Prevalence of submicroscopic plasmodium infection and glucose 6 phosphate dehydrogenase (g6pd) deficiency among febrile Patients in bonga town, southwest Ethiopia

Abstract

Background: The identification and management of Submicroscopic infection has become a new and increasingly important challenge for malaria control and elimination. Submicroscopic malaria infections with low parasite density serve as a silent reservoir for maintaining residual transmission in the malaria endemic areas. In addition to this, the lack of Glucose 6 Phosphate Dehydrogenase (G6PD) deficiency enzyme level poses risk to G6PDd deficient individuals when treated with primaquine for prevention of relapses due to liver stage. In Ethiopia, information on the magnitude of sub-microscopic malaria infection and G6PDd among febrile patents are scarce. Thus, the current study aimed at determining the prevalence of submicroscopic infections and frequency of G6PD deficiency among febrile individuals in Bonga town, south west Ethiopia. Objective: The objective of the study was to determine the prevalence of submicroscopic malaria infections and G6PD deficiency among febrile individuals visiting health facilities in Bonga town, south west Ethiopia. Methods: Health facility based cross-sectional study was conducted from July-Oct, 2020. Sample size was 384, convenience sampling technique was used and prevalence of submicroscopic Plasmodium infection was determined by quantitative PCR (qPCR) assay. G6PD deficiency prevalence was determined by using careSTART™ G6PD Biosensor. After checking the data for completeness, SPSS software package version 21.0 was used for analysis. Descriptive statistics was employed to summarize the demographic characteristics of the study subjects. Bivariate and multivariate logistic regression were used to determine the main predictors of malaria infection. Results: Three hundred seventy-two study subjects (with auxiliary body temperature ≥37.5℃) comprising 39.7% and 50.2% of males and females, respectively were enrolled in this study. The mean age of the study subjects was 30 years. The overall prevalence of Plasmodium infection by qPCR and microscopy was 110 (29.5%) and 26(6.9%), respectively. The submicroscopic Plasmodium infection was 84(22.5%). Moreover, of the 372 study subjects tested for G6PD, 56 (15%) were G6PDd, and of this, 53(14.2%) was with intermediate and all variables did not show significant association with Plasmodium infection (p > 0.05). Conclusion: Prevalence of submicroscopic malaria infection was high among Bonga area febrile patients. The results of G6PD phenotyping revealed a modest prevalence of G6PD deficiency among febrile patients in the study area. This could jeopardize the malaria control III and elimination efforts in Ethiopia. Therefore, to detect and treat this infection in the health facility, advanced diagnostic tools are required.