First evaluation of glucose-6-phosphate dehydrogenase (G6PD) deficiency in vivax malaria endemic regions in the Republic of Korea.
BACKGROUND
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect and affects more than 400 million people worldwide. This deficiency is believed to protect against malaria because its global distribution is similar. However, this genetic disorder may be associated with potential hemolytic anemia after treatment with anti-malarials, primaquine or other 8-aminoquinolines. Although primaquine is used for malaria prevention, no study has previously investigated the prevalence of G6PD variants and G6PD deficiency in the Republic of Korea (ROK).


METHODS
Two commercialized test kits (Trinity G-6-PDH and CareStart G6PD test) were used for G6PD deficiency screening. The seven common G6PD variants were investigated by DiaPlexC kit in blood samples obtained living in vivax malaria endemic regions in the ROK.


RESULTS
Of 1,044 blood samples tested using the CareStart G6PD test, none were positive for G6PD deficiency. However, a slightly elevated level of G6PD activity was observed in 14 of 1,031 samples tested with the Trinity G-6-PDH test. Forty-nine of the 298 samples with non-specific amplification by DiaPlexC kit were confirmed by sequencing to be negative for the G6PD variants.


CONCLUSIONS
No G6PD deficiency was observed using phenotypic- or genetic-based tests in individuals residing in vivax malaria endemic regions in the ROK. Because massive chemoprophylaxis using primaquine has been performed in the ROK military to kill hypnozoites responsible for relapse and latent stage vivax malaria, further regular monitoring is essential for the safe administration of primaquine.
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea; Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
Youn-Kyoung
YK
Goo
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.
So-Young
SY
Ji
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.
Hyun-Il
HI
Shin
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.
Jun-Hye
JH
Moon
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.
Shin-Hyung
SH
Cho
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.
Won-Ja
WJ
Lee
Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.
Jung-Yeon
JY
Kim
D001483:Base Sequence; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000201:enzymology* / Q000453:epidemiology* / Q000517:prevention & control; D008969:Molecular Sequence Data; D010641:Phenotype; D015995:Prevalence; D011319:Primaquine / Q000627:therapeutic use; D056910:Republic of Korea / Q000453:epidemiology; D017422:Sequence Analysis, DNA
D011319:Primaquine