scholarly journals Influence of hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency on diagnosis of diabetes by HbA1c among Tanzanian adults with and without HIV: A cross-sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244782
Author(s):  
Belinda Kweka ◽  
Eric Lyimo ◽  
Kidola Jeremiah ◽  
Suzanne Filteau ◽  
Andrea M. Rehman ◽  
...  
Keyword(s):  
Sickle Cell ◽  
G6pd Deficiency ◽  
Sickle Cell Trait ◽  
Sub Saharan Africa ◽  
Oral Glucose ◽  
Chronic Infections ◽  
Cross Sectional ◽  
Adjusted Analysis ◽  
High Prevalence ◽  
Glucose 6 Phosphate Dehydrogenase

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.

scholarly journals Glucose 6 phosphate dehydrogenase deficiency and hemoglobinopathy in South Western Region Nepal: a boon or burden

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Narayan Gautam ◽  
Bhagwati Gaire ◽  
Trishna Manandhar ◽  
Bishnu P. Marasini ◽  
Niranjan Parajuli ◽  
...  
Keyword(s):  
Sickle Cell ◽  
G6pd Deficiency ◽  
Sickle Cell Trait ◽  
Amplification Refractory Mutation System ◽  
Cellulose Acetate Electrophoresis ◽  
Positive Trait ◽  
Arms Pcr ◽  
Phenotypic Method ◽  
Mutation System ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract Objectives The study was carried out to optimize the phenotypic method to characterize the sickle cell trait (SCT), sickle cell anemia (SCA), and β-thalassemia (β-TT) suspected sample from tharu community of South Western province-5, Nepal. SCT and SCA were further evaluated by genotypic method employing amplification refractory mutation system (ARMS PCR). Moreover, Glucose 6 phosphate dehydrogenase (G6PD) was estimated in those hemoglobinopathy to observe its prevalence. The accurate and reliable method can play an important role in reduction of morbidity and mortality rate. Results The 100 suspected cases were subjected to phenotypic method adopting cellulose acetate electrophoresis and genotypic method using ARMS PCR which portraits (5%) SCA positive test showing HBS/HBS, (38%) SCT positive trait HBA/HBS and (36%) cases normal HBA/HBA. β-TT (21%) cases were confirmed by electropherogram. G6PD deficiency was observed in (40%) of SCA, (18.4%) of SCT, (4.8%) of β-TT and (2.8%) in normal cases. Increased G6PD were developed only in SCT (5.3%) and β-TT (4.8%). The study highlighted sickle cell disorder (SCD) and β-TT as the most common hemoglobinopathy coexisting with G6PD deficiency. Though hemoglobinopathy sometime could be protective in malaria but G6PD deficiency can cause massive hemolysis which may exacerbate the condition.

scholarly journals Genotypic glucose-6-phosphate dehydrogenase (G6PD) deficiency protects against Plasmodium falciparum infection in individuals living in Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257562
Author(s):  
Linda Eva Amoah ◽  
Kwame Kumi Asare ◽  
Donu Dickson ◽  
Joana Abankwa ◽  
Abena Busayo ◽  
...  
Keyword(s):  
G6pd Deficiency ◽  
Malaria Prevalence ◽  
Health Care Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Length Polymorphisms ◽  
G6pd Gene ◽  
High Prevalence ◽  
Care Facilities ◽  
Glucose 6 Phosphate Dehydrogenase

Introduction The global effort to eradicate malaria requires a drastic measure to terminate relapse from hypnozoites as well as transmission via gametocytes in malaria-endemic areas. Primaquine has been recommended for the treatment of P. falciparum gametocytes and P. vivax hypnozoites, however, its implementation is challenged by the high prevalence of G6PD deficient (G6PDd) genotypes in malaria endemic countries. The objective of this study was to profile G6PDd genotypic variants and correlate them with malaria prevalence in Ghana. Methods A cross-sectional survey of G6PDd genotypic variants was conducted amongst suspected malaria patients attending health care facilities across the entire country. Malaria was diagnosed using microscopy whilst G6PD deficiency was determined using restriction fragment length polymorphisms at position 376 and 202 of the G6PD gene. The results were analysed using GraphPad prism. Results A total of 6108 subjects were enrolled in the study with females representing 65.59% of the population. The overall prevalence of malaria was 36.31%, with malaria prevalence among G6PDd genotypic variants were 0.07% for A-A- homozygous deficient females, 1.31% and 3.03% for AA- and BA- heterozygous deficient females respectively and 2.03% for A- hemizygous deficient males. The odd ratio (OR) for detecting P. falciparum malaria infection in the A-A- genotypic variant was 0.0784 (95% CI: 0.0265–0.2319, p<0.0001). Also, P. malariae and P. ovale parasites frequently were observed in G6PD B variants relative to G6PD A- variants. Conclusion G6PDd genotypic variants, A-A-, AA- and A- protect against P. falciparum, P. ovale and P. malariae infection in Ghana.

scholarly journals Glucose-6-Phosphate Dehydrogenase (G6pd) Deficiency and Sickle Cell Trait among Blood Donors in Nigeria

2014 ◽  
Vol 2 (2) ◽  
pp. 51-55 ◽  
Author(s):  
Omisakin C.T ◽  
Esan A.J ◽  
Ogunleye A.A ◽  
O. Ojo-Bola ◽  
Owoseni M.F ◽  
...  
Keyword(s):  
Sickle Cell ◽  
G6pd Deficiency ◽  
Blood Donors ◽  
Sickle Cell Trait ◽  
Glucose 6 Phosphate Dehydrogenase

scholarly journals Glucose 6 Phosphate Dehydrogenase Deficiency and Hemoglobinopathy in South Western Region Nepal: A Boon or Burden

2019 ◽  
Author(s):  
Narayan Gautam ◽  
Bhagwati Gaire ◽  
Trishna Manandhar ◽  
Bishnu P Marasini ◽  
Niranjan Parajuli ◽  
...  
Keyword(s):  
Sickle Cell ◽  
G6pd Deficiency ◽  
Sickle Cell Trait ◽  
Amplification Refractory Mutation System ◽  
Cellulose Acetate Electrophoresis ◽  
Positive Trait ◽  
Arms Pcr ◽  
Phenotypic Method ◽  
Mutation System ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract Objectives: The study was carried out to optimize the phenotypic method to characterize the sickle cell trait (SCT), sickle cell anaemia (SCA) and β-thalassemia (β-TT) suspected sample from tharu community of South Western province-5, Nepal. SCT and SCA were further evaluated by genotypic method employing amplification refractory mutation system (ARMS PCR). Moreover, Glucose 6 Phosphate Dehydrogenase (G6PD) was estimated in those hemoglobinopathy to observe its prevalence. The accurate and reliable method can play an important role in reduction of morbidity and mortality rate. Results: The 100 suspected cases were subjected to phenotypic method adopting cellulose acetate electrophoresis and genotypic metod using ARMS PCR which portraits (5%) SCA positive test showing HBS/HBS, (38%) SCT positive trait HBA/HBS and (36%) cases normal HBA/HBA. β-TT (21%) cases were confirmed by electropherogram. G6PD deficiency was observed in (40%) of SCA, (18.4%) of SCT, (4.8%) of β-TT and (2.8%) in normal cases. Increased G6PD were developed only in SCT (5.3 %) and β-TT (4.8%). The study highlighted sickle cell disorder (SCD) and β-TT as the most common hemoglobinopathy coexisting with G6PD deficiency. Though hemoglobinopathy sometime could be protective in malaria but G6PD deficiency can cause massive hemolysis which may exacerbate the condition.

Screening of Glucose-6-Phosphate Dehydrogenase Deficiency in Neonatal Hyperbilirubinaemia at 300-Bedded Pyin Oo Lwin General Hospital

2019 ◽  
Vol 31 (3) ◽  
pp. 226-232
Keyword(s):  
General Hospital ◽  
G6pd Deficiency ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Cross Sectional ◽  
Qualitative And Quantitative ◽  
Quantitative Measurements ◽  
Human Enzyme ◽  
High Prevalence ◽  
Glucose 6 Phosphate Dehydrogenase

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human enzyme deficiencies in the world. It is particularly common in populations living in malaria-endemic areas, affecting more than 400 million people worldwide. This hospital- and laboratory-based, cross-sectional descriptive study was conducted with the aim of determining the prevalence of G6PD deficiency among 200 newborns at 300-bedded Pyin Oo Lwin General Hospital during January to March 2017. The participants were 103 girls (58.5%) and 97 boys (41.5%). Both qualitative and quantitative measurements by using Brewer's method and G-SIX kit method were applied for diagnosis of G6PD deficiency. Total serum bilirubin level was measured by Bilirubinometer. Of the 200 newborns, 21(10.5%) were G6PD deficient. The overall prevalence of G6PD deficiency was 10.5% (21/200) and male was predominant than female (17.5% vs 3.9%). Out of 10.5% (21/100)G6PD deficient newborns, 5(23.8%) and 16(76.2%) were mild and moderate G6PD deficiency, respectively. Regarding hyperbilirubinaemia, 9(42.9%), 3(14.3%), 2(19.0%) and 5(23.8%) were severe, moderate and mild hyperbilirubinaemia and normal bilirubin, respectively. This study showed that a significant correlation between the severity of hyperbili- rubinaemia and G6PD activity (p <0.05). Taking into consideration of the above results, the high prevalence can be useful for providing appropriate prevention and early treatment of complications in routine neonatal screening in this area.

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

2020 ◽  
Author(s):  
Jorge da Rocha ◽  
Houcemeddine Othman ◽  
Caroline T. Tiemessen ◽  
Gerrit Botha ◽  
Michèle Ramsay ◽  
...  
Keyword(s):  
Allele Frequency ◽  
G6pd Deficiency ◽  
Sequence Data ◽  
Sub Saharan Africa ◽  
Whole Genome Sequence ◽  
Interaction Factor ◽  
High Prevalence ◽  
Potential Risks ◽  
Sub Saharan ◽  
Glucose 6 Phosphate Dehydrogenase

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.

scholarly journals Frequency of haemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency in Basra

2003 ◽  
Vol 9 (1-2) ◽  
pp. 45-54
Author(s):  
M. K. Hassan ◽  
J. Y. Taha ◽  
L. M. Al Naama ◽  
N. M. Widad ◽  
S. N. Jasim
Keyword(s):  
Public Health ◽  
Sickle Cell ◽  
G6pd Deficiency ◽  
Sickle Cell Trait ◽  
Public Health Education ◽  
Management Plan ◽  
Beta Globin ◽  
Beta Thalassaemia ◽  
Thalassaemia Trait ◽  
Glucose 6 Phosphate Dehydrogenase

Basra, southern Iraq, was mapped for haemoglobinopathies and glucose-6-phosphate dehydrogenase [G6PD] deficiency. Of 1064 couples aged 14-60 years recruited from the Public Health Laboratory, 49 had beta-thalassaemia trait, 69 had sickle-cell trait, 2 had haemoglobin D trait, 2 had haemoglobin C trait and 1 had high persistent fetal haemoglobin. Carriers of major beta-globin disorders comprised 11.48%. G6PD deficiency was detected in 133 individuals [12.5%]. Only 10 couples [0.94%] were at risk of having children affected with either sickle-cell disease or beta-thalassaemia major. These defects constitute a real health problem and necessitate a management plan and public health education for early diagnosis and therapy

scholarly journals Glucose 6 Phosphate Dehydrogenase Deficiency and Hemoglobinopathy in South Western Region Nepal: A Boon or Burden

2019 ◽  
Author(s):  
Narayan Gautam ◽  
Bhagwati Gaire ◽  
Trishna Manandhar ◽  
Bishnu P Marasini ◽  
Niranjan Parajuli ◽  
...  
Keyword(s):  
Sickle Cell ◽  
G6pd Deficiency ◽  
Sickle Cell Trait ◽  
Amplification Refractory Mutation System ◽  
Cellulose Acetate Electrophoresis ◽  
Positive Trait ◽  
Arms Pcr ◽  
Phenotypic Method ◽  
Mutation System ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract Objectives: The study was carried out to optimize the phenotypic method to characterize the sickle cell trait (SCT), sickle cell anaemia (SCA) and β-thalassemia (β-TT) suspected sample from tharu community of South Western province-5, Nepal. SCT and SCA were further evaluated by genotypic method employing amplification refractory mutation system (ARMS PCR). Moreover, Glucose 6 Phosphate Dehydrogenase (G6PD) was estimated in those hemoglobinopathy to observe its prevalence. The accurate and reliable method can play an important role in reduction of morbidity and mortality rate. Results: The 100 suspected cases were subjected to phenotypic method adopting cellulose acetate electrophoresis and genotypic metod using ARMS PCR which portraits (5%) SCA positive test showing HBS/HBS, (38%) SCT positive trait HBA/HBS and (36%) cases normal HBA/HBA. β-TT (21%) cases were confirmed by electropherogram. G6PD deficiency was observed in (40%) of SCA, (18.4%) of SCT, (4.8%) of β-TT and (2.8%) in normal cases. Increased G6PD were developed only in SCT (5.3 %) and β-TT (4.8%). The study highlighted sickle cell disorder (SCD) and β-TT as the most common hemoglobinopathy coexisting with G6PD deficiency. Though hemoglobinopathy sometime could be protective in malaria but G6PD deficiency can cause massive hemolysis which may exacerbate the condition.

scholarly journals Validity of HbA1c in Diagnosing Diabetes Among People with Sickle Cell Trait in Tanzania

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4852-4852
Author(s):  
Belinda Kweka ◽  
Eric Lyimo ◽  
Jeremiah Kidola ◽  
Suzanne Filteau ◽  
Henrik Friis ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Sickle Cell ◽  
G6pd Deficiency ◽  
Conflicts Of Interest ◽  
Sickle Cell Trait ◽  
Categorical Variables ◽  
Oral Glucose ◽  
Diabetes Diagnosis ◽  
North Western ◽  
Western Tanzania

BACKGROUND: Hemoglobin A1c (HbA1c) measures the average of the past three month's glucose concentration and is recommended for diagnosing and monitoring diabetes. However in people with shorter red blood cells life spans like those with sickle cell trait (SCT), the test may underestimate the prevalence of diabetes. There are no data on the extent of this problem in East African region where the prevalence of SCT approaches 22%. OBJECTIVE: To compare diabetes diagnosis outcomes among adults with and without SCT by HbA1c and 2hrs oral glucose tolerance test (OGTT). METHODOLOGY: This was a cross sectional study conducted among patients who were previously recruited in the Chronic Infection, Cormobidities and Diabetes in Africa (CICADA) study, a cohort study investigating risk factors for diabetes in North western Tanzania during 2016 to 2021. Participants were included in this study if aged ≥18 years and were residents of Mwanza. After identification of eligible participants, stored blood samples were analyzed for SCT and other hemoglobinopathies i.e. thalassemia and G6PD deficiency through gene extraction, PCR and gel electrophoresis. Demographic, and anthropometric data as well as HbA1c and OGTT, hemoglobin, and lipids test results were available as part of CICADA study. Data were managed and analysed in stata. Student ttest was used for comparison of continuous variables while for categorical variables chi squire test was used. To investigate the validity of HbA1c, regression models were used to evaluate the association between SCT and diabetes diagnosis by HbA1c and OGTT separately. P< 0.05 indicated significant differences. RESULTS: 480 participants were included. Their mean age was 40.8 (±11.8) years, 292 (60.8%) were females, 128 (26.7%) had SCT and no sickle cell disease(SCD) which is homozygous trait observed. Those with SCT had lower body mass index (BMI) ((21.6(±4.3) vs. 22.5 (±5.0), P= 0.01) and lower HbA1c (5.2% vs. 5.9%, P<0.0001) compared to those without SCT. In multivariable logistic regression analysis adjusted for sex, age, BMI, another hemoglobinopathy which is thalassemia , G6PD deficiency , hemoglobin and lipids , participants with SCT were 88% less likely to be diagnosed with diabetes by HbA1c compared to those without SCT (OR=0.12, 95% CI (0.1,0.2), P <0.001). In contrast to logistic regression model adjusted for the same variables as above, SCT was not associated with diabetes diagnosis by OGTT (1.44, 95% CI (0.9, 2.3), P= 0.12). CONCLUSION: When compared with OGTT the findings shows that HbA1c systematically underestimate the prevalence of diabetes among people with SCT. The use of HbA1c for diabetes diagnosis should be done with caution especially in areas with high prevalence of SCT like in North Western Tanzania. Further research is needed to optimize the use of HbA1c in diagnosing and monitoring diabetes among people with SCT. Disclosures No relevant conflicts of interest to declare.

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