Anemia in Patients Receiving Sulphonamide Therapy for Malaria: Role of Glucose-6-Phosphate Dehydrogenase Deficiency and Antibodies to Sulphonamide

Abstract

Sulphonamide can cause anemia by antibody production as well as in individuals who are glucose–6–phosphate dehydrogenase (G6PD) deficient. Against the background of no data on the relationship between G6PD deficiency, sulphonamide antibody production and anemia among patients with malaria, this study was conducted. The study was conducted between April and November 2016. Blood specimens were collected from 500 patients with symptoms of malaria who had taken sulphonamide-containing anti-malaria. Screening for G6PD deficiency, detection of antibody to sulphonamide, in-vivo and in-vitro sensitization, and hemoglobin concentration were determined using standard techniques. A total of 110 (22%) and 79 (15.80%) out of the 500 patients had antibodies to sulphonamide and were G6PD deficient respectively. There was no significant association between sulphonamide antibody production and G6PD deficiency (OR=1.055, 95%CI=0.594, 1.874; P=0.9717). Presence of sulphonamide antibodies, G6PD deficiency, in-vivo and in-vitro sensitization were significantly associated with anemia (P<0.001). In-vivo and in-vitro sensitizations were significantly associated with sulphonamide antibody production and G6PD deficiency. The study observed no relationship between sulphonamide antibody production and G6PD deficiency in causing anemia. Also, sulphonamide antibody was associated with sensitization (in vivo and in vitro) of red blood cells.
Keywords: Anemia, Malaria, Sulphonamide antibody, Glucose–6–phosphate dehydrogenase, Sensitazation