{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:15:59Z","timestamp":1783764959908,"version":"3.55.0"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T00:00:00Z","timestamp":1619136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1054404"],"award-info":[{"award-number":["OPP1054404"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["200909"],"award-info":[{"award-number":["200909"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Georgina Sweet Award for Women in Quantitative Biomedical Science"},{"name":"CSL Centenary fellow"}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Glucose-6-phosphate dehydrogenase (G6PD) activity is dependent upon <jats:italic>G6PD<\/jats:italic> genotype and age of the red blood cell (RBC) population, with younger RBCs having higher activity. Peripheral parasitemia with <jats:italic>Plasmodium<\/jats:italic> spp. induces hemolysis, replacing older RBCs with younger cells with higher G6PD activity. This study aimed to assess whether G6PD activity varies between individuals with and without malaria or a history of malaria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>Individuals living in the Chittagong Hill Tracts of Bangladesh were enrolled into 3 complementary studies: (i) a prospective, single-arm clinical efficacy trial of patients (<jats:italic>n =<\/jats:italic> 175) with uncomplicated malaria done between 2014 and 2015, (ii) a cross-sectional survey done between 2015 and 2016 (<jats:italic>n =<\/jats:italic> 999), and (iii) a matched case\u2013control study of aparasitemic individuals with and without a history of malaria done in 2020 (<jats:italic>n =<\/jats:italic> 506). G6PD activity was compared between individuals with and without malaria diagnosed by microscopy, rapid diagnostic test (RDT), or polymerase chain reaction (PCR), and in aparasitemic participants with and without a history of malaria. In the cross-sectional survey and clinical trial, 15.5% (182\/1,174) of participants had peripheral parasitemia detected by microscopy or RDT, 3.1% (36\/1,174) were positive by PCR only, and 81.4% (956\/1,174) were aparasitemic. Aparasitemic individuals had significantly lower G6PD activity (median 6.9 U\/g Hb, IQR 5.2\u20138.6) than those with peripheral parasitemia detected by microscopy or RDT (7.9 U\/g Hb, IQR 6.6\u20139.8, <jats:italic>p &lt;<\/jats:italic> 0.001), but G6PD activity similar to those with parasitemia detected by PCR alone (submicroscopic parasitemia) (6.1 U\/g Hb, IQR 4.8\u20138.6, <jats:italic>p =<\/jats:italic> 0.312). In total, 7.7% (14\/182) of patients with malaria had G6PD activity &lt; 70% compared to 25.0% (248\/992) of participants with submicroscopic or no parasitemia (odds ratio [OR] 0.25, 95% CI 0.14\u20130.44, <jats:italic>p &lt;<\/jats:italic> 0.001). In the case\u2013control study, the median G6PD activity was 10.3 U\/g Hb (IQR 8.8\u201312.2) in 253 patients with a history of malaria and 10.2 U\/g Hb (IQR 8.7\u201311.8) in 253 individuals without a history of malaria (<jats:italic>p =<\/jats:italic> 0.323). The proportion of individuals with G6PD activity &lt; 70% was 11.5% (29\/253) in the cases and 15.4% (39\/253) in the controls (OR 0.7, 95% CI 0.41\u20131.23, <jats:italic>p =<\/jats:italic> 0.192). Limitations of the study included the non-contemporaneous nature of the clinical trial and cross-sectional survey.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patients with acute malaria had significantly higher G6PD activity than individuals without malaria, and this could not be accounted for by a protective effect of G6PD deficiency. G6PD-deficient patients with malaria may have higher than expected G6PD enzyme activity and an attenuated risk of primaquine-induced hemolysis compared to the risk when not infected.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pmed.1003576","type":"journal-article","created":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T17:31:55Z","timestamp":1619199115000},"page":"e1003576","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Glucose-6-phosphate dehydrogenase activity in individuals with and without malaria: Analysis of clinical trial, cross-sectional and case\u2013control data from 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Swe","family":"Phru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6490-344X","authenticated-orcid":true,"given":"Jenifar Quaiyum","family":"Ami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7536-7497","authenticated-orcid":true,"given":"Kamala","family":"Thriemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4638-536X","authenticated-orcid":true,"given":"Sarah","family":"Auburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8700-2209","authenticated-orcid":true,"given":"Nusrat","family":"Jahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-7331","authenticated-orcid":true,"given":"Fatema 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Ley","year":"2019","journal-title":"BMC Res Notes"},{"key":"pmed.1003576.ref032","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/1475-2875-12-112","article-title":"Review of key knowledge gaps in glucose-6-phosphate dehydrogenase deficiency detection with regard to the safe clinical deployment of 8-aminoquinoline treatment regimens: a workshop report.","volume":"12","author":"L von Seidlein","year":"2013","journal-title":"Malar J."},{"key":"pmed.1003576.ref033","volume-title":"Guidelines for the treatment of malaria","author":"World Health Organization","year":"2015","edition":"3"},{"issue":"2","key":"pmed.1003576.ref034","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.hoc.2015.11.006","volume":"30","author":"L Luzzatto","year":"2016","journal-title":"Hematol Oncol Clin North Am"},{"issue":"1","key":"pmed.1003576.ref035","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/iub.137","article-title":"Glucose-6-phosphate dehydrogenase laboratory assay: how, when, and why?","volume":"61","author":"A Minucci","year":"2009","journal-title":"IUBMB Life"},{"key":"pmed.1003576.ref036","doi-asserted-by":"crossref","first-page":"e23061","DOI":"10.7554\/eLife.23061","article-title":"Modelling primaquine-induced haemolysis in G6PD deficiency.","volume":"6","author":"J Watson","year":"2017","journal-title":"Elife"},{"key":"pmed.1003576.ref037","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1182\/asheducation-2009.1.87","article-title":"Malaria, erythrocytic infection, and anemia.","volume":"2009","author":"K Haldar","year":"2009","journal-title":"Hematology Am Soc Hematol Educ Program"},{"issue":"1","key":"pmed.1003576.ref038","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1182\/blood-2006-09-018069","article-title":"Malarial anemia: of mice and men","volume":"110","author":"AA Lamikanra","year":"2007","journal-title":"Blood"},{"issue":"3","key":"pmed.1003576.ref039","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1172\/JCI106001","article-title":"Characteristics of marrow production and reticulocyte maturation in normal man in response to anemia","volume":"48","author":"RS Hillman","year":"1969","journal-title":"J Clin Invest"},{"issue":"3","key":"pmed.1003576.ref040","first-page":"439","article-title":"The hemolytic effect of primaquine. IV. The relationship of cell age to hemolysis","volume":"44","author":"E Beutler","year":"1954","journal-title":"J Lab Clin Med"},{"key":"pmed.1003576.ref041","first-page":"621","article-title":"Mitigation of the haemolytic effect of primaquine and enhancement of its action against exoerythrocytic forms of the Chesson strain of Plasmodium vivax by intermittent regimens of drug administration: a preliminary report","volume":"22","author":"AS Alving","year":"1960","journal-title":"Bull World Health Organ"},{"issue":"2","key":"pmed.1003576.ref042","first-page":"171","article-title":"The hemolytic effect of primaquine. II. The natural course of the hemolytic anemia and the mechanism of its self-limited character","volume":"44","author":"RJ Dern","year":"1954","journal-title":"J Lab Clin Med"},{"key":"pmed.1003576.ref043","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1186\/1475-2875-13-418","article-title":"Primaquine: the risks and the benefits.","volume":"13","author":"EA Ashley","year":"2014","journal-title":"Malar J"},{"issue":"12","key":"pmed.1003576.ref044","doi-asserted-by":"crossref","first-page":"e1002992","DOI":"10.1371\/journal.pmed.1002992","article-title":"Performance of the Access Bio\/CareStart rapid diagnostic test for the detection of glucose-6-phosphate dehydrogenase deficiency: a systematic review and meta-analysis.","volume":"16","author":"B Ley","year":"2019","journal-title":"PLoS Med."},{"issue":"2","key":"pmed.1003576.ref045","doi-asserted-by":"crossref","first-page":"e1002224","DOI":"10.1371\/journal.pmed.1002224","article-title":"Haemolysis in G6PD heterozygous females treated with primaquine for Plasmodium vivax malaria: a nested cohort in a trial of radical curative regimens.","volume":"14","author":"CS Chu","year":"2017","journal-title":"PLoS Med."},{"issue":"7","key":"pmed.1003576.ref046","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1080\/20477724.2018.1536855","article-title":"Utility of pf\/pan RDT for diagnosis in the prevention of re-establishment of malaria in Sri Lanka.","volume":"112","author":"W Gunasekera","year":"2018","journal-title":"Pathog Glob Health"},{"issue":"10","key":"pmed.1003576.ref047","first-page":"840","article-title":"Precarity at the margins of malaria control in the Chittagong Hill Tracts in Bangladesh: a mixed-methods study.","volume":"9","author":"MA Matin","year":"2020"},{"issue":"6537","key":"pmed.1003576.ref048","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1038\/376246a0","article-title":"Natural selection of hemi- and heterozygotes for G6PD deficiency in Africa by resistance to severe malaria","volume":"376","author":"C Ruwende","year":"1995","journal-title":"Nature"},{"issue":"3","key":"pmed.1003576.ref049","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1371\/journal.pmed.0040066","article-title":"X-linked G6PD deficiency protects hemizygous males but not heterozygous females against severe malaria.","volume":"4","author":"A Guindo","year":"2007","journal-title":"PLoS Med."},{"key":"pmed.1003576.ref050","doi-asserted-by":"crossref","first-page":"e15085","DOI":"10.7554\/eLife.15085","article-title":"Characterisation of the opposing effects of G6PD deficiency on cerebral malaria and severe malarial anaemia.","volume":"6","author":"GM Clarke","year":"2017","journal-title":"Elife"},{"key":"pmed.1003576.ref051","doi-asserted-by":"crossref","first-page":"e62448","DOI":"10.7554\/eLife.62448","article-title":"Protective effect of Mediterranean-type glucose-6-phosphate dehydrogenase deficiency against Plasmodium vivax malaria.","volume":"10","author":"GR Awab","year":"2021","journal-title":"Elife."},{"issue":"23","key":"pmed.1003576.ref052","doi-asserted-by":"crossref","first-page":"5942","DOI":"10.1182\/bloodadvances.2020003015","article-title":"Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya.","volume":"4","author":"S Uyoga","year":"2020","journal-title":"Blood Adv."},{"key":"pmed.1003576.ref053","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1186\/1475-2875-12-418","article-title":"Spatial distribution of G6PD deficiency variants across malaria-endemic regions.","volume":"12","author":"RE Howes","year":"2013","journal-title":"Malar J"},{"issue":"1","key":"pmed.1003576.ref054","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12936-017-1788-x","article-title":"Genotypic and phenotypic characterization of G6PD deficiency in Bengali adults with severe and uncomplicated malaria.","volume":"16","author":"K Plewes","year":"2017","journal-title":"Malar J."}],"container-title":["PLOS Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1003576","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T17:32:54Z","timestamp":1619199174000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1003576"}},"subtitle":[],"editor":[{"given":"Kenji","family":"Hirayama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,23]]},"references-count":54,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmed.1003576","relation":{},"ISSN":["1549-1676"],"issn-type":[{"value":"1549-1676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,23]]}}}