Glucose-6-phosphate dehydrogenase deficiency among malaria patients of Honduras: a descriptive study of archival blood samples

Abstract

Background:The frequency of deficient variants of glucose-6-phosphate dehydrogenase (G6PDd) is particularly high in areas where malaria is endemic. The administration of antirelapse drugs, such as primaquine, has the potential to trigger an oxidative event in G6PD-deficient individuals. According to Honduras´ national scheme, malaria treatment requires the administration of chloroquine and primaquine for both Plasmodium vivax and Plasmodium falciparum infections. The present study aimed at investigating for the first time in Honduras the frequency of the two most common G6PDd variants.Methods: This was a descriptive study utilizing 398 archival DNA samples of patients that had been diagnosed with malaria due to P. vivax, P. falciparum, or both. The most common allelic variants of G6PD: G6PD A+ 376G and G6PD A− 376G/202A were assessed by two molecular methods (PCR-RFLP and a commercial kit). Results:The overall frequency of G6PD deficient genotypes was 16.08%. The frequency of the "African" genotype A− (Class III) was 11.9% (4.1% A− hemizygous males; 1.5% homozygous A− females; and 6.3% heterozygous A− females). A high frequency of G6PDd alleles was observed in samples from malaria patients residing in endemic regions of Northern Honduras. One case of Santamaria mutation (376G/542T) was detected. Conclusions:Compared to other studies in the Americas, as well as to data from predictive models, the present study identified a higher-than expected frequency of genotype A− in Honduras. Considering that the national standard of malaria treatment in the country includes primaquine, further research is necessary to ascertain the risk of PQ-triggered haemolytic reactions in sectors of the population more likely to carry G6PD mutations. Additionally, consideration should be given to utilizing point of care technologies to detect this genetic disorder prior administration of 8-aminoquinoline drugs, either primaquine or any new drug available in the near future.

Prevalence and molecular characterization of G6PD deficiency in two Plasmodium vivax endemic areas in Venezuela: predominance of the African A-202A/376G variant

“…Two mutations were detected in most (71 %) of subjects with biochemically determined deficiency, particularly the 202G → A and the 376A → G, defining together the variant G6PD A- 202A/376G , widely distributed in Africa where it seems to confer resistance to falciparum malaria [ 19 , 36 ], and identified under other names in Spain, Mexico, Italy, and many other parts of the world [ 12 , 37 ]. High prevalence of this G6PD variant has been reported in Brazil, Mexico, Cuba and Honduras [ 20 – 22 , 38 ], but a great diversity of variants has been described and spread across American, European and Asian countries [ 12 , 19 , 23 ]. Although in this study four regions were studied spanning five exons of the G6PD gene, which include the most common mutations described in G6PDd subjects of LA countries, it is not possible to exclude those mutations located in other gene regions which can be involved in the deficiency.…”

Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in malaria endemic region of Iran (Sistan and Baluchestan Province): Epidemiological profile and trends over time

“…Also, in malarious regions of the world, the prevalence rate of G6PD deficiency was reported to be 8% on average [25] which is lower than that (12%) in the present study. Nevertheless, the prevalence rate of the current report is lower than that of some parts of the world including Zuniga in Honduran (16.8%) [26] and is higher than that of some other areas such as Venezuela (3.6%) [26,27]. Interestingly, rate of G6PD deficiency among study participants in southeast and north of Iran is considerably higher than that in south and central part of Iran [28,29].…”

“…Several epidemiological studies demonstrated that G6PD deficiency is mainly distributed in areas of the world where malaria was previously or is currently endemic [11,21,25,26,32,35]. Similarly, there is various geographic distribution of G6PD deficiency in the study regions with the highest prevalence rate observed in Chahbahar District as one of the previously malaria endemic areas in contrast to the lowest prevalence rate seen in Zahedan District as non-malaria endemic region, although low/high prevalence of G6PD deficiency in endemic/non-endemic part can be due to some factors such as immigration of healthy or malarious individuals and method of sampling.…”

Glucose-6-phosphate dehydrogenase deficiency prevalence and genetic variants in malaria endemic areas of Colombia

“…Different prevalence of G6PDd has been reported in Africa (20 %), the Mediterranean (4–30 %) and Southeast Asia (10–20 %) [ 11 ]. In Latin America, where it has been less studied, prevalence ranges from <2 % in countries such as Guatemala, Mexico and Peru to 16 % in Honduras [ 2 , 12 ], including Venezuela with a prevalence of ~4 % [ 13 ]. The G6PDd African variants or “A” variants are among the most frequent worldwide, and the most common variants reported in the Americas.…”