Background Some anti-malarial drugs often cause haemolytic anaemia in glucose-6-phosphate-dehydrogenase deficiency (G6PDd) patients. This study aims to analyse the association of G6PDd and anaemia in malaria patients receiving anti-malarial drugs. Methods A literature search was performed in major database portals. All studies searched using keywords with Medical Subject Headings (MeSH) were included, without date or language restriction. Pooled mean difference of haemoglobin and risk ratio of anaemia were analysed using RevMan. Results Sixteen studies comprising 3474 malaria patients that included 398 (11.5%) with G6PDd were found. Mean difference of haemoglobin in G6PDd/G6PD normal (G6PDn) patients was − 0.16 g/dL (95% CI − 0.48, 0.15; I2 5%, p = 0.39), regardless of the type of malaria and dose of drugs. In particular with primaquine (PQ), mean difference of haemoglobin in G6PDd/G6PDn patients with dose < 0.5 mg/kg/day was − 0.04 (95% CI − 0.35, 0.27; I2 0%, p = 0.69). The risk ratio of developing anaemia in G6PDd patients was 1.02 (95% CI 0.75, 1.38; I2 0%, p = 0.79). Conclusion Single or daily standard doses of PQ (0.25 mg/kg/day) and weekly PQ (0.75 mg/kg/week) did not increase the risk of anaemia in G6PDd patients.
The high burden of infection mortality worldwide calls for the need for prompt risk assessment of its outcome. This article studied for accuracy of quick Sequential Organ Failure Assessment (qSOFA) combined with lactate measurement in predicting the mortality of adult patients with infection. Literature searching was performed in PubMed/Medline®, CINAHL®, Embase®, CENTRAL®, Proquest®, Scopus®, and hand searching of journals. All studies in searching keywords “infection”, “quick sequential organ failure assessment”, “qsofa”, “lactate” with Medical Subject Headings (MeSH) terms were included. Pooled sensitivity, specificity, and area under the curve (AUC) of qSOFA-lactate accuracy were analysed using the R program. Twenty-six studies comprised of 43,207 adult patients with infection were included in this review. Studies were performed in the emergency department, ward, and intensive care unit, with mortality rates ranging from 3.8% − 53.6%. The pooled sensitivity and specificity of 20 studies were 81.3% (95% CI 72.3%, 87.8%; I2 = 97%, p < 0.01) and 62.3% (95% CI 50.5%, 72.8%; I2 = 100%, p = 0). The AUC of qSOFA-lactate was 0.773 (95% CI 0.74, 0.80). There was no significant difference in accuracy results between septic and non-septic patients. The qSOFA-lactate measurement had good accuracy in predicting mortality in adult infectious patients.
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