The Genotyping of Glucose 6 Phosphate Dehydrogenase deficiency (G6PD-d) in Malaria Endemic South Central Timor, East Nusa Tenggara, Eastern Indonesia

Abstract

Approximately 18 million people live in malaria-endemic areas with 218,450 reported confirmed cases and 161 reported deaths in Indonesia. Currently, primaquine (PQ), the 8-aminoquinolines, is still the only drug for radical cure and preventing relapse of malaria. However, the individuals with G6PD deficiency (G6PD-d) have risk of hemolysis. Currently, few data of the prevalence of G6PD-d and genotyping are available. This study will provide the prevalence of G6PD-d and the genotyping in malaria cases in South Central Timor (TTS) district. G6PD status was analyzed with quantitative (Randox G6PD test, UK) follow with PCR-RFLP and sequencing to identify the variant of G6PD-d genotyping. Malaria was confirmed by n-PCR (Promega, Madison, USA). A total 64 of 181 individuals with G6PD-d from South Central Timor (TTS) district were analyzed. About 25 of 64 cases of G6PD-d were tested positive for malaria with P. vivax as the dominant species 56% (14/25) and most of the cases were female 73.3% (11/15). Among the 64 G6PD-d the genotyping Vanua Lava (10,883 T>C) WHO classifies G6PD-d genetic variants class II with severe deficiency <10% the enzyme activity were dominant. The variant of Vanua Lava is dominant and the high G6PD-d indicated that screening for G6PD deficiency is necessary.

G6PD Deficiency and Its Correlation to Anaemia Among People Living in High Endemic Malaria Area, Nimbokrang, Papua, Indonesia

“…However, there are three different genotypes found in female which are homozygous normal, homozygous deficient and heterozygous. As a result of deactivation in one of the X-chromosomes, known as Lyonization [4,5], the heterozygous females are, on average, genetic mosaics, meaning that half of their erythrocyte are G6PD normal and the other half are G6PD deficient [1,6,7]. In this condition, most females will express normal G6PD activity, but on the other hand the rest will overlap showing clinical symptoms consistent with homozygous G6PD deficiency.…”

“…Papua province has long been known for its malaria high endemicity in Indonesia along with West-Papua and East Nusa Tenggara province respectively, and currently one of the top-five regencies having highest malaria prevalence is Jayapura [5]. In the case of the Jayapura regency, a few districts, such as Nimbokrang District, have a relatively high incidence of malaria, even though various anti-malarial strategies have already been implemented.…”