Performance of BinaxNOW G6PD deficiency point-of-care diagnostic in P. vivax-infected subjects.
Accurate diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency is required to avoid the risk of acute hemolysis associated with 8-aminoquinoline treatment. The performance of the BinaxNOW G6PD test compared with the quantitative spectrophotometric analysis of G6PD activity was assessed in 356 Plasmodium vivax-infected subjects in Brazil, Peru, Thailand, and India. In the quantitative assay, the median G6PD activity was 8.81 U/g hemoglobin (range = 0.05-20.19), with 11 (3%) subjects identified as deficient. Sensitivity of the BinaxNOW G6PD to detect deficient subjects was 54.5% (6 of 11), and specificity was 100% (345 of 345). Room temperatures inadvertently falling outside the range required to perform the rapid test (18-25°C) together with subtlety of color change and insufficient training could partially explain the low sensitivity found. Ensuring safe use of 8-aminoquinolines depends on additional development of simple, highly sensitive G6PD deficiency diagnostic tests suitable for routine use in malaria-endemic areas.
Lyda
L
Osorio
Nick
N
Carter
Preetam
P
Arthur
Germana
G
Bancone
Sowmya
S
Gopalan
Sandeep K
SK
Gupta
Harald
H
Noedl
Sanjay K
SK
Kochar
Dhanpat K
DK
Kochar
Srivicha
S
Krudsood
Marcus V
MV
Lacerda
Alejandro
A
Llanos-Cuentas
Ronnatrai
R
Rueangweerayut
Ramadurai
R
Srinivasan
Moritz
M
Treiber
Jörg J
JJ
Möhrle
Justin
J
Green
D000962:Antimalarials / Q000627:therapeutic use*; D005953:Glycogen Storage Disease Type I / Q000175:diagnosis*; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity
D000962:Antimalarials