Germana BanconeDidier MenardNimol KhimSaorin KimLydie CanierChea NguongKoukeo PhommasoneMayfong MayxaySabine DittrichMalavanh VongsouvathNadine FievetJean Yves Le HesranValerie BriandSommay KeomanyPaul N. NewtonGornpan GorsawunKaelan TardyCindy S. ChuOrpreeya RattanapalrojLe Thanh DongHuynh Hong QuangNguyen Tam-UyenNguyen Thuy-NhienTran Tinh HienMichael KalnokyFrancois NostenFoundation for Innovative New Diagnostics, SwitzerlandInstitut Pasteur du CambodgeUniversite Paris DescartesUCLMahidol UniversityNuffield Department of Clinical MedicineInstitut Pasteur, ParisInstitute of Malariology Parasitology and Entomology - Quy Nhon (IMPE-QN)Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU)Bureau of Vector Borne DiseasesInstitute of Malariology-Parasitology and Entomology (IMPE)National Center for Parasitology, Entomology and Malaria Control (CNM)PATHSalavan Provincial HospitalUniversity of Health Sciences2020-01-272020-01-272019-01-23Malaria Journal. Vol.18, No.1 (2019)147528752-s2.0-85060396457https://repository.li.mahidol.ac.th/handle/20.500.14594/51111© 2019 The Author(s). Background: Plasmodium vivax malaria elimination can only be achieved by the deployment of 8-aminoquinolines (primaquine and tafenoquine) in combination with ACT to kill both blood and liver-stage parasites. However, primaquine and the other 8-aminoquinolines cause dose-dependent haemolysis in subjects with G6PD deficiency, an X-linked disorder of red blood cells that is very common in populations living in tropical and subtropical areas. In order to inform safer use of 8-aminoquinolines in the Greater Mekong Subregion, a multi-centre study was carried out to assess the prevalence of G6PD deficiency and to identify the main G6PD variants in samples collected in Cambodia, Lao PDR, Myanmar, Thailand and Vietnam. Methods: Blood samples were collected in the five countries during National Malaria Surveys or during Population Surveys. During Population Surveys samples were characterized for G6PD phenotype using the Fluorescent Spot Test. Samples were then genotyped for a panel of G6PD mutations. Results: G6PD deficiency was found to be common in the region with an overall mean prevalence of deficient or mutated hemizygous males of 14.0%, ranging from a mean 7.3% in Thailand, 8.1% in Lao PDR, 8.9% in Vietnam, 15.8% in Myanmar and 18.8% in Cambodia. Mahidol and Viangchan mutations were the most common and widespread variants found among the nine investigated. Conclusions: Owing to the high prevalence of G6PD deficiency in the Greater Mekong Subregion, strategies for vivax malaria elimination should include point-of-care G6PD testing (both qualitative and quantitative) to allow safe and wide treatment with 8-aminoquinolines.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.1186/s12936-019-2652-y