Validation of G6PD Point-of-Care Tests among Healthy Volunteers in Yangon, Myanmar

• Published in: PloS one Vol. 11; no. 4; p. e0152304
• Main Authors: Oo, Nwe Nwe, Bancone, Germana, Maw, Lwin Zar, Chowwiwat, Nongnud, Bansil, Pooja, Domingo, Gonzalo J., Htun, Moh Moh, Thant, Kyaw Zin, Htut, Ye, Nosten, Francois
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.04.2016; Public Library of Science (PLoS)
• Subjects: Adult; Antimalarials - therapeutic use; Biochemistry; Biology and Life Sciences; Blood tests; Care and treatment; Dehydrogenases; Dosage and administration; Drug dosages; Enzymes; Equipment Design; Erythrocytes; Female; Fluorescence; Glucose; Glucose 6 phosphate dehydrogenase; Glucosephosphate dehydrogenase; Glucosephosphate Dehydrogenase - blood; Glucosephosphate Dehydrogenase Deficiency - blood; Glucosephosphate Dehydrogenase Deficiency - diagnosis; Glucosephosphate Dehydrogenase Deficiency - epidemiology; Health aspects; Healthy Volunteers; Hematology; Humans; Laboratories; Malaria; Malaria, Falciparum - drug therapy; Malaria, Vivax - drug therapy; Male; Males; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Mutation; Myanmar - epidemiology; Phosphates; Plasmodium falciparum; Plasmodium falciparum - drug effects; Plasmodium vivax; Plasmodium vivax - drug effects; Point of care testing; Point-of-Care Systems; Primaquine; Primaquine - therapeutic use; Reagent Kits, Diagnostic; Sensitivity and Specificity; Spectrophotometry; Vector-borne diseases; Volunteers; Myanmar; Myanmar (Burma); Cambodia; Thailand; United States > US; ISW, Myanmar
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0152304

Primaquine and other 8-amnoquinoline based anti-malarials can cause haemolysis in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Correct diagnosis of G6PD status in patients is crucial for safe treatment of both relapsing stages of Plasmodium vivax and transmitting forms of Plasmodium falciparum. Lack of suitable point-of-care tests has hampered a much needed wide use of primaquine for malaria elimination. In this study we have assessed the performances of two qualitative tests, the fluorescent spot test (FST) and the G6PD CareStart test (CST), against the gold standard quantitative spectrophotometric assay in a population of 1000 random adult healthy volunteers living in Yangon, Myanmar. The prevalence of G6PD deficiency in the Bamar, Karen and in the whole sample set was 6.6% (10.1% in males), 9.2% (21.0% in males) and 6.8% (11.1% in males) respectively. The FST and CST showed comparable performances with sensitivity over 95% and specificity over 90%, however for cases with severe G6PD activity the FTS had improved performance. If used with a conservative interpretation of the signal, the CareStart test has the potential to be used in the field and, by allowing a wider use of primaquine, to help malaria elimination.