Point-of-Care Testing for G6PD Deficiency: Opportunities for Screening

Athena Anderle, Germana Bancone, Gonzalo J Domingo, Emily Gerth-Guyette, Sampa Pal, Ari W Satyagraha, Athena Anderle, Germana Bancone, Gonzalo J Domingo, Emily Gerth-Guyette, Sampa Pal, Ari W Satyagraha

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, an X-linked genetic disorder, is associated with increased risk of jaundice and kernicterus at birth. G6PD deficiency can manifest later in life as severe hemolysis, when the individual is exposed to oxidative agents that range from foods such as fava beans, to diseases such as typhoid, to medications such as dapsone, to the curative drugs for Plasmodium (P.) vivax malaria, primaquine and tafenoquine. While routine testing at birth for G6PD deficiency is recommended by the World Health Organization for populations with greater than 5% prevalence of G6PD deficiency and to inform P. vivax case management using primaquine, testing coverage is extremely low. Test coverage is low due to the need to prioritize newborn interventions and the complexity of currently available G6PD tests, especially those used to inform malaria case management. More affordable, accurate, point-of-care (POC) tests for G6PD deficiency are emerging that create an opportunity to extend testing to populations that do not have access to high throughput screening services. Some of these tests are quantitative, which provides an opportunity to address the gender disparity created by the currently available POC qualitative tests that misclassify females with intermediate G6PD activity as normal. In populations where the epidemiology for G6PD deficiency and P. vivax overlap, screening for G6PD deficiency at birth to inform care of the newborn can also be used to inform malaria case management over their lifetime.

Keywords: G6PD deficiency; Plasmodium vivax; diagnostics; glucose-6-phosphate dehydrogenase; malaria; point-of-care.

Conflict of interest statement

PATH supports a portfolio of G6PD test development efforts. PATH has no financial interests in the commercialization of any resulting products. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript; and in the decision to publish the results.

© 2018 by the authors.

Figures

Figure 1
Figure 1
Alignment between diagnostic platform for G6PD deficiency and tier of health care facility based on complexity of the diagnostic test and the typical resources available at each type of facility.

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