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

Background<br/> 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...

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Main Authors: Henriques, G, Phommasone, K, Tripura, R, Peto, T, Raut, S, Snethlage, C, Sambo, I, Sanann, N, Nguon, C, Adhikari, B, Pongvongsa, T, Imwong, M, von Seidlein, L, Day, N, White, N, Dondorp, A, Newton, P, Ley, B, Mayxay, M
Format: Journal article
Published: BioMed Central 2018
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author Henriques, G
Phommasone, K
Tripura, R
Peto, T
Raut, S
Snethlage, C
Sambo, I
Sanann, N
Nguon, C
Adhikari, B
Pongvongsa, T
Imwong, M
von Seidlein, L
Day, N
White, N
Dondorp, A
Newton, P
Ley, B
Mayxay, M
author_facet Henriques, G
Phommasone, K
Tripura, R
Peto, T
Raut, S
Snethlage, C
Sambo, I
Sanann, N
Nguon, C
Adhikari, B
Pongvongsa, T
Imwong, M
von Seidlein, L
Day, N
White, N
Dondorp, A
Newton, P
Ley, B
Mayxay, M
author_sort Henriques, G
collection OXFORD
description Background<br/> 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.<br/> Methods<br/> 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. <br/> Results<br/> 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. <br/> Conclusion<br/> The interpretation of RDT results requires some training but is a good alternative to the FST.
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spelling oxford-uuid:d6b214db-4c12-4815-940e-f1c60737a8922022-03-27T08:35:30ZComparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and CambodiaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d6b214db-4c12-4815-940e-f1c60737a892Symplectic Elements at OxfordBioMed Central2018Henriques, GPhommasone, KTripura, RPeto, TRaut, SSnethlage, CSambo, ISanann, NNguon, CAdhikari, BPongvongsa, TImwong, Mvon Seidlein, LDay, NWhite, NDondorp, ANewton, PLey, BMayxay, MBackground<br/> 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.<br/> Methods<br/> 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. <br/> Results<br/> 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. <br/> Conclusion<br/> The interpretation of RDT results requires some training but is a good alternative to the FST.
spellingShingle Henriques, G
Phommasone, K
Tripura, R
Peto, T
Raut, S
Snethlage, C
Sambo, I
Sanann, N
Nguon, C
Adhikari, B
Pongvongsa, T
Imwong, M
von Seidlein, L
Day, N
White, N
Dondorp, A
Newton, P
Ley, B
Mayxay, M
Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
title Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
title_full Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
title_fullStr Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
title_full_unstemmed Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
title_short Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia
title_sort comparison of glucose 6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in lao pdr and cambodia
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