Rapid Fire Presentation 8th International Conference on Plasmodium vivax Research 2022

G6PD Deficiency Prevalence across Indonesia: Distribution Map and Normal Activity Approximation (#326)

Arkasha Sadhewa 1 , Lydia Panggalo 1 , Iqbal Elyazar 2 , Alida R Harahap 1 , Ari Winasti Satyagraha 1
  1. Red Blood Cell Membrane and Enzyme Disorders Unit, Eijkman Institute for Molecular Biology, Jakarta Pusat, DKI Jakarta, Indonesia
  2. Biostatistics and Geospatial Group, Eijkman-Oxford Clinical Research Unit, Jakarta Pusat, DKI Jakarta, Indonesia

In 2020, according to WHO World Malaria Report, from around 254.000 malaria cases in Indonesia, 109.000 were due to vivax or mixed infections. By 2020, only 3 provinces had reached full elimination status according to Indonesian Ministry of Health Indonesia Health Profile report. Radical cure for vivax malaria requires treatment using 8-aminoquinoline (8-AQ) class of drugs, which may cause mild to severe hemolysis on people with X-linked enzymopathy G6PD deficiency (G6PDd). Studies on G6PDd prevalence and genetic variants in Indonesia are still very limited. This study collates data from past population samplings done by our group at the Eijkman Institute for Molecular Biology and G6PDd prevalence data from published studies in Indonesia. G6PD activity was quantitatively measured in population sampling between 2012-2018 to calculate prevalence and adjusted male median (AMM) that represents 100% of G6PD activity in a given population. Male G6PD activity data from one or more sites were combined to calculate AMM values in 11 provinces having at least 80 male G6PD activity data points. G6PDd prevalence data were also obtained from systematic data collection from published studies between 1964-2021. Our group had conducted sampling in 27 sites across 12 provinces of Indonesia, 5 of which had been published already. G6PDd prevalence was also obtained from 15 provinces from published data. In total G6PDd prevalence data from 22 provinces were obtained and mapped, leaving 12 provinces with malaria transmission with no G6PDd prevalence data. Complete view of G6PDd prevalence distribution across Indonesia still require extensive population sampling across more provinces, especially in malaria endemic areas. Combined AMM for each province calculated in this study might help in approximating deficiency threshold for 8-AQ treatment screening purposes at sites within the same province or other regions sharing the same ethnicity profile but is no substitute to calculating local AMM.