Molecular characterization and mapping of glucose-6-phosphate dehydrogenase (G6PD) mutations in the Greater Mekong Subregion

• Published in: Malaria Journal
• Main Authors: Germana Bancone, Didier Menard, Nimol Khim, Saorin Kim, Lydie Canier, Chea Nguong, Koukeo Phommasone, Mayfong Mayxay, Sabine Dittrich, Malavanh Vongsouvath, Nadine Fievet, Jean-Yves Le Hesran, Valerie Briand, Sommay Keomany, Paul N. Newton, Gornpan Gorsawun, Kaelan Tardy, Cindy S. Chu, Orpreeya Rattanapalroj, Le Thanh Dong, Huynh Hong Quang, Nguyen Tam-Uyen, Nguyen Thuy-Nhien, Tran Tinh Hien, Michael Kalnoky, Francois Nosten
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2019
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-019-2652-y; https://doaj.org/article/c2f274517de340cd9625d126c13a7a66

Abstract Background Plasmodium vivax malaria elimination can only be achieved by the deployment of 8-aminoquinolines (primaquine and tafenoquine) in combination with ACT to kill both blood and liver-stage parasites. However, primaquine and the other 8-aminoquinolines cause dose-dependent haemolysis in subjects with G6PD deficiency, an X-linked disorder of red blood cells that is very common in populations living in tropical and subtropical areas. In order to inform safer use of 8-aminoquinolines in the Greater Mekong Subregion, a multi-centre study was carried out to assess the prevalence of G6PD deficiency and to identify the main G6PD variants in samples collected in Cambodia, Lao PDR, Myanmar, Thailand and Vietnam. Methods Blood samples were collected in the five countries during National Malaria Surveys or during Population Surveys. During Population Surveys samples were characterized for G6PD phenotype using the Fluorescent Spot Test. Samples were then genotyped for a panel of G6PD mutations. Results G6PD deficiency was found to be common in the region with an overall mean prevalence of deficient or mutated hemizygous males of 14.0%, ranging from a mean 7.3% in Thailand, 8.1% in Lao PDR, 8.9% in Vietnam, 15.8% in Myanmar and 18.8% in Cambodia. Mahidol and Viangchan mutations were the most common and widespread variants found among the nine investigated. Conclusions Owing to the high prevalence of G6PD deficiency in the Greater Mekong Subregion, strategies for vivax malaria elimination should include point-of-care G6PD testing (both qualitative and quantitative) to allow safe and wide treatment with 8-aminoquinolines.