University of Khartoum

Prevalence of Glucose-6-phosphatedehydrogenase deficiency (G6PDd), point-ofcare test performance and genetic variants in two malaria-endemic areas in Sudan

Prevalence of Glucose-6-phosphatedehydrogenase deficiency (G6PDd), point-ofcare test performance and genetic variants in two malaria-endemic areas in Sudan

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Title: Prevalence of Glucose-6-phosphatedehydrogenase deficiency (G6PDd), point-ofcare test performance and genetic variants in two malaria-endemic areas in Sudan
Author: Albsheer, Musab M.Ali; Lover, Andrew A.; Eltom, Sara B.; Altinae, Lina; Muneer, Mohamed S.; Saad, Noah; Mohamad, Abdelrahim O.; Abdel Hamid, Muzamil Mahdi
Abstract: Background: Glucose-6-phosphate dehydrogenase deficiency (G6PDd) is the most common enzymopathy globally. Individuals with G6PDd can have a severe hemolysis after treatment with diverse medications, including antimalarial primaquine (an 8-aminoquinolines).. Malaria, including infections with P. vivax, is an important contributor to morbidity and mortality in the Republic of Sudan. With increasing evidence of Plasmodium (P.) vivax infections throughout subSaharan Africa, there is a pressing need for data at population-level on prevalence of G6PDd. Such evidence based data will guide the expansion of primaquine for P. vivax radical cure of and the single-low dose treatments of P. falciparum infections gametocidal activity Reports on G6PDd and different enzymatic variants are limited in Sudan. This study aimed at estimating the prevalence of G6PDd in Sudan. This will help in tailoring evidence-based primaquine treatment guidelines that may help in better malaria management and control.Methods: Blood samples were collected from 557 unrelated healthy persons in two malaria-endemic sites in eastern (New Halfa) and central (Gezira Slanj, rural Khartoum) Sudan. A pre-structured questionnaire was was administered to include data on include demographics, risk factors and treatment history. G6PD levels were measured using spectrophotometric method, and Carestart rapid diagnostic point of care test (POC). G6PD variants were determined by PCR/RFLP and confirmed sequencing by a subset of the samples. Results: The prevalence of G6PDd was estimated at 3.9% (22/557), and 14.5% (80/553) by by spectrophotometry and Carestart POC rapid test, respectively. The Carestart had an overall sensitivity of 81.8% (59.7% to 94.8%) and negative predictive value of 95.0% (87.7% to 98.6%). All persons genotyped were homozygotic for the G6PD G202Α; and diverse variants were observed at the G6PD A376G, but no African A- phenotype was detected. Genot from New Halfa B variant was (100%) while in Khartoum B was (90%), A (8%), and AB (2%). Only body weight was identified as a predictor for the enzyme activity (OD P value =0.014). Conclusions: G6PDd in Sudan is moderate but heterogeneous. POC rapid test demonstrated a modest performance for G6PDd detection in females with acceptable performance in males. The two sites harbored mostly the African B phenotype. A nationwide survey is recommended to draw Sudan GP6PDd map.
URI: http://khartoumspace.uofk.edu/123456789/27932


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