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

• Published in: PLoS neglected tropical diseases 2022-05, Vol.16 (5), p.e0010406
• Main Authors: Ley, Benedikt, Alam, Mohammad Shafiul, Satyagraha, Ari Winasti, Phru, Ching Swe, Thriemer, Kamala, Tadesse, Dagimawie, Shibiru, Tamiru, Hailu, Asrat, Kibria, Mohammad Golam, Hossain, Mohammad Sharif, Rahmat, Hisni, Poespoprodjo, Jeanne R, Khan, Wasif Ali, Simpson, Julie A, Price, Ric N
• Format: Article
• Language: English
• Subjects: Antimalarials - adverse effects; Biology and Life Sciences; Care and treatment; Consent; Control; Cross-Sectional Studies; Dehydrogenase; Dehydrogenases; Diagnosis; Dosage and administration; Enzymes; Erythrocytes; Ethics; Glucose; Glucose 6 phosphate dehydrogenase; Glucosephosphate dehydrogenase; Glucosephosphate Dehydrogenase - genetics; Glucosephosphate Dehydrogenase Deficiency - complications; Guardians; Haemolysis; Hemolysis; Hemolysis and hemolysins; Human diseases; Humans; Identification and classification; Infections; Laboratories; Longitudinal studies; Malaria; Malaria - epidemiology; Malaria, Falciparum - complications; Malaria, Vivax - complications; Malaria, Vivax - drug therapy; Medicine and Health Sciences; Methods; People and Places; Phosphates; Plasmodium falciparum; Primaquine; Primaquine - therapeutic use; Red blood cells; Reticulocytes; Risk factors; Surveys; Tafenoquine; Tropical diseases; Vector-borne diseases; X chromosomes
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0010406

Primaquine and tafenoquine are the only licensed drugs with activity against Plasmodium vivax hypnozoites but cause haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Malaria also causes haemolysis, leading to the replacement of older erythrocytes with low G6PD activity by reticulocytes and young erythrocytes with higher activity. Aim of this study was to assess the impact of acute malaria on G6PD activity. Selected patients with uncomplicated malaria were recruited in Bangladesh (n = 87), Indonesia (n = 75), and Ethiopia (n = 173); G6PD activity was measured at the initial presentation with malaria and a median of 176 days later (range 140 to 998) in the absence of malaria. Among selected participants (deficient participants preferentially enrolled in Bangladesh but not at other sites) G6PD activity fell between malaria and follow up by 79.1% (95%CI: 40.4 to 117.8) in 6 participants classified as deficient (