Characterizing the Global Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency

Abstract

Glucose-6-phosphate deficiency is the most prevalent enzyme deficiency with an estimated 400 million people affected worldwide. This inherited deficiency causes neonatal hyperbilirubinemia, and chronic hemolytic anemia. Although most affected individuals are asymptomatic, exposure to oxidative stressors such as certain drugs or infection, can elicit acute hemolysis. The purpose of this study was to characterize the global prevalence of G6PD deficiency. We conducted a systematic review of the G6PD deficiency literature, drawing studies from various databases, including MEDLINE/Pubmed and Biosis. Selected studies included cross-sectional and longitudinal studies published between 1996 and 2006. Additionally, meta-analytic procedures were employed to assess the degree of heterogeneity amongst studies and, where appropriate, obtain pooled prevalence estimates. The database searches yielded a total of 93 country-level prevalence estimates, corresponding to 76 studies. The highest prevalence rates were reported among Sub-Saharan African countries, with prevalence ranging from 13% to 28%. Among countries in the Middle East and Asia, the prevalence ranged from 1% to 20%. In the Americas and Europe, the prevalence ranged between less than one and 12%. Meta-analysis revealed a degree of heterogeneity that precluded computation of pooled global and region-level prevalence estimates. This heterogeneity in reported estimates appeared to be due to differences in G6PD deficiency assessment procedures and the years in which the studies were conducted. This systematic review describes the global, regional, and country-level prevalence rates of G6PD deficiency. This information is of public health import, particularly in planning programs to improve neonatal health and in the distribution of various medications, especially antimalarial drugs since G6PD deficiency is most prevalent in malaria-endemic areas.