Prevalence of G6PD deficiency and distribution of its genetic variants among malaria-suspected patients visiting Metehara health centre, Eastern Ethiopia

Abstract

Background Glucose-6-phosphate dehydrogenase (G6PD) is cytosolic enzyme, which has a vital role for the integrity and functioning of red blood cells. Lower activity of this enzyme leads to the occurrence of acute haemolytic anaemia after exposure to oxidative stressors like primaquine. Primaquine is an important drug for the radical cure of Plasmodium vivax and blocking transmission of Plasmodium falciparum, and thereby enhancing malaria elimination. However, there is a need to identify G6PD deficient individuals and administer the drug with caution due to its haemolytic side effects. The main objective of this study is to determine the prevalence of G6PD deficiency among malaria-suspected individuals. Methods A facility-based cross-sectional study was conducted from September 2020 to September 2021 in Metehara Health Centre, Eastern Ethiopia. A structured questionnaire was used to collect the socio-demographic and clinical information of the study participants. Capillary and venous blood samples were collected based on standard procedures for onsite screening, dried blood spot preparation, and malaria microscopy. The G6PD enzyme activity was measured by careSTART™ G6PD biosensor analyzer. Data was entered and analysed by SPSS. Results A total of 498 study participants were included in the study, of which 62% (309) were males. The overall prevalence of G6PD deficiency based on the biosensor screening was 3.6% (18/498), of which 2.9% and 4.8% were males and females, respectively. Eleven of the G6PD deficient samples had mutations confirmed by G6PD gene sequencing analysis. Mutations were detected in G267 + 119C/T, A376T, and ChrX:154535443. A significant association was found in sex and history of previous malaria infection with G6PD deficiency. Conclusions The study showed that the G6PD deficient phenotype exists in Metehara even if the prevalence is not very high. G267 + 119C/T mutation is the predominant G6PD variant in this area. Therefore, malaria patient treatment using primaquine should be monitored closely for any adverse effects.

The effect of single low-dose primaquine treatment for uncomplicated Plasmodium falciparum malaria on hemoglobin levels in Ethiopia: a longitudinal cohort study

“…For male study participants, class I was G6PD de cient with less than 30% AMM activity, while class II was normal with more than 30% AMM activity. Individuals with G6PD activity < 30%, 30-80%, or > 80% of the AMM activity in females are regarded as G6PD de cient, intermediate, or normal, respectively [42][43][44][45].…”

Prevalence and Characteristics of Plasmodium vivax Gametocytes in Duffy-Positive and Duffy-Negative Populations across Ethiopia

“… 13 The occurrence of gametocytogenesis is also influenced by factors associated with human hosts, such as immunity status, antimalaria drug treatment, and genetic factors. 14 , 15 …”

“…13 The occurrence of gametocytogenesis is also influenced by factors associated with human hosts, such as immunity status, antimalaria drug treatment, and genetic factors. 14,15 The distribution of P. vivax in Duffy-negative individuals across Ethiopia, as well as the parasite stages of these infections, remain largely unclear. The presence of gametocytes in symptomatic or asymptomatic individuals can lead to onward transmission in communities.…”

Prevalence and characteristics ofPlasmodium vivaxGametocytes in Duffy-positive and Duffy-negative populations across Ethiopia

“…13 The occurrence of gametocytogenesis is also influenced by factors associated with human hosts such as immunity status, antimalaria drug treatment and genetic factors. 14,15 The distribution of P. vivax in Duffy-negatives across Ethiopia as well as the parasite stages of these infections remain largely unclear. The presence of gametocytes in symptomatic or asymptomatic individuals can lead to onward transmission in the communities.…”