogle Scholar
Khan, NU, Wojtyniak, B and Saha, S (1997) Effects of Parental Consanguinity on Offspring Mortality in Rural Bangladesh. Centre for Health and Population Research, Demographic surveillance system, Dhaka.Google Scholar
Merten, M (2019) Keeping it in the family: consanguineous marriage and genetic disorders, from Islamabad to Bradford. British Medical Journal 365, 1851–1853.CrossRefGoogle ScholarPubMed
Ministry of Health, Sri Lanka (2016) Annual Health Bulletin. URL: http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/AHB/2017/AHS%202016.pdf (accessed 7th June 2019).Google Scholar
Ministry of Higher Education, Sri Lanka (2019) Country Overview. URL: http://www.mohe.gov.lk/index.php/about-ministry/overview (accessed 7th June 2019).Google Scholar
Mobarak, AM, Chaudhry, T, Brown, J, Zlenska, T, Nizam Khan, M and Chaudry, Set al. (2019) Estimating the health and socioeconomic effects of cousin marriage in South Asia. Journal of Biosocial Science 51, 418–435.CrossRefGoogle ScholarPubMed
Mudiyanse, R (2015) Safe marriage for prevention of thalassaemia: Sri Lankan experience. Appraisal of the concepts and challenges of implementation. Journal of Pharmacology & Biomedical Sciences 5(10), 791–796.Google Scholar
Ogawa, N (1981) The socioeconomic determinants of age at first marriage and its impact on fertility in Sri Lanka. Jinkogaku Kenkyu 4, 41–44.Google Scholar
Premawardhena, A, Allen, A, Piel, F, Fisher, C, Perera, L, Rodrigo, Ret al. (2017) The evolutionary and clinical implications of the uneven distribution of the frequency of the inherited haemoglobin variants over short geographical distances. British Journal of Haematology 176(3), 475–484.CrossRefGoogle ScholarPubMed
Reid, RM (1976) Effects of consanguineous marriage and inbreeding on couple fertility and offspring mortality in rural Sri Lanka. Human Biology 48(1), 139–146.Google ScholarPubMed
Shami, S, Schmitt, L and Bittles, AH (1989) Consanguinity-related prenatal and postnatal mortality of the populations of seven Pakistani Punjab cities. Journal of Medical Genetics 26, 267–271.CrossRefGoogle ScholarPubMed
Shami, SA and Iqbal, I (1983) Consanguineous marriages in the population of Sheikhupura (Punjab), Pakistan. Biologia (Lahore, Pakistan) 29(2), 231–244.Google ScholarPubMed
Sheikh, SM and Loney, T (2018) Is educating girls the best investment for South Asia? Association between female education and fertility choices in South Asia: a systematic review of the literature. Frontiers in Public Health 6, 172.CrossRefGoogle ScholarPubMed
Sinha, S, Black, ML, Agarwal, S, Colah, R, Das, R, Ryan, Ket al (2009) Profiling β-thalassaemia mutations in India at state and regional levels: implications for genetic education, screening and counselling programmes. HUGO Journal 3, 51–62.CrossRefGoogle ScholarPubMed
The Commomwealth (n.d.) Sri Lanka: History. URL: http://thecommonwealth.org/our-member-countries/sri-lanka/history (accessed 4th August 2019).Google Scholar
UK Essays (2018) Caste and Sri Lankan Marriage. URL: https://www.ukessays.com/essays/sociology/caste-as-a-consideration-for-sri-lankan-marriage-sociology-essay.php?vref=1 (accessed 7th June 2019).Google Scholar
Verma, IC, Prema, A and Puri, RK (1992) Health effects of consanguinity in Pondicherry. Indian Pediatrics 29(6), 685–692.Google ScholarPubMed