Prevalence and clinical presentation of glucose-6-phosphate dehydrogenase deficiency in Pakistani Pathan and Afghan refugee communities in Pakistan; implications for the use of primaquine in regional malaria control programmes.
Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency surveys in Afghan refugees and a local community in the North-West Frontier Province, Pakistan, showed that this trait was most common among Pathan and Uzbak refugees (15.8% and 9.1% respectively). The prevalence among Pakistani Pathans was 7.0%, and that in Tajik and Turkoman refugees was 2.9% and 2.1% respectively. Hospital studies showed that the type of G-6-PD deficiency in Pathans could cause severe haemolytic crises. The potentially fatal side effects of primaquine treatment in the Pathan communities, and the high risk of re-infection, render the anti-relapse treatment policy for Plasmodium vivax obsolete. However, epidemic conditions of P. falciparum malaria may justify the use of primaquine as a gametocidal drug, administered as a single dose, during the transmission season. These findings necessitate revision of the recommendations for the use of primaquine in the area.
Bouma
M J
MJ
Médecins Sans Frontières-Holland, Medical Department, Amsterdam, The Netherlands.
Goris
M
M
Akhtar
T
T
Khan
N
N
Khan
N
N
Kita
E
E
D000293:Adolescent; D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D000368:Aged; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D011319:Primaquine; D012036:Refugees
D011319:Primaquine