Glucose-6-phosphate dehydrogenase deficiency among Yemeni children residing in malaria-endemic areas of Hodeidah governorate and evaluation of a rapid diagnostic test for its detection

Autor: Ali Alhaj, Rashad Abdul-Ghani, Abdulhabib R. Alqubaty, Mohammed A. K. Mahdy, Samira M. A. Al-Eryani, Abdullah A. Al-Mikhlafy, Sameer A. Alkubati, Reyadh Saif-Ali, Abdusalam M. Al-Mekhlafi
Rok vydání: 2016
Předmět:
Male
Rural Population
Primaquine
Time Factors
Yemen
Physiology
Dehydrogenase
Rapid diagnostic test
chemistry.chemical_compound
Consanguinity
0302 clinical medicine
hemic and lymphatic diseases
030212 general & internal medicine
Child
Infectious Diseases
Child
Preschool
Female
Topography
Medical
medicine.drug
congenital
hereditary
and neonatal diseases and abnormalities
medicine.medical_specialty
Adolescent
030231 tropical medicine
Sensitivity and Specificity
03 medical and health sciences
Sex Factors
Predictive Value of Tests
parasitic diseases
medicine
Glucose-6-phosphate dehydrogenase
Humans
business.industry
Diagnostic Tests
Routine
Research
nutritional and metabolic diseases
medicine.disease
Malaria
Cross-Sectional Studies
Glucosephosphate Dehydrogenase Deficiency
Parasitology
chemistry
Tropical medicine
Immunology
business
Glucose-6-phosphate dehydrogenase deficiency
Zdroj: Malaria Journal
ISSN: 1475-2875
Popis: Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common genetic enzymopathy worldwide, is associated with an acute haemolytic anaemia in individuals exposed to primaquine. The present study aimed to determine G6PD deficiency among Yemeni children in malaria-endemic areas as well as to assess the performance of the CareStart™ G6PD rapid diagnostic test (RDT) for its detection. Methods A cross-sectional study recruiting 400 children from two rural districts in Hodeidah governorate was conducted. Socio-demographic data and blood samples were collected and G6PD deficiency was qualitatively detected in fresh blood in the field using the CareStart™ G6PD RDT, while the enzymatic assay was used to quantitatively measure enzyme activity. Performance of the CareStart™ G6PD RDT was assessed by calculating its sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) against the reference enzymatic assay. Results The ranges of enzyme activity were 0.14–18.45 and 0.21–15.94 units/g haemoglobin (U/gHb) for males and females, respectively. However, adjusted male median G6PD activity was 5.0 U/gHb. Considering the adjusted male median as representing 100 % normal enzyme activity, the prevalence rates of G6PD deficiency were 12.0 and 2.3 % at the cut-off activities of ≤60 and ≤10 %, respectively. Multivariable analysis showed that gender, district of residence and consanguinity between parents were independent risk factors for G6PD deficiency at the cut-off activity of ≤30 % of normal. The CareStart™ G6PD RDT showed 100 % sensitivity and NPV for detecting G6PD deficiency at the cut-off activities of ≤10 and ≤20 % of normal activity compared to the reference enzymatic method. However, it showed specificity levels of 90.0 and 95.4 % as well as positive/deficient predictive values (PPVs) of 18.0 and 66.0 % at the cut-off activities of ≤10 and ≤20 %, respectively, compared to the reference method. Conclusions G6PD deficiency with enzyme activity of ≤60 % of normal is prevalent among 12.0 % of children residing in malaria-endemic areas of Hodeidah governorate, with 2.3 % having severe G6PD deficiency. Gender, district of residence and consanguinity between parents are significant independent predictors of G6PD deficiency at the cut-off activity of ≤30 % of normal among children in malaria-endemic areas of Hodeidah. The CareStart™ G6PD RDT proved reliable as a point-of-care test to screen for severely G6PD-deficient patients, with 100 % sensitivity and NPV, and it can be used for making clinical decisions prior to the administration of primaquine in malaria elimination strategies.
Databáze: OpenAIRE
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