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NOT Open Access | Impairment of invasion and maturation and decreased selectivity of Plasmodium falciparum in G6PD Viangchan and Mahidol variants

October 2, 2021 - 13:00 -- NOT Open Access
Palasuwan D, Palasuwan A, Boonpeng K, Ketprasit N, Imwong M, Kulkeaw K
J Infect Dis. 2021 Sep 24:jiab484

Protection against Plasmodium falciparum is observed in a population deficient in glucose-6-phosphate dehydrogenase (G6PD), particularly in African and Mediterranean regions. However, such protection remains unknown among G6PD-deficient individuals in Southeast Asia. Here, we assessed the invasion and maturation of P. falciparum K1 in a culture of erythrocytes isolated from Thai subjects carrying Viangchan (871G>A) and Mahidol (487G>A).

Reference and point-of-care testing for G6PD deficiency: Blood disorder interference, contrived specimens, and fingerstick equivalence and precision

September 23, 2021 - 09:04 -- Open Access
Pal S, Myburgh J, Domingo GJ, et al.
PLoS One. 2021 Sep 20;16(9):e0257560

Certain clinical indications and treatments such as the use of rasburicase in cancer therapy and 8-aminoquinolines for Plasmodium vivax malaria treatment would benefit from a point-of-care test for glucose-6-phosphate dehydrogenase (G6PD) deficiency. Three studies were conducted to evaluate the performance of one such test: the STANDARD™ G6PD Test (SD BIOSENSOR, South Korea). First, biological interference on the test performance was evaluated in specimens with common blood disorders, including high white blood cell (WBC) counts.

Dynamics of G6PD activity in patients receiving weekly primaquine for therapy of Plasmodium vivax malaria

September 14, 2021 - 14:07 -- Open Access
Taylor WRJ, Kim S, Kheng S, Muth S, Tor P, Christophel E, Mukaka M, Kerleguer A, Luzzatto L, Baird JK, Menard D
PLoS Negl Trop Dis. 2021 Sep 8;15(9):e0009690

Acute Plasmodium vivax malaria is associated with haemolysis, bone marrow suppression, reticulocytopenia, and post-treatment reticulocytosis leading to haemoglobin recovery. Little is known how malaria affects glucose-6-phosphate dehydrogenase (G6PD) activity and whether changes in activity when patients present may lead qualitative tests, like the fluorescent spot test (FST), to misdiagnose G6PD deficient (G6PDd) patients as G6PD normal (G6PDn). Giving primaquine or tafenoquine to such patients could result in severe haemolysis.

Evaluation of a point-of-care diagnostic to identify glucose-6-phosphate dehydrogenase deficiency in Brazil

August 17, 2021 - 15:52 -- Open Access
Zobrist S, Brito M, Garbin E, Monteiro WM, Clementino Freitas S, Macedo M, Soares Moura A, Advani N, Kahn M, Pal S, Gerth-Guyette E, Bansil P, Domingo GJ, Pereira D, Lacerda MV
PLoS Negl Trop Dis. 2021 Aug 12;15(8):e0009649

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common enzyme deficiency, prevalent in many malaria-endemic countries. G6PD-deficient individuals are susceptible to hemolysis during oxidative stress, which can occur from exposure to certain medications, including 8-aminoquinolines used to treat Plasmodium vivax malaria. Accordingly, access to point-of-care (POC) G6PD testing in Brazil is critical for safe treatment of P. vivax malaria.

Assessment of CareStart G6PD rapid diagnostic test and CareStart G6PD biosensor in Mauritania

August 10, 2021 - 17:54 -- Open Access
Djigo OKM, Ould Khalef Y, Ould Ahmedou Salem MS, Gomez N, Basco L, Briolant S, Ould Mohamed Salem Boukhary A
Infect Dis Poverty. 2021 Aug 5;10(1):105

The elimination of Plasmodium vivax malaria requires 8-aminoquinolines, which are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency due to the risk of acute haemolytic anaemia. Several point-of-care devices have been developed to detect G6PD deficiency. The objective of the present study was to evaluate the performance of two of these devices against G6PD genotypes in Mauritania.

Genotypes and phenotypes of G6PD deficiency among Indonesian females across diagnostic thresholds of G6PD activity guiding safe primaquine therapy of latent malaria

July 20, 2021 - 13:04 -- Open Access
Satyagraha AW, Sadhewa A, Panggalo LV, Subekti D, Elyazar I, Soebianto S, Mahpud N, Harahap AR, Baird JK
PLoS Negl Trop Dis. 2021 Jul 16;15(7):e0009610

Plasmodium vivax occurs as a latent infection of liver and a patent infection of red blood cells. Radical cure requires both blood schizontocidal and hypnozoitocidal chemotherapies. The hypnozoitocidal therapies available are primaquine and tafenoquine, 8-aminoquinoline drugs that can provoke threatening acute hemolytic anemia in patients having an X-linked G6PD-deficiency. Heterozygous females may screen as G6PD-normal prior to radical cure and go on to experience hemolytic crisis.

Usability of a point-of-care diagnostic to identify glucose-6-phosphate dehydrogenase deficiency: a multi-country assessment of test label comprehension and results interpretation

July 14, 2021 - 10:58 -- Open Access
Emily Gerth-Guyette, Wondimagegn Adissu, Gonzalo J. Domingo, et al.
Malaria Journal 2021 20:307, 8 July 2021

Point-of-care glucose-6-phosphate dehydrogenase (G6PD) testing has the potential to make the use of radical treatment for vivax malaria safer and more effective. Widespread use of G6PD tests as part of malaria case management has been limited, in part due to due concerns regarding product usability, user training, and supervision. This study seeks to assess how well end users can understand the Standard™ G6PD Test (SD Biosensor, Suwon, South Korea) workflow, result output, and label after training. This will ultimately help inform test registration and introduction.

G6PD deficiency among malaria-infected national groups at the western part of Myanmar with implications for primaquine use in malaria elimination

June 16, 2021 - 09:51 -- Open Access
Han KT, Han ZY, Aye KH, Wai KT, Thi A, Cui L, Sattabongkot J
Trop Med Health. 2021 Jun 9;49(1):47

Glucose 6-phosphate dehydrogenase deficiency (G6PDd) plays a central role in readiness assessment for malaria elimination in Myanmar by 2030 that includes primaquine (PQ) use. The risk of hemolysis in G6PDd individuals hampers the widespread use of primaquine safely in malaria-infected patients. In the pre-elimination era, it is important to screen initially for asymptomatic malaria in combination with G6PD deficiency by applying more sensitive diagnostic tools. Therefore, this study examined the proportion of G6PDd and the distribution of G6PD genotypes among malaria-infected national groups in Myanmar before initiation of malaria elimination strategies.

Global economic costs due to vivax malaria and the potential impact of its radical cure: A modelling study

June 5, 2021 - 07:23 -- Open Access
Devine A, Battle KE, Meagher N, Howes RE, Dini S, Gething PW, Simpson JA, Price RN, Lubell Y
PLoS Med. 2021 Jun 1;18(6):e1003614

In 2017, an estimated 14 million cases of Plasmodium vivax malaria were reported from Asia, Central and South America, and the Horn of Africa. The clinical burden of vivax malaria is largely driven by its ability to form dormant liver stages (hypnozoites) that can reactivate to cause recurrent episodes of malaria. Elimination of both the blood and liver stages of the parasites (“radical cure”) is required to achieve a sustained clinical response and prevent ongoing transmission of the parasite. Novel treatment options and point-of-care diagnostics are now available to ensure that radical cure can be administered safely and effectively. We quantified the global economic cost of vivax malaria and estimated the potential cost benefit of a policy of radical cure after testing patients for glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study)

May 19, 2021 - 14:00 -- Open Access
Brito-Sousa JD, Murta F, Lacerda MVG, et al.
PLoS Negl Trop Dis. 2021 May 18;15(5):e0009415

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.


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