Glucose-6-phosphate dehydrogenase deficiency in an endemic area for malaria in Manaus: a cross-sectional survey in the Brazilian Amazon.
BACKGROUND
There is a paucity of information regarding glucose-6-phosphate dehydrogenase (G6PD) deficiency in endemic areas for malaria in Latin America.


RESULTS
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
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.
Santana
Marli Stela
MS
University of the State of Amazonas, Manaus, Amazonas, Brazil. marli.maciel@uol.com.br
de Lacerda
Marcus Vinícius Guimarães
MV
Barbosa
Maria das Graças Vale
Md
Alecrim
Wilson Duarte
WD
Alecrim
Maria das Graças Costa
Md
D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D040181:Genetic Diseases, X-Linked / Q000150:complications / Q000453:epidemiology*; D005954:Glucosephosphate Dehydrogenase / Q000235:genetics*; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D007109:Immunity / Q000235:genetics; D007223:Infant; D007565:Jaundice / Q000209:etiology; D016015:Logistic Models; D016780:Malaria, Vivax / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D055815:Young Adult
D000962:Antimalarials; D005954:Glucosephosphate Dehydrogenase