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Several children were the result of consanguineous marriages, in which the parents are related.

In the 2000s, papers on the genetics of Roma people still referred to the group with the outdated term “Gypsy,” which is considered a slur, or with pejorative terms such as “inbred” or “consanguineous.”

“Also, consanguineous marriages – first cousin to first cousin – have been reported to increase the incidence to as high as three percent, so we see more congenital heart disease in the Middle East North Africa countries.”

When the child of a consanguineous union develops a recessive disease, the responsible mutation usually lies within a larger identical block of DNA inherited from both parents.

“Ninety percent of the cases I see are caused by consanguineous marriages,” says Ms Zaki.