Testing for G6PD-defekt før primakinbehandling : praksis ved norske sykehus

Abstract

ABSTRACT Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is the most common enzyme deficiency worldwide, with the highest prevalence in Africa, Middle East and Southeast Asia. When patients with G6PD deficiency are treated with primaquine due to a malaria infection caused by P.vivax or P. ovale, they are in risk of developing a primaquine induced haemolytic anaemia. According to WHO guidelines, patients who are in risk of having the G6PD deficiency should be screened before primaquine treatment is started. In Norway we have no such guidelines. To minimize the risk of relapsing malaria infection, the Norwegian policy has been to treat P. vivax- and P. ovale infections with primaquine. Due to increasing immigration, the G6PD deficiency can be found in the Norwegian population. The objective of our study was to investigate if the Norwegian Hospitals perform screening for the enzyme deficiency before they start primaquine treatment. We have sent a questionnaire to all the Norwegian University Hospitals. Through our study we found that the hospitals have different procedures. Some of the hospitals screen patients in risk of having G6PD deficiency, others do not. Our main objective has been to make a suggestion to implement national guidelines for screening procedures before primaquine treatment is started. We conclude that patients regardless of sex, with genetic background from Africa, Middle East and Southeast Asia should be screened. Due to the small amount of P.vivax and P. ovale infections yearly, a centralization of the analysis may be cost beneficial.