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Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study

BACKGROUND: Sulphadoxine-Pyrimethamine (SP) is still the only recommended antimalarial for use in intermittent preventive treatment of malaria during pregnancy (IPTp) in some malaria endemic countries including Ghana. SP has the potential to cause acute haemolysis in G6PD deficient people resulting...

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Autores principales: Owusu, Ruth, Asante, Kwaku Poku, Mahama, Emmanuel, Awini, Elizabeth, Anyorigiya, Thomas, Dosoo, David, Amu, Alberta, Jakpa, Gabriel, Ofei, Emmanuel, Segbaya, Sylvester, Oduro, Abraham Rexford, Gyapong, Margaret, Hodgson, Abraham, Bart-Plange, Constance, Owusu-Agyei, Seth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556530/
https://www.ncbi.nlm.nih.gov/pubmed/26327623
http://dx.doi.org/10.1371/journal.pone.0136828
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author Owusu, Ruth
Asante, Kwaku Poku
Mahama, Emmanuel
Awini, Elizabeth
Anyorigiya, Thomas
Dosoo, David
Amu, Alberta
Jakpa, Gabriel
Ofei, Emmanuel
Segbaya, Sylvester
Oduro, Abraham Rexford
Gyapong, Margaret
Hodgson, Abraham
Bart-Plange, Constance
Owusu-Agyei, Seth
author_facet Owusu, Ruth
Asante, Kwaku Poku
Mahama, Emmanuel
Awini, Elizabeth
Anyorigiya, Thomas
Dosoo, David
Amu, Alberta
Jakpa, Gabriel
Ofei, Emmanuel
Segbaya, Sylvester
Oduro, Abraham Rexford
Gyapong, Margaret
Hodgson, Abraham
Bart-Plange, Constance
Owusu-Agyei, Seth
author_sort Owusu, Ruth
collection PubMed
description BACKGROUND: Sulphadoxine-Pyrimethamine (SP) is still the only recommended antimalarial for use in intermittent preventive treatment of malaria during pregnancy (IPTp) in some malaria endemic countries including Ghana. SP has the potential to cause acute haemolysis in G6PD deficient people resulting in significant haemoglobin (Hb) drop but there is limited data on post SP-IPTp Hb drop. This study determined the difference, if any in proportions of women with significant acute haemoglobin drop between G6PD normal, partial deficient and full deficient women after SP-IPTp. METHODS AND FINDINGS: Prospectively, 1518 pregnant women who received SP for IPTp as part of their normal antenatal care were enrolled. Their G6PD status were determined at enrollment followed by assessments on days 3, 7,14 and 28 to document any adverse effects and changes in post-IPTp haemoglobin (Hb) levels. The three groups were comparable at baseline except for their mean Hb (10.3 g/dL for G6PD normal, 10.8 g/dL for G6PD partial deficient and 10.8 g/dL for G6PD full defect women).The prevalence of G6PD full defect was 2.3% and 17.0% for G6PD partial defect. There was no difference in the proportions with fractional Hb drop ≥ 20% as compared to their baseline value post SP-IPTp among the 3 groups on days 3, 7, 14. The G6PD full defect group had the highest median fractional drop at day 7. There was a weak negative correlation between G6PD activity and fractional Hb drop. There was no statistical difference between the three groups in the proportions of those who started the study with Hb ≥ 8g/dl whose Hb level subsequently fell below 8g/dl post-SP IPTp. No study participant required transfusion or hospitalization for severe anaemia. CONCLUSIONS: There was no significant difference between G6PD normal and deficient women in proportions with significant acute haemoglobin drop post SP-IPTp and lower G6PD enzyme activity was not strongly associated with significant acute drug-induced haemoglobin drop post SP-IPTp but a larger study is required to confirm consistency of findings.
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spelling pubmed-45565302015-09-10 Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study Owusu, Ruth Asante, Kwaku Poku Mahama, Emmanuel Awini, Elizabeth Anyorigiya, Thomas Dosoo, David Amu, Alberta Jakpa, Gabriel Ofei, Emmanuel Segbaya, Sylvester Oduro, Abraham Rexford Gyapong, Margaret Hodgson, Abraham Bart-Plange, Constance Owusu-Agyei, Seth PLoS One Research Article BACKGROUND: Sulphadoxine-Pyrimethamine (SP) is still the only recommended antimalarial for use in intermittent preventive treatment of malaria during pregnancy (IPTp) in some malaria endemic countries including Ghana. SP has the potential to cause acute haemolysis in G6PD deficient people resulting in significant haemoglobin (Hb) drop but there is limited data on post SP-IPTp Hb drop. This study determined the difference, if any in proportions of women with significant acute haemoglobin drop between G6PD normal, partial deficient and full deficient women after SP-IPTp. METHODS AND FINDINGS: Prospectively, 1518 pregnant women who received SP for IPTp as part of their normal antenatal care were enrolled. Their G6PD status were determined at enrollment followed by assessments on days 3, 7,14 and 28 to document any adverse effects and changes in post-IPTp haemoglobin (Hb) levels. The three groups were comparable at baseline except for their mean Hb (10.3 g/dL for G6PD normal, 10.8 g/dL for G6PD partial deficient and 10.8 g/dL for G6PD full defect women).The prevalence of G6PD full defect was 2.3% and 17.0% for G6PD partial defect. There was no difference in the proportions with fractional Hb drop ≥ 20% as compared to their baseline value post SP-IPTp among the 3 groups on days 3, 7, 14. The G6PD full defect group had the highest median fractional drop at day 7. There was a weak negative correlation between G6PD activity and fractional Hb drop. There was no statistical difference between the three groups in the proportions of those who started the study with Hb ≥ 8g/dl whose Hb level subsequently fell below 8g/dl post-SP IPTp. No study participant required transfusion or hospitalization for severe anaemia. CONCLUSIONS: There was no significant difference between G6PD normal and deficient women in proportions with significant acute haemoglobin drop post SP-IPTp and lower G6PD enzyme activity was not strongly associated with significant acute drug-induced haemoglobin drop post SP-IPTp but a larger study is required to confirm consistency of findings. Public Library of Science 2015-09-01 /pmc/articles/PMC4556530/ /pubmed/26327623 http://dx.doi.org/10.1371/journal.pone.0136828 Text en © 2015 Owusu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Owusu, Ruth
Asante, Kwaku Poku
Mahama, Emmanuel
Awini, Elizabeth
Anyorigiya, Thomas
Dosoo, David
Amu, Alberta
Jakpa, Gabriel
Ofei, Emmanuel
Segbaya, Sylvester
Oduro, Abraham Rexford
Gyapong, Margaret
Hodgson, Abraham
Bart-Plange, Constance
Owusu-Agyei, Seth
Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study
title Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study
title_full Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study
title_fullStr Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study
title_full_unstemmed Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study
title_short Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study
title_sort glucose-6-phosphate dehydrogenase deficiency and haemoglobin drop after sulphadoxine-pyrimethamine use for intermittent preventive treatment of malaria during pregnancy in ghana – a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556530/
https://www.ncbi.nlm.nih.gov/pubmed/26327623
http://dx.doi.org/10.1371/journal.pone.0136828
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