Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia

• Published in: Malaria journal 2018-06, Vol.17 (1), p.243-243, Article 243
• Main Authors: Henriques, Gisela, Phommasone, Koukeo, Tripura, Rupam, Peto, Thomas J, Raut, Shristi, Snethlage, Coco, Sambo, Im, Sanann, Nou, Nguon, Chea, Adhikari, Bipin, Pongvongsa, Tiengkham, Imwong, Mallika, von Seidlein, Lorenz, Day, Nicholas P, White, Nicholas J, Dondorp, Arjen M, Newton, Paul, Ley, Benedikt, Mayxay, Mayfong
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cambodia; Care and treatment; Child; Child, Preschool; Comparative analysis; Dehydrogenase; Dehydrogenases; Diagnostic tests; Diagnostic Tests, Routine - instrumentation; Diagnostic Tests, Routine - methods; Dosage and administration; Dried Blood Spot Testing - instrumentation; Dried Blood Spot Testing - methods; Drug dosages; Enzymes; Female; Fluorescent antibody technique; Glucose; Glucose-6-phosphate dehydrogenase; Glucosephosphate dehydrogenase; Glucosephosphate Dehydrogenase - analysis; Glucosephosphate Dehydrogenase Deficiency - diagnosis; Haemolysis; Humans; Laboratories; Laos; Malaria; Male; Medical screening; Middle Aged; Phosphates; Plasmodium vivax; Polls & surveys; Primaquine; Rapid diagnostic test; Sensitivity and Specificity; Southeast Asia; Specificity; Spectrophotometry; Surveys; Training; Young Adult
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-018-2390-6

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy worldwide. Primaquine is the only licensed drug that effectively removes Plasmodium vivax hypnozoites from the human host and prevents relapse. While well tolerated by most recipients, primaquine can cause haemolysis in G6PD deficient individuals and is, therefore, underused. Rapid diagnostic tests (RDTs) could permit ascertainment of G6PD status outside of laboratory settings and hence safe treatment in remote areas. The performance of the fluorescent spot test (Trinity, Ireland; FST) and a G6PD RDT (Carestart, USA) against spectrophotometry were assessed. Participants were enrolled during cross-sectional surveys in Laos and by purposive sampling in Cambodia. FST and RDT were performed during village surveys and 3 mL of venous blood was collected for subsequent G6PD measurement by spectrophotometry. A total of 757 participants were enrolled in Laos and 505 in Cambodia. FST and RDT performed best at 30% cut-off activity and performed significantly better in Laos than in Cambodia. When defining intermediate results as G6PD deficient, the FST had a sensitivity of 100% (95%CI 90-100) and specificity of 90% (95%CI 87.7-92.2) in Laos and sensitivity of 98% (94.1-99.6) and specificity of 71% (95%CI 66-76) in Cambodia (p