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G6PD deficiency in Plasmodium falciparum and Plasmodium vivax malaria-infected Cambodian patients

2013; BioMed Central; Volume: 12; Issue: 1 Linguagem: Inglês

10.1186/1475-2875-12-171

1475-2875

Nimol Khim, Christophe Benedet, Saorin Kim, Sim Kheng, Siv Sovannaroth, Rithea Leang, Soley Lek, Sinuon Muth, Chea Nguon, Char Meng Chuor, Duong Socheat, Alexandra Kerléguer, Pety Tor, Pheaktra Chim, Lydie Canier, Benoît Witkowski, Walter RJ Taylor, Didier Ménard,

Pharmacological Effects and Toxicity Studies

Glucose-6-phosphate-dehydrogenase deficiency (G6PDd) rates are unknown in malaria-infected Cambodian patients. These data are key to a rational drug policy for malaria elimination of Plasmodium falciparum and Plasmodium vivax.From September 2010-2012, a two-year survey of G6PDd and haemoglobinopathies assessed by quantitative enzyme activity assay and haemoglobin electrophoresis, respectively, was conducted in malaria-infected patients presenting to 19 health centres throughout Cambodia.A total of 2,408 confirmed malaria patients of mean age 26.7 (range 2-81) years were recruited from mostly western Cambodia (n = 1,732, 71.9%); males outnumbered females by 3.9:1. Plasmodium falciparum was present in 1,443 (59.9%) and P. vivax in 965 (40.1%) patients. Mean G6PD activity was 11.6 (CI 95%: 11.4-11.8) U/g Hb, G6PDd was present in 13.9% of all patients (335/2,408) and severe G6PDd (including WHO Class I and II variants) was more common in western (158/1,732, 9.1%) versus eastern (21/414, 5.1%) Cambodia (P = 0.01). Of 997/2,408 (41.4%) had a haemoglobinopathy. Mean haemoglobin concentrations were inversely related to age: 8.1 g/dL < five years, 8.7 g/dL five to 14 years, and 10.4 g/dL >15 years (P <0.001).G6PDd prevalence, anaemia and haemoglobinopathies were common in malaria-infected patients. The deployment of primaquine in Cambodia should be preceded by primaquine safety studies paralleled with evaluations of easy to use tests to detect G6PDd.