title: G6PD deficiency in Plasmodium falciparum and Plasmodium vivax malaria-infected Cambodian patients.
abstract: BACKGROUND
  Glucose-6-phosphate-dehydrogenase deficiency (G6PDd) rates are unknown in malaria-infected Cambodian patients. These data are key to a rational drug policy for malaria elimination of Plasmodium falciparum and Plasmodium vivax.
  
  
  METHODS
  From September 2010-2012, a two-year survey of G6PDd and haemoglobinopathies assessed by quantitative enzyme activity assay and haemoglobin electrophoresis, respectively, was conducted in malaria-infected patients presenting to 19 health centres throughout Cambodia.
  
  
  RESULTS
  A total of 2,408 confirmed malaria patients of mean age 26.7 (range 2-81) years were recruited from mostly western Cambodia (n = 1,732, 71.9%); males outnumbered females by 3.9:1. Plasmodium falciparum was present in 1,443 (59.9%) and P. vivax in 965 (40.1%) patients. Mean G6PD activity was 11.6 (CI 95%: 11.4-11.8) U/g Hb, G6PDd was present in 13.9% of all patients (335/2,408) and severe G6PDd (including WHO Class I and II variants) was more common in western (158/1,732, 9.1%) versus eastern (21/414, 5.1%) Cambodia (P = 0.01). Of 997/2,408 (41.4%) had a haemoglobinopathy. Mean haemoglobin concentrations were inversely related to age: 8.1 g/dL < five years, 8.7 g/dL five to 14 years, and 10.4 g/dL >15 years (P <0.001).
  
  
  CONCLUSIONS
  G6PDd prevalence, anaemia and haemoglobinopathies were common in malaria-infected patients. The deployment of primaquine in Cambodia should be preceded by primaquine safety studies paralleled with evaluations of easy to use tests to detect G6PDd.
authors.forename: Nimol
authors.initials: N
authors.lastname: Khim
authors.forename: Christophe
authors.initials: C
authors.lastname: Benedet
authors.forename: Saorin
authors.initials: S
authors.lastname: Kim
authors.forename: Sim
authors.initials: S
authors.lastname: Kheng
authors.forename: Sovannaroth
authors.initials: S
authors.lastname: Siv
authors.forename: Rithea
authors.initials: R
authors.lastname: Leang
authors.forename: Soley
authors.initials: S
authors.lastname: Lek
authors.forename: Sinuon
authors.initials: S
authors.lastname: Muth
authors.forename: Nguon
authors.initials: N
authors.lastname: Chea
authors.forename: Char Meng
authors.initials: CM
authors.lastname: Chuor
authors.forename: Socheat
authors.initials: S
authors.lastname: Duong
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kerleguer
authors.forename: Pety
authors.initials: P
authors.lastname: Tor
authors.forename: Pheaktra
authors.initials: P
authors.lastname: Chim
authors.forename: Lydie
authors.initials: L
authors.lastname: Canier
authors.forename: Benoit
authors.initials: B
authors.lastname: Witkowski
authors.forename: Walter R J
authors.initials: WR
authors.lastname: Taylor
authors.forename: Didier
authors.initials: D
authors.lastname: Ménard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000453:epidemiology / Q000469:parasitology*; D006801:Humans; D016778:Malaria, Falciparum / Q000201:enzymology* / Q000453:epidemiology / Q000469:parasitology; D016780:Malaria, Vivax / Q000201:enzymology* / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D055815:Young Adult