Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency and Gametocytemia in a Pre-Elimination, Low Malaria Transmission Setting in Southern Zambia

Tamaki Kobayashi Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;

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Shaheen Kurani Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota;
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota;

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Harry Hamapumbu Macha Research Trust, Choma, Zambia;

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Jennifer C. Stevenson Macha Research Trust, Choma, Zambia;
W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

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Philip E. Thuma Macha Research Trust, Choma, Zambia;
W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

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William J. Moss Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

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for the Southern and Central Africa International Centers of Excellence for Malaria Research
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ABSTRACT

The WHO recommends single low-dose (SLD) primaquine as a gametocytocide to reduce Plasmodium falciparum transmission in areas of low transmission. Despite this recommendation, uptake of SLD primaquine has been low because of concerns of glucose-6-phosphate dehydrogenase (G6PD) deficiency. Individuals with G6PD deficiency can experience hemolysis when exposed to primaquine. In Southern Province, Zambia, malaria transmission has declined significantly over the past decade. Single low-dose primaquine may be an effective tool, but there is limited information on G6PD deficiency. We screened 137 residents in Macha, Southern Province, Zambia, and the prevalence of G6PD (A−) was 15%. We also revisited data collected from 2008 to 2013 in the same area and found the highest gametocyte burden among those aged 5–15 years. The findings from this study suggest that SLD primaquine targeted to school-aged children may be an effective tool to help achieve malaria elimination in southern Zambia.

Author Notes

Address correspondence to Tamaki Kobayashi, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., W4612, Baltimore, MD 21231. E-mail: tkobaya2@jhu.edu

The Southern and Central Africa International Centers of Excellence for Malaria Research includes the Biomedical Research and Training Institute, Zimbabwe; Johns Hopkins Malaria Research Institute, USA; Macha Research Trust, Zambia; National Institute of Health Research, Zimbabwe; Tropical Diseases Research Center, Zambia; University of the Witwatersrand, South Africa; and Université Protestante au Congo.

Financial support: This work was supported by the Johns Hopkins Malaria Research Institute, the Bloomberg Philanthropies, and the Division of Microbiology and Infectious Diseases, National Institutes of Allergies and Infectious Diseases, and National Institutes of Health as part of the International Centers of Excellence for Malaria Research (U19 AI089680).

Authors’ addresses: Tamaki Kobayashi, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: tkobaya2@jhu.edu. Shaheen Kurani, Mayo Clinic, Health Sciences Research, Rochester, MN, and Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, E-mail: kurani.shaheen@mayo.edu. Harry Hamapumbu, Macha Research Trust, Choma, Zambia, E-mail: harry.hamapumbu@macharesearch.org. Jennifer C. Stevenson, Macha Research Trust, Choma, Zambia, and W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: jennyc.stevenson@macharesearch.org. Philip E. Thuma, Macha Research Trust, Clinical Research Department, Choma, Zambia, and W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: phil.thuma@macharesearch.org. William J. Moss, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: wmoss1@jhu.edu.

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