Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency and Gametocytemia in a Pre-Elimination, Low Malaria Transmission Setting in Southern Zambia

Am J Trop Med Hyg. 2021 Jan 4;104(3):1000-1002. doi: 10.4269/ajtmh.20-1187.

Abstract

The WHO recommends single low-dose (SLD) primaquine as a gametocytocide to reduce Plasmodium falciparum transmission in areas of low transmission. Despite this recommendation, uptake of SLD primaquine has been low because of concerns of glucose-6-phosphate dehydrogenase (G6PD) deficiency. Individuals with G6PD deficiency can experience hemolysis when exposed to primaquine. In Southern Province, Zambia, malaria transmission has declined significantly over the past decade. Single low-dose primaquine may be an effective tool, but there is limited information on G6PD deficiency. We screened 137 residents in Macha, Southern Province, Zambia, and the prevalence of G6PD (A-) was 15%. We also revisited data collected from 2008 to 2013 in the same area and found the highest gametocyte burden among those aged 5-15 years. The findings from this study suggest that SLD primaquine targeted to school-aged children may be an effective tool to help achieve malaria elimination in southern Zambia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antimalarials / therapeutic use*
  • Child
  • Child, Preschool
  • Female
  • Gametogenesis / drug effects*
  • Germ Cells / microbiology
  • Glucosephosphate Dehydrogenase / drug effects*
  • Glucosephosphate Dehydrogenase Deficiency / chemically induced*
  • Glucosephosphate Dehydrogenase Deficiency / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Malaria / drug therapy*
  • Malaria / epidemiology
  • Malaria / prevention & control*
  • Malaria / transmission*
  • Male
  • Prevalence
  • Primaquine / therapeutic use*
  • Young Adult
  • Zambia / epidemiology

Substances

  • Antimalarials
  • Glucosephosphate Dehydrogenase
  • Primaquine