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Glucose-6-phosphate dehydrogenase deficiency in an endemic area for malaria in Manaus: a cross-sectional survey in the Brazilian Amazon.

Santana MS, de Lacerda MV, Barbosa Md, Alecrim WD, Alecrim Md - PLoS ONE (2009)

Bottom Line: Six individuals (3%) were deficient using the qualitative Brewer's test.The deficiency was not associated with the ethnic origin (P = 0.571).The apparent protection against multiple malarial infections in an area primarily endemic for Plasmodium vivax needs further investigation.

View Article: PubMed Central - PubMed

Affiliation: University of the State of Amazonas, Manaus, Amazonas, Brazil. marli.maciel@uol.com.br

ABSTRACT

Background: There is a paucity of information regarding glucose-6-phosphate dehydrogenase (G6PD) deficiency in endemic areas for malaria in Latin America.

Methodology/principal findings: This study determined the prevalence of the G6PD deficiency in 200 male non-consanguineous individuals residing in the Ismail Aziz Community, on the outskirts of Manaus (Brazilian Amazon). Six individuals (3%) were deficient using the qualitative Brewer's test. Gel electrophoresis showed that five of these patients were G6PD A(-). The deficiency was not associated with the ethnic origin (P = 0.571). In a multivariate logistic regression analysis, G6PD deficiency protected against three or more episodes of malaria (P = 0.049), independently of the age, and was associated with a history of jaundice (P = 0.020) and need of blood transfusion (P = 0.045) during previous treatment for malarial infection, independently of the age and the previous malarial exposure.

Conclusions/significance: The frequency of G6PD deficiency was similar to other studies performed in Brazil and the finding of a predominant G6PD A(-) variant will help the clinical management of patients with drug-induced haemolysis. The history of jaundice and blood transfusion during previous malarial infection may trigger the screening of patients for G6PD deficiency. The apparent protection against multiple malarial infections in an area primarily endemic for Plasmodium vivax needs further investigation.

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Geographic localization of the Ismail Aziz Community in an endemic area for malaria in Manaus, Amazonas State, Brazil.
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pone-0005259-g001: Geographic localization of the Ismail Aziz Community in an endemic area for malaria in Manaus, Amazonas State, Brazil.

Mentions: The study was carried out in the municipality of Manaus (03°08′ S/60°00′ W), in the Ismail Aziz Community, with an estimated population of 1,500 inhabitants (750 male), including natives and immigrants (Figure 1). Census data were used to estimate the population size. The community was chosen due to a high annual parasite index in 2006 (234/1,000 persons) [2]. The sample size was calculated for a population of 750 non-consaguineous men (in order to avoid the consanguinity bias) with an expected prevalence of G6PD deficiency of 3%, power of 80% and significance level below 5%. Therefore, 200 non-consanguineous men between 1 and 65 years-old (children under one year are physiologically G6PD deficient and over sixty-five, due to the decrease of enzyme activity during senile) were randomly selected (selection of the fourth man in the visit to all the houses of the community, except those who were consaguineous relatives of other selected subjects) and enrolled in a cross-sectional survey of G6PD deficiency, after informed consent has been obtained. Ethnic origin, previous malaria infection and previous clinical complications triggered by malarial infection were acquired through an individual interview, and all the data were recorded in a standard questionnaire.


Glucose-6-phosphate dehydrogenase deficiency in an endemic area for malaria in Manaus: a cross-sectional survey in the Brazilian Amazon.

Santana MS, de Lacerda MV, Barbosa Md, Alecrim WD, Alecrim Md - PLoS ONE (2009)

Geographic localization of the Ismail Aziz Community in an endemic area for malaria in Manaus, Amazonas State, Brazil.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2667256&req=5

pone-0005259-g001: Geographic localization of the Ismail Aziz Community in an endemic area for malaria in Manaus, Amazonas State, Brazil.
Mentions: The study was carried out in the municipality of Manaus (03°08′ S/60°00′ W), in the Ismail Aziz Community, with an estimated population of 1,500 inhabitants (750 male), including natives and immigrants (Figure 1). Census data were used to estimate the population size. The community was chosen due to a high annual parasite index in 2006 (234/1,000 persons) [2]. The sample size was calculated for a population of 750 non-consaguineous men (in order to avoid the consanguinity bias) with an expected prevalence of G6PD deficiency of 3%, power of 80% and significance level below 5%. Therefore, 200 non-consanguineous men between 1 and 65 years-old (children under one year are physiologically G6PD deficient and over sixty-five, due to the decrease of enzyme activity during senile) were randomly selected (selection of the fourth man in the visit to all the houses of the community, except those who were consaguineous relatives of other selected subjects) and enrolled in a cross-sectional survey of G6PD deficiency, after informed consent has been obtained. Ethnic origin, previous malaria infection and previous clinical complications triggered by malarial infection were acquired through an individual interview, and all the data were recorded in a standard questionnaire.

Bottom Line: Six individuals (3%) were deficient using the qualitative Brewer's test.The deficiency was not associated with the ethnic origin (P = 0.571).The apparent protection against multiple malarial infections in an area primarily endemic for Plasmodium vivax needs further investigation.

View Article: PubMed Central - PubMed

Affiliation: University of the State of Amazonas, Manaus, Amazonas, Brazil. marli.maciel@uol.com.br

ABSTRACT

Background: There is a paucity of information regarding glucose-6-phosphate dehydrogenase (G6PD) deficiency in endemic areas for malaria in Latin America.

Methodology/principal findings: This study determined the prevalence of the G6PD deficiency in 200 male non-consanguineous individuals residing in the Ismail Aziz Community, on the outskirts of Manaus (Brazilian Amazon). Six individuals (3%) were deficient using the qualitative Brewer's test. Gel electrophoresis showed that five of these patients were G6PD A(-). The deficiency was not associated with the ethnic origin (P = 0.571). In a multivariate logistic regression analysis, G6PD deficiency protected against three or more episodes of malaria (P = 0.049), independently of the age, and was associated with a history of jaundice (P = 0.020) and need of blood transfusion (P = 0.045) during previous treatment for malarial infection, independently of the age and the previous malarial exposure.

Conclusions/significance: The frequency of G6PD deficiency was similar to other studies performed in Brazil and the finding of a predominant G6PD A(-) variant will help the clinical management of patients with drug-induced haemolysis. The history of jaundice and blood transfusion during previous malarial infection may trigger the screening of patients for G6PD deficiency. The apparent protection against multiple malarial infections in an area primarily endemic for Plasmodium vivax needs further investigation.

Show MeSH
Related in: MedlinePlus