G6PD deficiency in malaria endemic areas of Nepal

• Published in: Malaria journal Vol. 19; no. 1; p. 287
• Main Authors: Marasini, Baburam, Lal, Bibek Kumar, Thapa, Suman, Awasthi, Kiran Raj, Bajracharya, Bijay, Khanal, Pratik, Neupane, Sanjeev, Jha, Shambhu Nath, Acharya, Sanjaya, Iama, Smriti, Koirala, Madan, Koirala, Dinesh, Bhandari, Suresh, Mahato, Ram Kumar, Chaudhary, Arun, Ghimire, Pramin, Magar, Rahachan Gharti, Bhattarai, Rajan Kumar, Gornsawun, Gornpan, Penpitchaporn, Pimsupah, Bancone, Germana, Acharya, Bhim Prasad
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.08.2020; BioMed Central; BMC
• Subjects: 8-Aminoquinolines; Adolescent; Adult; Age; Aged; Aged, 80 and over; Blood; Care and treatment; Child; Control; Cross-Sectional Studies; Ethnicity; Female; Females; G6PD deficiency; Genotype & phenotype; Genotyping; Geographical distribution; Glucose-6-phosphate dehydrogenase deficiency; Glucosephosphate dehydrogenase; Glucosephosphate Dehydrogenase Deficiency - epidemiology; Glucosephosphate Dehydrogenase Deficiency - genetics; Haemolysis; Health risks; Hemolysis; Households; Human diseases; Humans; Laboratories; Malaria; Malaria, Vivax - parasitology; Male; Males; Middle Aged; Minority & ethnic groups; Mutation; Nepal; Nepal - epidemiology; Phosphates; Plasmodium vivax; Plasmodium vivax - physiology; Population; Population studies; Prevalence; Primaquine; Regions; Risk factors; Sociodemographics; Statistics; Studies; Surveying; Tropical diseases; Vector-borne diseases; Young Adult; Nepal; Asia; Plasmodium vivax; Malaria; Primaquine; G6PD deficiency; Nepal; 8-Aminoquinolines
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-020-03359-6

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. 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. 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. 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.