Association of glucose-6-phosphate dehydrogenase deficiency and malaria: a systematic review and meta-analysis

作者：Mbanefo Evaristus Chibunna; Ahmed Ali Mahmoud; Titouna Afaf; Elmaraezy Ahmed; Nguyen Thi Huyen Trang; Nguyen Phuoc Long; Nguyen Hoang Anh; Tran Diem Nghi; Bui The Hung; Mai Van Hieu; Nguyen Ky Anh; Nguyen Tien Huy^*; Hirayama Kenji^*

来源：Scientific Reports, 2017, 7(1): 45963.

DOI：10.1038/srep45963

Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency overlaps with malaria endemicity although it predisposes carriers to hemolysis. This fact supports the protection hypothesis against malaria. The aim of this systematic review is to assess the presence and the extent of protective association between G6PD deficiency and malaria. Thirteen databases were searched for papers reporting any G6PD alteration in malaria patients. Twenty-eight of the included 30 studies were eligible for the metaanalysis. Results showed absence of negative association between G6PD deficiency and uncomplicated falciparum malaria (odds ratio (OR), 0.77; 95% confidence interval (CI), 0.59-1.02; p = 0.07). However, this negative association happened in Africa (OR, 0.59; 95% CI, 0.40-0.86; p = 0.007) but not in Asia (OR, 1.24; 95% CI, 0.96-1.61; p = 0.10), and in the heterozygotes (OR, 0.70; 95% CI, 0.57-0.87; p = 0.001) but not the homo/hemizygous (OR, 0.70; 95% CI, 0.46-1.07; p = 0.10). There was no association between G6PD deficiency and total severe malaria (OR, 0.82; 95% CI, 0.61-1.11; p = 0.20). Similarly, there was no association with other malaria species. G6PD deficiency can potentially protect against uncomplicated malaria in African countries, but not severe malaria. Interestingly, this protection was mainly in heterozygous, being x-linked thus related to gender.

• 出版日期2017-4-6