Abstract
BackgroundThis study aimed to evaluate the prevalence and alteration of hematological parameters in malaria patients with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, in the western region of Thailand, an endemic region for malaria.MethodsData about patients with malaria hospitalized between 2013 and 2015 were collected. Clinical and sociodemographic characteristics such as age and gender, diagnosis on admission, and parasitological results were mined from medical records of the laboratory unit of the Phop Phra Hospital in Tak Province, Thailand. Venous blood samples were collected at the time of admission to hospital to determine G6PD deficiency by fluorescence spot test and detect malaria parasites by thick and thin film examination. Other data such as complete blood count and parasite density were also collected and analyzed.ResultsAmong the 245 malaria cases, 28 (11.4 %) were diagnosed as Plasmodium falciparum infections and 217 cases (88.6 %) were diagnosed as P. vivax infections. Seventeen (6.9 %) patients had a G6PD deficiency and 228 (93.1 %) patients did not have a G6PD deficiency. Prevalence of male patients with G6PD deficiency was higher than that of female patients (P < 0.05, OR = 5.167). Among the patients with a G6PD deficiency, two (11.8 %) were infected with P. falciparum, while the remaining were infected with P. vivax. Malaria patients with a G6PD deficiency have higher monocyte counts (0.6 × 103/μL) than those without a G6PD deficiency (0.33 × 103/μL) (P < 0.05, OR = 5.167). Univariate and multivariate analyses also confirmed that malaria patients with a G6PD deficiency have high monocyte counts. The association between G6PD status and monocyte counts was independent of age, gender, nationality, Plasmodium species, and parasite density (P < 0.005).ConclusionThis study showed a prevalence of G6PD deficiency in a malaria-endemic area. This study also supported the assertion that patients with G6PD-deficient red blood cells had no protection against the P. falciparum infection. In addition, malaria patients with a G6PD deficiency had higher monocyte counts than those without a G6PD deficiency. These findings will help to recognize and diagnose malaria patients with a G6PD deficiency, as well as to identify the risks and protective factors against malaria in endemic areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0130-0) contains supplementary material, which is available to authorized users.
Highlights
This study aimed to evaluate the prevalence and alteration of hematological parameters in malaria patients with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, in the western region of Thailand, an endemic region for malaria
From January 2013 to April 2015, 245 individuals were diagnosed with a malaria infection at the Phop Phra Hospital, Thailand
This study showed that 6.9 % of malaria-infected patients were diagnosed with a G6PD deficiency, which is lower than reported by previous studies conducted in southeast Iran (27 %) [13], Cambodia (13.9 %) [14], and southwest Ethiopia (7.3 %) [15]
Summary
This study aimed to evaluate the prevalence and alteration of hematological parameters in malaria patients with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, in the western region of Thailand, an endemic region for malaria. Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme involved in the production of the NADPH required to protect cells against oxidative stress [1]. G6PD-deficient red blood cells (RBCs) are more susceptible to being destroyed by oxidative stress such as oxidative food (fava beans) and drugs (e.g., primaquine and sulfones). This disease is often manifested as acute hemolytic anemia (AHA) triggered by the intake of those stressors [3]. 186 mutations affecting the gene coding sequence have been reported, with most of these single-base substitutions leading to amino acid replacements [5]
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