The prevalence of glucose-6-phosphate dehydrogenase deficiency in the Cape Verdean population in the context of malaria elimination

Abstract

Cabo Verde aims to eliminate malaria by 2020. In the country, Plasmodium falciparum had been the main parasite responsible for indigenous cases and primaquine is the first line treatment of cases and for radical cure. However, the lack of knowledge of the national prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency may be one of the constraints to the malaria elimination process. Hence, this first study determines the prevalence of G6PD deficiency (G6PDd) in the archipelago. Blood samples were collected from patients who voluntarily agreed to participate in the study, in the health facilities of eight municipalities on four islands, tested with G6PD CareStart ™ deficiency Rapid Diagnosis Test (RDT). All subjects found to be G6PDd by RDT then underwent enzyme quantification by spectrophotometry. Descriptive statistics and inferences were done using SPSS 22.0 software. A total of 5.062 blood samples were collected, in majority from female patients (78.0%) and in Praia (35.6%). The RDT revealed the prevalence of G6PD deficiency in 2.5% (125/5062) of the general population, being higher in males (5.6%) than in females (1,6%). The highest G6PDd prevalence was recorded in São Filipe, Fogo, (5.4%), while in Boavista no case was detected. The G6PDd activity quantification shown a higher number of partially deficient and deficient males (respectively n = 26 and n = 22) compared to females (respectively n = 18 and n = 7), but more normal females (n = 35) than males (n = 11). According to the WHO classification, most of the G6PDd cases belongs to the class V (34.5%), while the Classes II and I were the less represented with respectively 5.8% and zero cases. This study in Cabo Verde determined the G6PDd prevalence in the population, relatively low compared to other

Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria

“…In our study 12% of males had intermediate G6PD activity (30%-70%) recorded during follow up ( S5 Table ); this was most apparent in Bangladesh where patients with lowest G6PD activities were purposively selected. The G6PD gene is located on the X-chromosome and males are thus either hemizygous deficient or normal [ 8 ], however intermediate activities have been reported from previous cross-sectional surveys [ 23 , 38 , 39 ] and may reflect the AMM (100% activity) being calculated from heterogenous populations with G6PD variants associated with different severity.…”

Malaria diagnostic methods with the elimination goal in view

“…However, the Island still records a few cases of indigenous infections and imported cases, mostly originating from neighboring African countries. The country aimed at eliminating malaria by 2020 but experienced an epidemic in 2017 however; its last local case was in January 2018 (DePina et al 2020 ; Da Veiga Leal et al 2021 ) and has currently applied for malaria elimination status (WHO 2021a , b , c ). As part of its strategic plan to attain elimination, the country ensured that quality-assured diagnoses were done in all health facilities and, as such become the main source of passives cases following, which confirmed cases are reported within 24 h and hospitalized for treatment (WHO 2021a , b , c ).…”

Effects of Single and Double Mutants in Human Glucose-6-Phosphate Dehydrogenase Variants Present in the Mexican Population: Biochemical and Structural Analysis

“…G6PD deficiency, a hereditary genetic defect, is the most common enzymopathy in humans, affecting more than 400 million people worldwide, indicating a global prevalence of 4.9% [4]. The prevalence of G6PD deficiency correlates with the geographical distribution of endemic areas malaria, and has been postulate that G6PD deficiency is an adaptative response as protection against severe forms of P. falciparum malaria and that inheriting the G6PD deficiency gene reduces the severity of malaria infection [5][6][7][8].…”