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Background Threat of haemolytic anaemia in individuals with a deficiency in glucose-6-phosphate dehydrogenase (G6PD) enzyme activity prevents widespread use of primaquine, a vital drug for malaria elimination. Significant genetic variation underpins this human enzyme disorder, reflected as a spectrum of clinical severity following exposure to oxidative agents such as primaquine. Across malaria endemic countries (MECs), the prevalence and genetic basis of this predisposing condition vary greatly. An understanding of the relative risks presented by G6PD deficiency, in terms of prevalence and severity, is necessary to rationally determine primaquine drug policy.

Spatial patterns of clinically significant G6PD deficiency: variants, prevalence and an overall national risk index