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Title: Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia NCT01872702 NCT
Authors: Gisela Henriques
Koukeo Phommasone
Rupam Tripura
Thomas J. Peto
Shristi Raut
Coco Snethlage
Im Sambo
Nou Sanann
Chea Nguon
Bipin Adhikari
Tiengkham Pongvongsa
Mallika Imwong
Lorenz Von Seidlein
Nicholas P. Day
Nicholas J. White
Arjen M. Dondorp
Paul Newton
Benedikt Ley
Mayfong Mayxay
Menzies School of Health Research
Imperial College London
Mahidol University
Nuffield Department of Clinical Medicine
University of Amsterdam
University of Health Sciences
Wellcome Trust Research Unit
National Centre for Parasitology, Entomology and Malaria Control
Savannakhet Provincial Station of Malariology
Keywords: Immunology and Microbiology;Medicine
Issue Date: 22-Jun-2018
Citation: Malaria Journal. Vol.17, No.1 (2018)
Abstract: © 2018 The Author(s). Background: 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. Methods: 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. Results: 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 < 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 < 0.001). The RDT performed significantly better (all p < 0.05) than the FST when intermediate FST results were defined as G6PD deficient. Conclusion: The interpretation of RDT results requires some training but is a good alternative to the FST. Trial registration; NCT01872702; 06/27/2013;
ISSN: 14752875
Appears in Collections:Scopus 2018

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