Khim Nimol, Benedet Christophe, Kim Saorin, Kheng Sim, Siv Sovannaroth, Leang Rithea, Lek Soley, Muth Sinuon, Chea Nguon, Chuor Char Meng, Duong Socheat, Kerleguer Alexandra, Tor Pety, Chim Pheaktra, Canier Lydie, Witkowski Benoit, Taylor Walter R J, Ménard Didier
Malar J. 2013 May 28;12:171. doi: 10.1186/1475-2875-12-171.
Glucose-6-phosphate-dehydrogenase deficiency (G6PDd) rates are unknown in malaria-infected Cambodian patients. These data are key to a rational drug policy for malaria elimination of Plasmodium falciparum and Plasmodium vivax.
From September 2010-2012, a two-year survey of G6PDd and haemoglobinopathies assessed by quantitative enzyme activity assay and haemoglobin electrophoresis, respectively, was conducted in malaria-infected patients presenting to 19 health centres throughout Cambodia.
A total of 2,408 confirmed malaria patients of mean age 26.7 (range 2-81) years were recruited from mostly western Cambodia (n = 1,732, 71.9%); males outnumbered females by 3.9:1. Plasmodium falciparum was present in 1,443 (59.9%) and P. vivax in 965 (40.1%) patients. Mean G6PD activity was 11.6 (CI 95%: 11.4-11.8) U/g Hb, G6PDd was present in 13.9% of all patients (335/2,408) and severe G6PDd (including WHO Class I and II variants) was more common in western (158/1,732, 9.1%) versus eastern (21/414, 5.1%) Cambodia (P = 0.01). Of 997/2,408 (41.4%) had a haemoglobinopathy. Mean haemoglobin concentrations were inversely related to age: 8.1 g/dL < five years, 8.7 g/dL five to 14 years, and 10.4 g/dL >15 years (P <0.001).
G6PDd prevalence, anaemia and haemoglobinopathies were common in malaria-infected patients. The deployment of primaquine in Cambodia should be preceded by primaquine safety studies paralleled with evaluations of easy to use tests to detect G6PDd.
柬埔寨疟疾感染患者中葡萄糖-6-磷酸脱氢酶缺乏症（G6PDd）的发生率尚不清楚。这些数据是制定消除恶性疟原虫和间日疟原虫疟疾合理药物政策的关键。
2010年9月至2012年，对柬埔寨各地19个卫生中心的疟疾感染患者进行了为期两年的G6PDd和血红蛋白病调查，分别通过定量酶活性测定和血红蛋白电泳进行评估。
共招募了2408例确诊疟疾患者，平均年龄26.7岁（范围2至81岁），大多来自柬埔寨西部（n = 1732，71.9%）；男性与女性的比例为3.9:1。1443例（59.9%）患者感染恶性疟原虫，965例（40.1%）患者感染间日疟原虫。平均G6PD活性为11.6（95%置信区间：11.4 - 11.8）U/g Hb，所有患者中13.9%（335/2408）存在G6PDd，严重G6PDd（包括世界卫生组织I类和II类变体）在柬埔寨西部（158/1732，9.1%）比东部（21/414，5.1%）更常见（P = 0.01）。2408例中有997例（41.4%）患有血红蛋白病。平均血红蛋白浓度与年龄呈负相关：5岁以下为8.1 g/dL，5至14岁为8.7 g/dL，15岁以上为10.4 g/dL（P <0.001）。
G6PDd患病率、贫血和血红蛋白病在疟疾感染患者中很常见。在柬埔寨使用伯氨喹之前，应先进行伯氨喹安全性研究，并同时评估易于使用的检测G6PDd的方法。
