G6PD deficiency in malaria endemic areas of Nepal.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

• Authors: Baburam Marasini, Bibek Kumar Lal, Suman Thapa, Kiran Raj Awasthi, Bijay Bajracharya, Pratik Khanal, Sanjeev Neupane, Shambhu Nath Jha, Sanjaya Acharya, Smriti Iama, Madan Koirala, Dinesh Koirala, Suresh Bhandari, Ram Kumar Mahato, Arun Chaudhary, Pramin Ghimire, Rahachan Gharti Magar, Rajan Kumar Bhattarai, Gornpan Gornsawun, Pimsupah Penpitchaporn, Germana Bancone, Bhim Prasad Acharya
• Journal: Malaria journal (Malar J) Vol. 19 Issue 1 Pg. 287 (Aug 12 2020) ISSN: 1475-2875 [Electronic] England
• PMID: 32787970 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Cross-Sectional Studies
• Female
• Glucosephosphate Dehydrogenase Deficiency (epidemiology, genetics)
• Humans
• Malaria, Vivax (parasitology)
• Male
• Middle Aged
• Mutation
• Nepal (epidemiology)
• Plasmodium vivax (physiology)
• Prevalence
• Young Adult