Public Health Resources

 

Authors

Benedikt Ley, Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University
Nick Luter, PATH, Diagnostics Program, Seattle, WA
Fe Esperanza Espino, Research Institute of Tropical Medicine, Manila, Philippines
Angela Devine, Mahidol‑Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
Michael Kalnoky, PATH, Diagnostics Program, Seattle, WA
Yoel Lubell, Research Institute of Tropical Medicine, Manila, Philippines
Kamala Thriemer, Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University
J. Kevin Baird, US Navy ResearchFollow
Eugenie Poirot, The Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA
Nolwenn Conan, Malaria Consortium, Bangkok, Thailand
Chong Chee Kheong, Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
Lek Dysoley, National Center for Parasitology Entomology and Malaria Control, Phnom Penh, Cambodia
Wasif Ali Khan, International Center for Diarrheal Disease Research, Bangladesh
April G. Dion‑Berboso, Newborn Screening Center, Institute of Human Genetics, National Institutes of Health, University of the Philippines, Manila, Philippines
Germana Bancone, Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand
Jimee Hwang, The Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA
Ritu Kumar, PATH, Diagnostics Program, Seattle, WA
Ric N. Price, Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin UniversityFollow
Lorenz von Seidlein, Mahidol‑Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
Gonzalo J. Domingo, PATH, Diagnostics Program, Seattle, WA

Date of this Version

2015

Citation

Ley et al. Malar J (2015) 14:377

Comments

U.S. Government Work

Abstract

The only currently available drug that effectively removes malaria hypnozoites from the human host is primaquine. The use of 8-aminoquinolines is hampered by haemolytic side effects in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. Recently a number of qualitative and a quantitative rapid diagnostic test (RDT) format have been developed that provide an alternative to the current standard G6PD activity assays. The WHO has recently recommended routine testing of G6PD status prior to primaquine radical cure whenever possible. A workshop was held in the Philippines in early 2015 to discuss key challenges and knowledge gaps that hinder the introduction of routine G6PD testing. Two point-of-care (PoC) test formats for the measurement of G6PD activity are currently available: qualitative tests comparable to malaria RDT as well as biosensors that provide a quantitative reading. Qualitative G6PD PoC tests provide a binomial test result, are easy to use and some products are comparable in price to the widely used fluorescent spot test. Qualitative test results can accurately classify hemizygous males, heterozygous females, but may misclassify females with intermediate G6PD activity. Biosensors provide a more complex quantitative readout and are better suited to identify heterozygous females. While associated with higher costs per sample tested biosensors have the potential for broader use in other scenarios where knowledge of G6PD activity is relevant as well. The introduction of routine G6PD testing is associated with additional costs on top of routine treatment that will vary by setting and will need to be assessed prior to test introduction. Reliable G6PD PoC tests have the potential to play an essential role in future malaria elimination programmes, however require an improved understanding on how to best integrate routine G6PD testing into different health settings.

Share

COinS