Peixoto Henry M, Brito Marcelo A M, Romero Gustavo A S, Monteiro Wuelton M, de Lacerda Marcus V G, de Oliveira Maria Regina F
Centre for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil.
University Centre of Brasília, Brasília, Federal District, Brazil.
Malar J. 2015 Mar 24;14:126. doi: 10.1186/s12936-015-0647-x.
Deficiency of the enzyme G6PD (G6PDd) is caused by mutations in the gene G6PD, which plays an important role in protecting the red blood cell against oxidizing agents; it is linked to chromosome X, and it may affects both sexes. The clinically relevant manifestations, such as acute haemolytic anaemia, mainly occur in men, however. The 8-aminoquinoline primaquine, which is the medication used in the radical treatment of malaria caused by Plasmodium vivax, represents the main factor that triggers complications associated with G6PDd. The current study aims to estimate the costs of G6PDd among male individuals infected by P. vivax in the Brazilian Amazon.
This is an economic analysis developed within the Brazilian National Health System perspective for the years of 2009, 2010 and 2011. Direct medical and non-medical costs were estimated for G6PDd in the Brazilian Amazon, considering among those suffering from the deficiency the costs of diagnosing infection by P. vivax, its treatment and severe adverse events that require hospitalization and were connected to the use of primaquine.
The estimates of the average costs of diagnosing vivax malaria, of its treatment and of severe adverse events after using primaquine among the carriers of G6PDd, over the three evaluated years, corresponded to US$ 739,410.42; US$ 2,120.04 and US$ 4,858,108.87, respectively. The results indicate that the average total cost in the study period corresponded to US$ 5,599,639.33, varying in accordance with the sensitivity analysis between US$ 4,439,512.14 and US$ 6,702,619.24.
The results indicate that the use of primaquine among men with G6PDd who are infected by P. vivax represents a heavy burden on the public health service of Brazil.
葡萄糖-6-磷酸脱氢酶缺乏症（G6PDd）是由G6PD基因突变引起的，该基因在保护红细胞免受氧化剂侵害方面发挥着重要作用；它与X染色体相连，可能影响两性。然而，急性溶血性贫血等临床相关表现主要发生在男性身上。8-氨基喹啉伯氨喹是用于根治间日疟原虫引起的疟疾的药物，是引发G6PDd相关并发症的主要因素。本研究旨在估算巴西亚马逊地区感染间日疟原虫的男性个体中G6PDd的成本。
这是一项从巴西国家卫生系统角度对2009年、2010年和2011年进行的经济分析。估算了巴西亚马逊地区G6PDd的直接医疗和非医疗成本，其中考虑了G6PDd患者中诊断间日疟原虫感染的成本、其治疗成本以及因使用伯氨喹而需要住院治疗的严重不良事件的成本。
在评估的三年中，G6PDd携带者诊断间日疟原虫疟疾的平均成本、治疗成本以及使用伯氨喹后的严重不良事件成本分别为739,410.42美元、2,120.04美元和4,858,108.87美元。结果表明，研究期间的平均总成本为5,599,639.33美元，根据敏感性分析，在4,439,512.14美元至6,702,619.24美元之间变化。
结果表明，在感染间日疟原虫的G6PDd男性中使用伯氨喹给巴西公共卫生服务带来了沉重负担。
