Glucose-6-phosphate dehydrogenase deficiency among malaria suspects attending Gambella hospital, southwest Ethiopia

Abstract

BackgroundGlucose-6-phosphate dehydrogenase deficiency (G6PDd) is widespread across malaria endemic regions. G6PD-deficient individuals are at risk of haemolysis when exposed, among other agents, to primaquine and tafenoquine, which are capable of blocking malaria transmission by killing Plasmodium falciparum gametocytes and preventing Plasmodium vivax relapses by targeting hypnozoites. It is evident that no measures are currently in place to ensure safe delivery of these drugs within the context of G6PDd risk. Thus, determining G6PDd prevalence in malarious areas would contribute towards avoiding possible complications in malaria elimination using the drugs. This study, therefore, was aimed at determining G6PDd prevalence in Gambella hospital, southwest Ethiopia, using CareStart™ G6PDd fluorescence spot test.MethodsVenous blood samples were collected from febrile patients (n = 449) attending Gambella hospital in November-December 2013. Malaria was diagnosed using blood films and G6PDd was screened using CareStart™ G6PDd screening test (Access Bio, New Jersey, USA). Haematological parameters were also measured. The association of G6PD phenotype with sex, ethnic group and malaria smear positivity was tested.ResultsMalaria prevalence was 59.2% (96.6% of the cases being P. falciparum mono infections). Totally 33 participants (7.3%) were G6PD-deficient with no significant difference between the sexes. The chance of being G6PD-deficient was significantly higher for the native ethnic groups (Anuak and Nuer) compared to the ‘highlanders’/settlers (odds ratio (OD) = 3.9, 95% confidence interval (CI) 0.481-31.418 for Anuak vs ‘highlanders’; OD = 4.9, 95% CI 0.635-38.00 for Nuer vs ‘highlanders’). G6PDd prevalence among the Nuer (14.3%) was significantly higher than that for the Anuak (12.0%).ConclusionsG6PDd prevalence in the area is substantial with 30 (90.9%) of the 33 deficient individuals having malaria suggesting the non-protective role of the disorder at least from clinical malaria. The indigenous Nilotic people tend to have a higher chance of being G6PD-deficient as 32 (96.9%) of the total 33 cases occurred among them.

Glucose-6-phosphate dehydrogenase deficiency among Yemeni children residing in malaria-endemic areas of Hodeidah governorate and evaluation of a rapid diagnostic test for its detection

“…Male children were at a 2.5-fold higher risk than females for developing G6PD deficiency (12.8 vs 5.5 %) in malaria-endemic areas of Hodeidah. This finding is consistent with that recently reported among G6PD-deficient Ethiopian malaria suspects [ 37 ]. The higher frequency of G6PD deficiency among males has been reported from different parts of the world and is explained by the fact that G6PD deficiency is an X-linked hereditary disorder [ 13 , 14 , 21 , 38 – 40 ].…”

Prevalence and hematological indicators of G6PD deficiency in malaria-infected patients

“…This indicates that malaria and G6PD deficiency share similar geographical distributions. This study showed that 6.9 % of malaria-infected patients were diagnosed with a G6PD deficiency, which is lower than reported by previous studies conducted in southeast Iran (27 %) [ 13 ], Cambodia (13.9 %) [ 14 ], and southwest Ethiopia (7.3 %) [ 15 ]. However, it was higher than that reported in Eastern Indonesia (5.1 %) [ 16 ] and the Brazilian Amazon (4.5 %) [ 17 ].…”

Submicroscopic carriage of Plasmodium falciparum and Plasmodium vivax in a low endemic area in Ethiopia where no parasitaemia was detected by microscopy or rapid diagnostic test

“…G6PDd due to the two most common mutations appears absent or of very low prevalence in the region. In contrast, a recent study reported a 7.3% absence of G6PD enzyme activity in southwest Ethiopia [ 43 ] with a significant degree of variation among different ethnic groups that was also reported in other studies [ 44 , 45 ]. The approaches in the current study may have missed rare variants of G6PD .…”