title: Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Ouest and Sud-Est departments of Haiti.
abstract: Malaria remains a significant public health issue in Haiti, with chloroquine (CQ) used almost exclusively for the treatment of uncomplicated infections. Recently, single dose primaquine (PQ) was added to the Haitian national malaria treatment policy, despite a lack of information on the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency within the population. G6PD deficient individuals who take PQ are at risk of developing drug induced hemolysis (DIH). In this first study to examine G6PD deficiency rates in Haiti, 22.8% (range 14.9%-24.7%) of participants were found to be G6PD deficient (class I, II, or III) with 2.0% (16/800) of participants having severe deficiency (class I and II). Differences in deficiency were observed by gender, with males having a much higher prevalence of severe deficiency (4.3% vs. 0.4%) compared to females. Male participants were 1.6 times more likely to be classified as deficient and 10.6 times more likely to be classified as severely deficient compared to females, as expected. Finally, 10.6% (85/800) of the participants were considered to be at risk for DIH. Males also had much higher rates than females (19.3% vs. 4.6%) with 4.9 times greater likelihood (p value 0.000) of having an activity level that could lead to DIH. These findings provide useful information to policymakers and clinicians who are responsible for the implementation of PQ to control and manage malaria in Haiti.
authors.affiliation: Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32610, United States; Department of Environmental and Global Health, University of Florida, PO Box 100188, Gainesville, FL 32610, United States. Electronic address: Michaelvonfricken@epi.ufl.edu.
authors.forename: Michael E
authors.initials: ME
authors.lastname: von Fricken
authors.affiliation: Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32610, United States; Department of Environmental and Global Health, University of Florida, PO Box 100188, Gainesville, FL 32610, United States. Electronic address: riptos@ufl.edu.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Weppelmann
authors.affiliation: Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32610, United States. Electronic address: Weaton@ufl.edu.
authors.forename: Will T
authors.initials: WT
authors.lastname: Eaton
authors.affiliation: Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32610, United States. Electronic address: mtalam@epi.ufl.edu.
authors.forename: Meer T
authors.initials: MT
authors.lastname: Alam
authors.affiliation: Genetics Institute, University of Florida, 2033 Mowry Road, Gainesville, FL 32610, United States; Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, United States. Electronic address: tamarec@ufl.edu.
authors.forename: Tamar E
authors.initials: TE
authors.lastname: Carter
authors.affiliation: Community Coalition for Haiti, Portail Leogane Clinic, Jacmel, Haiti. Electronic address: Laura@cchaiti.org.
authors.forename: Laura
authors.initials: L
authors.lastname: Schick
authors.affiliation: Christianville Foundation, Christianville Boulevard Mareshall, Gressier, Haiti. Electronic address: Drarosie.m@hotmail.com.
authors.forename: Roseline
authors.initials: R
authors.lastname: Masse
authors.affiliation: Hôpital Sainte Croix, Leogane, Haiti. Electronic address: Rooseveld2008@yahoo.fr.
authors.forename: Jean R
authors.initials: JR
authors.lastname: Romain
authors.affiliation: Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL 32610, United States; Department of Environmental and Global Health, University of Florida, PO Box 100188, Gainesville, FL 32610, United States. Electronic address: Bokech@ufl.edu.
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Okech
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000453:epidemiology*; D006205:Haiti / Q000453:epidemiology; D006461:Hemolysis; D006801:Humans; D008288:Malaria / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011319:Primaquine / Q000009:adverse effects / Q000627:therapeutic use; D018570:Risk Assessment; D012737:Sex Factors; D055815:Young Adult
chemical_list: D011319:Primaquine
keywords: Drug induced hemolysis; Glucose-6-phosphate dehydrogenase deficiency; Haiti; Malaria; Malaria elimination; Primaquine