title: Association of glucose-6-phosphate dehydrogenase deficiency and malaria: a systematic review and meta-analysis.
abstract: Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency overlaps with malaria endemicity although it predisposes carriers to hemolysis. This fact supports the protection hypothesis against malaria. The aim of this systematic review is to assess the presence and the extent of protective association between G6PD deficiency and malaria. Thirteen databases were searched for papers reporting any G6PD alteration in malaria patients. Twenty-eight of the included 30 studies were eligible for the meta-analysis. Results showed absence of negative association between G6PD deficiency and uncomplicated falciparum malaria (odds ratio (OR), 0.77; 95% confidence interval (CI), 0.59-1.02; p = 0.07). However, this negative association happened in Africa (OR, 0.59; 95% CI, 0.40-0.86; p = 0.007) but not in Asia (OR, 1.24; 95% CI, 0.96-1.61; p = 0.10), and in the heterozygotes (OR, 0.70; 95% CI, 0.57-0.87; p = 0.001) but not the homo/hemizygous (OR, 0.70; 95% CI, 0.46-1.07; p = 0.10). There was no association between G6PD deficiency and total severe malaria (OR, 0.82; 95% CI, 0.61-1.11; p = 0.20). Similarly, there was no association with other malaria species. G6PD deficiency can potentially protect against uncomplicated malaria in African countries, but not severe malaria. Interestingly, this protection was mainly in heterozygous, being x-linked thus related to gender.
authors.affiliation: Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan.|Department of Parasitology and Entomology, Nnamdi Azikiwe University, P.M.B. Awka, Nigeria.
authors.forename: Evaristus Chibunna
authors.initials: EC
authors.lastname: Mbanefo
authors.affiliation: Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
authors.forename: Ali Mahmoud
authors.initials: AM
authors.lastname: Ahmed
authors.affiliation: Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Afaf
authors.initials: A
authors.lastname: Titouna
authors.affiliation: Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elmaraezy
authors.affiliation: University of Medicine and Pharmacy at Hue City, Hue City, Vietnam.
authors.forename: Nguyen Thi Huyen
authors.initials: NT
authors.lastname: Trang
authors.affiliation: University of Medicine and Pharmacy at Ho Chi Minh City, Hong Bang, Ho Chi Minh, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Phuoc Long
authors.affiliation: School of Medicine, Vietnam National University, Ho Chi Minh City, Ho Chi Minh, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Hoang Anh
authors.affiliation: School of Medicine, Vietnam National University, Ho Chi Minh City, Ho Chi Minh, Vietnam.
authors.forename: Tran
authors.initials: T
authors.lastname: Diem Nghi
authors.affiliation: University of Medicine and Pharmacy at Ho Chi Minh City, Hong Bang, Ho Chi Minh, Vietnam.
authors.forename: Bui
authors.initials: B
authors.lastname: The Hung
authors.affiliation: School of Medicine, Vietnam National University, Ho Chi Minh City, Ho Chi Minh, Vietnam.
authors.forename: Mai
authors.initials: M
authors.lastname: Van Hieu
authors.affiliation: University of Medicine and Pharmacy at Ho Chi Minh City, Hong Bang, Ho Chi Minh, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Ky Anh
authors.affiliation: Evidence Based Medicine Research Group &Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.|Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Nguyen Tien
authors.initials: NT
authors.lastname: Huy
authors.affiliation: Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirayama
mesh_terms: D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism*; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications* / Q000201:enzymology*; D006579:Heterozygote; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000201:enzymology* / Q000517:prevention & control; D010963:Plasmodium falciparum / Q000502:physiology; D013045:Species Specificity
chemical_list: D005954:Glucosephosphate Dehydrogenase