Cohort studyindependent cross-checkabstract checked★ key study I-LEG-105 standard review
Fava-bean versus other triggers in children with G6PD deficiency
Fava Bean- Versus Non-Fava Bean-Induced Acute Hemolytic Crisis in Children With Glucose-6-Phosphate Dehydrogenase Deficiency: A Prospective Comparative Study.
Overview
Prashanth GP et al.. Pediatr Blood Cancer 2025 · PMID 39956941 · DOI 10.1002/pbc.31609
In Oman, about half of children's haemolytic crises followed fava beans, and these were more severe.
Does the study support the specific claim? Yes · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Compare fava-triggered and other haemolytic episodes.
- How was the study done?
Hospital cohort.
- How many people, animals or samples were studied?
236 episodes in children.
- What was actually found?
Fava episodes more severe.
- How large was the observed effect?
Haemoglobin 4.8 vs 6.7 g/dL.
- What do the results mean in everyday life?
For children with G6PD deficiency, fava beans can cause dangerous anaemia.
- What are the study's limitations?
One hospital; history-based triggers.
- What does it say about Elawady's specific claim?
Supports C-LEG-03 and the safety note.
- Do the results apply to Germany and Europe?
Relevant to migrant families.
- What can explicitly not be concluded from this study?
It does not show risk for children without G6PD deficiency.
Scientific in-depth review
1. Full reference
- Authors
- Prashanth GP et al.
- Journal
- Pediatr Blood Cancer
- Year
- 2025
- Identifier
- PMID 39956941 DOI 10.1002/pbc.31609
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref works API
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Not stated in abstract.
2. Research question
Do fava-bean-induced haemolytic episodes differ from non-fava episodes in G6PD-deficient children?
3. Study design and population
- Study design
- Cohort study – Prospective comparative cohort of hospitalised children with acute haemolytic episodes
- Population
Children hospitalised for acute haemolytic episodes due to G6PD deficiency, regional referral hospital
- Country
Oman
- Period
3 years (dates not given in abstract)
- Sample size
236 episodes
- Inclusion and exclusion criteria
Hospitalised children with G6PD-related acute haemolysis.
4. Methods and endpoints
- Exposure / intervention
Documented precipitating factor: fava bean vs other
- Comparator
Non-fava-bean-induced haemolysis
- Endpoints
Severity (haemoglobin), laboratory markers
- Statistical methods
Group comparison; least squares regression
5. Actual results
- Results
51.6% of episodes attributed to fava beans; fava-induced cases were younger, more often had abdominal pain and had lower admission haemoglobin (4.8 vs 6.7 g/dL; p<0.001).
- Absolute risks
Not reported
- Authors' conclusion
Fava-induced episodes are more severe; culturally sensitive dietary education is needed where fava beans are a staple.
6. Strengths
- Arab-region paediatric data
- Prospective recruitment
7. Weaknesses
- Single centre
- Trigger attribution from documentation
- Abstract only
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Trigger classification by history; confounding by genotype and age.
9. Assessment of the statistical interpretation
Large haemoglobin difference (1.9 g/dL) is clinically relevant; regression R2 76.6% is descriptive.
10. Relevance to the specific claim
Confirms that fava beans are the leading and most severe trigger of haemolysis in G6PD-deficient children in a fava-eating Arab population.
11. Independent contrary findings
Almost half of episodes had other triggers (infections, drugs), so fava avoidance alone does not prevent all crises.
12. Transferability to Germany and Europe
Relevant to children of Middle Eastern origin.
13. Overall methodological judgement
Strong regional confirmation of favism severity in children.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Genotype-specific risks.