scholarly journals G6PD distribution in sub-Saharan Africa and potential risks of using chloroquine/hydroxychloroquine based treatments for COVID-19

Author(s):  
Jorge E. B. da Rocha ◽  
Houcemeddine Othman ◽  
Caroline T. Tiemessen ◽  
Gerrit Botha ◽  
Michèle Ramsay ◽  
...  

AbstractChloroquine/hydroxychloroquine have been proposed as potential treatments for COVID-19. These drugs have warning labels for use in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Analysis of whole genome sequence data of 458 individuals from sub-Saharan Africa showed significant G6PD variation across the continent. We identified nine variants, of which four are potentially deleterious to G6PD function, and one (rs1050828) that is known to cause G6PD deficiency. We supplemented data for the rs1050828 variant with genotype array data from over 11,000 Africans. Although this variant is common in Africans overall, large allele frequency differences exist between sub-populations. African sub-populations in the same country can show significant differences in allele frequency (e.g. 16.0% in Tsonga vs 0.8% in Xhosa, both in South Africa, p = 2.4 × 10−3). The high prevalence of variants in the G6PD gene found in this analysis suggests that it may be a significant interaction factor in clinical trials of chloroquine and hydroxychloroquine for treatment of COVID-19 in Africans.

2020 ◽  
Author(s):  
Jorge da Rocha ◽  
Houcemeddine Othman ◽  
Caroline T. Tiemessen ◽  
Gerrit Botha ◽  
Michèle Ramsay ◽  
...  

AbstractChloroquine/hydroxychloroquine have been proposed as potential treatments for COVID-19. These drugs have warning labels for use in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Analysis of whole-genome sequence data of 458 individuals from sub-Saharan Africa showed significant G6PD variation across the continent. We identified nine variants, of which four are potentially deleterious to G6PD function, and one (rs1050828) that is known to cause G6PD deficiency. We supplemented data for the rs1050828 variant with genotype array data from over 11,000 Africans. Although this variant is common in Africans overall, large allele frequency differences exist between sub-populations. African sub-populations in the same country can show significant differences in allele frequency (e.g. 16.0% in Tsonga vs 0.8% in Xhosa, both in South Africa, p = 2.4 × 10−3). The high prevalence of variants in the G6PD gene found in this analysis suggests that it may be a significant interaction factor in clinical trials of chloroquine and hydrochloroquine for treatment of COVID-19 in Africans.


2020 ◽  
Vol 4 (1) ◽  
pp. e000750
Author(s):  
Yared Asmare Aynalem ◽  
Getaneh Baye Mulu ◽  
Tadesse Yirga Akalu ◽  
Wondimeneh Shibabaw Shiferaw

BackgroundHyperbilirubinaemia is a silent cause of newborn disease and death worldwide. However, studies of the disease in sub-Saharan Africa are highly variable with respect to its prevalence. Hence, this study aimed to estimate the overall magnitude of neonatal hyperbilirubinaemia and its association with glucose-6-phosphate dehydrogenase (G6PD) deficiency and blood-type incompatibility in sub-Saharan Africa.MethodsPubMed, Scopus, Google Scholar and the Cochrane Review were systematically searched online to retrieve hyperbilirubinaemia-related articles. All observational studies reported the prevalence of hyperbilirubinaemia in sub-Saharan Africa were included for analysis and excluded if the study failed to determine the desired outcome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Heterogeneity across the included studies was evaluated using the inconsistency index (I2). Subgroup and meta- regression analysis were also done. Publication bias was examined by funnel plot and the Egger’s regression test. The random-effect model was fitted to estimate the pooled prevalence of neonatal hyperbilirubinaemia. The meta-analysis was performed using the STATA V.14 software.ResultsA total of 30 486 studies were collected from the different databases and 10 articles were included for the final analysis. The overall magnitude of neonatal hyperbilirubinaemia was 28.08% (95% CI20.23 to 35.94, I2=83.2) in sub-Saharan Africa. Neonates with G6PD deficiency (OR 2.42, 95% CI 1.64 to 3.56, I2=37%) and neonates that had a blood type that was incompatible with their mother’s (OR 3.3, (95% CI 1.96 to 5.72, I2=84%) were more likely to develop hyperbilirubinaemia.ConclusionThe failure to prevent and screen G6PD deficiency and blood-type incompatibility with their mother’s results in high burden of neonatal hyperbilirubinaemia in sub-Saharan Africa. Therefore, early identification and care strategies should be developed to the affected neonates with G6PD deficiency and blood-type incompatibility with their mother’s to address long-term medical and scholastic damages among those exposed to hyperbilirubinaemia


2020 ◽  
Author(s):  
Yared Asmare Aynalem ◽  
Getaneh Baye Mulu1 ◽  
Tadesse Yirga Akalu ◽  
Wondimeneh Shibabaw Shiferaw

Abstract Background: Severe indirect hyperbilirubinemia is a silent cause of newborn disease and death worldwide. However, studies of the disease in sub-Saharan Africa are highly variable with respect to its prevalence. Hence, this study aimed to estimate the overall magnitude of neonatal hyperbilirubinemia and its association with glucose-6-phosphate dehydrogenase (GP6D) deficiency and blood type incompatibility in sub-Saharan Africa.Methods: PubMed, Scopus, Google Scholar, and the Cochrane Review were systematically searched online to retrieve hyperbilirubinemia-related articles. All observational studies reported the prevalence of hyperbilirubinemia in sub-Saharan Africa were included for analysis and excluded if the study failed to determine the desired outcome. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. Heterogeneity across the included studies was evaluated using the inconsistency index (I2). Publication bias was examined by funnel plot and the Egger’s regression test. The random-effect model was fitted to estimate the pooled prevalence of neonatal hyperbilirubinemia among patients in Sub Saharan Africa. The meta-analysis was performed using the STATA™ version 14 software.Results: A total of 30,486 studies were collected from the different databases and 10 articles were included for the final analysis. The overall magnitude of neonatal hyperbilirubinemia was 28.08 % (95% CI: (20.23, 35.94)) in sub-Saharan Africa. Neonates with G6PD deficiency were 2.42 times (95% CI: 1.64, 3.56) more likely to develop hyperbilirubinemia as compared to infants with normal G6PD levels. Moreover, the risk of developing hyperbilirubinemia was 3.3 times (95% CI: 1.96, 5.72) higher among neonates that had a blood type that was incompatible with their mother’s.Conclusion: The failure to prevent and screen G6PD deficiency and blood type incompatibility with their mother’s results in high burden of neonatal hyperbilirubinemia in sub-Saharan Africa. Therefore, early identification and care strategies should be developed to the affected neonates with G6PD deficiency and blood type incompatibility with their mother’s to address long-term medical and scholastic damages among those exposed to severe hyperbilirubinemia


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244782
Author(s):  
Belinda Kweka ◽  
Eric Lyimo ◽  
Kidola Jeremiah ◽  
Suzanne Filteau ◽  
Andrea M. Rehman ◽  
...  

Introduction Hemoglobin A1c (HbA1c) is recommended for diagnosing and monitoring diabetes. However, in people with sickle cell disease (SCD), sickle cell trait (SCT), α-thalassemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency, HbA1c may underestimate the prevalence of diabetes. There are no data on the extent of this problem in sub-Saharan Africa despite having high prevalence of these red blood cell disorders. Methods Blood samples from 431 adults in northwestern Tanzania, randomly selected from the prospective cohort study, Chronic Infections, Comorbidities and Diabetes in Africa (CICADA), were analysed for SCT/SCD, α-thalassemia and G6PD deficiency and tested for associations with the combined prevalence of prediabetes and diabetes (PD/DM) by HbA1c, using the HemoCue 501 HbA1c instrument, and by 2-hour oral glucose tolerance test (OGTT). Results The mean age of the participants was 40.5 (SD11.6) years; 61% were females and 71% were HIV-infected. Among 431 participants, 110 (25.5%) had SCT and none had SCD. Heterozygous α-thalassemia (heterozygous α+ AT) was present in 186 (43%) of the participants, while 52 participants (12%) had homozygous α-thalassemia (homozygous α+ AT). Furthermore, 40 (9.3%) participants, all females, had heterozygous G6PD deficiency while 24 (5.6%) males and 4 (0.9%) females had hemizygous and homozygous G6PD deficiency, respectively. In adjusted analysis, participants with SCT were 85% less likely to be diagnosed with PD/DM by HbA1c compared to those without SCT (OR = 0.15, 95% CI: 0.08, 0.26, P < 0.001). When using OGTT, in adjusted analysis, SCT was not associated with diagnosis of PD/DM while participants with homozygous α+ AT and hemizygous G6PD deficiency were more likely to be diagnosed with PD/DM. Conclusions HbA1c underestimates the prevalence of PD/DM among Tanzanian adults with SCT. Further research using other HbA1c instruments is needed to optimize HbA1c use among populations with high prevalence of hemoglobinopathies or G6PD deficiency.


Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 982
Author(s):  
Jana Těšíková ◽  
Jarmila Krásová ◽  
Joëlle Goüy de Bellocq

Rodents are a speciose group of mammals with strong zoonotic potential. Some parts of Africa are still underexplored for the occurrence of rodent-borne pathogens, despite this high potential. Angola is at the convergence of three major biogeographical regions of sub-Saharan Africa, each harbouring a specific rodent community. This rodent-rich area is, therefore, strategic for studying the diversity and evolution of rodent-borne viruses. In this study we examined 290 small mammals, almost all rodents, for the presence of mammarenavirus and hantavirus RNA. While no hantavirus was detected, we found three rodent species positive for distinct mammarenaviruses with a particularly high prevalence in Namaqua rock rats (Micaelamys namaquensis). We characterised four complete virus genomes, which showed typical mammarenavirus organisation. Phylogenetic and genetic distance analyses revealed: (i) the presence of a significantly divergent strain of Luna virus in Angolan representatives of the ubiquitous Natal multimammate mouse (Mastomys natalensis), (ii) a novel Okahandja-related virus associated with the Angolan lineage of Micaelamys namaquensis for which we propose the name Bitu virus (BITV) and (iii) the occurrence of a novel Mobala-like mammarenavirus in the grey-bellied pygmy mouse (Mus triton) for which we propose the name Kwanza virus (KWAV). This high virus diversity in a limited host sample size and in a relatively small geographical area supports the idea that Angola is a hotspot for mammarenavirus diversity.


Parasitology ◽  
2019 ◽  
Vol 147 (3) ◽  
pp. 287-294 ◽  
Author(s):  
Etienne K. Angora ◽  
Jean-François Allienne ◽  
Olivier Rey ◽  
Hervé Menan ◽  
André O. Touré ◽  
...  

AbstractSchistosomiasis is a neglected tropical disease, though it is highly prevalent in many parts of sub-Saharan Africa. While Schistosoma haematobium-bovis hybrids have been reported in West Africa, no data about Schistosoma hybrids in humans are available from Côte d'Ivoire. This study aimed to identify and quantify S. haematobium-bovis hybrids among schoolchildren in four localities of Côte d'Ivoire. Urine samples were collected and examined by filtration to detect Schistosoma eggs. Eggs were hatched and 503 miracidia were individually collected and stored on Whatman® FTA cards for molecular analysis. Individual miracidia were molecularly characterized by analysis of mitochondrial cox1 and nuclear internal transcribed spacer 2 (ITS 2) DNA regions. A mitochondrial cox1-based diagnostic polymerase chain reaction was performed on 459 miracidia, with 239 (52.1%) exhibiting the typical band for S. haematobium and 220 (47.9%) the S. bovis band. The cox1 and ITS 2 amplicons were Sanger sequenced from 40 randomly selected miracidia to confirm species and hybrids status. Among the 33 cox1 sequences analysed, we identified 15 S. haematobium sequences (45.5%) belonging to seven haplotypes and 18 S. bovis sequences (54.5%) belonging to 12 haplotypes. Of 40 ITS 2 sequences analysed, 31 (77.5%) were assigned to pure S. haematobium, four (10.0%) to pure S. bovis and five (12.5%) to S. haematobium-bovis hybrids. Our findings suggest that S. haematobium-bovis hybrids are common in Côte d'Ivoire. Hence, intense prospection of domestic and wild animals is warranted to determine whether zoonotic transmission occurs.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marina Aferiba Tandoh ◽  
Abigail Owusuaa Appiah ◽  
Anthony Kwaku Edusei

Anemia among adolescent females is a major worldwide public health problem which should be given appropriate attention. Half of all anemic cases are caused by iron deficiency. In addition to anemia, poor nutrition is also a challenge in sub-Saharan Africa. This study determined the prevalence of anemia and undernutrition among adolescent females in school. A cross-sectional study was conducted among 151 adolescent females in four basic schools in the Ahafo region of Ghana. The hemoglobin level and anthropometry measures of participants were taken to determine their anemic and nutritional status. The prevalence of anemia among adolescent females in school was 50.3%. Out of the 151 participants, 6.6%, 19.9%, and 23.8% were severely anemic, moderately anemic, or mildly anemic, respectively. Only 2% of the participants were underweight, but the rate of stunting was 26.5%. The notable high prevalence of anemia that was found among adolescent females was correlated with other health and wellness concerns. Anemia and under nutrition negatively affect academic performance, productivity, and general wellbeing of adolescents; therefore, effective measures should be put in place to correct and eradicate these nutritional problems.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Douglas Mugarura ◽  
Herbert Izo Ninsiima ◽  
Hellen Kinyi ◽  
Ejike Daniel Eze ◽  
Sam Tumwesigire ◽  
...  

The prevalence of stunting among children in Uganda and Sub-Saharan Africa is still high, and if Uganda is to achieve the food-related Sustainable Development Goals (SDGs), it must urgently invest in improving nutrition and sanitation. In a food rich area like Bushenyi, chronic undernutrition could be due to several other factors than mere scarcity of food. The Objective(s). This study was carried out to determine the prevalence and socioclinical factors responsible for chronic undernutrition (stunting) among preschool children aged 1–5 years in selected Health facilities in Bushenyi district. Methodology. This was a cross-sectional study assessing the prevalence of stunting and its associated factors among children aged 1–5 years attending selected health centers in Bushenyi District. Data was collected using a pretested questionnaire, taking anthropometric measurements (height/length), and stool analysis for eggs of soil-transmitted helminthes. Prevalence of stunting was presented as percentages. Logistic regression with adjusted prevalence ratio was performed to test the association between the sociodemographic and clinical factors and stunting at bivariate levels of analysis. Results. Most of the children were female, with a median age of 2.1 years and resided in semiurban areas of Bushenyi with their parents. Prevalence of stunting was 89.3%. Only 10.7% of the children were infested with soil-transmitted helminthes. Children likely to be stunted were those who drank unboiled water and were exclusively breastfed. Conclusion. There is a high prevalence of chronic malnutrition in Bushenyi district associated with parents’/care takers’ low level of knowledge.


2016 ◽  
Vol 52 (02) ◽  
pp. 076-099
Author(s):  
Gagandeep Singh ◽  
Monika Singla

ABSTRACTNeurocysticercosis (NCC) is infestation of the human brain by the larva of worm, Taenia solium and is the most prevalent central nervous system (CNS) helminthiasis. The disease is widespread in tropical and subtropical regions of the world, including the Indian subcontinent, China, Sub-Saharan Africa, Central and South America and contributes substantially to the burden of epilepsy in these areas(1) . CNS involvement is seen in 60-90% of systemic cysticercosis. About 2.5 million people worldwide are infected with T. solium, and antibodies to T. solium are seen in up to 25% of people in endemic areas(1-3) . A higher prevalence of epilepsy and seizures in endemic countries is partly because of a high prevalence of cysticercosis in these regions. Seizures are thought to be caused by NCC in as many as 30% of adult patients and in 51% of children in population based endemic regions (2) . About 12% of admissions to neurological services in endemic regions are attributed to NCC and nearly half a million deaths occurring annually worldwide can be attributed directly or indirectly to NCC (Bern et al.). Punctate calcific foci on CT scan are a very common finding in asymptomatic people residing in endemic areas, found in 14-20 % of CT scans. Both seizures and positive cysticercus serology are associated with the detection of cysticerci on CT scans. Seroprevalence using a recently developed CDC- based enzyme-linked immunotransfer blot (EITB) assay is estimated at 8-12% in Latin America and 4.9-24% in Africa and South-East Asia. It is estimated that 20 million people harbour neurocysticercosis worldwide(1) .


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