Implementing radical cure diagnostics for malaria: user perspectives on G6PD testing in Bangladesh.
Implementing radical cure diagnostics for malaria: user perspectives on G6PD testing in Bangladesh.
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DOI：
10.1186/s12936-021-03743-w
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发表时间：
2021-05-12
期刊：
影响因子：
3
通讯作者：
Alam MS
中科院分区：
文献类型：
--
作者：
Engel N;Ghergu C;Matin MA;Kibria MG;Thriemer K;Price RN;Ding XC;Howes RE;Ley B;Incardona S;Alam MS
间日疟原虫的根治需要用8-氨基喹啉类药物治疗，如伯氨喹和他非诺喹，以根除肝脏催眠虫阶段，这些阶段可以重新激活，导致复发性感染。安全的治疗方案需要事先筛查葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症的患者，以避免潜在的危及生命的药物引起的溶血。在疟疾流行的国家很少有检测，但需要支持常规使用根治方法。本研究调查了孟加拉国终端用户对引入定量G6PD测试（SD Biosensor STANDARD™G6PD分析仪）以支持消除疟疾的看法。通过与孟加拉国的保健提供者和疟疾方案官员进行半结构化访谈和焦点小组讨论，分析了用户对可持续发展生物传感器测试的看法。分析了关于将这一测试引入日常实践的可行性的主要新主题，包括感知到的障碍。总共采访了63名参与者。与会者强调了生物传感器的救生潜力，但也提出了一些担忧，包括工作人员时间有限、工作量大以及设备的一些技术方面的影响。与会者强调，由于资金、工作量和复杂的测试基础设施方面的挑战，间日疟患者既太少又太多，无法实施G6PD测试。实施生物传感器需要灵活性和临场应变能力，以应对偏远地区，克服低怀疑指数和患者数量下降和不愿测试的相互作用。这种方法将产生新的证据形式，以证明在政策中引入的合理性，并在患者数量下降的情况下仔细考虑部署问题。研究结果表明，在消除疟疾的背景下，决策者和受影响社区都需要保持疟疾的重要性，在这种情况下，通过确保间日疟、PQ治疗和G6PD缺乏仍然可见。诸如生物传感器之类的新技术的出现，将引发关于资源分配优先次序的持续争论，这些资源必须适应不断变化的目标。有关生物传感器的技术和后勤问题应通过今后的产品设计、充分的培训、加强供应链以及在卫生系统各级仔细规划沟通、宣传和工作人员互动来解决。在线版本包含补充材料，可在10.1186/s12936-021-03743-w获得。
The radical cure of Plasmodium vivax requires treatment with an 8-aminoquinoline drug, such as primaquine and tafenoquine, to eradicate liver hypnozoite stages, which can reactivate to cause relapsing infections. Safe treatment regimens require prior screening of patients for glucose-6-phosphate dehydrogenase (G6PD) deficiency to avoid potential life-threatening drug induced haemolysis. Testing is rarely available in malaria endemic countries, but will be needed to support routine use of radical cure. This study investigates end-user perspectives in Bangladesh on the introduction of a quantitative G6PD test (SD Biosensor STANDARD™ G6PD analyser) to support malaria elimination. The perspectives of users on the SD Biosensor test were analysed using semi-structured interviews and focus group discussions with health care providers and malaria programme officers in Bangladesh. Key emerging themes regarding the feasibility of introducing this test into routine practice, including perceived barriers, were analysed. In total 63 participants were interviewed. Participants emphasized the life-saving potential of the biosensor, but raised concerns including the impact of limited staff time, high workload and some technical aspects of the device. Participants highlighted that there are both too few and too many P. vivax patients to implement G6PD testing owing to challenges of funding, workload and complex testing infrastructure. Implementing the biosensor would require flexibility and improvisation to deal with remote sites, overcoming a low index of suspicion and mutual interplay of declining patient numbers and reluctance to test. This approach would generate new forms of evidence to justify introduction in policy and carefully consider questions of deployment given declining patient numbers. The results of the study show that, in an elimination context, the importance of malaria needs to be maintained for both policy makers and the affected communities, in this case by ensuring P. vivax, PQ treatment, and G6PD deficiency remain visible. Availability of new technologies, such as the biosensor, will fuel ongoing debates about priorities for allocating resources that must be adapted to a constantly evolving target. Technical and logistical concerns regarding the biosensor should be addressed by future product designs, adequate training, strengthened supply chains, and careful planning of communication, advocacy and staff interactions at all health system levels. The online version contains supplementary material available at 10.1186/s12936-021-03743-w.
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影响因子：
3
作者：
Alam MS;Kabir MM;Hossain MS;Naher S;Ferdous NE;Khan WA;Mondal D;Karim J;Shamsuzzaman AK;Ahmed BN;Islam A;Haque R
通讯作者：
Haque R
影响因子：
3.7
作者：
Haque, Ubydul;Ahmed, Syed Masud;Haque, Rashidul
通讯作者：
Haque, Rashidul
影响因子：
--
作者：
Chu, Cindy S;Bancone, Germana;Gerth-Guyette, Emily
通讯作者：
Gerth-Guyette, Emily
影响因子：
3.7
作者：
Engel, Nora;Ganesh, Gayatri;Pai, Madhukar
通讯作者：
Pai, Madhukar
DOI：
10.4269/ajtmh.2010.09-0521
发表时间：
2010-06-01
影响因子：
3.3
作者：
Grietens, Koen Peeters;Soto, Veronica;Gamboa, Dionicia
通讯作者：
Gamboa, Dionicia