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Glucose-6-phosphate dehydrogenase status and severity of malarial anaemia in Nigerian children
Adebola Emmanuel Orimadegun1, Olugbemiro Sodeinde
1Institute of Child Health, College of Medicine, University of Ibadan, Ibadan Nigeria. beorimadegun@yahoo.com
Insights
Glucose-6-phosphate dehydrogenase (G6PD) deficiency protects males against severe malarial anemia. This study found G6PD-deficient boys had lower rates of severe anemia compared to G6PD-normal boys.
Area of Science:
- Genetics and Molecular Biology
- Tropical Medicine
- Pediatrics
Background:
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a significant health issue in sub-Saharan Africa.
- Data on the G6PD deficiency and malaria interaction in children is limited.
- G6PD deficiency is a known hemolytic factor, potentially influencing malaria severity.
Purpose of the Study:
- To investigate the relationship between G6PD deficiency and severe malarial anemia (SMA) in children.
- To determine if G6PD deficiency affects the incidence or severity of malaria in pediatric populations.
- To compare malaria outcomes in G6PD-deficient versus G6PD-normal children.
Main Methods:
- A cohort of 930 children (0.5-12 years) with confirmed Plasmodium falciparum malaria was studied.
- G6PD and hemoglobin typing were performed using fluorescent spot test and electrophoresis.
- Hematocrit, hemoglobin type, blood group, sickle cell trait, and parasite counts were analyzed in relation to G6PD status.
Main Results:
- The prevalence of G6PD deficiency was 16.4% in boys and 8.1% in girls.
- G6PD-deficient boys showed a significantly lower incidence of severe anemia (PCV ≤ 10% and PCV ≤ 15%) compared to G6PD-normal boys.
- Mean parasite counts were lower in G6PD-deficient children, irrespective of sickle cell trait (HbAS).
Conclusions:
- G6PD deficiency was associated with a reduced risk of severe malarial anemia in male children.
- No significant association was observed between G6PD deficiency and severe malarial anemia in female children.
- G6PD deficiency may confer a protective effect against severe malaria outcomes in boys.
Introduction:
Glucose-6-phosphate dehydrogenase (G6PD) deficiency (Gd-) contributes to morbidity and mortality in sub-Saharan Africa but recent data on the interaction between Gd- and malaria among children is scarce. We hypothesised that, being a haemolytic factor, Gd- makes severe malarial anaemia (SMA) more common and even more severe.
Methodology:
We selected 930 children aged 0.5-12 years attending a reference hospital with microscopically proven falciparum malaria. G6PD and haemoglobin were typed by the fluorescent spot test and electrophoresis, respectively. Molecular typing by PCR and restriction enzyme digestion was also performed on 15% of randomly selected samples. Haematocrit (PCV) values, haemoglobin type, blood group, presence of sickle cell trait (HbAS), and parasite counts were compared between G6PD-normal and deficient children.
Results:
Prevalence of Gd- was 16.4% and 8.1% among boys and girls with malaria, respectively. Mean PCV was 22.8% in deficient children compared with 21.0% in normal children (p = 0.041). In boys, 2.7% of Gd- had PCV ≤ 10%, as compared to 13.6% in Gd+ (p = 0.005). Similarly, 21.3% of Gd- had PCV ≤ 15% compared with 39.4% in Gd+ (p = 0.003). No such difference was found among girls. Overall, HbAS was typed in 7.6% and was more common in Gd- (13.0%) than in Gd+ (6.8%), but the difference was not statistically significant (p = 0.058). The mean parasite counts were significantly lower in Gd- (15477.5/µl) than in Gd+ (19784.4/µl; p = 0.013), and it was independent from HbAS.
Conclusion:
Gd- males but not females were significantly less likely to develop severe malarial anaemia.
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