G6PD deficiency at Sumba in Eastern Indonesia is prevalent, diverse and severe: implications for primaquine therapy against relapsing Vivax malaria

PLoS Neglected Tropical Diseases
Ari W SatyagrahaJ Kevin Baird

Abstract

Safe treatment of Plasmodium vivax requires diagnosis of both the infection and status of erythrocytic glucose-6-phosphate dehydrogenase (G6PD) activity because hypnozoitocidal therapy against relapse requires primaquine, which causes a mild to severe acute hemolytic anemia in G6PD deficient patients. Many national malaria control programs recommend primaquine therapy without G6PD screening but with monitoring due to a broad lack of G6PD deficiency screening capacity. The degree of risk in doing so hinges upon the level of residual G6PD activity among the variants present in any given area. We conducted studies on Sumba Island in eastern Indonesia in order to assess the potential threat posed by primaquine therapy without G6PD screening. We sampled 2,033 residents of three separate districts in western Sumba for quantitative G6PD activity and 104 (5.1%) were phenotypically deficient (<4.6U/gHb; median normal 10U/gHb). The villages were in two distinct ecosystems, coastal and inland. A positive correlation occurred between the prevalence of malaria and G6PD deficiency: 5.9% coastal versus inland 0.2% for malaria (P<0.001), and 6.7% and 3.1% for G6PD deficiency (P<0.001) at coastal and inland sites, respectively. The dominant gen...Continue Reading

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Citations

Apr 26, 2016·Infectious Diseases of Poverty·Manas KotepuiNuoil Phiwklam
Sep 7, 2016·Revista Da Sociedade Brasileira De Medicina Tropical·Marcelo Augusto Mota BritoMarcus Vinícius Guimarães de Lacerda
Feb 20, 2016·PLoS Neglected Tropical Diseases·Ari W SatyagrahaJ Kevin Baird
Jul 24, 2015·Current Opinion in Infectious Diseases·Peter A Zimmerman, Rosalind E Howes
Jul 1, 2020·The American Journal of Tropical Medicine and Hygiene·Novi SulistyaningrumWanna Chaijaroenkul
Sep 15, 2020·PLoS Neglected Tropical Diseases·Benedikt LeyMohammad Shafiul Alam
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Apr 2, 2021·Frontiers in Pharmacology·Germana Bancone, Cindy S Chu
Jul 21, 2021·Food and Nutrition Bulletin·Kesso Gabrielle van ZutphenAlida Melse-Boonstra

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Methods Mentioned

BETA
genotyping
size-exclusion chromatography
PCR

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