Clinical complications of G6PD deficiency in Latin American and Caribbean populations: systematic review and implications for malaria elimination programmes

Malaria Journal

Research

Quique Bassat¹  Henry M Peixoto²  Maria Regina F Oliveira³  Gustavo AS Romero³  Gabriel P Franca⁴  Marcelo Brito⁵  Marcus VG Lacerda⁵  Gisely C Melo⁵  Wuelton M Monteiro⁵  Amanda LM Queiroz⁵ 

[1] Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain;Faculdade de Medicina, Universidade de Brasília (UnB), Brasília, DF, Brazil;Faculdade de Medicina, Universidade de Brasília (UnB), Brasília, DF, Brazil;National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, RS, Brazil;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Av. Pedro Teixeira, 25, 69040-000, Dom Pedro, Manaus, AM, Brazil;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Av. Pedro Teixeira, 25, 69040-000, Dom Pedro, Manaus, AM, Brazil;Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas (ESA-UEA), Manaus, AM, Brazil;

关键词: Glucose-6-phosphate dehydrogenase deficiency;    Primaquine;    Haemolysis;    Malaria;    Plasmodium vivax;   

DOI  :  10.1186/1475-2875-13-70

 received in 2013-10-14, accepted in 2014-02-20,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAlthough G6PDd individuals are generally asymptomatic throughout their life, the clinical burden of this genetic condition includes a range of haematological conditions, including acute haemolytic anaemia (AHA), neonatal jaundice (NNJ) and chronic non-sphaerocytic anaemia (CNSA). In Latin America (LA), the huge knowledge gap regarding G6PDd is related to the scarce understanding of the burden of clinical manifestation underlying G6PDd carriage. The aim of this work was to study the clinical significance of G6PDd in LA and the Caribbean region through a systematic review.MethodsA systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Only original research was included. All study designs were included, as long as any clinical information was present. Studies were eligible for inclusion if they reported clinical information from populations living in LA or Caribbean countries or about migrants from these countries living in countries outside this continent.ResultsThe Medline search generated 487 papers, and the LILACS search identified 140 papers. After applying the inclusion criteria, 100 original papers with any clinical information on G6PDd in LA were retrieved. Additionally, 16 articles were included after reading the references from these papers. These 116 articles reported data from 18 LA and Caribbean countries. The major clinical manifestations reported from LA countries were those related to AHA, namely drug-induced haemolysis. Most of the published works regarding drug-induced haemolysis in LA referred to haemolytic crises in P. vivax malaria patients during the course of the treatment with primaquine (PQ). Favism, infection-induced haemolysis, NNJ and CNSA appear to play only a minor public health role in this continent.ConclusionHaemolysis in patients using PQ seems to be the major clinical manifestation of G6PDd in LA and contributes to the morbidity of P. vivax infection in this continent, although the low number of reported cases, which could be linked to under-reporting of complications. These results support the need for better strategies to diagnose and manage G6PDd in malaria field conditions. Additionally, Malaria Control Programmes in LA should not overlook this condition in their national guidelines.

【 授权许可】

CC BY   
© Monteiro et al.; licensee BioMed Central Ltd. 2014