Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency Among Children in Eastern Saudi Arabia

Abstract

Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common red blood cell enzyme deficiency worldwide. The disease is widely distributed in regions where malaria is prevalent, affecting mostly males because the enzyme is inherited as an X-link recessive pattern. In Saudi Arabia, we lack newborn screening (NBS) for G6PD deficiency, despite early reports about high prevalence. Methods This is a 10-year retrospective study of children who were screened for G6PD deficiency during their hospitalization between January 2008 to December 2017. The test was carried out using a qualitative fluorescence test suitable for mass screening to determine the prevalence of G6PD deficiency among the admitted children between 0 and 14 years of age. Results A total of 48,889 patients were screened which included 27,634 (56.5%) males and 21,255 (43.5%) females with a mean age of 1.93 + 3.98 years. The overall prevalence of G6PD deficiency was 25%, whereas it was 33.8% in the male subset and 13.2% in the female subset. Male sex was significantly correlated with G6PD deficiency. A total of 25,628 newborns were screened, with 14,219 (55.5%) males and 11,409 (44.5%) females, who had a G6PD deficiency prevalence of 18.8%. There was a G6PD deficiency prevalence of 26% in males and 9.9% in females. Conclusion The present study confirms the high prevalence of G6PD deficiency in our community. Therefore, we need to establish an NBS program to screen for G6PD deficiency in order to prevent neonatal hyperbilirubinemia encephalopathy, avoidable hemolytic episodes, and to increase awareness among health practitioners.

Prevalence of clinical malaria and household characteristics of patients in tribal districts of Pakistan

“…37% (n = 157 out of 429) patients infected by both Plasmodium species were children of the age group between 1 and 15 years old as shown in Table 3. We observed a high prevalence of P. vivax malaria in children (35%; n = 132 out of 373) and among late adolescents (between the age of [15][16][17][18][19][20]. The incidence of both Plasmodium species gradually increased between the ages of 1-20.…”

“…This is possibly due to unawareness, no utilization of insecticides treated bed-nets and low availability of malarial drugs to these areas. Additionally, due to emergency law-and-order situation in tribal districts accelerate limited health care provision [14][15][16][17][18][19].…”

“…The diversity in prevalence and species distribution of malaria-causing parasites varies in different parts of the country and unfortunately it has not been fully described [20]. However, due to insufficient or imprecise data availability it is hard to estimate the prevalence of dominant Plasmodium species or the type of infection in the FATA region of Pakistan [15]. We sampled within the transmission season (the P. vivax transmission season peaks between April and September, while the P. falciparum peaks between August and December) [14].…”

“…To eliminate the risk of haemolysis in P. vivax infected cases, a screening test was performed for the detection of Glucose-6-phosphate dehydrogenase (G6PD) deficiency immediately after the diagnosis of malaria (15).…”

“…A significant level of inconsistency between microscopic and nPCR diagnosis was observed. According to comparative studies, nPCRismore sensitive and reliable for Plasmodium diagnosis then other techniques [14][15][16][17]. Because of the noticeable discrepancies between microscopy and nPCR detections, we decided to rely on nPCR diagnosis.…”