G6PD deficiency in Latin America: systematic review on prevalence and variants

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 109; no. 5; pp. 553 - 568
• Main Authors: Monteiro, Wuelton M, Val, Fernando F. A, Siqueira, André M, Franca, Gabriel P, Sampaio, Vanderson S, Melo, Gisely C, Almeida, Anne C. G, Brito, Marcelo A. M, Peixoto, Henry M, Fuller, Douglas, Bassat, Quique, Romero, Gustavo A. S, Oliveira, Maria Regina F, Larcerda, Marcus Vinícius G
• Format: Journal Article
• Language: English
• Published: Brazil Fundação Oswaldo Cruz, Fiocruz 01-08-2014; Instituto Oswaldo Cruz, Ministério da Saúde; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Amerindians; Antimalarials; Caribbean Region - epidemiology; Contraindications; Female; G6PD deficiency; Geographic Mapping; Glucosephosphate Dehydrogenase - genetics; Glucosephosphate Dehydrogenase Deficiency - epidemiology; Glucosephosphate Dehydrogenase Deficiency - genetics; haemolysis; Hemolysis - drug effects; Humans; Latin America - epidemiology; malaria control; Malaria, Vivax - drug therapy; Malaria, Vivax - epidemiology; Male; PARASITOLOGY; Plasmodium vivax; Prevalence; Primaquine; TROPICAL MEDICINE; malaria control; Plasmodium vivax; Amerindians; primaquine; haemolysis; G6PD deficiency
• ISSN: 1678-8060; 0074-0276; 1678-8060
• DOI: 10.1590/0074-0276140123

Plasmodium vivax radical cure requires the use of primaquine (PQ), a
drug that induces haemolysis in glucose-6-phosphate dehydrogenase
deficient (G6PDd) individuals, which further hampers malaria control
efforts. The aim of this work was to study the G6PDd prevalence and
variants in Latin America (LA) and the Caribbean region. A systematic
search of the published literature was undertaken in August 2013.
Bibliographies of manuscripts were also searched and additional
references were identified. Low prevalence rates of G6PDd were
documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies
from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and
Trinidad, as well as some surveys carried out in areas of Brazil,
Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd.
The G6PD A-202A mutation was the variant most broadly distributed
across LA and was identified in 81.1% of the deficient individuals
surveyed. G6PDd is a frequent phenomenon in LA, although certain
Amerindian populations may not be affected, suggesting that PQ could be
safely used in these specific populations. Population-wide use of PQ as
part of malaria elimination strategies in LA cannot be supported unless
a rapid, accurate and field-deployable G6PDd diagnostic test is made
available.