ArticlePLoS neglected tropical diseases2015
G6PD deficiency at Sumba in Eastern Indonesia is prevalent, diverse and severe: implications for primaquine therapy against relapsing Vivax malaria.
Article in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 48 citations in OpenAlex.
- G6PD deficiency in Indonesia: a systematic review and update of prevalence and variant maps in the context of malaria elimination.The Lancet regional health. Western Pacific · 2026Article
- No G6PD A- (G202A) variant detected amongMalariaWorld journal · 2026Article
- Community perceptions and acceptance of ivermectin for malaria control on Sumba Island, Indonesia.PloS one · 2026Article
- Shrinking the malaria map in Indonesia: progress of subnational control, elimination, and future strategies.BMC medicine · 2025Review
- Challenges associated with dapsone for leprosy treatment in Indonesia - urgent need for access to alternative antimicrobial drugs.The Lancet regional health. Southeast Asia · 2025Review
- An insight into Indonesia's progress for newborn screening program: What is currently going on.Heliyon · 2024Article
- Case Series of Primaquine-Induced Haemolytic Events in Controlled Trials with G6PD Screening.Pathogens (Basel, Switzerland) · 2023Article
- Glucose-6-Phosphate Dehydrogenase (G6PD) Measurement Using Biosensors by Community-Based Village Malaria Workers and Hospital Laboratory Staff in Cambodia: A Quantitative Study.Pathogens (Basel, Switzerland) · 2023Article
- Genetic Variants of Glucose-6-Phosphate Dehydrogenase and Their Associated Enzyme Activity: A Systematic Review and Meta-Analysis.Pathogens (Basel, Switzerland) · 2022Review
- Massively parallel sequencing uncovered disease-associated variant spectra of glucose-6-phosphate dehydrogenase deficiency, phenylketonuria and galactosemia in Vietnamese pregnant women.Molecular genetics & genomic medicine · 2022Article
- Population pharmacogenomics: an update on ethnogeographic differences and opportunities for precision public health.Human genetics · 2022Review
- Developing sero-diagnostic tests to facilitate Plasmodium vivax Serological Test-and-Treat approaches: modeling the balance between public health impact and overtreatment.BMC medicine · 2022Article
- Repeatability and reproducibility of a handheld quantitative G6PD diagnostic.PLoS neglected tropical diseases · 2022Article
- Distribution of G6PD deficiency genotypes among Southeast Asian populations.Tropical medicine and health · 2021Review
- Genotypes and phenotypes of G6PD deficiency among Indonesian females across diagnostic thresholds of G6PD activity guiding safe primaquine therapy of latent malaria.PLoS neglected tropical diseases · 2021Article
- Knowledge Gaps in Understanding the Etiology of Anemia in Indonesian Adolescents.Food and nutrition bulletin · 2021Review
- G6PD Variants and Haemolytic Sensitivity to Primaquine and Other Drugs.Frontiers in pharmacology · 2021Review
- Wide range of G6PD activities found among ethnic groups of the Chittagong Hill Tracts, Bangladesh.PLoS neglected tropical diseases · 2020Article
- Prevalence of Glucose 6-Phosphate Dehydrogenase Variants in Malaria-Endemic Areas of South Central Timor, Eastern Indonesia.The American journal of tropical medicine and hygiene · 2020Article
- G6PD genetic variations in neonatal Hyperbilirubinemia in Indonesian Deutromalay population.BMC pediatrics · 2019Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
Safe treatment of Plasmodium vivax requires diagnosis of both the infection and status of erythrocytic glucose-6-phosphate dehydrogenase (G6PD) activity because hypnozoitocidal therapy against relapse requires primaquine, which causes a mild to severe acute hemolytic anemia in G6PD deficient patients. Many national malaria control programs recommend primaquine therapy without G6PD screening but with monitoring due to a broad lack of G6PD deficiency screening capacity. The degree of risk in doing so hinges upon the level of residual G6PD activity among the variants present in any given area. We conducted studies on Sumba Island in eastern Indonesia in order to assess the potential threat posed by primaquine therapy without G6PD screening. We sampled 2,033 residents of three separate districts in western Sumba for quantitative G6PD activity and 104 (5.1%) were phenotypically deficient (<4.6U/gHb; median normal 10U/gHb). The villages were in two distinct ecosystems, coastal and inland. A positive correlation occurred between the prevalence of malaria and G6PD deficiency: 5.9% coastal versus inland 0.2% for malaria (P<0.001), and 6.7% and 3.1% for G6PD deficiency (P<0.001) at coastal and inland sites, respectively. The dominant genotypes of G6PD deficiency were Vanua Lava, Viangchan, and Chatham, accounting for 98.5% of the 70 samples genotyped. Subjects expressing the dominant genotypes all had less than 10% of normal enzyme activities and were thus considered severe variants. Blind administration of anti-relapse primaquine therapy at Sumba would likely impose risk of serious harm.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.