Genetic counseling in the context of Bangladesh: current scenario, challenges, and a framework for genetic service implementation

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.

Keywords: Collaborative research; Disease burden in Bangladesh; Genetic counseling; Genetic service; Legal and social issues; Neonatal screening.

Fig. 1

Patient education and infrastructure development on a genetic service implementation perspective in Bangladesh

Fig. 2

Model for implementing genetic diagnostics and counseling in Bangladesh. Patients will be identified, and histopathological and biochemical tests will be performed using the available facilities of the collaborating medical colleges. The molecular analysis will be performed at the genetic facilities of the university and foreign collaborators. This “Medical College-University-Foreign expert” model can be an effective model for setting up genetic counseling service provision systems in low-income and lower-middle-income countries. GDR genetic disease resource