Tools for mass screening of G6PD deficiency: validation of the WST8/1-methoxy-PMS enzymatic assay in Uganda.


Autoria(s): De Niz Hidalgo, Mariana; Eziefula, Alice C; Othieno, Lucas; Mbabazi, Edith; Nabukeera, Damalie; Ssemmondo, Emmanuel; Gonahasa, Samuel; Tumwebaze, Patrick; Diliberto, Deborah; Maiteki-Sebuguzi, Catherine; Staedke, Sarah G; Drakeley, Chris
Data(s)

2013

Resumo

BACKGROUND The distribution of the enzymopathy glucose-6-phosphate dehydrogenase (G6PD) deficiency is linked to areas of high malaria endemicity due to its association with protection from disease. G6PD deficiency is also identified as the cause of severe haemolysis following administration of the anti-malarial drug primaquine and further use of this drug will likely require identification of G6PD deficiency on a population level. Current conventional methods for G6PD screening have various disadvantages for field use. METHODS The WST8/1-methoxy PMS method, recently adapted for field use, was validated using a gold standard enzymatic assay (R&D Diagnostics Ltd ®) in a study involving 235 children under five years of age, who were recruited by random selection from a cohort study in Tororo, Uganda. Blood spots were collected by finger-prick onto filter paper at routine visits, and G6PD activity was determined by both tests. Performance of the WST8/1-methoxy PMS test under various temperature, light, and storage conditions was evaluated. RESULTS The WST8/1-methoxy PMS assay was found to have 72% sensitivity and 98% specificity when compared to the commercial enzymatic assay and the AUC was 0.904, suggesting good agreement. Misclassifications were at borderline values of G6PD activity between mild and normal levels, or related to outlier haemoglobin values (<8.0 gHb/dl or >14 gHb/dl) associated with ongoing anaemia or recent haemolytic crises. Although severe G6PD deficiency was not found in the area, the test enabled identification of low G6PD activity. The assay was found to be highly robust for field use; showing less light sensitivity, good performance over a wide temperature range, and good capacity for medium-to-long term storage. CONCLUSIONS The WST8/1-methoxy PMS assay was comparable to the currently used standard enzymatic test, and offers advantages in terms of cost, storage, portability and use in resource-limited settings. Such features make this test a potential key tool for deployment in the field for point of care assessment prior to primaquine administration in malaria-endemic areas. As with other G6PD tests, outlier haemoglobin levels may confound G6PD level estimation.

Formato

application/pdf

Identificador

http://boris.unibe.ch/71392/1/DeNiz_Eziefula.pdf

De Niz Hidalgo, Mariana; Eziefula, Alice C; Othieno, Lucas; Mbabazi, Edith; Nabukeera, Damalie; Ssemmondo, Emmanuel; Gonahasa, Samuel; Tumwebaze, Patrick; Diliberto, Deborah; Maiteki-Sebuguzi, Catherine; Staedke, Sarah G; Drakeley, Chris (2013). Tools for mass screening of G6PD deficiency: validation of the WST8/1-methoxy-PMS enzymatic assay in Uganda. Malaria journal, 12(210), p. 210. BioMed Central 10.1186/1475-2875-12-210 <http://dx.doi.org/10.1186/1475-2875-12-210>

doi:10.7892/boris.71392

info:doi:10.1186/1475-2875-12-210

info:pmid:23782846

urn:issn:1475-2875

Idioma(s)

eng

Publicador

BioMed Central

Relação

http://boris.unibe.ch/71392/

Direitos

info:eu-repo/semantics/openAccess

Fonte

De Niz Hidalgo, Mariana; Eziefula, Alice C; Othieno, Lucas; Mbabazi, Edith; Nabukeera, Damalie; Ssemmondo, Emmanuel; Gonahasa, Samuel; Tumwebaze, Patrick; Diliberto, Deborah; Maiteki-Sebuguzi, Catherine; Staedke, Sarah G; Drakeley, Chris (2013). Tools for mass screening of G6PD deficiency: validation of the WST8/1-methoxy-PMS enzymatic assay in Uganda. Malaria journal, 12(210), p. 210. BioMed Central 10.1186/1475-2875-12-210 <http://dx.doi.org/10.1186/1475-2875-12-210>

Palavras-Chave #570 Life sciences; biology #500 Science
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed