Evidence map›Paper›PMID 27128675›Full record

Observational studyPloS one2016

G6PD Deficiency and Antimalarial Efficacy for Uncomplicated Malaria in Bangladesh: A Prospective Observational Study.

Benedikt Ley, Mohammad Shafiul Alam, Kamala Thriemer, Mohammad Sharif Hossain, Mohammad Golam Kibria, Sarah Auburn, Eugenie Poirot, Ric N Price, Wasif Ali Khan

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02389374 (A Study to Assess Safety of Current Standard Malaria Treatment and an Assessment of Glucose-6-dehydrogenase Status in South-east Bangladesh), which is not on this map. Cited by 32 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 12 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02389374 phase4completednot on this map

A Study to Assess Safety of Current Standard Malaria Treatment and an Assessment of Glucose-6-dehydrogenase Status in South-east Bangladesh

TypeinterventionalSponsorMenzies School of Health ResearchRan2014 to 2015Enrolled181ConditionsMalariaArmschloroquine, Artemether-lumefantrine combination, Primaquine
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 12 syntheses or guidelines pooled it, 47 citations in OpenAlex.

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  19. Novel highly-multiplexed AmpliSeq targeted assay forFrontiers in cellular and infection microbiology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 4 countries.

Benedikt LeyGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
Mohammad Shafiul AlamInternational Centre for Diarrheal Diseases and Research, Dhaka, Bangladesh.
Kamala ThriemerGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
Mohammad Sharif HossainInternational Centre for Diarrheal Diseases and Research, Dhaka, Bangladesh.
Mohammad Golam KibriaInternational Centre for Diarrheal Diseases and Research, Dhaka, Bangladesh.
Sarah AuburnGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
Eugenie PoirotGlobal Health Group, University of California San Francisco, San Francisco, California, United States of America.
Ric N PriceGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
Wasif Ali KhanInternational Centre for Diarrheal Diseases and Research, Dhaka, Bangladesh.
International Centre for Diarrhoeal Disease Research · BDCharles Darwin University · AUGlobal Brain Health Institute · USMenzies School of Health Research · AU

Funding

Wellcome Trust 091625
6 · The paper itself

Abstract

backgroundThe Bangladeshi national treatment guidelines for uncomplicated malaria follow WHO recommendations but without G6PD testing prior to primaquine administration. A prospective observational study was conducted to assess the efficacy of the current antimalarial policy.

methodsPatients with uncomplicated malaria, confirmed by microscopy, attending a health care facility in the Chittagong Hill Tracts, Bangladesh, were treated with artemether-lumefantrine (days 0-2) plus single dose primaquine (0.75mg/kg on day2) for P. falciparum infections, or with chloroquine (days 0-2) plus 14 days primaquine (3.5mg/kg total over 14 days) for P. vivax infections. Hb was measured on days 0, 2 and 9 in all patients and also on days 16 and 30 in patients with P. vivax infection. Participants were followed for 30 days. The study was registered with the clinical trials website (NCT02389374).

resultsBetween September 2014 and February 2015 a total of 181 patients were enrolled (64% P. falciparum, 30% P. vivax and 6% mixed infections). Median parasite clearance times were 22.0 (Interquartile Range, IQR: 15.2-27.3) hours for P. falciparum, 20.0 (IQR: 9.5-22.7) hours for P. vivax and 16.6 (IQR: 10.0-46.0) hours for mixed infections. All participants were afebrile within 48 hours, two patients with P. falciparum infection remained parasitemic at 48 hours. No patient had recurrent parasitaemia within 30 days. Adjusted male median G6PD activity was 7.82U/gHb. One male participant (1/174) had severe G6PD deficiency (<10% activity), five participants (5/174) had mild G6PD deficiency (10-60% activity). The Hb nadir occurred on day 2 prior to primaquine treatment in P. falciparum and P. vivax infected patients; mean fractional fall in Hb was -8.8% (95%CI -6.7% to -11.0%) and -7.4% (95%CI: -4.5 to -10.4%) respectively.

conclusionThe current antimalarial policy remains effective. The prevalence of G6PD deficiency was low. Main contribution to haemolysis in G6PD normal individuals was attributable to acute malaria rather than primaquine administration.

trial registrationClinicalTrials.gov NCT02389374.

Indexed as

AdolescentAdultAgedAntimalarialsBangladeshChildChild, PreschoolFemaleGlucosephosphate Dehydrogenase DeficiencyHumansInfantMalaria, FalciparumMalaria, VivaxMaleMiddle AgedYoung AdultAntimalarials

Identifiers

PMID27128675
PMCPMC4851315
OpenAlexW2344402727

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.