The prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency among Apparently Healthy Individuals in Selected Malaria Endemic Areas from Different Agroecological Zones of Ethiopia using Phenotyping and Genotyping approaches
No Thumbnail Available
Date
2017-09
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: - Glucose-6-phosphate dehydrogenase deficiency (G6PDd) is common in malaria
endemic regions that hinder the use of 8-aminoquinoline drugs as a radical cure for malaria due
to the risk of inducing hemolytic anemia.
Objective: - To investigate G6PDd among apparently healthy individuals in selected malaria
endemic areas from different agroecological zones of Ethiopia.
Methods: - a community based cross sectional survey involving 1609 individuals was done
using genotypic and phenotypic analysis. CareStartTM Rapid Diagnostic kit (RDT) was used to
screen for G6PD enzyme activity. Sequencing and polymerase chain reaction based restriction
fragment length polymorphism were done for further confirmation for all phenotypically
detected enzymatic deficiencies and screened representative samples from those which tested
phenotypically normal. Dried Blood Spot was collected for molecular analysis. Phenotypically
deficient individuals were genotyped for the mutations, G202A, A376G and C563T. Plasmodium
blood-stage parasitaemia detection was performed using the CareStartTM Malaria Ag
PLDH/HRP2 and nested Polymerase Chain Reaction.
Results: - G6PDd detected using the phenotypic approach was less (22/1609, 1.4%) than the
genotypic approach (31/222, 14%). Of the 22 G6PDd individuals detected by CareStartTM RDT,
13 (1.50%) males and 9 (1.21%) females, 16/400 (4.00%), 4/484 (0.8%) and 2/401 (0.5%) were
from Gambella, Oromiya and Benishangule Gumuz respectively. Moreover, the G6PDd
phenotypic prevalence was significantly higher 6.50 % (13/200) in the Agnuwak ethnic groups
(x2 =47.3431 and P = 0.001). Of the 31 individuals found to be G6PDd by sequencing, 29% (9)
hemizygous males, 16.13% (5) homozygous females and 54.84% (17) heterozygous females
were found for 376A+ mutation. The highest asymptomatic malaria infection detected with RDT
was P. falciparum.
Conclusion: - This study found high Genetic diversity (14%) across the G6PD gene in the study
population. As the use of currently available radical cures (gametocidal drugs) against
plasmodium are known to induce hemolytic anemia, further studies in larger groups needs to be
done. In this study the limited number (222/1609) of samples sequenced from all study sites
resulted in higher number of G6PDd individuals. .
Keywords: - G6PD, G6PDd, Haemolytic anaemia, DNA sequencing, Haplotype, Gene mutation,
Malaria, Ethiopia.
Description
Keywords
G6PD, G6PDd, Haemolytic anaemia; DNA sequencing; Haplotype; Gene mutation; Malaria; Ethiopia