Glucose-6-Phosphate Dehydrogenase (G6PD) Measurement Using Biosensors by Community-Based Village Malaria Workers and Hospital Laboratory Staff in Cambodia: A Quantitative Study.
Glucose-6-Phosphate Dehydrogenase (G6PD) Measurement Using Biosensors by Community-Based Village Malaria Workers and Hospital Laboratory Staff in Cambodia: A Quantitative Study.
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DOI：
10.3390/pathogens12030400
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发表时间：
2023-03-01
期刊：
影响因子：
--
通讯作者：
Seidlein LV
中科院分区：
文献类型：
--
作者：
Adhikari B;Tripura R;Dysoley L;Peto TJ;Callery JJ;Heng C;Vanda T;Simvieng O;Cassidy-Seyoum S;Thriemer K;Dondorp AM;Ley B;Seidlein LV
由于寄生虫的休眠肝脏阶段，间日疟在初次感染后可能复发。根治性治疗可以防止复发，但需要测量葡萄糖-6-磷酸脱氢酶（G6 PD）活性，以确定G6 PD缺陷患者的药物诱导溶血的风险。在缺乏可靠的G6 PD检测的情况下，间日疟患者在许多地方，包括柬埔寨农村地区，得不到根治性治疗。一种新型生物传感器，“G6 PD标准”（SD Biosensor，大韩民国;生物传感器），可以在护理点测量G6 PD活性。本研究的目的是比较G6 PD活性读数使用生物传感器由村疟疾工作人员（VMW）和医院为基础的实验室技术人员（LT），并比较G6 PD缺乏症的分类推荐的生物传感器制造商的类别来自当地估计调整的男性中位数（AMM）在Kravanh区，柬埔寨。参与者于2021年至2022年在柬埔寨西部招募。28名VMW和5名LT均接受了生物传感器及其使用的标准化培训。通过VMW测量社区中确定的发热患者的G6 PD活性;在一个子集中，通过LT进行第二次阅读。所有参与者都通过快速诊断测试（RDT）进行了疟疾检测。调整后的男性中位数（AMM）是根据所有RDT阴性受试者计算的，定义为100% G6 PD活性。VMW测量了1344名参与者的活动。其中，1327个（98.7%）读数被纳入分析，其中68个具有阳性RDT结果。我们计算出100%活性为6.4 U/gHb（四分位数范围：4.5至7.8）; 9.9%（124/1259）的RDT阴性参与者的G6 PD活性低于30%，15.2%（191/1259）的活性在30%至70%之间，75.0%（944/1259）的活性大于70%。114名参与者的重复测量显示，VMW和LT之间的G6 PD读数具有显著相关性（rs = 0.784，p < 0.001）。根据制造商的建议，285名参与者（21.5%）的活性低于30%;然而，根据AMM，132名参与者（10.0%）的活性低于30%。VMW和LT的G6 PD测量结果相似。通过提供培训、监督和监测，VMW可以在间日疟管理中发挥重要作用，这对于在区域内迅速消除疟疾至关重要。基于制造商建议和人群特定AMM的缺陷定义存在显著差异，这可能需要对这些建议进行修订。
Vivax malaria can relapse after an initial infection due to dormant liver stages of the parasite. Radical cure can prevent relapses but requires the measurement of glucose-6-phosphate dehydrogenase enzyme (G6PD) activity to identify G6PD-deficient patients at risk of drug-induced haemolysis. In the absence of reliable G6PD testing, vivax patients are denied radical curative treatment in many places, including rural Cambodia. A novel Biosensor, ‘G6PD Standard’ (SD Biosensor, Republic of Korea; Biosensor), can measure G6PD activity at the point of care. The objectives of this study were to compare the G6PD activity readings using Biosensors by village malaria workers (VMWs) and hospital-based laboratory technicians (LTs), and to compare the G6PD deficiency categorization recommended by the Biosensor manufacturer with categories derived from a locally estimated adjusted male median (AMM) in Kravanh district, Cambodia. Participants were enrolled between 2021 and 2022 in western Cambodia. Each of the 28 VMWs and 5 LTs received a Biosensor and standardized training on its use. The G6PD activities of febrile patients identified in the community were measured by VMWs; in a subset, a second reading was done by LTs. All participants were tested for malaria by rapid diagnostic test (RDT). The adjusted male median (AMM) was calculated from all RDT-negative participants and defined as 100% G6PD activity. VMWs measured activities in 1344 participants. Of that total, 1327 (98.7%) readings were included in the analysis, and 68 of these had a positive RDT result. We calculated 100% activity as 6.4 U/gHb (interquartile range: 4.5 to 7.8); 9.9% (124/1259) of RDT-negative participants had G6PD activities below 30%, 15.2% (191/1259) had activities between 30% and 70%, and 75.0% (944/1259) had activities greater than 70%. Repeat measurements among 114 participants showed a significant correlation of G6PD readings (rs = 0.784, p < 0.001) between VMWs and LTs. Based on the manufacturer’s recommendations, 285 participants (21.5%) had less than 30% activity; however, based on the AMM, 132 participants (10.0%) had less than 30% activity. The G6PD measurements by VMWs and LTs were similar. With the provisions of training, supervision, and monitoring, VMWs could play an important role in the management of vivax malaria, which is critical for the rapid elimination of malaria regionally. Definitions of deficiency based on the manufacturer’s recommendations and the population-specific AMM differed significantly, which may warrant revision of these recommendations.
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影响因子：
3
作者：
Adhikari B;Awab GR;von Seidlein L
通讯作者：
von Seidlein L
影响因子：
3
作者：
Engel N;Ghergu C;Matin MA;Kibria MG;Thriemer K;Price RN;Ding XC;Howes RE;Ley B;Incardona S;Alam MS
通讯作者：
Alam MS
影响因子：
5.6
作者：
Gómez-Manzo S;Marcial-Quino J;Vanoye-Carlo A;Serrano-Posada H;Ortega-Cuellar D;González-Valdez A;Castillo-Rodríguez RA;Hernández-Ochoa B;Sierra-Palacios E;Rodríguez-Bustamante E;Arreguin-Espinosa R
通讯作者：
Arreguin-Espinosa R
地中海型葡萄糖-6-磷酸脱氢酶缺乏症对间日疟原虫疟疾的保护作用。
影响因子：
7.7
作者：
Awab GR;Aaram F;Jamornthanyawat N;Suwannasin K;Pagornrat W;Watson JA;Woodrow CJ;Dondorp AM;Day NP;Imwong M;White NJ
通讯作者：
White NJ
影响因子：
3
作者：
John GK;Douglas NM;von Seidlein L;Nosten F;Baird JK;White NJ;Price RN
通讯作者：
Price RN