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

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

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    Abstract

    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. 

    Original languageEnglish
    Article number243
    Pages (from-to)1-7
    Number of pages7
    JournalMalaria Journal
    Volume17
    DOIs
    Publication statusPublished - 22 Jun 2018

    Fingerprint

    Laos
    Cambodia
    Glucosephosphate Dehydrogenase
    Routine Diagnostic Tests
    Primaquine
    Spectrophotometry
    Glucosephosphate Dehydrogenase Deficiency
    Plasmodium vivax
    Sensitivity and Specificity
    Hemolysis
    Ireland
    Cross-Sectional Studies
    Recurrence

    Cite this

    Henriques, G., Phommasone, K., Tripura, R., Peto, T. J., Raut, S., Snethlage, C., ... Mayxay, M. (2018). Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia. Malaria Journal, 17, 1-7. [243]. https://doi.org/10.1186/s12936-018-2390-6
    Henriques, Gisela ; Phommasone, Koukeo ; Tripura, Rupam ; Peto, Thomas J. ; Raut, Shristi ; Snethlage, Coco ; Sambo, Im ; Sanann, Nou ; Nguon, Chea ; Adhikari, Bipin ; Pongvongsa, Tiengkham ; Imwong, Mallika ; Von Seidlein, Lorenz ; Day, Nicholas P. ; White, Nicholas J. ; Dondorp, Arjen M. ; Newton, Paul ; Ley, Benedikt ; Mayxay, Mayfong. / Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia. In: Malaria Journal. 2018 ; Vol. 17. pp. 1-7.
    @article{96e71134fe204218a974a3baaccdbab3,
    title = "Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia",
    abstract = "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. ",
    keywords = "Glucose-6-phosphate dehydrogenase, Malaria, Rapid diagnostic test, Southeast Asia",
    author = "Gisela Henriques and Koukeo Phommasone and Rupam Tripura and Peto, {Thomas J.} and Shristi Raut and Coco Snethlage and Im Sambo and Nou Sanann and Chea Nguon and Bipin Adhikari and Tiengkham Pongvongsa and Mallika Imwong and {Von Seidlein}, Lorenz and Day, {Nicholas P.} and White, {Nicholas J.} and Dondorp, {Arjen M.} and Paul Newton and Benedikt Ley and Mayfong Mayxay",
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    Henriques, G, Phommasone, K, Tripura, R, Peto, TJ, Raut, S, Snethlage, C, Sambo, I, Sanann, N, Nguon, C, Adhikari, B, Pongvongsa, T, Imwong, M, Von Seidlein, L, Day, NP, White, NJ, Dondorp, AM, Newton, P, Ley, B & Mayxay, M 2018, 'Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia', Malaria Journal, vol. 17, 243, pp. 1-7. https://doi.org/10.1186/s12936-018-2390-6

    Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia. / Henriques, Gisela; Phommasone, Koukeo; Tripura, Rupam; Peto, Thomas J.; Raut, Shristi; Snethlage, Coco; Sambo, Im; Sanann, Nou; Nguon, Chea; Adhikari, Bipin; Pongvongsa, Tiengkham; Imwong, Mallika; Von Seidlein, Lorenz; Day, Nicholas P.; White, Nicholas J.; Dondorp, Arjen M.; Newton, Paul; Ley, Benedikt; Mayxay, Mayfong.

    In: Malaria Journal, Vol. 17, 243, 22.06.2018, p. 1-7.

    Research output: Contribution to journalReview articleResearchpeer-review

    TY - JOUR

    T1 - Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia

    AU - Henriques, Gisela

    AU - Phommasone, Koukeo

    AU - Tripura, Rupam

    AU - Peto, Thomas J.

    AU - Raut, Shristi

    AU - Snethlage, Coco

    AU - Sambo, Im

    AU - Sanann, Nou

    AU - Nguon, Chea

    AU - Adhikari, Bipin

    AU - Pongvongsa, Tiengkham

    AU - Imwong, Mallika

    AU - Von Seidlein, Lorenz

    AU - Day, Nicholas P.

    AU - White, Nicholas J.

    AU - Dondorp, Arjen M.

    AU - Newton, Paul

    AU - Ley, Benedikt

    AU - Mayxay, Mayfong

    PY - 2018/6/22

    Y1 - 2018/6/22

    N2 - 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. 

    AB - 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. 

    KW - Glucose-6-phosphate dehydrogenase

    KW - Malaria

    KW - Rapid diagnostic test

    KW - Southeast Asia

    UR - http://www.scopus.com/inward/record.url?scp=85048860747&partnerID=8YFLogxK

    U2 - 10.1186/s12936-018-2390-6

    DO - 10.1186/s12936-018-2390-6

    M3 - Review article

    VL - 17

    SP - 1

    EP - 7

    JO - Malaria Journal

    JF - Malaria Journal

    SN - 1475-2875

    M1 - 243

    ER -