Glucose-6-phosphate dehydrogenase deficiency A- variant in febrile patients in Haiti

Am J Trop Med Hyg. 2014 Aug;91(2):412-4. doi: 10.4269/ajtmh.14-0053. Epub 2014 Jun 2.

Abstract

Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A-. We estimated the frequency of G6PDd A- in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A- allele (includes A- hemizygous males, A- homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alleles*
  • Anemia, Hemolytic / etiology
  • Anemia, Hemolytic / prevention & control*
  • Antimalarials / administration & dosage
  • Child
  • Child, Preschool
  • Contraindications
  • Female
  • Fever / complications
  • Fever / drug therapy
  • Fever / enzymology
  • Fever / genetics*
  • Genotype
  • Glucosephosphate Dehydrogenase / genetics*
  • Glucosephosphate Dehydrogenase / metabolism
  • Glucosephosphate Dehydrogenase Deficiency / complications
  • Glucosephosphate Dehydrogenase Deficiency / drug therapy
  • Glucosephosphate Dehydrogenase Deficiency / enzymology
  • Glucosephosphate Dehydrogenase Deficiency / genetics*
  • Haiti
  • Heterozygote
  • Homozygote
  • Humans
  • Infant
  • Malaria, Falciparum / complications
  • Malaria, Falciparum / drug therapy
  • Malaria, Falciparum / enzymology
  • Malaria, Falciparum / genetics*
  • Male
  • Middle Aged
  • Mutation
  • Primaquine / administration & dosage

Substances

  • Antimalarials
  • Glucosephosphate Dehydrogenase
  • Primaquine