Copyright © 2014 by The American Society of Tropical Medicine and Hygiene Short Report: Glucose-6-Phosphate Dehydrogenase Deficiency A − Variant in Febrile Patients in Haiti

Abstract. Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A−. We estimated the frequency of G6PDd A − in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A − allele (includes A − hemizygous males, A− homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti. Glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) is a genetic red blood cell disorder caused by muta-tions in the G6PD gene on the X chromosome. The reduced G6PD enzyme concentration increases oxidative damage in red blood cells resulting in hemolysis. One of the more common G6PDd variants, G6PDd A−, has only 12 % enzym