Published in:
Open Access
01-12-2013 | Research
G6PD deficiency in Plasmodium falciparum and Plasmodium vivax malaria-infected Cambodian patients
Authors:
Nimol Khim, Christophe Benedet, Saorin Kim, Sim Kheng, Sovannaroth Siv, Rithea Leang, Soley Lek, Sinuon Muth, Nguon Chea, Char Meng Chuor, Socheat Duong, Alexandra Kerleguer, Pety Tor, Pheaktra Chim, Lydie Canier, Benoit Witkowski, Walter RJ Taylor, Didier Ménard
Published in:
Malaria Journal
|
Issue 1/2013
Login to get access
Abstract
Background
Glucose-6-phosphate-dehydrogenase deficiency (G6PDd) rates are unknown in malaria-infected Cambodian patients. These data are key to a rational drug policy for malaria elimination of Plasmodium falciparum and Plasmodium vivax.
Methods
From September 2010–2012, a two-year survey of G6PDd and haemoglobinopathies assessed by quantitative enzyme activity assay and haemoglobin electrophoresis, respectively, was conducted in malaria-infected patients presenting to 19 health centres throughout Cambodia.
Results
A total of 2,408 confirmed malaria patients of mean age 26.7 (range 2–81) years were recruited from mostly western Cambodia (n = 1,732, 71.9%); males outnumbered females by 3.9:1. Plasmodium falciparum was present in 1,443 (59.9%) and P. vivax in 965 (40.1%) patients. Mean G6PD activity was 11.6 (CI 95%: 11.4-11.8) U/g Hb, G6PDd was present in 13.9% of all patients (335/2,408) and severe G6PDd (including WHO Class I and II variants) was more common in western (158/1,732, 9.1%) versus eastern (21/414, 5.1%) Cambodia (P = 0.01). Of 997/2,408 (41.4%) had a haemoglobinopathy. Mean haemoglobin concentrations were inversely related to age: 8.1 g/dL < five years, 8.7 g/dL five to 14 years, and 10.4 g/dL >15 years (P <0.001).
Conclusions
G6PDd prevalence, anaemia and haemoglobinopathies were common in malaria-infected patients. The deployment of primaquine in Cambodia should be preceded by primaquine safety studies paralleled with evaluations of easy to use tests to detect G6PDd.