G6PD Deficiency at Sumba in Eastern Indonesia Is Prevalent, Diverse and Severe: Implications for Primaquine Therapy against Relapsing Vivax Malaria: e0003602

Safe treatment of Plasmodium vivax requires diagnosis of both the infection and status of erythrocytic glucose-6-phosphate dehydrogenase (G6PD) activity because hypnozoitocidal therapy against relapse requires primaquine, which causes a mild to severe acute hemolytic anemia in G6PD deficient patient...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2015-03, Vol.9 (3)
Main Authors: Satyagraha, Ari Winasti, Sadhewa, Arkasha, Baramuli, Vanessa, Elvira, Rosalie, Ridenour, Chase, Elyazar, Iqbal, Noviyanti, Rintis, Coutrier, Farah Novita, Harahap, Alida Roswita, Baird, J Kevin
Format: Article
Language:English
Subjects:
Dehydrogenases
Drug dosages
Enzymatic activity
Enzymes
Experiments
Genotypes
Glucose
Malaria
Public health
Studies
Tropical diseases
Vector-borne diseases
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Summary:Safe treatment of Plasmodium vivax requires diagnosis of both the infection and status of erythrocytic glucose-6-phosphate dehydrogenase (G6PD) activity because hypnozoitocidal therapy against relapse requires primaquine, which causes a mild to severe acute hemolytic anemia in G6PD deficient patients. Many national malaria control programs recommend primaquine therapy without G6PD screening but with monitoring due to a broad lack of G6PD deficiency screening capacity. The degree of risk in doing so hinges upon the level of residual G6PD activity among the variants present in any given area. We conducted studies on Sumba Island in eastern Indonesia in order to assess the potential threat posed by primaquine therapy without G6PD screening. We sampled 2,033 residents of three separate districts in western Sumba for quantitative G6PD activity and 104 (5.1%) were phenotypically deficient (
ISSN:1935-2727
1935-2735
DOI:10.1371/journal.pntd.0003602