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Kassahun W, Tunta A, Abera A, Shiferaw M. Glucose-6-phosphate dehydrogenase deficiency among neonates with jaundice in Africa; systematic review and meta-analysis. Heliyon 2023; 9:e18437. [PMID: 37539282 PMCID: PMC10393755 DOI: 10.1016/j.heliyon.2023.e18437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic disorder caused by a structural abnormality in the enzyme. G6PD deficiency is most prevalent among African, Asian, and Mediterranean people. This study aimed to investigate how prevalent G6PD deficiency is in African neonates with jaundice. Methods The public sources, such as PubMed, Science Direct, Google Scholar, and Africa Journal Online were searched for articles that reported the prevalence of G6PD deficiency published before March 21st, 2022. The Joanna Briggs Institute's (JBI) critical assessment checklist was used to evaluate the quality of individual studies. STATA-17 was used to do the statistical analysis. The pooled prevalence of G6PD deficiency in neonates with jaundice in Africa was calculated using a forest plot and a random effects model. I2 statistics and Galbraith plots were used to assess heterogeneity. Publication bias was assessed using a funnel plot and Egger's statistical test. Results Ten studies involving 1555 neonates with jaundice were involved in the study. G6PD deficiency was prevalent in 24.60% of African neonates with jaundice (95% CI:12.47-36.74) with considerable heterogeneity (I2 = 100%). Nigerian neonates with jaundice had the highest G6PD deficiency (49.67%), whereas South Africans had the lowest (3.14%). Conclusion G6PD deficiency has been implicated in a significant portion of African neonates with jaundice, notwithstanding the need for greater research on predisposing variables from other countries. Therefore, it should be thought of performing screening and diagnostic laboratory tests for G6PD deficiency.
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Affiliation(s)
- Woldeteklehaymanot Kassahun
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Po Box, 400, Woldia, Ethiopia
| | - Abayneh Tunta
- Biomedical Unit, School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Atitegeb Abera
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mulu Shiferaw
- Biomedical Unit, School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Aldossari RM, Ali A, Rehman MU, Rashid S, Ahmad SB. Computational Approaches for Identification of Potential Plant Bioactives as Novel G6PD Inhibitors Using Advanced Tools and Databases. Molecules 2023; 28:molecules28073018. [PMID: 37049781 PMCID: PMC10096328 DOI: 10.3390/molecules28073018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
In glucose metabolism, the pentose phosphate pathway (PPP) is the major metabolic pathway that plays a crucial role in cancer growth and metastasis. Although it has been pointed out that blockade of the PPP is a promising approach against cancer, in the clinical setting, effective anti-PPP agents are still not available. Dysfunction of the G6PD enzyme in this pathway leads to cancer development as this enzyme possesses oncogenic activity. In the present study, an attempt was made to identify bioactive compounds that can be developed as potential G6PD inhibitors. In the present study, 11 natural compounds and a controlled drug were taken. The physicochemical and toxicity properties of the compounds were determined via ADMET and ProTox-II analysis. In the present study, the findings of docking studies revealed that staurosporine was the most effective compound with the highest binding energy of −9.2 kcal/mol when docked against G6PD. Homology modeling revealed that 97.56% of the residues were occupied in the Ramachandran-favored region. The modeled protein gave a quality Z-score of −10.13 by ProSA tool. iMODS server provided significant insights into the mobility, stability and flexibility of the G6PD protein that described the collective functional protein motion. In the present study, the physical and functional interactions between proteins were determined by STRING. CASTp server determined the topological and geometric properties of the G6PD protein. The findings of the present study revealed that staurosporine could be developed as a potential G6PD inhibitor; however, further in vivo and in vitro studies are needed for further validation of these results.
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Affiliation(s)
- Rana M. Aldossari
- Department of Pharmacology & Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
| | - Aarif Ali
- Division of Veterinary Biochemistry, Faculty of Veterinary Science and Animal Husbandry, SKUAST-Kashmir, Alustang, Shuhama 190006, Jammu & Kashmir, India
| | - Muneeb U. Rehman
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Summya Rashid
- Department of Pharmacology & Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
- Correspondence:
| | - Sheikh Bilal Ahmad
- Division of Veterinary Biochemistry, Faculty of Veterinary Science and Animal Husbandry, SKUAST-Kashmir, Alustang, Shuhama 190006, Jammu & Kashmir, India
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Yu F, Zhang S, Chen B, Zhou Y, Ma C, Yang S, Tang Y, Huang D, Xie X, Xiao Q, Wang L. Evaluation of the Diagnostic Accuracy of the CareStart™ Glucose-6-Phosphate Dehydrogenase Deficiency Rapid Diagnostic Test among Chinese Newborns. J Trop Pediatr 2020; 66:495-503. [PMID: 32040187 DOI: 10.1093/tropej/fmaa003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Previous studies have shown that the CareStart™ G6PD Deficiency rapid diagnostic test has high diagnostic accuracy on G6PD deficiency in Africa and Thailand, but not in China. As there are regional differences of G6PD genotype distribution, we are attending to verify the effectiveness of the kit in Chinese population. The study cohort included 247 newborns admitted to our hospital for jaundice. The quantitative detection of G6PD enzyme activity and G6PD gene mutations analysis was used to classify the status of G6PD deficiency. The performance of CareStart™ assays was verified by calculating the sensitivity, specificity and area under the receiver operating characteristic curve (AUC) based on the corrected G6PD deficiency status. In male newborns, the sensitivity of the CareStart™ assay was 98.9%, the specificity was 94.2% and the AUC was 0.97. In female newborns, the sensitivity was 58.5% when the cutoff value of residual enzyme activity was 100%; however, the sensitivity was 100% when the cutoff value was 60%. Therefore, the CareStart™ test can effectively screen G6PD deficiency in male newborns and female infants with less than 60% residual enzyme activity, female infants with residual enzyme activities of 60-100% are more likely to be missed diagnosed among Chinese newborns.
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Affiliation(s)
- Fengting Yu
- Department of Clinical and Research Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Sufen Zhang
- Department of Clinical Laboratory, Zhuhai Municipal Maternal and Child Healthcare Hospital, Zhuhai Institute of Medical Genetics, Zhuhai, Guangdong, China
| | - Binhuan Chen
- Department of Nephrology, The Fifth Hospital Affiliated, Sun Yat-sen University, Guangzhou, China
| | - Yuqiu Zhou
- Department of Clinical Laboratory, Zhuhai Municipal Maternal and Child Healthcare Hospital, Zhuhai Institute of Medical Genetics, Zhuhai, Guangdong, China
| | - Chengjie Ma
- Department of Clinical and Research Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Siyuan Yang
- Department of Clinical and Research Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yunxia Tang
- Department of Clinical and Research Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Dan Huang
- Department of Infectious Diseases, Peking University Ditan Teaching, Hospital, Beijing, China
| | - Xiaohui Xie
- Department of Infectious Diseases, Peking University Ditan Teaching, Hospital, Beijing, China
| | - Qizhi Xiao
- Department of Clinical Laboratory, Zhuhai Municipal Maternal and Child Healthcare Hospital, Zhuhai Institute of Medical Genetics, Zhuhai, Guangdong, China
| | - Linghang Wang
- Department of Clinical and Research Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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CHÁVEZ-PEÑA TERESA, MARTÍNEZ-CAMBEROS ALEJANDRA, COSSIO-GURROLA GLADYS, ARÁMBULA-MERAZ ELIAKYM, HERRERA-RODRÍGUEZ INDIRA, ROMO-MARTÍNEZ ENRIQUE, GARCÍA-MAGALLANES NOEMI. Prevalence of UGT1A1 (TA)n promoter polymorphism in Panamanians neonates with G6PD deficiency. J Genet 2020. [DOI: 10.1007/s12041-020-01223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Saddala MS, Lennikov A, Huang H. Discovery of Small-Molecule Activators for Glucose-6-Phosphate Dehydrogenase (G6PD) Using Machine Learning Approaches. Int J Mol Sci 2020; 21:ijms21041523. [PMID: 32102234 PMCID: PMC7073180 DOI: 10.3390/ijms21041523] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023] Open
Abstract
Glucose-6-Phosphate Dehydrogenase (G6PD) is a ubiquitous cytoplasmic enzyme converting glucose-6-phosphate into 6-phosphogluconate in the pentose phosphate pathway (PPP). The G6PD deficiency renders the inability to regenerate glutathione due to lack of Nicotine Adenosine Dinucleotide Phosphate (NADPH) and produces stress conditions that can cause oxidative injury to photoreceptors, retinal cells, and blood barrier function. In this study, we constructed pharmacophore-based models based on the complex of G6PD with compound AG1 (G6PD activator) followed by virtual screening. Fifty-three hit molecules were mapped with core pharmacophore features. We performed molecular descriptor calculation, clustering, and principal component analysis (PCA) to pharmacophore hit molecules and further applied statistical machine learning methods. Optimal performance of pharmacophore modeling and machine learning approaches classified the 53 hits as drug-like (18) and nondrug-like (35) compounds. The drug-like compounds further evaluated our established cheminformatics pipeline (molecular docking and in silico ADMET (absorption, distribution, metabolism, excretion and toxicity) analysis). Finally, five lead molecules with different scaffolds were selected by binding energies and in silico ADMET properties. This study proposes that the combination of machine learning methods with traditional structure-based virtual screening can effectively strengthen the ability to find potential G6PD activators used for G6PD deficiency diseases. Moreover, these compounds can be considered as safe agents for further validation studies at the cell level, animal model, and even clinic setting.
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Dantas AVVC, Farias LJR, de Paula SJ, Moreira RP, da Silva VM, Lopes MVDO, Guedes NG. Nursing Diagnosis of Neonatal Jaundice: Study of Clinical Indicators. J Pediatr Nurs 2018; 39:e6-e10. [PMID: 29248302 DOI: 10.1016/j.pedn.2017.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 12/01/2017] [Accepted: 12/02/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to identify the defining characteristics of, and examine their association with, the nursing diagnosis (ND) of Neonatal Jaundice (00194) in sample of hospitalized newborns. DESIGN AND METHODS A cross-sectional study developed with 100 newborns aged between 24h and ten days. Data collection was performed in a public hospital of tertiary health care between March and June of 2016. RESULTS The ND of Neonatal jaundice was present in 31% of the sample. The most frequent defining characteristics were yellow-orange skin color (65%) and abnormal blood profile (75%). Yellow mucous membranes, yellow-orange skin color and bruised skin showed statistically significant sensitivity and specificity. Yellow mucous membranes, yellow sclera and yellow-orange skin color were statistically associated with Neonatal jaundice. Yellow mucous membranes showed the best diagnostic accuracy measurements. CONCLUSIONS The clinical indicators that best predicted and increased the probability of developing jaundice were identified. PRACTICE IMPLICATIONS These clinical indicators increase the ability of nurses to clinically infer nursing diagnoses. This allows nurses to identify signs and symptoms of health conditions in a sensible and definitive manner, decreasing the possibility of errors.
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Dombrowski JG, Souza RM, Curry J, Hinton L, Silva NRM, Grignard L, Gonçalves LA, Gomes AR, Epiphanio S, Drakeley C, Huggett J, Clark TG, Campino S, Marinho CRF. G6PD deficiency alleles in a malaria-endemic region in the Western Brazilian Amazon. Malar J 2017; 16:253. [PMID: 28619120 PMCID: PMC5471696 DOI: 10.1186/s12936-017-1889-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 05/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasmodium vivax parasites are the predominant cause of malaria infections in the Brazilian Amazon. Infected individuals are treated with primaquine, which can induce haemolytic anaemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals and may lead to severe and fatal complications. This X-linked disorder is distributed globally and is caused by allelic variants with a geographical distribution that closely reflects populations exposed historically to endemic malaria. In Brazil, few studies have reported the frequency of G6PD deficiency (G6PDd) present in malaria-endemic areas. This is particularly important, as G6PDd screening is not currently performed before primaquine treatment. The aim of this study was to determine the prevalence of G6PDd in the region of Alto do Juruá, in the Western Brazilian Amazon, an area characterized by a high prevalence of P. vivax infection. METHODS Five-hundred and sixteen male volunteers were screened for G6PDd using the fluorescence spot test (Beutler test) and CareStart™ G6PD Biosensor system. Demographic and clinical-epidemiological data were acquired through an individual interview. To assess the genetic basis of G6PDd, 24 SNPs were genotyped using the Kompetitive Allele Specific PCR assay. RESULTS Twenty-three (4.5%) individuals were G6PDd. No association was found between G6PDd and the number of malaria cases. An increased risk of reported haemolysis symptoms and blood transfusions was evident among the G6PDd individuals. Twenty-two individuals had the G6PDd A(-) variant and one the G6PD A(+) variant. The Mediterranean variant was not present. Apart from one polymorphism, almost all SNPs were monomorphic or with low frequencies (0-0.04%). No differences were detected among ethnic groups. CONCLUSIONS The data indicates that ~1/23 males from the Alto do Juruá could be G6PD deficient and at risk of haemolytic anaemia if treated with primaquine. G6PD A(-) is the most frequent deficiency allele in this population. These results concur with reported G6PDd in other regions in Brazil. Routine G6PDd screening to personalize primaquine administration should be considered, particularly as complete treatment of patients with vivax malaria using chloroquine and primaquine, is crucial for malaria elimination.
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Affiliation(s)
- Jamille G Dombrowski
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rodrigo M Souza
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Multidisciplinary Center, Federal University of Acre, Acre, Brazil
| | | | | | - Natercia R M Silva
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Lynn Grignard
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Ligia A Gonçalves
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ana Rita Gomes
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sabrina Epiphanio
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jim Huggett
- Molecular and Cell Biology, LGC, Teddington, Middlesex, UK.,School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Taane G Clark
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Susana Campino
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Claudio R F Marinho
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
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8
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Liu H, Liu W, Tang X, Wang T. Association between G6PD deficiency and hyperbilirubinemia in neonates: a meta-analysis. Pediatr Hematol Oncol 2015; 32:92-8. [PMID: 24684295 DOI: 10.3109/08880018.2014.887803] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hyperbilirubinemia is prevalent in newborns and multiple factors are responsible for the occurrence of neonatal hyperbilirubinemia. G6PD (Glucose-6-Phosphate Dehydrogenase) deficiency is recognized as one of the risk factors. However, many pediatricians did not take into account the probable effect of G6PD-deficiency when severe neonatal hyperbilirubinemia occurred. The aim of the present study was to perform a meta-analysis to investigate whether G6PD-deficiency increases the risk of hyperbilirubinemia and phototherapy in newborn. We searched PubMed and Embase databases for eligible articles according to explicit study inclusion and exclusion criteria. Risk ratios (RRs) and 95% confidence interval (CI) were selected as the evaluation indexes. Cochrane Q and I(2) test were utilized to assess the heterogeneity among studies. A total of five cohort studies were included in this meta-analysis. There were 21,585 participants enrolled in these studies including 877 newborns with hyperbilirubinemia and 261 newborns receiving phototherapy. Comparison of the incidence of hyperbilirubinemia in newborns with G6PD-deficiency to the ones with normal G6PD in each study yielded a pooled RR of 3.92 (95% CI, 2.13-7.20; P <.0001). The pooled RR of receiving phototherapy in G6PD-deficiency neonates is 3.01 (95% CI, 2.20-4.12; P <.0001) when compared to G6PD normal neonates. This study revealed a significant correlation between G6PD-deficiency and neonatal hyperbilirubinemia, as well as G6PD-deficiency and phototherapy. G6PD-deficient newborns have higher risk of hyperbilirubinemia and phototherapy than the ones with normal G6PD. Monitoring the level of G6PD in newborns is important for predicting the occurrence of hyperbilirubinemia.
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Affiliation(s)
- Huajun Liu
- 1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Alkhotani A, Eldin EEMN, Zaghloul A, Mujahid S. Evaluation of neonatal jaundice in the Makkah region. Sci Rep 2014; 4:4802. [PMID: 24763104 PMCID: PMC3999454 DOI: 10.1038/srep04802] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 04/09/2014] [Indexed: 11/27/2022] Open
Abstract
The aims of this study were to detect the frequency at which the different types of neonatal jaundice occur in Makkah and to estimate the malondialdehyde (MDA) levels. This study included 239 neonates with neonatal jaundice, 20 anemic neonates and 21 healthy neonates. ABO incompatibility was observed in 31.6% of neonates with indirect hyperbilirubinemia, in 14.3% of those with early onset jaundice, in 9.5% of those with persistent jaundice, in 8.5% of those with physiological jaundice, in 5% of anemic neonates and in 12% of all neonates. glucose-6-phosphate dehydrogenase (G6PD) deficiency was observed in 10.5% of neonates with indirect hyperbilirubinemia, in 3.9% of those with physiological jaundice, in 11.1% of those with direct hyperbilirubinemia, in 12% of those with persistent jaundice, in 10% of anemic neonates and in 6.6% of all neonates. Rh incompatibility and polycythemia were found in 2.6% of neonates with indirect hyperbilirubinemia and in 0.4% of all neonates. In comparison to control group, MDA was significantly higher in all groups except for the anemic group. In conclusion, ABO incompatibility and G6PD deficiency frequently result in neonatal jaundice in Makkah, whereas Rh incompatibility and polycythemia are rare. The MDA level may serve as an indicator of oxidative stress.
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Affiliation(s)
- Abdulaziz Alkhotani
- Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Makkah, K.S.A
| | | | - Amal Zaghloul
- Department of Hematology and Immunology, Faculty of Medicine, Umm Al-Qura University, Makkah, K.S.A
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Monteiro WM, Franca GP, Melo GC, Queiroz ALM, Brito M, Peixoto HM, Oliveira MRF, Romero GAS, Bassat Q, Lacerda MVG. Clinical complications of G6PD deficiency in Latin American and Caribbean populations: systematic review and implications for malaria elimination programmes. Malar J 2014; 13:70. [PMID: 24568147 PMCID: PMC3938641 DOI: 10.1186/1475-2875-13-70] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 02/20/2014] [Indexed: 12/29/2022] Open
Abstract
Background Although G6PDd individuals are generally asymptomatic throughout their life, the clinical burden of this genetic condition includes a range of haematological conditions, including acute haemolytic anaemia (AHA), neonatal jaundice (NNJ) and chronic non-sphaerocytic anaemia (CNSA). In Latin America (LA), the huge knowledge gap regarding G6PDd is related to the scarce understanding of the burden of clinical manifestation underlying G6PDd carriage. The aim of this work was to study the clinical significance of G6PDd in LA and the Caribbean region through a systematic review. Methods A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Only original research was included. All study designs were included, as long as any clinical information was present. Studies were eligible for inclusion if they reported clinical information from populations living in LA or Caribbean countries or about migrants from these countries living in countries outside this continent. Results The Medline search generated 487 papers, and the LILACS search identified 140 papers. After applying the inclusion criteria, 100 original papers with any clinical information on G6PDd in LA were retrieved. Additionally, 16 articles were included after reading the references from these papers. These 116 articles reported data from 18 LA and Caribbean countries. The major clinical manifestations reported from LA countries were those related to AHA, namely drug-induced haemolysis. Most of the published works regarding drug-induced haemolysis in LA referred to haemolytic crises in P. vivax malaria patients during the course of the treatment with primaquine (PQ). Favism, infection-induced haemolysis, NNJ and CNSA appear to play only a minor public health role in this continent. Conclusion Haemolysis in patients using PQ seems to be the major clinical manifestation of G6PDd in LA and contributes to the morbidity of P. vivax infection in this continent, although the low number of reported cases, which could be linked to under-reporting of complications. These results support the need for better strategies to diagnose and manage G6PDd in malaria field conditions. Additionally, Malaria Control Programmes in LA should not overlook this condition in their national guidelines.
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Affiliation(s)
- Wuelton M Monteiro
- Fundação de Medicina Tropical Dr, Heitor Vieira Dourado (FMT-HVD), Av, Pedro Teixeira, 25, Dom Pedro, Manaus, AM 69040-000, Brazil.
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