The American journal of tropical medicine and hygiene · 2014
Performance of BinaxNOW G6PD deficiency point-of-care diagnostic in P. vivax-infected subjects.
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Osorio Lyda, Carter Nick, Arthur Preetam, Bancone Germana, Gopalan Sowmya, Gupta Sandeep K, Noedl Harald, Kochar Sanjay K, Kochar Dhanpat K, Krudsood Srivicha, Lacerda Marcus V, Llanos-Cuentas Alejandro, Rueangweerayut Ronnatrai, Srinivasan Ramadurai, Treiber Moritz, Möhrle Jörg J, Green Justin
Аннотация
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.