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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Spatial distribution of G6PD deficiency variants across malaria-endemic regions
Malaria Journal, Volume 12, No. 1, Article 418, Year 2013
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Description
Background: Primaquine is essential for malaria control and elimination since it is the only available drug preventing multiple clinical attacks by relapses of Plasmodium vivax. It is also the only therapy against the sexual stages of Plasmodium falciparum infectious to mosquitoes, and is thus useful in preventing malaria transmission. However, the difficulties of diagnosing glucose-6-phosphate dehydrogenase deficiency (G6PDd) greatly hinder primaquine's widespread use, as this common genetic disorder makes patients susceptible to potentially severe and fatal primaquine-induced haemolysis. The risk of such an outcome varies widely among G6PD gene variants. Methods. A literature review was conducted to identify surveys of G6PD variant frequencies among representative population groups. Informative surveys were assembled into two map series: (1) those showing the relative proportions of the different variants among G6PDd individuals; and (2) those showing allele frequencies of G6PD variants based on population surveys without prior G6PDd screening. Results: Variants showed conspicuous geographic patterns. A limited repertoire of variants was tested for across sub-Saharan Africa, which nevertheless indicated low genetic heterogeneity predominated by the G6PD A-§ssup§ 202A §esup§ mutation, though other mutations were common in western Africa. The severe G6PD Mediterranean variant was widespread across western Asia. Further east, a sharp shift in variants was identified, with high variant heterogeneity in the populations of China and the Asia-Pacific where no single variant dominated. Conclusions: G6PD variants exhibited distinctive region-specific distributions with important primaquine policy implications. Relative homogeneity in the Americas, Africa, and western Asia contrasted sharply with the heterogeneity of variants in China, Southeast Asia and Oceania. These findings will inform rational risk assessments for primaquine in developing public health strategies for malaria control and elimination, and support the future development of regionally targeted policies. The major knowledge gaps highlighted here strongly advocate for further investigation of G6PD variant diversity and their primaquine-sensitivity phenotypes. © 2013 Howes et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3835423/bin/1475-2875-12-418-S1.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3835423/bin/1475-2875-12-418-S2.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3835423/bin/1475-2875-12-418-S3.tif
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Authors & Co-Authors
Howes, Rosalind E.
United Kingdom, Oxford
University of Oxford
Dewi, Mewahyu
Viet Nam, Ho Chi Minh City
Oxford University Clinical Research Unit
Piel, Frédéric Bernard
United Kingdom, Oxford
University of Oxford
Monteiro, Wuelton Marcelo
Brazil, Manaus
Tropical Medicine Foundation Dr. Heitor Vieira Dourado
Brazil, Manaus
Universidade do Estado do Amazonas
Battle, Katherine E.
United Kingdom, Oxford
University of Oxford
Messina, Jane Paula
United Kingdom, Oxford
University of Oxford
Sakuntabhai, Anavaj
France, Paris
Institut Pasteur, Paris
Satyagraha, Ari Winasti
Indonesia, Jakarta
Eijkman Institute for Molecular Biology
Williams, Thomas Neil
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, London
St Mary's Hospital
Baird, John Kevin
Viet Nam, Ho Chi Minh City
Oxford University Clinical Research Unit
United Kingdom, Oxford
Nuffield Department of Medicine
Hay, Simon I.
United Kingdom, Oxford
University of Oxford
Statistics
Citations: 139
Authors: 11
Affiliations: 9
Identifiers
Doi:
10.1186/1475-2875-12-418
e-ISSN:
14752875
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Systematic review