Publication: Real-life implementation of a g6pd deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian amazon (Safeprim study)
Issued Date
2021-05-01
Resource Type
ISSN
19352735
19352727
19352727
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2-s2.0-85106982899
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLoS Neglected Tropical Diseases. Vol.15, No.5 (2021)
Suggested Citation
Jose Diego Brito-Sousa, Felipe Murta, Sheila Vitor-Silva, Vanderson S. Sampaio, Maxwell O. Mendes, Marcelo A.M. Brito, Talita S.B. Batista, Alicia P.C. Santos, Leonardo L.G. Marques, Laila R.A. Barbosa, Marly M. Melo, Djane C. Baia-Da-silva, Alexandre V. Silva-Neto, Thalie C. Santos, Brenda K.A. Souza, Erick F.G. Figueiredo, Emanuelle L. Silva, Sheila Rodovalho, Theresa H. Nakagawa, Ana Ruth Arcanjo, André M. Siqueira, Gisely C. Melo, Judith Recht, Gonzalo J. Domingo, Quique Bassat, Germana Bancone, Wuelton M. Monteiro, Marcus V.G. Lacerda Real-life implementation of a g6pd deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian amazon (Safeprim study). PLoS Neglected Tropical Diseases. Vol.15, No.5 (2021). doi:10.1371/journal.pntd.0009415 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78220
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Title
Real-life implementation of a g6pd deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian amazon (Safeprim study)
Author(s)
Jose Diego Brito-Sousa
Felipe Murta
Sheila Vitor-Silva
Vanderson S. Sampaio
Maxwell O. Mendes
Marcelo A.M. Brito
Talita S.B. Batista
Alicia P.C. Santos
Leonardo L.G. Marques
Laila R.A. Barbosa
Marly M. Melo
Djane C. Baia-Da-silva
Alexandre V. Silva-Neto
Thalie C. Santos
Brenda K.A. Souza
Erick F.G. Figueiredo
Emanuelle L. Silva
Sheila Rodovalho
Theresa H. Nakagawa
Ana Ruth Arcanjo
André M. Siqueira
Gisely C. Melo
Judith Recht
Gonzalo J. Domingo
Quique Bassat
Germana Bancone
Wuelton M. Monteiro
Marcus V.G. Lacerda
Felipe Murta
Sheila Vitor-Silva
Vanderson S. Sampaio
Maxwell O. Mendes
Marcelo A.M. Brito
Talita S.B. Batista
Alicia P.C. Santos
Leonardo L.G. Marques
Laila R.A. Barbosa
Marly M. Melo
Djane C. Baia-Da-silva
Alexandre V. Silva-Neto
Thalie C. Santos
Brenda K.A. Souza
Erick F.G. Figueiredo
Emanuelle L. Silva
Sheila Rodovalho
Theresa H. Nakagawa
Ana Ruth Arcanjo
André M. Siqueira
Gisely C. Melo
Judith Recht
Gonzalo J. Domingo
Quique Bassat
Germana Bancone
Wuelton M. Monteiro
Marcus V.G. Lacerda
Other Contributor(s)
Faculty of Tropical Medicine, Mahidol University
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Institució Catalana de Recerca i Estudis Avançats
PATH Seattle
Organisation Mondiale de la Santé
Instituto Nacional de Infectologia Evandro Chagas (INI)
Fiocruz Amazônia
Nuffield Department of Medicine
Universidade do Estado do Amazonas
Universitat de Barcelona
Universidade Federal do Amazonas
Centro de Investigação em Saúde de Manhiça (CISM)
Fundação de Vigilância em Saúde do Amazonas
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado
Laboratório Central de Saúde Pública do Amazonas
Independent Consultant
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Institució Catalana de Recerca i Estudis Avançats
PATH Seattle
Organisation Mondiale de la Santé
Instituto Nacional de Infectologia Evandro Chagas (INI)
Fiocruz Amazônia
Nuffield Department of Medicine
Universidade do Estado do Amazonas
Universitat de Barcelona
Universidade Federal do Amazonas
Centro de Investigação em Saúde de Manhiça (CISM)
Fundação de Vigilância em Saúde do Amazonas
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado
Laboratório Central de Saúde Pública do Amazonas
Independent Consultant
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD testing is not routinely performed before primaquine treatment in most P. vivax endemic areas. Method/Principal findings The qualitative CareStart G6PD screening test was implemented in 12 malaria treatment units (MTUs) in the municipality of Rio Preto da Eva, Western Brazilian Amazon, a malaria endemic area, between February 2019 and early January 2020. Training materials were developed and validated; evaluations were conducted on the effectiveness of training health care professionals (HCPs) to perform the test, the interpretation and reliability of routine testing performed by HCPs, and perceptions of HCPs and patients. Most HCPs were unaware of G6PD deficiency and primaquine-related adverse effects. Most of 110 HCPs trained (86/110, 78%) were able to correctly perform the G6PD test after a single 4-hour training session. The test performed by HCPs during implementation showed 100.0% (4/4) sensitivity and 68.1% (62/91) specificity in identifying G6PD deficient patients as compared to a point-of-care quantitative test (Standard G6PD). Conclusions/Significance G6PD screening using the qualitative CareStart G6PD test performed by HCPs in MTUs of an endemic area showed high sensitivity and concerning low specificity. The amount of false G6PD deficiency detected led to substantial loss of opportunities for radical cure.