title: Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in southeast Iran: implications for malaria elimination.
abstract: BACKGROUND
  Glucose-6-phosphate dehydrogenase deficiency (G6PD) is an X-linked genetic disorder with a relatively high frequency in malaria-endemic regions. It is an obstacle to malaria elimination, as primaquine administered in the treatment of malaria can cause hemolysis in G6PD-deficient individuals. This study presents information on the prevalence of G6PD deficiency in Sistan and Balouchetsan province, which hosts more than 90% of Plasmodium vivax malaria cases in Iran. This type of information is needed for a successful malaria elimination program.
  
  
  METHODS
  A total of 526 students were randomly recruited through schools located in southeast Iran. Information was collected by interviewing the students using a structured questionnaire. Blood samples taken on filter papers were examined for G6PD deficiency using the fluorescent spot test.
  
  
  RESULTS
  Overall, 72.8% (383/526) of the subjects showed normal G6PD enzyme function. Mild and severe G6PD deficiency was observed in 14.8% (78) and 12.2% (64) of subjects, respectively. A total 193/261 males (73.9%) and 190/265 (72%) females had normal enzyme activity. Mild G6PD deficiency was observed in 10.8% (28) and 18.9% (50) of male and female subjects, respectively. However, in comparison with females, a greater proportion of males showed severe enzyme deficiency (15.3% versus 9.1%). All these differences were statistically significant (p < 0.006).
  
  
  CONCLUSIONS
  G6PD deficiency is highly prevalent in southeast Iran. G6PD-deficient individuals are susceptible to potentially severe and life-threatening hemolytic reactions after primaquine treatment. In order to achieve malaria elimination goals in the province, G6PD testing needs to be made routinely available within the health system.
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. zu.healthdeputy@gmail.com.
authors.forename: Seyed Mehdi
authors.initials: SM
authors.lastname: Tabatabaei
authors.forename: Alireza
authors.initials: A
authors.lastname: Salimi Khorashad
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sakeni
authors.forename: Ahmad
authors.initials: A
authors.lastname: Raeisi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Metanat
mesh_terms: D000293:Adolescent; D000962:Antimalarials / Q000009:adverse effects; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008288:Malaria / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control; D008297:Male; D015995:Prevalence; D011319:Primaquine / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000962:Antimalarials; D011319:Primaquine