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Journal article

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.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12936-018-2390-6

Authors


More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDM; Tropical Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author


Publisher:
BioMed Central
Journal:
Malaria Journal More from this journal
Volume:
17
Issue:
1
Pages:
1
Publication date:
2018-06-22
Acceptance date:
2018-06-13
DOI:
EISSN:
1475-2875


Keywords:
Pubs id:
pubs:859209
UUID:
uuid:d6b214db-4c12-4815-940e-f1c60737a892
Local pid:
pubs:859209
Source identifiers:
859209
Deposit date:
2018-06-25

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