Screening for G6PD Enzyme Deficiency Among Children aged Five Years and Below in Diyala Province / Iraq.

Abstract

Background: G6PD deficiency is the most common gene mutation in the world and the numerous mutations have been classified by the WHO.

Objective: is to estimate the prevalence of G6PD enzyme deficiency among ≤5 years old children attending Al Batool Obstetrics and Pediatric Teaching Hospital in Baqubah city, Diyala, Iraq, and to see whether screening for G6PD enzyme deficiency is worthy.

Study setting, design and sample size: A hospital based observational cross-sectional study consisting of 1500 children (820 boys and 680 girls), in children aged 5 years and below who attended Al Batool Obstetrics and Pediatric Teaching Hospital in Baqubah city, Diyala, Iraq during period from December 1^st 2018 to June30^th 2019. Blood samples were collected from each child and analyzed for Hemoglobin (Hb) level, and G6PD enzyme activity assay.

Results: Out of 1500 children tested for enzyme activity only 20 children (1.33%) had low enzyme activity.

Conclusion: The prevalence of G6PD enzyme deficiency is low, so screening for the enzyme deficiency is not warranted at least in Diyala province.

Keywords

• Screening,G6PD,children

References

1. [1]Minucci A, Giardina B, Zuppi C, Capoluongo E. Glucose-6-phosphate laboratory assay: How, when, and why? IUBMB Life. 2009; 61:27–34.
2. [2] Saha N, Hawkins BR, Wong HB: Distribution of ABO and Rhesus blood groups in G6PD deficient Chinese and Malay newborns; Acta Genet Med Gemellol (Roma). 1975;24(1-2):131-5
3. [3]Bancone, G.; Kalnoky, M.; Chu, C.S.; Chowwiwat, N.; Kahn, M.; Malleret, B.; el al ; The G6PD flow-cytometric assay is a reliable tool for diagnosis of G6PD deficiency in women and anaemic subjects. Sci. Rep. 2017, 7, 9822
4. [4] Getasew Shitaye, Endalamaw Gadisa, Lynn Grignard, Girma Shumie, Wakweya Chali, Temesgen Menberu et al: Low and heterogeneous prevalence of glucose-6-phosphate dehydrogenase deficiency in different settings in Ethiopia using phenotyping and genotyping approaches, Malaria Journal201817:281; doi.org/10.1186/s12936-018-2437-8
5. [5]Kalnoky, M.; Bancone, G.; Kahn, M.; Chu, C.S.; Chowwiwat, N.;Wilaisrisak, P. et al. Cytochemical flow analysis of intracellular G6PD and aggregate analysis of mosaic G6PD expression. Eur. J. Haematol. 2018, 100, 294–303.
6. [6] Nantakomol, D.; Paul, R.; Palasuwan, A.; Day, N.P.; White, N.J.; Imwong, M. Evaluation of the phenotypic test and genetic analysis in the detection of glucose-6-phosphate dehydrogenase deficiency. Malar. J. 2013, 12, 289.
7. [7]Peters, A.L.; Veldthuis, M.; van Leeuwen, K.; Bossuyt, P.M.M.; Vlaar, A.P.J.; van Bruggen, R.; et al: Comparison of Spectrophotometry, Chromate Inhibition, and Cytofluorometry Versus Gene Sequencing for Detection of Heterozygously Glucose-6-Phosphate Dehydrogenase-Deficient Females. J. Histochem. Cytochem. Off. J. Histochem. Soc. 2017, 65, 627–636.
8. [8] Ogunlesi, T. A., Dedeke, I. O., Adekanmbi, A. F., Fetuga, M. B. & Ogunfowora, O. B. The incidence and outcome of bilirubin encephalopathy in Nigeria: a bi-centre study. Journal of the National Association of Resident Doctors of Nigeria 16, 354–359 (2007).

9. [9] Cunningham, A. D., Hwang, S. & Mochly-Rosen, D. Glucose-6- Phosphate Dehydrogenase Deficiency and the Need for a Novel Treatment to Prevent Kernicterus. Clinics in perinatology 43, 341–354, https://doi.org/10.1016/j.clp.2016.01.010 (2016).
10. [10] WHO Working Group. Glucose-6-phosphate dehydrogenase deficiency. Bull. World Health Organ. 1989, 67, 601–611.
11. [11]Amin-Zaki L, Taj El-Din S, Kubba K. Glucose-6-phosphate dehydrogenase deficiency among ethnic groups in Iraq. Bull World Health Organ 1972; 47(1):1-5.
12. [12]Usanga EA, Ameen R. Glucose-6-phosphate dehydrogenase deficiency in Kuwait, Syria, Egypt, Iran, Jordan and Lebanon. Hum Hered. 2000; 50(3): 158-61.
13. [13]Hamamy HA, Saeed TK. Glucose-6-phosphate dehydrogenase deficiency in Iraq. Hum Genet 1981; 58(4): 434-5.
14. [14]Hilmi FA, Al-Allawi NA, Rassam M, AlShamma G, Al-Hashimi A. Red cell glucose-6-phosphate dehydrogenase phenotypes in Iraq. East Mediterr Health J. 2002; 8(1): 42-8.
15. [15]Al-Allawi N, Eissa AA, Jubrael JMS, Jamal SAAR, Hamamy H. Prevalence and molecular characterization of Glucose-6-Phosphate dehydrogenase deficient variants among the Kurdish population of Northern Iraq. BMC Blood Disord. 2010; 10:6.
16. [16]Center of Arab Genomic Studies(The Catalogue for Transmission Genetics in Arabs / CTGA Database). 22252 Dubi, United Arab Emirates
17. [17]Teebi AS. Introduction. In: Teebi AS, Farag TI, editors. Genetic Disorders among Arab Populations. New York (NY): Oxford University Press; 1997. pp. 1-26.
18. [18]Warsy AS, El-Hamzi MA,G6PD Deficiency, Distribution And Variants In Saudi Arabia: An overview: Annals of Saudi Medicine: 2001: pp.174- 177
19. [19]Alabdulaali MK, Alayed KM et al. Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency and Sickled cell trait among blood donors in Riyadh. Asian J Transf Sci, 2010: 4: pp.31-33
20. [20]Al-Riyami A, Ebrahim GJ. Genetic Blood Disorders Survey in the Sultanate of Oman. J Trop Pediatr 2003; 49 pp.11-20.
21. [21]White JM, Christie BS, Nam D, Daar S, Higgs DR. Frequency and clinical significance of erythrocyte genetic abnormalities in Omanis. J Med Genet 1993; 30: pp.396-400
22. [22]Amin-Zaki L, El-Din ST, Kubba K. Glucose-6- phosphate Dehydrogenase Deficiency among Ethnic Groups in Iraq. WHO Bull 1972; 47: pp.1-5.
23. [23] He M, Lin K, Huang Y, Zhou L, Yang Q, Li S, Jiang W.; Prevalence and Molecular Study of G6PD Deficiency in the Dai and Jingpo Ethnic Groups in the Dehong Prefecture of the Yunnan Province. Hum Hered. 2018;83(2):55-64. doi: 10.1159/000489009.
24. [24]Hammamy HA, Saeed TK. Glucose-6-Phosphate Dehydrogenase Deficiency in Iraq. Hum Genet, 1981: 58: pp.434-435
25. [25]Hilmi FA, Al-Allawi NA, Rassam M, Al-Shamma G, Al-Hashimi A, 2002. Red cell glucose-6-phosphate dehydrogenase phenotypes in Iraq. East Mediterr Health J 8: pp.42–48.
26. [26]Anvery SM. Glucose-6-phosphate dehydrogenase deficiency in Abu Dhabi. Emirates Medical Journal 1980; 1: pp.24-26
27. [27]Miller et al. A Hematological Survey Of Preschool Children Of United Arab Emirates. Saudi Med J 2003: 24. pp.09-613 [28]Settin A, Al-Haggar M et al. Screening for G6PD Mediterranean mutation among Egyptian neonates with high or prolonged jaundice. Haema 2006: 9 (1):pp.83-90.
28. [29]Usanga EA, Ameen R. Glucose-6-phosphate Dehydrogenase Deficiency in Kuwait, Syria, Egypt, Iran, Jordan and Lebanon. Hum Hered 2000; 50: pp.158-61.
29. [30]H Hamamy, A Alwan. Hereditary Disorders in the Eastern Mediterranean Region. Bulletin of the World Health Organization, 1994, 72: pp.145-154
30. [31] El-Megdadi F et al. Pyruvate kinase and glucose-6- phosphate dehydrogenase activities in children living above (Jordan vally) and below (Amman and Irbid) sea level. Journal of Chinese clinical Medicine. 2008: 3: pp.633-638.
31. [32]Der Kaloustian VM, Naffah J, Loiselet J.:Genetic Diseases in Lebanon. Am J Med Genet 1980; 7: pp.187-203.
32. [33] Ragab AH, El-Alfi OS, Abboud AM. Incidence of Glucose-6- phosphate Dehydrogenase Deficiency in Egypt. Am J Hum Genet 1966; 18: pp.21-25.
33. [34] El-Menshay AA, Khalifa NM et al. Prevalence of Glucose-6- Phosphate Dehydrogenase Deficiency in Jaundice Neonate in Egypt. Australian Journal of Basic and Applied Sciences. 2009:3: pp.2016- 2023
34. [35] Blibech R, Gharbi Y, Mrad A, Zahra H, Mahjoub T, Belhaj A, et al:. Incidence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Tunisian populations. Nouv Rev Fr Hematol. 1989; 31:pp.189-91.
35. [36] A. J. Baxi, V. Balakrishnan, J. V. Undevia, and L. D. Sanghvi, “Glucose-6-phosphate dehydrogenase deficiency in the Parsee community, Bombay.,” Indian journal of medical sciences, vol. 17, pp. 493–500, 1963.
36. [37] S.N. Naik, “Glucose-6-phosphate dehydrogenase deficiency in India and its clinical significance.,” The Journal of the Association of Physicians of India, vol.42,no.3,pp.229–234,1994.
37. [38]Chan TK. Glucose-6-phosphate dehydrogenase deficiency: A review glucose-6-phosphate dehydrogenase. University of Hong Kong; 2013.
38. [39]Bhutan VK, Kaplan M, Gladder B, Cotton M, Kleinert J, Pamula V. Point of-care quantitative measure of glucose-6-phosphate dehydrogenase enzyme deficiency. Pediatrics. 2015 Nov;:2122.
39. [40]Hameed NN, Na’ Ma AM, Vilms R, Bhutani VK. Severe neonatal hyperbilirubinemia and adverse short-term consequences in Baghdad, Iraq. Neonatology. 2011;100(1):57–63.
40. [41] Iranpour R, Hashimpour M, Talaei SM, Soroshnia M, Amini A. :Newborn screening for glucose-6-phosphate dehydrogenase deficiency in Isfahan, Iran: a quantitative assay. J Med Screen. 2008;15:62–64.
41. [42] Hassan MK, Taha JY, Al-Naama LM, Widad NM, Jasim SN. Frequency of haemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency in Basra. East Mediterr Health J. 2003;9:
42. [43] Soheir Abo Elella, Mahaa Tawfik, Naglaa Barseem, and Wafaa Moustafa: Prevalence of glucose-6-phosphate dehydrogenase deficiency in neonates in Egypt; Ann Saudi Med. 2017 Sep-Oct; 37(5): 362–365