葡萄糖-6-磷酸脱氢酶正常和缺乏的尼日利亚儿童疟疾感染的特征及结果

Features and outcomes of malaria infection in glucose-6-phosphatedehydrogenase normal and deficient Nigerian children.

作者信息

Orimadegun Adebola Emmanuel, Sodeinde Olugbemiro

机构信息

Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.

出版信息

J Vector Borne Dis. 2014 Mar;51(1):33-9.

PMID:24717200

Abstract

BACKGROUND & OBJECTIVES: Malaria and G6PD deficiency-related haemolyses are known causes of hospital admissions in Nigeria and pose great danger to child survival but data on interactions of these two pathologies are scarce. This study was carried out to determine the association between features of Plasmodium falciparum infection and G6PD status.

METHODS

G6PD and haemoglobin were typed by fluorescent spot test and electrophoresis respectively, in 1120 children with microscopically-proven falciparum malaria. Clinical features of malaria were compared between G6PD normal and deficient children.

RESULTS

There were 558 males and 562 females with median age of 35 months (range, 6 months-12 yr). In males, prevalence of G6PD-deficiency in patients with uncomplicated malaria (UM), severe malarial anaemia (SMA) and cerebral malaria (CM) was 23.4, 7 and 16.7%, respectively compared with 11.1, 7.3 and 4.4%, respectively among females. In both males and females, convulsion and rectal temperature above 38°C were less likely presentations among G6PD-deficient compared with G6PD-normal children (p <0.05). The proportions of children with pallor, convulsion and impaired consciousness were significantly lower among G6PD-deficient than normal males (p <0.05) but these features were not different between deficient and normal females (p >0.05).

INTERPRETATION & CONCLUSION: Convulsions, pallor and elevated temperature were more frequent features of malaria in G6PD normal than deficient children. G6PD-deficient male children are protected against impaired consciousness. These differences may offer useful hints in malaria treatment and researches in endemic regions.

摘要

背景与目的

疟疾和葡萄糖-6-磷酸脱氢酶（G6PD）缺乏相关的溶血是尼日利亚医院收治患者的已知病因，对儿童生存构成巨大威胁，但关于这两种病症相互作用的数据却很匮乏。本研究旨在确定恶性疟原虫感染特征与G6PD状态之间的关联。

方法

对1120名经显微镜确诊为恶性疟的儿童，分别采用荧光斑点试验和电泳法检测G6PD和血红蛋白。比较G6PD正常和缺乏的儿童疟疾临床特征。

结果

共558名男性和562名女性，中位年龄35个月（范围6个月至12岁）。男性中，非重症疟疾（UM）、重症疟疾贫血（SMA）和脑型疟疾（CM）患者的G6PD缺乏患病率分别为23.4%、7%和16.7%，而女性分别为11.1%、7.3%和4.4%。在男性和女性中，与G6PD正常的儿童相比，G6PD缺乏的儿童惊厥和直肠温度高于38°C的情况较少见（p<0.05）。G6PD缺乏的男性儿童面色苍白、惊厥和意识障碍的比例显著低于正常男性（p<0.05），但这些特征在缺乏和正常的女性之间并无差异（p>0.05）。