G6PD deficiency alleles in a malaria-endemic region in the Western Brazilian Amazon

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Dombrowski, Jamille G. ; Souza, Rodrigo M. ; Curry, Jonathan ; Hinton, Laura ; Silva, Natercia R. M. ; Grignard, Lynn ; Goncalves, Ligia A. ; Gomes, Ana Rita ; Epiphanio, Sabrina ; Drakeley, Chris ; Huggett, Jim ; Clark, Taane G. ; Campino, Susana ; Marinho, Claudio R. F.

• Tipo de documento: Artigo Científico
• Fonte: Malaria Journal; v. 16, JUN 15 2017.
• Citações Web of Science: 5

Resumo

Background: Plasmodium vivax parasites are the predominant cause of malaria infections in the Brazilian Amazon. Infected individuals are treated with primaquine, which can induce haemolytic anaemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals and may lead to severe and fatal complications. This X-linked disorder is distributed globally and is caused by allelic variants with a geographical distribution that closely reflects populations exposed historically to endemic malaria. In Brazil, few studies have reported the frequency of G6PD deficiency (G6PDd) present in malaria-endemic areas. This is particularly important, as G6PDd screening is not currently performed before primaquine treatment. The aim of this study was to determine the prevalence of G6PDd in the region of Alto do Jurua, in the Western Brazilian Amazon, an area characterized by a high prevalence of P. vivax infection. Methods: Five-hundred and sixteen male volunteers were screened for G6PDd using the fluorescence spot test (Beutler test) and CareStart (TM) G6PD Biosensor system. Demographic and clinical-epidemiological data were acquired through an individual interview. To assess the genetic basis of G6PDd, 24 SNPs were genotyped using the Kompetitive Allele Specific PCR assay. Results: Twenty-three (4.5%) individuals were G6PDd. No association was found between G6PDd and the number of malaria cases. An increased risk of reported haemolysis symptoms and blood transfusions was evident among the G6PDd individuals. Twenty-two individuals had the G6PDd A(-) variant and one the G6PD A(+) variant. The Mediterranean variant was not present. Apart from one polymorphism, almost all SNPs were monomorphic or with low frequencies (0-0.04%). No differences were detected among ethnic groups. Conclusions: The data indicates that similar to 1/23 males from the Alto do Jurua could be G6PD deficient and at risk of haemolytic anaemia if treated with primaquine. G6PD A(-) is the most frequent deficiency allele in this population. These results concur with reported G6PDd in other regions in Brazil. Routine G6PDd screening to personalize primaquine administration should be considered, particularly as complete treatment of patients with vivax malaria using chloroquine and primaquine, is crucial for malaria elimination. (AU)

• Processo FAPESP: 12/04755-3 - Associação entre malária gestacional, restrição do crescimento intrauterino e baixo peso ao nascer na Amazônia Extremo-Ocidental Brasileira
• Beneficiário: Jamille Gregório Dombrowski
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 14/20451-0 - O papel das células endoteliais na imunopatogênese da LPA/SDRA murina associado à malária: efeitos e mecanismos
• Beneficiário: Sabrina Epiphanio
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 14/09964-5 - O papel dos inflamassomas na patogênese da malária associada à gravidez: efeitos e mecanismos
• Beneficiário: Cláudio Romero Farias Marinho
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 15/06106-0 - O papel dos inflamassomas na patogênese da malária associada à gravidez: efeitos e mecanismos
• Beneficiário: Cláudio Romero Farias Marinho
• Modalidade de apoio: Auxílio à Pesquisa - Pesquisador Visitante - Internacional
• Processo FAPESP: 16/13465-0 - Análise genômica do Plasmodium vivax: identificação de recaídas e associação com efeitos adversos na gravidez em mulheres da Amazônia Brasileira
• Beneficiário: Jamille Gregório Dombrowski
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado Direto