title: Comparison of Three Screening Test Kits for G6PD Enzyme Deficiency: Implications for Its Use in the Radical Cure of Vivax Malaria in Remote and Resource-Poor Areas in the Philippines.
abstract: OBJECTIVE
  We evaluated a battery of Glucose-6-Phosphate Dehydrogenase diagnostic point-of-care tests (PoC) to assess the most suitable product in terms of performance and operational characteristics for remote areas.
  
  
  METHODS
  Samples were collected in Puerto Princesa City, Palawan, Philippines and tested for G6PD deficiency with a fluorescent spot test (FST; Procedure 203, Trinity Biotech, Ireland), the semiquantitative WST8/1-methoxy PMS (WST; Dojindo, Japan) and the Carestart G6PD Rapid Diagnostic Test (CSG; AccessBio, USA). Results were compared to spectrophotometry (Procedure 345, Trinity Biotech, Ireland). Sensitivity and specificity were calculated for each test with cut-off activities of 10%, 20%, 30% and 60% of the adjusted male median.
  
  
  RESULTS
  The adjusted male median was 270.5 IU/10(12) RBC. FST and WST were tested on 621 capillary blood samples, the CSG was tested on venous and capillary blood on 302 samples. At 30% G6PD activity, sensitivity for the FST was between 87.7% (95%CI: 76.8% to 93.9%) and 96.5% (95%CI: 87.9% to 99.5%) depending on definition of intermediate results; the WST was 84.2% (95%CI: 72.1% to 92.5%); and the CSG was between 68.8% (95%CI: 41.3% to 89.0%) and 93.8% (95%CI: 69.8% to 99.8%) when the test was performed on capillary or venous blood respectively. Sensitivity of FST and CSG (tested with venous blood) were comparable (p>0.05). The analysis of venous blood samples by the CSG yielded significantly higher results than FST and CSG performed on capillary blood (p<0.05). Sensitivity of the CSG varied depending on source of blood used (p<0.05).
  
  
  CONCLUSIONS
  The operational characteristics of the CSG were superior to all other test formats. Performance and operational characteristics of the CSG performed on venous blood suggest the test to be a good alternative to the FST.
authors: Department of Parasitology, Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa City, Philippines.
authors: Fe Esperanza
authors: FE
authors: Espino
authors: Department of Parasitology, Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa City, Philippines.
authors: Jo-Anne
authors: JA
authors: Bibit
authors: Department of Parasitology, Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa City, Philippines.
authors: Johanna Beulah
authors: JB
authors: Sornillo
authors: Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa City, Philippines.
authors: Alvin
authors: A
authors: Tan
authors: Mahidol Oxford Research Unit, Bangkok, Thailand.
authors: Lorenz
authors: L
authors: von Seidlein
authors: Menzies School of Health Research and Charles Darwin University, Global and Tropical Health Division, Darwin, Australia.
authors: Benedikt
authors: B
authors: Ley
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications* / Q000453:epidemiology*; D006295:Health Resources / Q000600:supply & distribution*; D006801:Humans; D016780:Malaria, Vivax / Q000150:complications* / Q000628:therapy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010679:Philippines / Q000453:epidemiology; D019095:Point-of-Care Systems; D055815:Young Adult