G6PD deficiency in malaria endemic areas of Nepal

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is currently a threat to malaria elimination due to risk of primaquine-induced haemolysis in G6PD deficient individuals. The World Health Organization (WHO) recommends G6PD screening before providing primaquine as a radical treatment against vivax...

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Published in:	Malaria journal Vol. 19; no. 1; p. 287
Main Authors:	Marasini, Baburam, Lal, Bibek Kumar, Thapa, Suman, Awasthi, Kiran Raj, Bajracharya, Bijay, Khanal, Pratik, Neupane, Sanjeev, Jha, Shambhu Nath, Acharya, Sanjaya, Iama, Smriti, Koirala, Madan, Koirala, Dinesh, Bhandari, Suresh, Mahato, Ram Kumar, Chaudhary, Arun, Ghimire, Pramin, Magar, Rahachan Gharti, Bhattarai, Rajan Kumar, Gornsawun, Gornpan, Penpitchaporn, Pimsupah, Bancone, Germana, Acharya, Bhim Prasad
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 12-08-2020 BioMed Central BMC
Subjects:	8-Aminoquinolines Adolescent Adult Age Aged Aged, 80 and over Blood Care and treatment Child Control Cross-Sectional Studies Ethnicity Female Females G6PD deficiency Genotype & phenotype Genotyping Geographical distribution Glucose-6-phosphate dehydrogenase deficiency Glucosephosphate dehydrogenase Glucosephosphate Dehydrogenase Deficiency - epidemiology Glucosephosphate Dehydrogenase Deficiency - genetics Haemolysis Health risks Hemolysis Households Human diseases Humans Laboratories Malaria Malaria, Vivax - parasitology Male Males Middle Aged Minority & ethnic groups Mutation Nepal Nepal - epidemiology Phosphates Plasmodium vivax Plasmodium vivax - physiology Population Population studies Prevalence Primaquine Regions Risk factors Sociodemographics Statistics Studies Surveying Tropical diseases Vector-borne diseases Young Adult Nepal Asia Plasmodium vivax Malaria Primaquine G6PD deficiency Nepal 8-Aminoquinolines
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Summary:	Glucose-6-phosphate dehydrogenase (G6PD) deficiency is currently a threat to malaria elimination due to risk of primaquine-induced haemolysis in G6PD deficient individuals. The World Health Organization (WHO) recommends G6PD screening before providing primaquine as a radical treatment against vivax malaria. However, evidence regarding the prevalence and causing mutations of G6PD deficiency in Nepal is scarce. A cross-sectional, population-based, prevalence study was carried out from May to October 2016 in 12 malaria-endemic districts of Nepal. The screening survey included 4067 participants whose G6PD status was determined by G6PD Care Start™ rapid diagnostic test and genotyping. The prevalence of G6PD deficiency at the national level was 3.5% (4.1% among males and 2.1% among females). When analysed according to ethnic groups, G6PD deficiency was highest among the Janajati (6.2% overall, 17.6% in Mahatto, 7.7% in Chaudhary and 7.5% in Tharu) and low among Brahman and Chhetri (1.3%). District-wise, prevalence was highest in Banke (7.6%) and Chitwan (6.6%). Coimbra mutation (592 C>T) was found among 75.5% of the G6PD-deficient samples analysed and Mahidol (487 G>A) and Mediterranean (563 C>T) mutations were found in equal proportions in the remaining 24.5%. There was no specific geographic or ethnic distribution for the three mutations. This study has identified populations with moderate to high prevalence of G6PD deficiency which provides strong evidence supporting the WHO recommendations to screen G6PD deficiency at health facility level before the use of primaquine-based radical curative regimen for Plasmodium vivax.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1475-2875 1475-2875
DOI:	10.1186/s12936-020-03359-6