Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania
Abstract Background The use of primaquine for mass drug administration (MDA) is being considered as a key strategy for malaria elimination. In addition to being the only drug active against the dormant and relapsing forms of Plasmodium vivax, primaquine is the sole potent drug against mature/infecti...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-023-04801-1 |
| _version_ | 1797398155034099712 |
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| author | Alphaxard Manjurano Eric Lyimo Coleman Kishamawe Justin Omolo Jacklin Mosha Miyaye Donald Paul Kazyoba Saidi Kapiga John Changalucha |
| author_facet | Alphaxard Manjurano Eric Lyimo Coleman Kishamawe Justin Omolo Jacklin Mosha Miyaye Donald Paul Kazyoba Saidi Kapiga John Changalucha |
| author_sort | Alphaxard Manjurano |
| collection | DOAJ |
| description | Abstract Background The use of primaquine for mass drug administration (MDA) is being considered as a key strategy for malaria elimination. In addition to being the only drug active against the dormant and relapsing forms of Plasmodium vivax, primaquine is the sole potent drug against mature/infectious Plasmodium falciparum gametocytes. It may prevent onward transmission and help contain the spread of artemisinin resistance. However, higher dose of primaquine is associated with the risk of acute haemolytic anaemia in individuals with a deficiency in glucose-6-phosphate dehydrogenase. In many P. falciparum endemic areas there is paucity of information about the distribution of individuals at risk of primaquine-induced haemolysis at higher dose 45 mg of primaquine. Methods A retrospective cross-sectional study was carried out using archived samples to establish the prevalence of G6PD deficiency in a malaria hotspot area in Misungwi district, located in Mwanza region, Tanzania. Blood samples collected from individuals recruited between August and November 2010 were genotyped for G6PD deficiency and submicroscopic parasites carriage using polymerase chain reaction. Results A total of 263 individuals aged between 0 and 87 were recruited. The overall prevalence of the X-linked G6PD A− mutation was 83.7% (220/263) wild type, 8% (21/263) heterozygous and 8.4% (22/263) homozygous or hemizygous. Although, assessment of the enzymatic activity to assign the phenotypes according to severity and clinical manifestation as per WHO was not carried out, the overall genotype and allele frequency for the G6PD deficiency was 16.4% and 13. 2%, respectively. There was no statistically significant difference in among the different G6PD genotypes (p > 0.05). Out of 248 samples analysed for submicroscopic parasites carriage, 58.1% (144/248) were P. falciparum positive by PCR. G6PD heterozygous deficiency were associated with carriage of submicroscopic P. falciparum (p = 0.029). Conclusions This study showed that 16.4% of the population in this part of North-western Tanzania carry the G6PD A− mutation, within the range of 15–32% seen in other parts of Africa. G6PD gene mutation is widespread and heterogeneous across the study area where primaquine would be valuable for malaria control and elimination. The maps and population estimates presented here reflect potential risk of higher dose of primaquine being associated with the risk of acute haemolytic anaemia (AHA) in individuals with a deficiency in glucose-6-phosphate dehydrogenase and call further research on mapping of G6PD deficiency in Tanzania. Therefore, screening and education programmes for G6PD deficiency is warranted in a programme of malaria elimination using a higher primaquine dose. |
| first_indexed | 2024-03-09T01:21:38Z |
| format | Article |
| id | doaj.art-9d672fc4bf4146dc8c7cb9c102482c57 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-03-09T01:21:38Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
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| series | Malaria Journal |
| spelling | doaj.art-9d672fc4bf4146dc8c7cb9c102482c572023-12-10T12:08:18ZengBMCMalaria Journal1475-28752023-12-0122111010.1186/s12936-023-04801-1Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, TanzaniaAlphaxard Manjurano0Eric Lyimo1Coleman Kishamawe2Justin Omolo3Jacklin Mosha4Miyaye Donald5Paul Kazyoba6Saidi Kapiga7John Changalucha8Mwanza Centre, National Institute for Medical ResearchMwanza Centre, National Institute for Medical ResearchMwanza Centre, National Institute for Medical ResearchMabibo Centre, National Institute for Medical ResearchMwanza Centre, National Institute for Medical ResearchMwanza Centre, National Institute for Medical ResearchMabibo Centre, National Institute for Medical ResearchMwanza Intervention Trials Unit, National Institute for Medical ResearchMwanza Centre, National Institute for Medical ResearchAbstract Background The use of primaquine for mass drug administration (MDA) is being considered as a key strategy for malaria elimination. In addition to being the only drug active against the dormant and relapsing forms of Plasmodium vivax, primaquine is the sole potent drug against mature/infectious Plasmodium falciparum gametocytes. It may prevent onward transmission and help contain the spread of artemisinin resistance. However, higher dose of primaquine is associated with the risk of acute haemolytic anaemia in individuals with a deficiency in glucose-6-phosphate dehydrogenase. In many P. falciparum endemic areas there is paucity of information about the distribution of individuals at risk of primaquine-induced haemolysis at higher dose 45 mg of primaquine. Methods A retrospective cross-sectional study was carried out using archived samples to establish the prevalence of G6PD deficiency in a malaria hotspot area in Misungwi district, located in Mwanza region, Tanzania. Blood samples collected from individuals recruited between August and November 2010 were genotyped for G6PD deficiency and submicroscopic parasites carriage using polymerase chain reaction. Results A total of 263 individuals aged between 0 and 87 were recruited. The overall prevalence of the X-linked G6PD A− mutation was 83.7% (220/263) wild type, 8% (21/263) heterozygous and 8.4% (22/263) homozygous or hemizygous. Although, assessment of the enzymatic activity to assign the phenotypes according to severity and clinical manifestation as per WHO was not carried out, the overall genotype and allele frequency for the G6PD deficiency was 16.4% and 13. 2%, respectively. There was no statistically significant difference in among the different G6PD genotypes (p > 0.05). Out of 248 samples analysed for submicroscopic parasites carriage, 58.1% (144/248) were P. falciparum positive by PCR. G6PD heterozygous deficiency were associated with carriage of submicroscopic P. falciparum (p = 0.029). Conclusions This study showed that 16.4% of the population in this part of North-western Tanzania carry the G6PD A− mutation, within the range of 15–32% seen in other parts of Africa. G6PD gene mutation is widespread and heterogeneous across the study area where primaquine would be valuable for malaria control and elimination. The maps and population estimates presented here reflect potential risk of higher dose of primaquine being associated with the risk of acute haemolytic anaemia (AHA) in individuals with a deficiency in glucose-6-phosphate dehydrogenase and call further research on mapping of G6PD deficiency in Tanzania. Therefore, screening and education programmes for G6PD deficiency is warranted in a programme of malaria elimination using a higher primaquine dose.https://doi.org/10.1186/s12936-023-04801-1G6PD deficiencyMDAPrimaquineMalariaSubmicroscopic Plasmodium falciparum |
| spellingShingle | Alphaxard Manjurano Eric Lyimo Coleman Kishamawe Justin Omolo Jacklin Mosha Miyaye Donald Paul Kazyoba Saidi Kapiga John Changalucha Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania Malaria Journal G6PD deficiency MDA Primaquine Malaria Submicroscopic Plasmodium falciparum |
| title | Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania |
| title_full | Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania |
| title_fullStr | Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania |
| title_full_unstemmed | Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania |
| title_short | Prevalence of G6PD deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in Northwest, Tanzania |
| title_sort | prevalence of g6pd deficiency and submicroscopic malaria parasites carriage in malaria hotspot area in northwest tanzania |
| topic | G6PD deficiency MDA Primaquine Malaria Submicroscopic Plasmodium falciparum |
| url | https://doi.org/10.1186/s12936-023-04801-1 |
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