Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya
Few previous studies have reported the effects of glucose-6-phosphate dehydrogenase (G6PD)–deficiency on child health in Africa. We conducted a case-control study in which cases (n = 6829) were children admitted, for any reason, to Kilifi County Hospital, Kenya, while controls (n = 10 179) were recr...
| Principais autores: | , , , , , , , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado em: |
American Society of Hematology
2020
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| _version_ | 1826272760363483136 |
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| author | Uyoga, S Macharia, AW Ndila, CM Nyutu, G Shebe, M Awuondo, KO Mturi, N Peshu, N Tsofa, B Scott, JAG Maitland, K Williams, TN |
| author_facet | Uyoga, S Macharia, AW Ndila, CM Nyutu, G Shebe, M Awuondo, KO Mturi, N Peshu, N Tsofa, B Scott, JAG Maitland, K Williams, TN |
| author_sort | Uyoga, S |
| collection | OXFORD |
| description | Few previous studies have reported the effects of glucose-6-phosphate dehydrogenase (G6PD)–deficiency on child health in Africa. We conducted a case-control study in which cases (n = 6829) were children admitted, for any reason, to Kilifi County Hospital, Kenya, while controls (n = 10 179) were recruited from the surrounding community. Cases were subclassified based on their clinical and laboratory findings at admission. We calculated the prevalence of specific diseases by G6PD c.202 genotype, the only significant cause of G6PD-deficiency in this area, then estimated the association between genotype and admission with specific conditions using logistic regression. Among neonates, the prevalence of jaundice was higher in both G6PD c.202T heterozygotes (40/88; 45.5%; P = .004) and homo/hemizygotes (81/134; 60.5%; P < .0001) than in wild-type homozygotes (157/526; 29.9%). Median bilirubin levels also increased across the groups, being highest (239 mmol/L; interquartile range 96-390 mmol/L) in G6PD c.202T homo/hemizygotes. No differences were seen in admission hemoglobin concentrations or the prevalence of anemia or severe anemia by G6PD c.202 genotype. On case control analysis, G6PD heterozygosity was negatively associated with all-cause hospital admission (odds ratio 0.81; 95% confidence interval 0.73-0.90; P < .0001) and, specifically, admission with either pneumonia or Plasmodium falciparum parasitemia; while, conversely, it was positively associated with Gram-positive bacteremia. G6PD c.202T homo/heterozygosity was positively associated with neonatal jaundice, severe pneumonia, the receipt of a transfusion, and in-patient death. Our study supports the conclusion that G6PD c.202T is a balanced polymorphism in which a selective advantage afforded to heterozygous females against malaria is counterbalanced by increased risks of neonatal jaundice, invasive bacterial infections, and anemia. |
| first_indexed | 2024-03-06T22:17:40Z |
| format | Journal article |
| id | oxford-uuid:53f66919-bbdb-4e00-a734-693cdad8a60d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:17:40Z |
| publishDate | 2020 |
| publisher | American Society of Hematology |
| record_format | dspace |
| spelling | oxford-uuid:53f66919-bbdb-4e00-a734-693cdad8a60d2022-03-26T16:34:51ZGlucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, KenyaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:53f66919-bbdb-4e00-a734-693cdad8a60dEnglishSymplectic ElementsAmerican Society of Hematology2020Uyoga, SMacharia, AWNdila, CMNyutu, GShebe, MAwuondo, KOMturi, NPeshu, NTsofa, BScott, JAGMaitland, KWilliams, TNFew previous studies have reported the effects of glucose-6-phosphate dehydrogenase (G6PD)–deficiency on child health in Africa. We conducted a case-control study in which cases (n = 6829) were children admitted, for any reason, to Kilifi County Hospital, Kenya, while controls (n = 10 179) were recruited from the surrounding community. Cases were subclassified based on their clinical and laboratory findings at admission. We calculated the prevalence of specific diseases by G6PD c.202 genotype, the only significant cause of G6PD-deficiency in this area, then estimated the association between genotype and admission with specific conditions using logistic regression. Among neonates, the prevalence of jaundice was higher in both G6PD c.202T heterozygotes (40/88; 45.5%; P = .004) and homo/hemizygotes (81/134; 60.5%; P < .0001) than in wild-type homozygotes (157/526; 29.9%). Median bilirubin levels also increased across the groups, being highest (239 mmol/L; interquartile range 96-390 mmol/L) in G6PD c.202T homo/hemizygotes. No differences were seen in admission hemoglobin concentrations or the prevalence of anemia or severe anemia by G6PD c.202 genotype. On case control analysis, G6PD heterozygosity was negatively associated with all-cause hospital admission (odds ratio 0.81; 95% confidence interval 0.73-0.90; P < .0001) and, specifically, admission with either pneumonia or Plasmodium falciparum parasitemia; while, conversely, it was positively associated with Gram-positive bacteremia. G6PD c.202T homo/heterozygosity was positively associated with neonatal jaundice, severe pneumonia, the receipt of a transfusion, and in-patient death. Our study supports the conclusion that G6PD c.202T is a balanced polymorphism in which a selective advantage afforded to heterozygous females against malaria is counterbalanced by increased risks of neonatal jaundice, invasive bacterial infections, and anemia. |
| spellingShingle | Uyoga, S Macharia, AW Ndila, CM Nyutu, G Shebe, M Awuondo, KO Mturi, N Peshu, N Tsofa, B Scott, JAG Maitland, K Williams, TN Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya |
| title | Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya |
| title_full | Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya |
| title_fullStr | Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya |
| title_full_unstemmed | Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya |
| title_short | Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya |
| title_sort | glucose 6 phosphate dehydrogenase deficiency and susceptibility to childhood diseases in kilifi kenya |
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