Glucose-6-Phosphate Dehydrogenase Deficiency among Children Attending the Emergency Department of Yankin Children’s Hospital, Yangon

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Abstract

Yankin Children’s Hospital is one of the tertiary children hospitals in Myanmar, where some oxidative medications are commonly used in the management of illnesses. Paediatrician’s awareness of G6PD status in this population is very important for effective management and prevention of complications in G6PD deficient children. This preliminary study aims to determine the prevalence of G6PD deficiency according to WHO classification among children seeking medical care at Emergency Department of Yankin Children’s Hospital (YKCH). It was a cross-sectional descriptive study on 124 children, aged 1 month to 13 years. G6PD enzyme activity was determined by spectrophotometric assay within 24 hours of sample collection. Randox G6PD quantitative in vitro test kit (Randox Laboratories, Crumlin, UK) was used and G6PD activity was calculated as unit per gram (U/g) of haemoglobin (Hb). For classification of G6PD deficiency, 10% and 60% level of normal enzyme activities were calculated according to the suggestion by World Health Organization (WHO); G6PD activity <10% was defined as severe deficiency and 10-60% was defined as moderate deficiency. According to WHO classification, 18.5% (23/124) of children in this study was classified as G6PD deficient, with 3.2% severe deficiency and 15.3% moderate deficiency. The prevalence of G6PD deficiency in Myanmar children is higher than the previous reported prevalence if quantitative spectrophotometric method is used for diagnosis, detecting more individuals with moderate deficiency. The high prevalence of G6PD deficiency in this study warrants for the need to do neonatal screening to avoid the potentially fatal complications of this disease.
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在仰光Yankin儿童医院急诊科就诊的儿童中葡萄糖-6-磷酸脱氢酶缺乏
燕京儿童医院是缅甸的三级儿童医院之一,在治疗疾病时通常使用一些氧化药物。儿科医生对该人群G6PD状况的认识对于有效管理和预防G6PD缺陷儿童的并发症非常重要。本初步研究旨在根据WHO分类确定在Yankin儿童医院急诊科就诊的儿童中G6PD缺乏症的患病率。这是一项对124名1个月至13岁儿童的横断面描述性研究。采用分光光度法测定样品采集24小时内G6PD酶活性。使用Randox G6PD体外定量检测试剂盒(Randox Laboratories, Crumlin, UK),以单位每克血红蛋白(Hb)计算G6PD活性。G6PD缺乏症的分型依据世界卫生组织(WHO)建议计算正常酶活性的10%和60%水平;G6PD活性<10%定义为重度缺乏,10-60%定义为中度缺乏。根据WHO的分类,本研究中18.5%(23/124)的儿童被划分为G6PD缺乏,其中重度缺乏3.2%,中度缺乏15.3%。如果使用定量分光光度法进行诊断,缅甸儿童G6PD缺乏症的患病率高于先前报道的患病率,检测出更多中度缺乏症个体。本研究中G6PD缺乏症的高患病率证明有必要进行新生儿筛查,以避免这种疾病潜在的致命并发症。
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