Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania

Djigo, Oum Kelthoum Mamadou; Bollahi, Mohamed Abdallahi; Ebou, Moina Hasni; Salem, Mohamed Salem Ould Ahmedou; Tahar, Rachida; Bogreau, Hervé; Basco, Léonardo K.; Boukhary, Ali Ould Mohamed Salem

doi:10.1371/journal.pone.0220977

Cited by 9 publications

(13 citation statements)

References 40 publications

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“…All other ethnic groups are of black African ancestry. Based on this information, as well as on earlier studies carried out in sub-Saharan African countries bordering Mauritania and in Mauritania, it was further hypothesized that some individuals belonging to the ethnic groups of black African descent may carry the African-type G6PD A- genotype [ 4 , 18 , 19 , 24 , 25 , 26 , 27 ].…”

Section: Introductionmentioning

confidence: 98%

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Molecular Epidemiology of G6PD Genotypes in Different Ethnic Groups Residing in Saharan and Sahelian Zones of Mauritania

et al. 2021

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Plasmodium vivax malaria is endemic in Mauritania. Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency may develop acute hemolytic anemia when exposed to 8-aminoquinoline antimalarial drugs, which are indispensable for a complete cure. The prevalence of G6PD allelic variants was assessed in different ethno-linguistic groups present in Mauritania. A total of 996 blood samples (447 males and 549 females; 499 white Moors and 497 individuals of black African ancestry) were collected from febrile patients in 6 different study sites: Aleg, Atar, Kiffa, Kobeni, Nouakchott, and Rosso. The presence of the African-type G6PD A- (G202A, A376G, A542T, G680T, and T968C mutations) and the Mediterranean-type G6PD B- (C563T) variants was assessed by PCR followed by restriction fragment length polymorphism and/or DNA sequencing. The prevalence of African-type G6PD A- genotype was 3.6% (36/996), with 6.3% (28/447) of hemizygote (A-) males and 1.5% (8/549) of homozygous (A-A-) females. Forty of 549 (7.3%) women were heterozygous (AA-). The following genotypes were observed among hemizygous men and/or homozygous women: A376G/G202A (22/996; 2.2%), A376G/T968C Betica-Selma (12/996; 1.2%), and A376G/A542T Santamaria (2/996; 0.2%). The Mediterranean-type G6PD B- genotype was not observed. The prevalence rates of G6PD A- genotype in male (10/243; 4.1%) and heterozygous female (6/256; 2.3%) white Moors were lower (p < 0.05) than those of males (18/204; 8.8%) and heterozygous females (34/293; 11.6%) of black African ancestry. There were only a few homozygous women among both white Moors (3/256; 1.2%) and those of black African ancestry (5/293; 1.7%). The prevalence of G6PD deficiency in Mauritania was comparable to that of neighboring countries in the Maghreb. Because of the purportedly close ethnic ties between the Mauritanian white Moors and the peoples in the Maghreb, further investigations on the possible existence of the Mediterranean-type allele are required. Moreover, a surveillance system of G6PD phenotype and/or genotype screening is warranted to establish and monitor a population-based prevalence of G6PD deficiency.

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Section: Introductionmentioning

confidence: 98%

“…At present, the amount of data available on G6PD genotypes (or phenotypes) in Mauritania is limited to two studies conducted in Nouakchott [ 18 , 19 ]. It is known that G6PD polymorphisms are associated with ethnicity [ 8 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology of G6PD Genotypes in Different Ethnic Groups Residing in Saharan and Sahelian Zones of Mauritania

et al. 2021

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“…As one of the first steps to facilitate implementation of the new drug policy including primaquine, the current prevalence of G6PD genotypes in Mauritania was assessed in our recent works [41,42]. The preliminary database showed that, overall, 6.3% of Mauritanian men and 1.5% of Mauritanian women are affected by G6PD genetic polymorphisms leading to the African-type G6PD deficiency, and that the Mediterranean-type G6PD deficiency is absent [42].…”

Section: Discussionmentioning

confidence: 99%

Assessment of CareStart G6PD rapid diagnostic test and CareStart G6PD biosensor in Mauritania

Djigo

Khalef²,

Salem

et al. 2021

Infect Dis Poverty

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Background The elimination of Plasmodium vivax malaria requires 8-aminoquinolines, which are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency due to the risk of acute haemolytic anaemia. Several point-of-care devices have been developed to detect G6PD deficiency. The objective of the present study was to evaluate the performance of two of these devices against G6PD genotypes in Mauritania. Methods Outpatients were screened for G6PD deficiency using CareStart™ rapid diagnostic test (RDT) and CareStart™ G6PD biosensor in Nouakchott, Mauritania, in 2019–2020. African-type and Mediterranean-type G6PD genotypes commonly observed in Africa were determined by polymerase chain reaction-restriction fragment length polymorphism and sequencing. Qualitative variables were compared using Fisher’s exact test. Results Of 323 patients (74 males and 249 females), 5 males and 2 homozygous females had the African-type A- genotype: A−(202) in 3 males and 2 females and G6PD A−(968) in 2 males. Among heterozygous females, 13 carried G6PD A−(202), 12 G6PD A−(968), and 3 G6PD A−(542) variants. None had the Mediterranean-type G6PD genotype. Eight had a positive G6PD RDT result, including all 7 hemizygous males and homozygous females with A- or A-A- (0.12 to 2.34 IU/g haemoglobin, according to G6PD biosensor), but RDT performed poorly (sensitivity, 11.1% at the cut-off level of < 30%) and yielded many false negative tests. Thirty-seven (50.0%) males and 141 (56.6%) females were anaemic. The adjusted median values of G6PD activity were 5.72 and 5.34 IU/g haemoglobin in non-anaemic males (n = 35) and non-anaemic males and females (n = 130) with normal G6PD genotypes using G6PD biosensor, respectively. Based on the adjusted median of 5.34 IU/g haemoglobin, the performance of G6PD biosensor against genotyping was as follows: at 30% cut-off, the sensitivity and specificity were 85.7% and 91.7%, respectively, and at 80% cut-off, the sensitivity was 100% while the specificity was 64.9%. Conclusions Although this pilot study supports the utility of biosensor to screen for G6PD deficiency in patients, further investigation in parallel with spectrophotometry is required to promote and validate a more extensive use of this point-of-care device in areas where P. vivax is highly prevalent in Mauritania. Graphic abstract

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“…For future control and to aim towards eventual elimination, radical cure of P . vivax infections using either primaquine or tafenoquine will be needed, which would require screening for glucose 6-phosphate dehydrogenase deficiency of patients to reduce the risk of haemolytic anaemia as a side effect [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…As P. vivax showed no evidence of a clonal or epidemic structure in extremely dry areas studied here, it is likely that many infections persist for multiple years due to latency of liver-stage parasites, occasional relapses allowing ongoing transmission to occur when conditions allow. For future control and to aim towards eventual elimination, radical cure of P. vivax infections using either primaquine or tafenoquine will be needed, which would require screening for glucose 6-phosphate dehydrogenase deficiency of patients to reduce the risk of haemolytic anaemia as a side effect [32].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Multi-locus genotyping reveals established endemicity of a geographically distinct Plasmodium vivax population in Mauritania, West Africa

Auburn

Jacob

et al. 2020

PLoS Negl Trop Dis

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Background Plasmodium vivax has been recently discovered as a significant cause of malaria in Mauritania, although very rare elsewhere in West Africa. It has not been known if this is a recently introduced or locally remnant parasite population, nor whether the genetic structure reflects epidemic or endemic transmission. Methodology/Principal findings To investigate the P. vivax population genetic structure in Mauritania and compare with populations previously analysed elsewhere, multi-locus genotyping was undertaken on 100 clinical isolates, using a genome-wide panel of 38 single nucleotide polymorphisms (SNPs), plus seven SNPs in drug resistance genes. The Mauritanian P. vivax population is shown to be genetically diverse and divergent from populations elsewhere, indicated consistently by genetic distance matrix analysis, principal components analyses, and fixation indices. Only one isolate had a genotype clearly indicating recent importation, from a southeast Asian source. There was no linkage disequilibrium in the local parasite population, and only a small number of infections appeared to be closely genetically related, indicating that there is ongoing genetic recombination consistent with endemic transmission. The P. vivax diversity in a remote mining town was similar to that in the capital Nouakchott, with no indication of local substructure or of epidemic population structure. Drug resistance alleles were virtually absent in Mauritania, in contrast with P. vivax in other areas of the world. Conclusions/Significance The molecular epidemiology indicates that there is long-standing endemic transmission that will be very challenging to eliminate. The virtual absence of drug resistance alleles suggests that most infections have been untreated, and that this endemic infection has been more neglected in comparison to P. vivax elsewhere.

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Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania

Cited by 9 publications

References 40 publications

Molecular Epidemiology of G6PD Genotypes in Different Ethnic Groups Residing in Saharan and Sahelian Zones of Mauritania

Molecular Epidemiology of G6PD Genotypes in Different Ethnic Groups Residing in Saharan and Sahelian Zones of Mauritania

Assessment of CareStart G6PD rapid diagnostic test and CareStart G6PD biosensor in Mauritania

Multi-locus genotyping reveals established endemicity of a geographically distinct Plasmodium vivax population in Mauritania, West Africa

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