No G6PD A- (G202A) variant detected among Plasmodium falciparum-positive patients in Awka, Southeast Nigeria: a hospital-based study

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency, prevalent in malaria-endemic regions, has been associated with a reduced risk of severe malaria due to impaired parasite growth in deficient erythrocytes. The G6PD gene, located on the X chromosome, harbours various mutations associated with differing enzyme activity levels. This study investigates the prevalence of G6PD deficiency variants and their impact on parasite density and haemoglobin levels among malaria-positive patients in Awka, Anambra State, Nigeria. Materials and Methods: Blood samples were collected from 100 malaria positive participants; 64 participants with complete genotyping and clinical data were included in the analysis and screened for the A376G and G202A variants using PCR and Sanger sequencing. Results: Molecular analysis indicated that the B variant (normal) was predominant, with 83% of the participants possessing this variant. None of the participants tested had the A- variant, associated with G6PD defciency, suggesting no evidence of the G202A (A-) variant in this hospital-based sample. The B variant and the A+ variant showed no significant impact on the haemoglobin and parasitaemia levels of the study participants. Conclusions: The findings support the absence of the G202A (A-) variant in this cohort and show no detectable differences in parasitaemia or haemoglobin between A+ and B genotypes. Broader genotyping and/or G6PD enzyme activity testing in community representative samples is recommended before drawing population-level conclusions or informing treatment policy.