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

Malaria Journal

Research

Komal Raj Rijal¹  Baburam Marasini²  Leonard Ortega³  Bipin Adhikari⁴  Garib Das Thakur⁵  Prakash Ghimire⁶  Nihal Singh⁶ 

[1] Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal;Epidemiology & Disease Control Division, Ministry of Health, Kathmandu, Nepal;Global Malaria Programme, World Health Organization, Geneva, Switzerland;Mahidol Oxford Research Unit, Bangkok, Thailand;Ministry of Health, Kathmandu, Nepal;World Health Organization, Country Office Nepal, UN House, Pulchowk, Lalitpur, Nepal;

关键词: Malaria;    G6PDd;    Nepal;    Ethnic group;    Antimalarial drugs;    Risk;   

DOI  :  10.1186/s12936-017-1864-2

 received in 2016-12-10, accepted in 2017-05-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundGlucose-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.MethodsA 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.ResultsOut 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).ConclusionsThe 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.

【 授权许可】

CC BY   
© The Author(s) 2017