Glucose-6-phosphate dehydrogenase (G6PD) deficiency is believed to confer protection against Plasmodium falciparum malaria, but the precise nature of the protective effect has proved difficult to define as G6PD deficiency has multiple allelic variants with different effects in males and females, and it has heterogeneous effects on the clinical outcome of P. falciparum infection. Here we report an analysis of multiple allelic forms of G6PD deficiency in a large multi-centre case-control study of severe malaria, using the WHO classification of G6PD mutations to estimate each individual’s level of enzyme activity from their genotype. Aggregated across all genotypes, we find that increasing levels of G6PD deficiency are associated with decreasing risk of cerebral malaria, but with increased risk of severe malarial anaemia. Models of balancing selection based on these findings indicate that an evolutionary trade-off between different clinical outcomes of P. falciparum infection could have been a major cause of the high levels of G6PD polymorphism seen in human populations.DOI: http://dx.doi.org/10.7554/eLife.15085.001

International audienceSummary:In order to obtain an approximate assessment of the public health burden that will be posed by the inherited disorders of haemoglobin in southern Vietnam, several thousand individuals were screened for these conditions. A smaller sample was screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency. The important haemoglobin disorders identified were β thalassaemia, haemoglobin E and a variety of different forms of α thalassaemia. There were sufficient G6PD-deficient individuals to materially affect malaria control programme design. The most remarkable finding was wide variation in the gene frequencies of these conditions among the ethnic groups sampled. The approximate number of babies expected to be born with clinically-significant haemoglobin disorders in Vietnam was estimated from the gene-frequency data. This study emphasizes the importance of wide-scale population screening, including ethnic subgroups, to establish the requirements for inherited haemoglobin disorder programmes in resource-limited settings

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Objective: To evaluate the results of laparoscopic management of tubal cystectomy at the National Hospital of Obstetrics and Gynecology. Subjects and research methods: A retrospective descriptive study of medical records of patients with tubal cystectomy at the National Hospital of Obstetrics and Gynecology from November 1, 2020, to the end of December 31, 2020. Results: The most common age group for tubal pregnancy is 25-34 years old (59.1%), and the least common is under 20 years old (1.1%). 57% of patients had less than two children. The size of the gestational mass at surgery ≤ 3cm accounted for the highest percentage (86%), and the group of patients with gestational mass ≥ 5cm accounted for only 1.1%. Morphology of the gestational mass before surgery: most of the gestational masses were unbroken, accounting for 69.9%, and 5.9% had ruptured gestational masses. Mainly during surgery, the amount of blood in the abdomen is from 100-500 ml (54.8%), and blood volume >500 ml only accounts for 8.1%. There were 7.5% of patients who had laparoscopic tubal conservation, and the remaining 92.5% had a laparoscopic tubal resection. The group of patients who had never had children and had only one child had the highest rate of tubal preservation, in which the rate of tubal preservation in the group of patients without children was up to 17.6%. Total treatment time after laparoscopic surgery is usually less than 4 days, an average of 2.6±1.2 days. Out of 186 patients studied, only one patient required a blood transfusion. There were no cases of complications after laparoscopic surgery. Conclusions: The most common age group to get pregnant is women of reproductive age. Most of the patients come to the hospital in the early stage, the pregnancy mass has not broken, and the size is small. Patients without children had the highest rate of tubal preservation. The proportion of patients requiring blood transfusion was not significant, and there were no cases of complications after laparoscopic surgery. Keywords: results of treatment, GEU at the infundibulum of fallopian tube, endoscopic surgery.