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 trea...

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Bibliographic Details
Published in:Malaria Journal
Main 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
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2020
Subjects:
G6PD deficiency
Malaria
Nepal
Plasmodium vivax
Primaquine
8-Aminoquinolines
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1186/s12936-020-03359-6
https://doaj.org/article/a9d536b273974e9ba272261206e78911
Description
Summary: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.

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