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Published in: Malaria Journal 1/2014

Open Access 01-12-2014 | Research

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

Authors: Arega Tsegaye, Lemu Golassa, Hassen Mamo, Berhanu Erko

Published in: Malaria Journal | Issue 1/2014

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Abstract

Background

Glucose-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.

Methods

Venous 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.

Results

Malaria 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%).

Conclusions

G6PDd 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.
Literature
2.
3.
go back to reference Allison A: Observational, hypothesis-driven and genomics research strategies for analyzing inherited differences in responses to infectious diseases. Public Health Genomics. 2009, 12: 41-52. 10.1159/000154817.CrossRefPubMed Allison A: Observational, hypothesis-driven and genomics research strategies for analyzing inherited differences in responses to infectious diseases. Public Health Genomics. 2009, 12: 41-52. 10.1159/000154817.CrossRefPubMed
4.
go back to reference Kwiatkowski DP: How malaria has affected the human genome and what human genetics can teach us about malaria. Am J Hum Genet. 2005, 77: 171-192. 10.1086/432519.PubMedCentralCrossRefPubMed Kwiatkowski DP: How malaria has affected the human genome and what human genetics can teach us about malaria. Am J Hum Genet. 2005, 77: 171-192. 10.1086/432519.PubMedCentralCrossRefPubMed
5.
go back to reference Lewis R: Human Genetics. 1997, Chicago, IL: Wm. C. Brown publishers Lewis R: Human Genetics. 1997, Chicago, IL: Wm. C. Brown publishers
6.
go back to reference Carson PE, Flanagan CL, Ickes CE, Alving AS: Enzymatic deficiency in primaquine-sensitive erythrocytes. Science. 1956, 124: 484-485.CrossRefPubMed Carson PE, Flanagan CL, Ickes CE, Alving AS: Enzymatic deficiency in primaquine-sensitive erythrocytes. Science. 1956, 124: 484-485.CrossRefPubMed
7.
go back to reference White NJ: Primaquine to prevent transmission of falciparum malaria. Lancet Infect Dis. 2012, 13: 175-181.CrossRefPubMed White NJ: Primaquine to prevent transmission of falciparum malaria. Lancet Infect Dis. 2012, 13: 175-181.CrossRefPubMed
9.
go back to reference Shanks GD, Oloo AJ, Aleman GM, Ohrt C, Klotz FW, Braitman D, Horton J, Brueckner R: A new primaquine analogue, tafenoquine (WR 238605), for prophylaxis against Plasmodium falciparum malaria". Clin Infect Dis. 2001, 33: 1968-1974. 10.1086/324081.CrossRefPubMed Shanks GD, Oloo AJ, Aleman GM, Ohrt C, Klotz FW, Braitman D, Horton J, Brueckner R: A new primaquine analogue, tafenoquine (WR 238605), for prophylaxis against Plasmodium falciparum malaria". Clin Infect Dis. 2001, 33: 1968-1974. 10.1086/324081.CrossRefPubMed
10.
go back to reference Howes RE, Dewi M, Pie FB, Monteiro WM, Battle KE, Messina JP, Sakuntabhai A, Satyagraha AW, Williams TN, Baird JK, Hay SI: Spatial distribution of G6PD deficiency variants across malaria-endemic regions. Malar J. 2013, 12: 418-10.1186/1475-2875-12-418.PubMedCentralCrossRefPubMed Howes RE, Dewi M, Pie FB, Monteiro WM, Battle KE, Messina JP, Sakuntabhai A, Satyagraha AW, Williams TN, Baird JK, Hay SI: Spatial distribution of G6PD deficiency variants across malaria-endemic regions. Malar J. 2013, 12: 418-10.1186/1475-2875-12-418.PubMedCentralCrossRefPubMed
11.
go back to reference Howes RE, Battle KE, Satyagraha AW, Baird JK, Hay SI: G6PD deficiency: global distribution, genetic variants and primaquine therapy. Adv Parasitol. 2013, 81: 133-201.CrossRefPubMed Howes RE, Battle KE, Satyagraha AW, Baird JK, Hay SI: G6PD deficiency: global distribution, genetic variants and primaquine therapy. Adv Parasitol. 2013, 81: 133-201.CrossRefPubMed
12.
go back to reference WHO Working Group: Glucose-6-phosphate dehydrogenase deficiency. Bull World Health Organ. 1989, 67: 601-611. WHO Working Group: Glucose-6-phosphate dehydrogenase deficiency. Bull World Health Organ. 1989, 67: 601-611.
13.
go back to reference WHO: Guidelines for the treatment of malaria. 2010, Geneva, Switzerland: World Health Organization, 2 WHO: Guidelines for the treatment of malaria. 2010, Geneva, Switzerland: World Health Organization, 2
18.
go back to reference Krafsur ES, Armstrong JC: Epidemology of Plasmodium malaria infection in Gambella. Parasitologia. 1982, 24: 105-120. Krafsur ES, Armstrong JC: Epidemology of Plasmodium malaria infection in Gambella. Parasitologia. 1982, 24: 105-120.
19.
go back to reference Lwanga SK, Lemeshow S: Sample size determination in health science studies: A practical manual. 1991, Geneva, Switzerland: World Health Organization Lwanga SK, Lemeshow S: Sample size determination in health science studies: A practical manual. 1991, Geneva, Switzerland: World Health Organization
20.
go back to reference WHO: Basic Malaria Microscopy. Part I Learners Guide. 2010, Geneva, Switzerland: World Health Organization, 2 WHO: Basic Malaria Microscopy. Part I Learners Guide. 2010, Geneva, Switzerland: World Health Organization, 2
21.
go back to reference Nigatu W, Abebe M, Dejene A: Plasmodium vivax and P. falciparum epidemiology in Gambella, south-west Ethiopia. Trop Med Parasitol. 1992, 43: 181-185.PubMed Nigatu W, Abebe M, Dejene A: Plasmodium vivax and P. falciparum epidemiology in Gambella, south-west Ethiopia. Trop Med Parasitol. 1992, 43: 181-185.PubMed
22.
go back to reference Deressa W, Ali A, Enqusellassie F: Self-treatment of malaria in rural communities, Butajira, Southern Ethiopia. Bull World Health Organ. 2003, 81: 261-268.PubMedCentralPubMed Deressa W, Ali A, Enqusellassie F: Self-treatment of malaria in rural communities, Butajira, Southern Ethiopia. Bull World Health Organ. 2003, 81: 261-268.PubMedCentralPubMed
23.
go back to reference Jima D, Gezahagne T, Deressa W, Woyissa A, Daniel K, Desta A: Baseline survey for the implementation of insecticide treated mosquito nets in malaria. Ethiop J Health Dev. 2005, 19: 16-23. Jima D, Gezahagne T, Deressa W, Woyissa A, Daniel K, Desta A: Baseline survey for the implementation of insecticide treated mosquito nets in malaria. Ethiop J Health Dev. 2005, 19: 16-23.
24.
go back to reference Rodrigues MO, Freire AP, Martins G, Pereira J, Martins MD, Monteiro C: Glucose-6-phosphate dehydrogenase deficiency in Portugal: biochemical and mutational profiles, heterogeneity, and haplotype association. Blood Cells Mol Dis. 2002, 28: 249-259. 10.1006/bcmd.2002.0505.CrossRefPubMed Rodrigues MO, Freire AP, Martins G, Pereira J, Martins MD, Monteiro C: Glucose-6-phosphate dehydrogenase deficiency in Portugal: biochemical and mutational profiles, heterogeneity, and haplotype association. Blood Cells Mol Dis. 2002, 28: 249-259. 10.1006/bcmd.2002.0505.CrossRefPubMed
25.
go back to reference Sukumar S, Mukherjee MB, Colah RB, Mohanty D: Molecular basis of G6PD deficiency in India. Blood Cells Mol Dis. 2004, 33: 141-145. 10.1016/j.bcmd.2004.06.003.CrossRefPubMed Sukumar S, Mukherjee MB, Colah RB, Mohanty D: Molecular basis of G6PD deficiency in India. Blood Cells Mol Dis. 2004, 33: 141-145. 10.1016/j.bcmd.2004.06.003.CrossRefPubMed
26.
go back to reference Missiou-Tsagaraki S: Screening for glucose-6-phosphate dehydrogenase deficiency as a preventive measure: prevalence among 1,286,000 Greek newborn infants. J Pediatr. 1991, 119: 293-299. 10.1016/S0022-3476(05)80747-4.CrossRefPubMed Missiou-Tsagaraki S: Screening for glucose-6-phosphate dehydrogenase deficiency as a preventive measure: prevalence among 1,286,000 Greek newborn infants. J Pediatr. 1991, 119: 293-299. 10.1016/S0022-3476(05)80747-4.CrossRefPubMed
27.
go back to reference Maffi D, Pasquino MT, Mandarino L, Tortora P, Girelli G, Meo D, Grazzini G, Caprari P: Glucose-6 phosphate dehydrogenase deficiency in Italian blood donors: prevalence and molecular defect characterization. Vox Sanguinis. 2014, 106: 227-233. 10.1111/vox.12096.CrossRefPubMed Maffi D, Pasquino MT, Mandarino L, Tortora P, Girelli G, Meo D, Grazzini G, Caprari P: Glucose-6 phosphate dehydrogenase deficiency in Italian blood donors: prevalence and molecular defect characterization. Vox Sanguinis. 2014, 106: 227-233. 10.1111/vox.12096.CrossRefPubMed
28.
go back to reference Gupte SC, Shaw AN, Shah KC: Hematological findings and severity of G6PD deficiency in Vataliya Prajapati subjects. J Assoc Physicians India. 2005, 53: 1027-1030.PubMed Gupte SC, Shaw AN, Shah KC: Hematological findings and severity of G6PD deficiency in Vataliya Prajapati subjects. J Assoc Physicians India. 2005, 53: 1027-1030.PubMed
29.
go back to reference Al-Nood HA, Bazara FA, Al-Absi R, Habori MA: Glucose-6-Phosphate Dehydrogenase deficiency among male blood donors in Sana’a city, Yemen. Oman Med J. 2012, 27: 46-49. 10.5001/omj.2012.09.PubMedCentralCrossRefPubMed Al-Nood HA, Bazara FA, Al-Absi R, Habori MA: Glucose-6-Phosphate Dehydrogenase deficiency among male blood donors in Sana’a city, Yemen. Oman Med J. 2012, 27: 46-49. 10.5001/omj.2012.09.PubMedCentralCrossRefPubMed
30.
go back to reference Warsy AS, El-Hazmi MA: G6PD deficiency, distribution and variants in Saudi Arabia: an overview. Ann Saudi Med. 2001, 21: 174-177.PubMed Warsy AS, El-Hazmi MA: G6PD deficiency, distribution and variants in Saudi Arabia: an overview. Ann Saudi Med. 2001, 21: 174-177.PubMed
31.
go back to reference Meloni T, Forteleoni G, Meloni GF: Marked decline of favism after neonatal glucose-6-phosphate dehydrogenase screening and health education: the northern Sardinian experience. Acta Haematol. 1992, 87: 29-31. 10.1159/000204709.CrossRefPubMed Meloni T, Forteleoni G, Meloni GF: Marked decline of favism after neonatal glucose-6-phosphate dehydrogenase screening and health education: the northern Sardinian experience. Acta Haematol. 1992, 87: 29-31. 10.1159/000204709.CrossRefPubMed
32.
go back to reference The malERA Consultative Group on Diagnoses Diagnostics: A research agenda for malaria eradication: diagnoses and diagnostics. PLoS Med. 2011, 8: e1000396-CrossRef The malERA Consultative Group on Diagnoses Diagnostics: A research agenda for malaria eradication: diagnoses and diagnostics. PLoS Med. 2011, 8: e1000396-CrossRef
33.
go back to reference Douglas NM, Nosten F, Ashley EA, Phaiphun L, van Vugt M, Singhasivanon P, White NJ, Price RN: Plasmodium vivax recurrence following falciparum and mixed species malaria: risk factors and effect of antimalarial kinetics. Clin Infect Dis. 2011, 52: 612-620. 10.1093/cid/ciq249.PubMedCentralCrossRefPubMed Douglas NM, Nosten F, Ashley EA, Phaiphun L, van Vugt M, Singhasivanon P, White NJ, Price RN: Plasmodium vivax recurrence following falciparum and mixed species malaria: risk factors and effect of antimalarial kinetics. Clin Infect Dis. 2011, 52: 612-620. 10.1093/cid/ciq249.PubMedCentralCrossRefPubMed
34.
go back to reference Okebe J, Amambua-Ngwa A, Parr J, Nishimura S, Daswani M, Takem EN, Affara M, Ceesay SJ, Nwakanma D, Alessandro UD: The prevalence of glucose-6-phosphate dehydrogenase deficiency in Gambian school children. Malar J. 2014, 13: 148-10.1186/1475-2875-13-148.PubMedCentralCrossRefPubMed Okebe J, Amambua-Ngwa A, Parr J, Nishimura S, Daswani M, Takem EN, Affara M, Ceesay SJ, Nwakanma D, Alessandro UD: The prevalence of glucose-6-phosphate dehydrogenase deficiency in Gambian school children. Malar J. 2014, 13: 148-10.1186/1475-2875-13-148.PubMedCentralCrossRefPubMed
35.
go back to reference Williams O, Gbadero D, Edowhorhu G, Brearley A, Slusher T, Lund TC: Glucose-6-Phosphate Dehydrogenase Deficiency in Nigerian Children. PLoS ONE. 2013, 8: e68800-10.1371/journal.pone.0068800.PubMedCentralCrossRefPubMed Williams O, Gbadero D, Edowhorhu G, Brearley A, Slusher T, Lund TC: Glucose-6-Phosphate Dehydrogenase Deficiency in Nigerian Children. PLoS ONE. 2013, 8: e68800-10.1371/journal.pone.0068800.PubMedCentralCrossRefPubMed
36.
go back to reference Balgir RS: Ethnic and regional variations in the red cell glucose-6-phosphate dehydrogenase deficiency in India. Indian J Haematol Blood Transfus. 1989, 7: 101- Balgir RS: Ethnic and regional variations in the red cell glucose-6-phosphate dehydrogenase deficiency in India. Indian J Haematol Blood Transfus. 1989, 7: 101-
37.
go back to reference Guindo A, Fairhurst RM, Doumbo OK, Wellems TE, Diallo DA: X-linked G6PD deficiency protects hemizygous males but not heterozygous females against severe malaria. PLoS Med. 2007, 4: e66-10.1371/journal.pmed.0040066.PubMedCentralCrossRefPubMed Guindo A, Fairhurst RM, Doumbo OK, Wellems TE, Diallo DA: X-linked G6PD deficiency protects hemizygous males but not heterozygous females against severe malaria. PLoS Med. 2007, 4: e66-10.1371/journal.pmed.0040066.PubMedCentralCrossRefPubMed
38.
go back to reference Kar S, Seth S, Seth PK: Prevalence of malaria in Ao Nagas and its association with G6PD and HbE. Hum Biol. 1992, 64: 187-PubMed Kar S, Seth S, Seth PK: Prevalence of malaria in Ao Nagas and its association with G6PD and HbE. Hum Biol. 1992, 64: 187-PubMed
39.
go back to reference Ruwende C, Khoo SC, Snow RW, Yates SN, Kwiatkowski D, Gupta S, Warn P, Allsopp CE, Gilbert SC, Peschu N, Newbold CI, Greenwood BM, Marsh K, Hill AVS: Natural selection of hemi- and heterozygotes for G6PD deficiency in Africa by resistance to severe malaria. Nature. 1995, 376: 246-249. 10.1038/376246a0.CrossRefPubMed Ruwende C, Khoo SC, Snow RW, Yates SN, Kwiatkowski D, Gupta S, Warn P, Allsopp CE, Gilbert SC, Peschu N, Newbold CI, Greenwood BM, Marsh K, Hill AVS: Natural selection of hemi- and heterozygotes for G6PD deficiency in Africa by resistance to severe malaria. Nature. 1995, 376: 246-249. 10.1038/376246a0.CrossRefPubMed
40.
go back to reference Tine RC, Ndiaye M, Hansson HH, Ndour CT, Faye B, Alifrangis M, Sylla K, Ndiaye JL, Magnussen P, Bygbjerg IC, Gaye O: The association between malaria parasitaemia, erythrocyte polymorphisms, malnutrition and anaemia in children less than 10 years in Senegal: a case control study. BMC Res Notes. 2012, 5: 565-10.1186/1756-0500-5-565.PubMedCentralCrossRefPubMed Tine RC, Ndiaye M, Hansson HH, Ndour CT, Faye B, Alifrangis M, Sylla K, Ndiaye JL, Magnussen P, Bygbjerg IC, Gaye O: The association between malaria parasitaemia, erythrocyte polymorphisms, malnutrition and anaemia in children less than 10 years in Senegal: a case control study. BMC Res Notes. 2012, 5: 565-10.1186/1756-0500-5-565.PubMedCentralCrossRefPubMed
41.
go back to reference Vafa M, Troye-Blomberg M, Anchang J, Garcia A, Migot-Nabias F: Multiplicity of Plasmodium falciparum infection in asymptomatic children in Senegal: relation to transmission, age and erythrocyte variants. Malar J. 2008, 7: 17-10.1186/1475-2875-7-17.PubMedCentralCrossRefPubMed Vafa M, Troye-Blomberg M, Anchang J, Garcia A, Migot-Nabias F: Multiplicity of Plasmodium falciparum infection in asymptomatic children in Senegal: relation to transmission, age and erythrocyte variants. Malar J. 2008, 7: 17-10.1186/1475-2875-7-17.PubMedCentralCrossRefPubMed
42.
go back to reference Nateghpour M, Miahipour A, Yousefi M, Mohammadiha A, Fagani Y: A Patient with G6PD Deficiency and Falciparum Malaria, Case report. Iranian J Parasitol. 2007, 2: 43-45. Nateghpour M, Miahipour A, Yousefi M, Mohammadiha A, Fagani Y: A Patient with G6PD Deficiency and Falciparum Malaria, Case report. Iranian J Parasitol. 2007, 2: 43-45.
43.
go back to reference Pasvol G, Wilson RJM: The interaction of malaria parasites with red blood cells. Br Med Bull. 1982, 38: 133-140.PubMed Pasvol G, Wilson RJM: The interaction of malaria parasites with red blood cells. Br Med Bull. 1982, 38: 133-140.PubMed
44.
go back to reference Friedman MJ: Oxidant damage mediates variant red cell resistance to malaria. Nature. 1979, 280: 245-10.1038/280245a0.CrossRefPubMed Friedman MJ: Oxidant damage mediates variant red cell resistance to malaria. Nature. 1979, 280: 245-10.1038/280245a0.CrossRefPubMed
45.
go back to reference Yoshida A, Roth EFJ: Glucose-6-phosphate dehydrogenase of malaria parasite P. falciparum. Blood. 1989, 69: 1528-30. Yoshida A, Roth EFJ: Glucose-6-phosphate dehydrogenase of malaria parasite P. falciparum. Blood. 1989, 69: 1528-30.
46.
go back to reference Johnson MK, Clark TD, Njama-Meya D, Rosenthal PJ, Parikh S: Impact of the method of G6PD deficiency assessment on genetic association studies of malaria susceptibility. PLoS One. 2009, 4: e7246-10.1371/journal.pone.0007246.PubMedCentralCrossRefPubMed Johnson MK, Clark TD, Njama-Meya D, Rosenthal PJ, Parikh S: Impact of the method of G6PD deficiency assessment on genetic association studies of malaria susceptibility. PLoS One. 2009, 4: e7246-10.1371/journal.pone.0007246.PubMedCentralCrossRefPubMed
47.
go back to reference Luzzatto L, Poggi V: Glucose-6-phosphate dehydrogenase deficiency. Nathan and Oski's Hematology of Infancy and Childhood. Edited by: Orkin SH, Fisher DE, Thomas Look A, Lux ISE, Ginsburg D, Nathan DG. 2009, Philadelphia: Sanders, 884-911. 7 Luzzatto L, Poggi V: Glucose-6-phosphate dehydrogenase deficiency. Nathan and Oski's Hematology of Infancy and Childhood. Edited by: Orkin SH, Fisher DE, Thomas Look A, Lux ISE, Ginsburg D, Nathan DG. 2009, Philadelphia: Sanders, 884-911. 7
48.
go back to reference Mehdi SR, Al Dahmash BA: A comparative study of hematological parameters of α and β thalassemias in a high prevalence zone: Saudi Arabia. Indian J Hum Genet. 2011, 17: 207-211. 10.4103/0971-6866.92106.PubMedCentralCrossRefPubMed Mehdi SR, Al Dahmash BA: A comparative study of hematological parameters of α and β thalassemias in a high prevalence zone: Saudi Arabia. Indian J Hum Genet. 2011, 17: 207-211. 10.4103/0971-6866.92106.PubMedCentralCrossRefPubMed
Metadata
Title
Glucose-6-phosphate dehydrogenase deficiency among malaria suspects attending Gambella hospital, southwest Ethiopia
Authors
Arega Tsegaye
Lemu Golassa
Hassen Mamo
Berhanu Erko
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2014
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-13-438

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