title: G6PD testing in support of treatment and elimination of malaria: recommendations for evaluation of G6PD tests.
abstract: Malaria elimination will be possible only with serious attempts to address asymptomatic infection and chronic infection by both Plasmodium falciparum and Plasmodium vivax. Currently available drugs that can completely clear a human of P. vivax (known as "radical cure"), and that can reduce transmission of malaria parasites, are those in the 8-aminoquinoline drug family, such as primaquine. Unfortunately, people with glucose-6-phosphate dehydrogenase (G6PD) deficiency risk having severe adverse reactions if exposed to these drugs at certain doses. G6PD deficiency is the most common human enzyme defect, affecting approximately 400 million people worldwide.Scaling up radical cure regimens will require testing for G6PD deficiency, at two levels: 1) the individual level to ensure safe case management, and 2) the population level to understand the risk in the local population to guide Plasmodium vivax treatment policy. Several technical and operational knowledge gaps must be addressed to expand access to G6PD deficiency testing and to ensure that a patient's G6PD status is known before deciding to administer an 8-aminoquinoline-based drug.In this report from a stakeholder meeting held in Thailand on October 4 and 5, 2012, G6PD testing in support of radical cure is discussed in detail. The focus is on challenges to the development and evaluation of G6PD diagnostic tests, and on challenges related to the operational aspects of implementing G6PD testing in support of radical cure. The report also describes recommendations for evaluation of diagnostic tests for G6PD deficiency in support of radical cure.
authors.affiliation: PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA. gdomingo@path.org.
authors.forename: Gonzalo J
authors.initials: GJ
authors.lastname: Domingo
authors.forename: Ari Winasti
authors.initials: AW
authors.lastname: Satyagraha
authors.forename: Anup
authors.initials: A
authors.lastname: Anvikar
authors.forename: Kevin
authors.initials: K
authors.lastname: Baird
authors.forename: Germana
authors.initials: G
authors.lastname: Bancone
authors.forename: Pooja
authors.initials: P
authors.lastname: Bansil
authors.forename: Nick
authors.initials: N
authors.lastname: Carter
authors.forename: Qin
authors.initials: Q
authors.lastname: Cheng
authors.forename: Janice
authors.initials: J
authors.lastname: Culpepper
authors.forename: Chi
authors.initials: C
authors.lastname: Eziefula
authors.forename: Mark
authors.initials: M
authors.lastname: Fukuda
authors.forename: Justin
authors.initials: J
authors.lastname: Green
authors.forename: Jimee
authors.initials: J
authors.lastname: Hwang
authors.forename: Marcus
authors.initials: M
authors.lastname: Lacerda
authors.forename: Sarah
authors.initials: S
authors.lastname: McGray
authors.forename: Didier
authors.initials: D
authors.lastname: Menard
authors.forename: Francois
authors.initials: F
authors.lastname: Nosten
authors.forename: Issarang
authors.initials: I
authors.lastname: Nuchprayoon
authors.forename: Nwe Nwe
authors.initials: NN
authors.lastname: Oo
authors.forename: Pongwit
authors.initials: P
authors.lastname: Bualombai
authors.forename: Wadchara
authors.initials: W
authors.lastname: Pumpradit
authors.forename: Kun
authors.initials: K
authors.lastname: Qian
authors.forename: Judith
authors.initials: J
authors.lastname: Recht
authors.forename: Arantxa
authors.initials: A
authors.lastname: Roca
authors.forename: Wichai
authors.initials: W
authors.lastname: Satimai
authors.forename: Siv
authors.initials: S
authors.lastname: Sovannaroth
authors.forename: Lasse S
authors.initials: LS
authors.lastname: Vestergaard
authors.forename: Lorenz
authors.initials: L
authors.lastname: Von Seidlein
mesh_terms: D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000175:diagnosis*; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D016780:Malaria, Vivax / Q000188:drug therapy*; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000458:organization & administration*; D010963:Plasmodium falciparum; D010966:Plasmodium vivax; D013785:Thailand
chemical_list: D000962:Antimalarials