THE PREVALENCE AND SEVERITY OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY AMONG JAUNDICED NEWBORNS AT THE UNIVERSITY OF CALABAR TEACHING HOSPITAL, CALABAR

Abstract

Background; Neonatal jaundice is one of the most common life threatening
consequences of Glucose-6-phosphate dehydrogenase deficiency, and
kernicterus may result in these infants.
Aim; This descriptive cross-sectional study was undertaken to determine the
prevalence and severity of G6PD deficiency among jaundiced neonates in
University of Calabar Teaching Hospital (UCTH). An additional focus was to
correlate the degree of enzyme deficiency with the level of jaundice in the
affected newborns.
Method; Consecutive jaundiced neonates admitted into the newborn unit of the
University of Calabar Teaching Hospital, during the study period April to
December 2012 were investigated. A proforma was used to collect biodata,
sociodemographic data and perinatal history on mother-neonate pair. A thorough
physical examination was undertaken on the neonates before blood samples
were drawn for laboratory investigations. Bilirubin levels where estimated and the
G6PD status of the patients was determined using the quantitative assay method
devised by Randox. Other baseline investigations included blood group (ABO) for
mother and baby, Coomb’s test and full blood counts including blood culture for
neonates with risk factors for sepsis.
Results; Out of the 218 jaundiced neonates, 58 (26.6%) had severe enzyme
deficiency, 92 (42.2%) had intermediate enzyme deficiency and the overall
prevalence of G6PD deficiency was 68.8%. Of the neonates with severe enzyme
deficiency, males were 31 (27.4%) and females were 27 (25.7%); for
intermediate deficiency, males were 46 (40.7%) and females 46 (43.8%). The
difference was not significant. (x2 = 0.82, p=0.77) The overall mean peak bilirubin
concentration was 197.6±76.8µmol/L; females: 196.0±78.2 µmol/L and males:
199.1±75.4 µmol/L. The mean G6PD enzyme levels was 153.0± 83.5mu x 10-9 ;
males 150.6± 79.2mu x 10-9 , females 156.3± 88.2mux10-9 There was an inverse
relationship between the mean bilirubin levels and the G6PD assay levels (r=
0.149, p<0.028). A multiple regression analysis identified G6PD deficiency and
prematurity as major predictors of severity of jaundice
Conclusion; It is concluded that G6PD deficiency is common in this
environment, and both gender are fairly similarly affected both with its
intermediate and severe forms. Most studies applied the qualitative /screening
test this study was quantitative, hence this emphasizes the need for quantitative
G6PD assay as part of newborn investigations. This will help identify G6PD
deficient females who are most times presumably missed out.

THE PREVALENCE AND SEVERITY OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY AMONG JAUNDICED NEWBORNS AT THE UNIVERSITY OF CALABAR TEACHING HOSPITAL, CALABAR