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Title: G6PD deficiency in malaria endemic areas of Nepal
Authors: Baburam Marasini
Bibek Kumar Lal
Suman Thapa
Kiran Raj Awasthi
Bijay Bajracharya
Pratik Khanal
Sanjeev Neupane
Shambhu Nath Jha
Sanjaya Acharya
Smriti Iama
Madan Koirala
Dinesh Koirala
Suresh Bhandari
Ram Kumar Mahato
Arun Chaudhary
Pramin Ghimire
Rahachan Gharti Magar
Rajan Kumar Bhattarai
Gornpan Gornsawun
Pimsupah Penpitchaporn
Germana Bancone
Bhim Prasad Acharya
Save the Children Fund
Tribhuvan University
Shoklo Malaria Research Unit
Nuffield Department of Medicine
Epidemiology and Disease Control Division
Keywords: Immunology and Microbiology;Medicine
Issue Date: 12-Aug-2020
Citation: Malaria Journal. Vol.19, No.1 (2020)
Abstract: © 2020 The Author(s). Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is currently a threat to malaria elimination due to risk of primaquine-induced haemolysis in G6PD deficient individuals. The World Health Organization (WHO) recommends G6PD screening before providing primaquine as a radical treatment against vivax malaria. However, evidence regarding the prevalence and causing mutations of G6PD deficiency in Nepal is scarce. Methods: A cross-sectional, population-based, prevalence study was carried out from May to October 2016 in 12 malaria-endemic districts of Nepal. The screening survey included 4067 participants whose G6PD status was determined by G6PD Care Start™ rapid diagnostic test and genotyping. Results: The prevalence of G6PD deficiency at the national level was 3.5% (4.1% among males and 2.1% among females). When analysed according to ethnic groups, G6PD deficiency was highest among the Janajati (6.2% overall, 17.6% in Mahatto, 7.7% in Chaudhary and 7.5% in Tharu) and low among Brahman and Chhetri (1.3%). District-wise, prevalence was highest in Banke (7.6%) and Chitwan (6.6%). Coimbra mutation (592 C>T) was found among 75.5% of the G6PD-deficient samples analysed and Mahidol (487 G>A) and Mediterranean (563 C>T) mutations were found in equal proportions in the remaining 24.5%. There was no specific geographic or ethnic distribution for the three mutations. Conclusions: This study has identified populations with moderate to high prevalence of G6PD deficiency which provides strong evidence supporting the WHO recommendations to screen G6PD deficiency at health facility level before the use of primaquine-based radical curative regimen for Plasmodium vivax.
ISSN: 14752875
Appears in Collections:Scopus 2020

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