Rapid epidemiologic assessment of glucose‐6‐phosphate dehydrogenase deficiency in malaria‐endemic areas in Southeast Asia using a novel diagnostic kit

Abstract

SummaryWe recently reported a new rapid screening method for glucose-6-phosphate dehydrogenase (G6PD) deficiency. This method incorporates a new formazan substrate (WST-8) and is capable of detecting heterozygous females both qualitatively and quantitatively. Here, we report its evaluation during field surveys at three malaria centres and in malaria-endemic villages of Myanmar and Indonesia, either alone or in combination with a rapid on-site diagnosis of malaria. A total of 57 severe (45 males and 12 females) and 34 mild (five males and 29 females) cases of G6PD deficiency were detected among 855 subjects in Myanmar whilst 30 severe (25 males and five females) and 23 mild (six males and 17 females) cases were found among 1286 subjects in Indonesia. In all cases, severe deficiency was confirmed with another formazan method but due to limitations in its detection threshold, mild cases were misdiagnosed as G6PD-normal by this latter method. Our results indicate that the novel method can qualitatively detect both severely deficient subjects as well as heterozygous females in the field. The antimalarial drug, primaquine, was safely prescribed to Plasmodium vivax-infected patients in Myanmar. Our new, rapid screening method may be essential for the diagnosis of G6PD deficiency particularly in rural areas without electricity, and can be recommended for use in malaria control programmes.keywords rapid test, glucose-6-phosphate dehydrogenase, G6PD deficiency, malaria, field survey, Southeast Asia

Glucose-6-phosphate dehydrogenase (G6PD) mutations in Myanmar: G6PD Mahidol (487G>A) is the most common variant in the Myanmar population

“…Among those tested, we found more than 200 malaria cases and 121 cases of G6PD deficiency. These results are described elsewhere (Jalloh et al 2004). During these activities, we received informed consent from 50 persons to analyze their Fig.…”

“…Now we can detect not only complete G6PD deficiency but also partial G6PD deficiency (female heterozygote). After these developments, we were able to identify G6PD-deficient persons more easily (Jalloh et al 2004) and have collected more information on G6PD variants in the Myanmar population.…”

G6PD deficiency assessment in Freetown, Sierra Leone, reveals further insight into the molecular heterogeneity of G6PD A-

“…at the PCMH microbiology laboratory were screened for G6PD deficiency as described previously (Tantular and Kawamoto 2003;Jalloh et al 2004). Filter-paper blood samples were collected from all consenting patients, air-dried, and later brought to Jichi Medical University in Tochigi, Japan, for confirmatory screening using Fujii's spot test (Fujii et al 1984), and for molecular analyses.…”

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