Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya.

Case-Control Studies Child Female Genotype Glucosephosphate Dehydrogenase / genetics Glucosephosphate Dehydrogenase Deficiency / epidemiology Humans Infant, Newborn Kenya / epidemiology

Journal

Blood advances

ISSN: 2473-9537

Titre abrégé: Blood Adv

Pays: United States

ID NLM: 101698425

Informations de publication

Date de publication:
08 12 2020

Historique:

received: 22 07 2020

accepted: 09 10 2020

entrez: 4 12 2020

pubmed: 5 12 2020

medline: 15 5 2021

Statut: ppublish

Résumé

Few previous studies have reported the effects of glucose-6-phosphate dehydrogenase (G6PD)-deficiency on child health in Africa. We conducted a case-control study in which cases (n = 6829) were children admitted, for any reason, to Kilifi County Hospital, Kenya, while controls (n = 10 179) were recruited from the surrounding community. Cases were subclassified based on their clinical and laboratory findings at admission. We calculated the prevalence of specific diseases by G6PD c.202 genotype, the only significant cause of G6PD-deficiency in this area, then estimated the association between genotype and admission with specific conditions using logistic regression. Among neonates, the prevalence of jaundice was higher in both G6PD c.202T heterozygotes (40/88; 45.5%; P = .004) and homo/hemizygotes (81/134; 60.5%; P < .0001) than in wild-type homozygotes (157/526; 29.9%). Median bilirubin levels also increased across the groups, being highest (239 mmol/L; interquartile range 96-390 mmol/L) in G6PD c.202T homo/hemizygotes. No differences were seen in admission hemoglobin concentrations or the prevalence of anemia or severe anemia by G6PD c.202 genotype. On case control analysis, G6PD heterozygosity was negatively associated with all-cause hospital admission (odds ratio 0.81; 95% confidence interval 0.73-0.90; P < .0001) and, specifically, admission with either pneumonia or Plasmodium falciparum parasitemia; while, conversely, it was positively associated with Gram-positive bacteremia. G6PD c.202T homo/heterozygosity was positively associated with neonatal jaundice, severe pneumonia, the receipt of a transfusion, and in-patient death. Our study supports the conclusion that G6PD c.202T is a balanced polymorphism in which a selective advantage afforded to heterozygous females against malaria is counterbalanced by increased risks of neonatal jaundice, invasive bacterial infections, and anemia.

Identifiants

DOI: 10.1182/bloodadvances.2020003015 PMID: 33275767 PMC: PMC7724908

pubmed: 33275767

pii: S2473-9529(20)32020-6

doi: 10.1182/bloodadvances.2020003015

pmc: PMC7724908

doi:

Substances chimiques

Glucosephosphate Dehydrogenase EC 1.1.1.49

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng