Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study)
Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2021-05, Vol.15 (5), p.e0009415-e0009415 |
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| creator | Brito-Sousa, Jose Diego Murta, Felipe Vitor-Silva, Sheila Sampaio, Vanderson S Mendes, Maxwell O Brito, Marcelo A M Batista, Talita S B Santos, Alicia P C Marques, Leonardo L G Barbosa, Laila R A Melo, Marly M Baia-da-Silva, Djane C Silva-Neto, Alexandre V Santos, Thalie C Souza, Brenda K A Figueiredo, Erick F G Silva, Emanuelle L Rodovalho, Sheila Nakagawa, Theresa H Arcanjo, Ana Ruth Siqueira, André M Melo, Gisely C Recht, Judith Domingo, Gonzalo J Bassat, Quique Bancone, Germana Monteiro, Wuelton M Lacerda, Marcus V G |
| description | Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD testing is not routinely performed before primaquine treatment in most P. vivax endemic areas.
The qualitative CareStart G6PD screening test was implemented in 12 malaria treatment units (MTUs) in the municipality of Rio Preto da Eva, Western Brazilian Amazon, a malaria endemic area, between February 2019 and early January 2020. Training materials were developed and validated; evaluations were conducted on the effectiveness of training health care professionals (HCPs) to perform the test, the interpretation and reliability of routine testing performed by HCPs, and perceptions of HCPs and patients. Most HCPs were unaware of G6PD deficiency and primaquine-related adverse effects. Most of 110 HCPs trained (86/110, 78%) were able to correctly perform the G6PD test after a single 4-hour training session. The test performed by HCPs during implementation showed 100.0% (4/4) sensitivity and 68.1% (62/91) specificity in identifying G6PD deficient patients as compared to a point-of-care quantitative test (Standard G6PD).
G6PD screening using the qualitative CareStart G6PD test performed by HCPs in MTUs of an endemic area showed high sensitivity and concerning low specificity. The amount of false G6PD deficiency detected led to substantial loss of opportunities for radical cure. |
| doi_str_mv | 10.1371/journal.pntd.0009415 |
| format | Article |
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The qualitative CareStart G6PD screening test was implemented in 12 malaria treatment units (MTUs) in the municipality of Rio Preto da Eva, Western Brazilian Amazon, a malaria endemic area, between February 2019 and early January 2020. Training materials were developed and validated; evaluations were conducted on the effectiveness of training health care professionals (HCPs) to perform the test, the interpretation and reliability of routine testing performed by HCPs, and perceptions of HCPs and patients. Most HCPs were unaware of G6PD deficiency and primaquine-related adverse effects. Most of 110 HCPs trained (86/110, 78%) were able to correctly perform the G6PD test after a single 4-hour training session. The test performed by HCPs during implementation showed 100.0% (4/4) sensitivity and 68.1% (62/91) specificity in identifying G6PD deficient patients as compared to a point-of-care quantitative test (Standard G6PD).
G6PD screening using the qualitative CareStart G6PD test performed by HCPs in MTUs of an endemic area showed high sensitivity and concerning low specificity. The amount of false G6PD deficiency detected led to substantial loss of opportunities for radical cure.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0009415</identifier><identifier>PMID: 34003840</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anemia ; Antioxidants ; Biology and Life Sciences ; Blood cells ; Complications and side effects ; Defence mechanisms ; Diagnosis ; Drug dosages ; Drug therapy ; Engineering and Technology ; Erythrocytes ; Glucose-6-phosphate dehydrogenase deficiency ; Glucosephosphate dehydrogenase ; Haemolysis ; Hemolysis ; Hospitals ; Human diseases ; Malaria ; Medical screening ; Medicine and Health Sciences ; Methods ; Oxidative stress ; Patients ; People and Places ; Pharmacovigilance ; Primaquine ; Procedures ; Public health ; Reliability analysis ; Rural areas ; Test procedures ; Training ; Tropical diseases ; Vector-borne diseases</subject><ispartof>PLoS neglected tropical diseases, 2021-05, Vol.15 (5), p.e0009415-e0009415</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Brito-Sousa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Kevin</contributor><creatorcontrib>Brito-Sousa, Jose Diego</creatorcontrib><creatorcontrib>Murta, Felipe</creatorcontrib><creatorcontrib>Vitor-Silva, Sheila</creatorcontrib><creatorcontrib>Sampaio, Vanderson S</creatorcontrib><creatorcontrib>Mendes, Maxwell O</creatorcontrib><creatorcontrib>Brito, Marcelo A M</creatorcontrib><creatorcontrib>Batista, Talita S B</creatorcontrib><creatorcontrib>Santos, Alicia P C</creatorcontrib><creatorcontrib>Marques, Leonardo L G</creatorcontrib><creatorcontrib>Barbosa, Laila R A</creatorcontrib><creatorcontrib>Melo, Marly M</creatorcontrib><creatorcontrib>Baia-da-Silva, Djane C</creatorcontrib><creatorcontrib>Silva-Neto, Alexandre V</creatorcontrib><creatorcontrib>Santos, Thalie C</creatorcontrib><creatorcontrib>Souza, Brenda K A</creatorcontrib><creatorcontrib>Figueiredo, Erick F G</creatorcontrib><creatorcontrib>Silva, Emanuelle L</creatorcontrib><creatorcontrib>Rodovalho, Sheila</creatorcontrib><creatorcontrib>Nakagawa, Theresa H</creatorcontrib><creatorcontrib>Arcanjo, Ana Ruth</creatorcontrib><creatorcontrib>Siqueira, André M</creatorcontrib><creatorcontrib>Melo, Gisely C</creatorcontrib><creatorcontrib>Recht, Judith</creatorcontrib><creatorcontrib>Domingo, Gonzalo J</creatorcontrib><creatorcontrib>Bassat, Quique</creatorcontrib><creatorcontrib>Bancone, Germana</creatorcontrib><creatorcontrib>Monteiro, Wuelton M</creatorcontrib><creatorcontrib>Lacerda, Marcus V G</creatorcontrib><title>Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study)</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD testing is not routinely performed before primaquine treatment in most P. vivax endemic areas.
The qualitative CareStart G6PD screening test was implemented in 12 malaria treatment units (MTUs) in the municipality of Rio Preto da Eva, Western Brazilian Amazon, a malaria endemic area, between February 2019 and early January 2020. Training materials were developed and validated; evaluations were conducted on the effectiveness of training health care professionals (HCPs) to perform the test, the interpretation and reliability of routine testing performed by HCPs, and perceptions of HCPs and patients. Most HCPs were unaware of G6PD deficiency and primaquine-related adverse effects. Most of 110 HCPs trained (86/110, 78%) were able to correctly perform the G6PD test after a single 4-hour training session. The test performed by HCPs during implementation showed 100.0% (4/4) sensitivity and 68.1% (62/91) specificity in identifying G6PD deficient patients as compared to a point-of-care quantitative test (Standard G6PD).
G6PD screening using the qualitative CareStart G6PD test performed by HCPs in MTUs of an endemic area showed high sensitivity and concerning low specificity. The amount of false G6PD deficiency detected led to substantial loss of opportunities for radical cure.</description><subject>Anemia</subject><subject>Antioxidants</subject><subject>Biology and Life Sciences</subject><subject>Blood cells</subject><subject>Complications and side effects</subject><subject>Defence mechanisms</subject><subject>Diagnosis</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Engineering and Technology</subject><subject>Erythrocytes</subject><subject>Glucose-6-phosphate dehydrogenase deficiency</subject><subject>Glucosephosphate dehydrogenase</subject><subject>Haemolysis</subject><subject>Hemolysis</subject><subject>Hospitals</subject><subject>Human diseases</subject><subject>Malaria</subject><subject>Medical screening</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Oxidative stress</subject><subject>Patients</subject><subject>People and 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Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brito-Sousa, Jose Diego</au><au>Murta, Felipe</au><au>Vitor-Silva, Sheila</au><au>Sampaio, Vanderson S</au><au>Mendes, Maxwell O</au><au>Brito, Marcelo A M</au><au>Batista, Talita S B</au><au>Santos, Alicia P C</au><au>Marques, Leonardo L G</au><au>Barbosa, Laila R A</au><au>Melo, Marly M</au><au>Baia-da-Silva, Djane C</au><au>Silva-Neto, Alexandre V</au><au>Santos, Thalie C</au><au>Souza, Brenda K A</au><au>Figueiredo, Erick F G</au><au>Silva, Emanuelle L</au><au>Rodovalho, Sheila</au><au>Nakagawa, Theresa H</au><au>Arcanjo, Ana Ruth</au><au>Siqueira, André M</au><au>Melo, Gisely C</au><au>Recht, Judith</au><au>Domingo, Gonzalo J</au><au>Bassat, Quique</au><au>Bancone, Germana</au><au>Monteiro, Wuelton M</au><au>Lacerda, Marcus V G</au><au>Baird, J. Kevin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study)</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2021-05-18</date><risdate>2021</risdate><volume>15</volume><issue>5</issue><spage>e0009415</spage><epage>e0009415</epage><pages>e0009415-e0009415</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD testing is not routinely performed before primaquine treatment in most P. vivax endemic areas.
The qualitative CareStart G6PD screening test was implemented in 12 malaria treatment units (MTUs) in the municipality of Rio Preto da Eva, Western Brazilian Amazon, a malaria endemic area, between February 2019 and early January 2020. Training materials were developed and validated; evaluations were conducted on the effectiveness of training health care professionals (HCPs) to perform the test, the interpretation and reliability of routine testing performed by HCPs, and perceptions of HCPs and patients. Most HCPs were unaware of G6PD deficiency and primaquine-related adverse effects. Most of 110 HCPs trained (86/110, 78%) were able to correctly perform the G6PD test after a single 4-hour training session. The test performed by HCPs during implementation showed 100.0% (4/4) sensitivity and 68.1% (62/91) specificity in identifying G6PD deficient patients as compared to a point-of-care quantitative test (Standard G6PD).
G6PD screening using the qualitative CareStart G6PD test performed by HCPs in MTUs of an endemic area showed high sensitivity and concerning low specificity. The amount of false G6PD deficiency detected led to substantial loss of opportunities for radical cure.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34003840</pmid><doi>10.1371/journal.pntd.0009415</doi><orcidid>https://orcid.org/0000-0002-0019-9369</orcidid><orcidid>https://orcid.org/0000-0003-2208-0294</orcidid><orcidid>https://orcid.org/0000-0002-1004-4395</orcidid><orcidid>https://orcid.org/0000-0003-0875-7596</orcidid><orcidid>https://orcid.org/0000-0002-6739-2315</orcidid><orcidid>https://orcid.org/0000-0003-3374-9985</orcidid><orcidid>https://orcid.org/0000-0003-1659-3763</orcidid><orcidid>https://orcid.org/0000-0001-8480-0352</orcidid><orcidid>https://orcid.org/0000-0001-7307-8851</orcidid><orcidid>https://orcid.org/0000-0002-5613-0467</orcidid><orcidid>https://orcid.org/0000-0003-3572-0457</orcidid><orcidid>https://orcid.org/0000-0001-5929-8049</orcidid><orcidid>https://orcid.org/0000-0003-4550-0431</orcidid><orcidid>https://orcid.org/0000-0003-4414-3989</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2021-05, Vol.15 (5), p.e0009415-e0009415 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_2541857297 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Public Library of Science (PLoS); PubMed Central |
| subjects | Anemia Antioxidants Biology and Life Sciences Blood cells Complications and side effects Defence mechanisms Diagnosis Drug dosages Drug therapy Engineering and Technology Erythrocytes Glucose-6-phosphate dehydrogenase deficiency Glucosephosphate dehydrogenase Haemolysis Hemolysis Hospitals Human diseases Malaria Medical screening Medicine and Health Sciences Methods Oxidative stress Patients People and Places Pharmacovigilance Primaquine Procedures Public health Reliability analysis Rural areas Test procedures Training Tropical diseases Vector-borne diseases |
| title | Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T01%3A39%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Real-life%20implementation%20of%20a%20G6PD%20deficiency%20screening%20qualitative%20test%20into%20routine%20vivax%20malaria%20diagnostic%20units%20in%20the%20Brazilian%20Amazon%20(SAFEPRIM%20study)&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Brito-Sousa,%20Jose%20Diego&rft.date=2021-05-18&rft.volume=15&rft.issue=5&rft.spage=e0009415&rft.epage=e0009415&rft.pages=e0009415-e0009415&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0009415&rft_dat=%3Cgale_plos_%3EA663951048%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2541857297&rft_id=info:pmid/34003840&rft_galeid=A663951048&rft_doaj_id=oai_doaj_org_article_9e3396f344f349bea322e90d8e54919e&rfr_iscdi=true |