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Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) is a rate limiting enzyme of the pentose phosphate pathway and is closely associated with the haemolytic disorders among patients receiving anti-malarial drugs, such as primaquine. G6PD deficiency (G6PDd) is an impending factor for radical treatme...

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Autores principales: Ghimire, Prakash, Singh, Nihal, Ortega, Leonard, Rijal, Komal Raj, Adhikari, Bipin, Thakur, Garib Das, Marasini, Baburam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442674/
https://www.ncbi.nlm.nih.gov/pubmed/28535765
http://dx.doi.org/10.1186/s12936-017-1864-2
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author Ghimire, Prakash
Singh, Nihal
Ortega, Leonard
Rijal, Komal Raj
Adhikari, Bipin
Thakur, Garib Das
Marasini, Baburam
author_facet Ghimire, Prakash
Singh, Nihal
Ortega, Leonard
Rijal, Komal Raj
Adhikari, Bipin
Thakur, Garib Das
Marasini, Baburam
author_sort Ghimire, Prakash
collection PubMed
description BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) is a rate limiting enzyme of the pentose phosphate pathway and is closely associated with the haemolytic disorders among patients receiving anti-malarial drugs, such as primaquine. G6PD deficiency (G6PDd) is an impending factor for radical treatment of malaria which affects the clearance of gametocytes from the blood and subsequent delay in the achievement of malaria elimination. The main objective of this study was to assess the prevalence of G6PD deficiency in six malaria endemic districts in Southern Nepal. METHODS: A cross-sectional population based prevalence survey was conducted in six malaria endemic districts of Nepal, during April–Dec 2013. A total of 1341 blood samples were tested for G6PDd using two different rapid diagnostic test kits (Binax-Now(®) and Care Start™). Equal proportions of participants from each district (n ≥ 200) were enrolled considering ethnic and demographic representation of the population groups. RESULTS: Out of total 1341 blood specimens collected from six districts, the overall prevalence of G6PDd was 97/1341; 7.23% on Binax Now and 81/1341; 6.0% on Care Start test. Higher prevalence was observed in male than females [Binax Now: male 10.2%; 53/521 versus female 5.4%; 44/820 (p = 0.003) and Care Start: male 8.4%; 44/521 versus female 4.5%; 37/820 (p = 0.003)]. G6PDd was higher in ethnic groups Rajbanshi (11.7%; 19/162) and Tharu (5.6%; 56/1005) (p = 0.006), major inhabitant of the endemic districts. Higher prevalence of G6PDd was found in Jhapa (22/224; 9.8%) and Morang districts (18/225; 8%) (p = 0.031). In a multivariate analysis, male were found at more risk for G6PDd than females, on Binax test (aOR = 1.97; CI 1.28–3.03; p = 0.002) and Care Start test (aOR = 1.86; CI 1.16–2.97; p = 0.009). CONCLUSIONS: The higher prevalence of G6PDd in certain ethnic group, gender and geographical region clearly demonstrates clustering of the cases and ascertained the risk groups within the population. This is the first study in Nepal which identified the vulnerable population groups for G6PDd in malaria endemic districts. The finding of this study warrants the need for G6PDd testing in vulnerable population groups in endemic districts, and also facilitates use of primaquine in mass supporting timely progress for malaria elimination.
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spelling pubmed-54426742017-05-25 Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal Ghimire, Prakash Singh, Nihal Ortega, Leonard Rijal, Komal Raj Adhikari, Bipin Thakur, Garib Das Marasini, Baburam Malar J Research BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) is a rate limiting enzyme of the pentose phosphate pathway and is closely associated with the haemolytic disorders among patients receiving anti-malarial drugs, such as primaquine. G6PD deficiency (G6PDd) is an impending factor for radical treatment of malaria which affects the clearance of gametocytes from the blood and subsequent delay in the achievement of malaria elimination. The main objective of this study was to assess the prevalence of G6PD deficiency in six malaria endemic districts in Southern Nepal. METHODS: A cross-sectional population based prevalence survey was conducted in six malaria endemic districts of Nepal, during April–Dec 2013. A total of 1341 blood samples were tested for G6PDd using two different rapid diagnostic test kits (Binax-Now(®) and Care Start™). Equal proportions of participants from each district (n ≥ 200) were enrolled considering ethnic and demographic representation of the population groups. RESULTS: Out of total 1341 blood specimens collected from six districts, the overall prevalence of G6PDd was 97/1341; 7.23% on Binax Now and 81/1341; 6.0% on Care Start test. Higher prevalence was observed in male than females [Binax Now: male 10.2%; 53/521 versus female 5.4%; 44/820 (p = 0.003) and Care Start: male 8.4%; 44/521 versus female 4.5%; 37/820 (p = 0.003)]. G6PDd was higher in ethnic groups Rajbanshi (11.7%; 19/162) and Tharu (5.6%; 56/1005) (p = 0.006), major inhabitant of the endemic districts. Higher prevalence of G6PDd was found in Jhapa (22/224; 9.8%) and Morang districts (18/225; 8%) (p = 0.031). In a multivariate analysis, male were found at more risk for G6PDd than females, on Binax test (aOR = 1.97; CI 1.28–3.03; p = 0.002) and Care Start test (aOR = 1.86; CI 1.16–2.97; p = 0.009). CONCLUSIONS: The higher prevalence of G6PDd in certain ethnic group, gender and geographical region clearly demonstrates clustering of the cases and ascertained the risk groups within the population. This is the first study in Nepal which identified the vulnerable population groups for G6PDd in malaria endemic districts. The finding of this study warrants the need for G6PDd testing in vulnerable population groups in endemic districts, and also facilitates use of primaquine in mass supporting timely progress for malaria elimination. BioMed Central 2017-05-23 /pmc/articles/PMC5442674/ /pubmed/28535765 http://dx.doi.org/10.1186/s12936-017-1864-2 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ghimire, Prakash
Singh, Nihal
Ortega, Leonard
Rijal, Komal Raj
Adhikari, Bipin
Thakur, Garib Das
Marasini, Baburam
Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal
title Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal
title_full Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal
title_fullStr Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal
title_full_unstemmed Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal
title_short Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal
title_sort glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of nepal
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442674/
https://www.ncbi.nlm.nih.gov/pubmed/28535765
http://dx.doi.org/10.1186/s12936-017-1864-2
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