Case series / case reportindependent cross-checkabstract only checked★ key study I-LEG-05 in-depth review
Favism in Egyptian children
Study of Glucose-6-Phosphate Dehydrogenase Deficiency: 5 Years Retrospective Egyptian Study.
Overview
Hagag AA et al.. Endocr Metab Immune Disord Drug Targets 2018 · PMID 28982343 · DOI 10.2174/1871530317666171003160350
In 1,000 Egyptian children with G6PD deficiency, haemolysis was most often triggered by fava beans and falafel.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Describe Egyptian G6PD patients
- How was the study done?
Retrospective series
- How many people, animals or samples were studied?
1,000 children
- What was actually found?
Diet main trigger, especially fava
- How large was the observed effect?
32.6% fava, 19.4% falafel
- What do the results mean in everyday life?
Fava avoidance matters for G6PD-deficient children in Egypt.
- What are the study's limitations?
History-based
- What does it say about Elawady's specific claim?
Supports favism; weak for lentils
- Do the results apply to Germany and Europe?
High (Egypt)
- What can explicitly not be concluded from this study?
Cannot show legumes harm G6PD-normal people.
Scientific in-depth review
1. Full reference
- Authors
- Hagag AA et al.
- Journal
- Endocr Metab Immune Disord Drug Targets
- Year
- 2018
- Identifier
- PMID 28982343 DOI 10.2174/1871530317666171003160350
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Clinical profile and precipitants of haemolysis in G6PD-deficient children.
3. Study design and population
- Study design
- Case series / case report – Retrospective hospital case series
- Population
Children with G6PD deficiency anaemia, Tanta University Hospital
- Country
Egypt
- Period
Nov 2011 - Nov 2016
- Sample size
1,000
- Inclusion and exclusion criteria
Registered G6PD-deficient patients
4. Methods and endpoints
- Exposure / intervention
Diets, infections, drugs
- Comparator
None
- Endpoints
Precipitating factors, clinical features
- Statistical methods
Descriptive
5. Actual results
- Results
932 males, 68 females; 92% aged 1-3 years; diet precipitant 83.4% (fava beans 32.6%, falafel 19.4%, chickpea 10.8%, broad bean 7.6%, green pea 4.4%, peanuts 3.8%, lentil 2.8%, black-eyed peas 2%); infections 12.4%; drugs 4.2%.
- Absolute risks
not reported
- Authors' conclusion
Patients should avoid precipitating factors; recommend neonatal screening and molecular studies in Egypt.
6. Strengths
- Large Egyptian series
7. Weaknesses
- Retrospective; precipitants from history
- Single centre
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- high
- Rationale
History-based attribution; no challenge testing.
9. Assessment of the statistical interpretation
Descriptive proportions.
10. Relevance to the specific claim
Egyptian burden of favism (C-LEG-03); weak signal on other legumes (C-LEG-05).
11. Independent contrary findings
Luzzatto 2020 names fava specifically.
12. Transferability to Germany and Europe
Egypt-specific.
13. Overall methodological judgement
Confirms favism burden in Egypt; non-fava attributions uncertain.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | high |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | not replicated |
| Consistency with the overall evidence | unknown |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Whether non-fava legumes truly trigger haemolysis.
15. Linked fact checks
- Fava bean ingestion triggers acute haemolytic anaemia (favism) in people with G6PD deficiency, which is the most common human enzyme defect and is frequent around the Mediterranean, the Middle East and Egypt. – Studies supporting the claim
- In G6PD deficiency, haemolysis is triggered by merely smelling fava beans and by eating lentils, as well as by aspirin and antibiotics. – Studies with mixed or unclear results