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 |
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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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