Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Ouest and Sud-Est departments of Haiti

Fricken, Michael E. von; Weppelmann, Thomas A.; Eaton, Will T.; Alam, Meer T.; Carter, Tamar E.; Schick, Laura; Masse, Roseline; Romain, Jean R.; Okech, Bernard A.

doi:10.1016/j.actatropica.2014.03.011

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…A map of Haiti including the enrollment locations, study communes, and departments is presented in Figure 1. Enrollment was based on convenience sampling from both clinical and non-clinical settings, as part of a larger study on host protective genetic factors [17]. Study sites included a rural community, two schools, and a clinic located in the Ouest and Sud-Est departments of Haiti, with participation open to all individuals attending each site.…”

Section: Methodsmentioning

confidence: 99%

Age-specific malaria seroprevalence rates: a cross-sectional analysis of malaria transmission in the Ouest and Sud-Est departments of Haiti

Fricken

Weppelmann

Lam

et al. 2014

Malar J

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BackgroundMalaria transmission continues to occur in Haiti, with 25,423 confirmed cases of Plasmodium falciparum and 161,236 suspected infections reported in 2012. At low prevalence levels, passive surveillance measures, which rely primarily on reports from health systems, becomes less appropriate for capturing annual malaria incidence. To improve understanding of malaria transmission in Haiti, participants from the Ouest and Sud-Est departments were screened using a highly sensitive enzyme-linked immunosorbent assay (ELISA).MethodsBetween February and May 2013, samples were collected from four different sites including a rural community, two schools, and a clinic located in the Ouest and Sud-Est departments of Haiti. A total of 815 serum samples were screened for malaria antibodies using an indirect ELISA coated with vaccine candidates apical membrane antigen (AMA-1) and merozoite surface protein-1 (MSP-119). The classification of previous exposure was established by using a threshold value that fell three standard deviations above the mean absorbance for suspected seronegative population members (OD of 0.32 and 0.26 for AMA-1 and MSP-1, respectively). The observed seroprevalence values were used to fit a modified reverse catalytic model to yield estimates of seroconversion rates.ResultsOf the samples screened, 172 of 815 (21.1%) were AMA-1 positive, 179 of 759 (23.6%) were MSP-119 positive, and 247 of 815 (30.3%) were positive for either AMA-1 or MSP-1; indicating rates of previous infections between 21.1% and 30.3%. Not surprisingly, age was highly associated with the likelihood of previous infection (p-value <0.001). After stratification by age, the estimated seroconversion rate indicated that the annual malaria transmission in the Ouest and Sud-Est department is approximately 2.5% (95% CI SCR: 2.2%, 2.8%).ConclusionsThese findings suggest that despite the absence of sustained malaria control efforts in Haiti, transmission has remained relatively low over multiple decades. Elimination in Haiti appears to be feasible; however, surveillance must continue to be strengthened in order to respond to areas with high transmission and measure the impact of future interventions.

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Section: Methodsmentioning

confidence: 99%

Age-specific malaria seroprevalence rates: a cross-sectional analysis of malaria transmission in the Ouest and Sud-Est departments of Haiti

Fricken

Weppelmann

Lam

et al. 2014

Malar J

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“…Classification of G6PD activity was made using the WHO recommendations of residual enzyme activity as a percentage of the mean G6PD activity. 10 Using a method similar to that previously described 7 , the mean of this population was set using a subsample (N = 168) of healthy, nonanemic participants that had G6PD activity levels greater than or equal to 4.6 U/g hemoglobin and hemoglobin concentrations greater than or equal to 12 g hemoglobin/dL, which gave a population mean of 9.5 U/g hemoglobin that was used to define the mild, moderate, and severe G6PD deficiency. They are as follows: (1) severe deficiency (classes I and II) with residual activity less than 10% of the mean (less than 0.95 U/g hemoglobin), (2) moderate deficiency (class III) with residual activity between 10% and 30% of the mean (0.95-2.84 U/g hemoglobin), and (3) mild deficiency (class III) with residual activity between 30% and 60% of the mean (2.84-5.68 U/g hemoglobin).…”

Section: Methodsmentioning

confidence: 99%

“…4,6 More recently, G6PD deficiency rates were estimated to range from 14.9% to 24.7% of the population in a sample of 800 Haitians from the Ouest and Sud-Est Departments. 7 The current quantitative standard methodology for detecting G6PD activity levels is the spectrophotometric assay, which measures the enzymatic activity of G6PD. This test requires a consistent source of electricity, refrigeration for reagents and substrates, information on patient hemoglobin levels, a spectrophotometer to measure the change of absorbance, and skilled personnel to perform the test, making it difficult to use in resource-poor settings.…”

Section: Introductionmentioning

confidence: 99%

Performance of the CareStart Glucose-6-Phosphate Dehydrogenase (G6PD) Rapid Diagnostic Test in Gressier, Haiti

Fricken¹,

Weppelmann²,

Eaton³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Administering primaquine (PQ) to treat malaria patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency can pose a serious risk of drug-induced hemolysis (DIH). New easy to use point-of-care rapid diagnostic tests are being developed as an alternative to labor-intensive spectrophotometric methods, but they require field testing before they can be used at scale. This study screened 456 participants in Gressier, Haiti using the Access Bio CareStart qualitative G6PD rapid detection test compared with the laboratory-based Trinity Biotech quantitative spectrophotometric assay. Findings suggest that the CareStart test was 90% sensitive for detecting individuals with severe deficiency and 84.8% sensitive for detecting individuals with moderate and severe deficiency compared with the Trinity Biotech assay. A high negative predictive value of 98.2% indicates excellent performance in determining those patients able to take PQ safely. The CareStart G6PD test holds much value for screening malaria patients to determine eligibility for PQ therapy.

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“…Blood samples were collected by venipuncture and screened for G6PD deficiency (G6PD kit #345B, Trinity Biotech, St. Louis, MO, USA), current malaria infection using a rapid diagnostic test (First Response Malaria Combo, Premier Medical Corporation Ltd., Kachigam, India), and previous malaria infection (presence of antibodies toward Plasmodium falciparum MSP-1 or AMA-1 antigens using indirect ELISA) as previously described [14,15]. A subset of 43 male students from the 90th and 10th percentiles of hemoglobin concentrations were selected at random and screened for serum ferritin concentrations using an IMMULITE 2000 Immunoassay System (Siemans Healthcare GmbH, Erlangen, Germany).…”

Section: Sample Collection and Laboratory Analysismentioning

confidence: 99%

Indicators of anemia and physical growth in schoolchildren from the Ouest and Sud-Est Departments of Haiti: a cross-sectional study

Weppelmann

Fricken

Masse³

et al. 2016

BMC Nutr

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Background: The identification and correction of malnutrition in children remains a critical public health issue in many developing countries. In this study, the rate of anemia and standardized indicators of physical growth were investigated in schoolchildren from Haiti. Methods: Hemoglobin concentrations, height, and weight were collected from schoolchildren (n = 615) and evaluated by World Health Organization (WHO) standardized classifications for anemia and child growth. Data on glucose-6-dehydrogenase (G6PD) deficiency and current or previous malaria infection available for all students; a subset of anemia and non-anemic males (n = 43) were tested for serum ferritin. School A (n = 504) had a school-based supplemental nutrition program, while School B (n = 111) did not. Results: Anemia was identified in 48.3% of students (95% CI: 44.3, 52.3), and not associated with BMI Z scores (P = 0.28) or serum ferritin concentrations (P = 0.17). The average Z scores for body mass index (BMI) of students at School A was within the normal range, while Z scores for BMI at School B were below average. Compared to school A, students at School B had significantly higher (P <0.001) rates of anemia (44.4% vs 65.8%) and were significantly (P <0.001) more likely to be underweight (16.5% vs 43.2%). Conclusions: The high prevalence of anemia in children with and without normal BMIs represents a major public health concern that warrants further investigation with more comprehensive methods. This study may also highlight some potential benefits of in-school nutritional supplementation programs in achieving lower rates of anemia and reaching WHO standards for child growth.

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Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Ouest and Sud-Est departments of Haiti

Cited by 13 publications

References 17 publications

Age-specific malaria seroprevalence rates: a cross-sectional analysis of malaria transmission in the Ouest and Sud-Est departments of Haiti

Age-specific malaria seroprevalence rates: a cross-sectional analysis of malaria transmission in the Ouest and Sud-Est departments of Haiti

Performance of the CareStart Glucose-6-Phosphate Dehydrogenase (G6PD) Rapid Diagnostic Test in Gressier, Haiti

Indicators of anemia and physical growth in schoolchildren from the Ouest and Sud-Est Departments of Haiti: a cross-sectional study

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