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

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...

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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
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cited_by cdi_FETCH-LOGICAL-c560t-54457e1de3b476e2464d84a74475f4810327cac8c340a35c788fb6adbb1640323
cites cdi_FETCH-LOGICAL-c560t-54457e1de3b476e2464d84a74475f4810327cac8c340a35c788fb6adbb1640323
container_end_page 243
container_issue 1
container_start_page 243
container_title Malaria journal
container_volume 17
creator 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
description 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 
doi_str_mv 10.1186/s12936-018-2390-6
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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 &lt; 0.001). The RDT had sensitivity and specificity of 100% (95%CI 90-100) and 99% (95%CI 97-99) in Laos and sensitivity and specificity of 91% (86-96) and 93% (90-95) in Cambodia (p &lt; 0.001). The RDT performed significantly better (all p &lt; 0.05) than the FST when intermediate FST results were defined as G6PD deficient. The interpretation of RDT results requires some training but is a good alternative to the FST. Trial registration clinicaltrials.gov; NCT01872702; 06/27/2013; https://clinicaltrials.gov/ct2/show/NCT01872702.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>29929514</pmid><doi>10.1186/s12936-018-2390-6</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-0282-6469</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1475-2875
ispartof Malaria journal, 2018-06, Vol.17 (1), p.243-243, Article 243
issn 1475-2875
1475-2875
language eng
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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
title Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
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