Performance of BinaxNOW G6PD deficiency point-of-care diagnostic in P. vivax-infected subjects

10 Nov 2014

Lyda Osorio, Nick Carter, Preetam Arthur, Germana Bancone, Sowmya Gopalan, Sandeep K. Gupta, Harald Noedl, Sanjay K. Kochar, Dhanpat K. Kochar, Srivicha Krudsood, Marcus V. Lacerda, Alejandro Llanos-Cuentas, Ronnatrai Rueangweerayut, Ramadurai Srinivasan, Moritz Treiber, Jörg J. Möhrle and Justin Green

The American Journal of Tropical Medicine and Hygiene



Accurate diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency is required to avoid the risk of acute hemolysis associated with 8-aminoquinoline treatment. The performance of the BinaxNOW G6PD test compared with the quantitative spectrophotometric analysis of G6PD activity was assessed in 356 Plasmodium vivax-infected subjects in Brazil, Peru, Thailand, and India. In the quantitative assay, the median G6PD activity was 8.81 U/g hemoglobin (range = 0.05-20.19), with 11 (3%) subjects identified as deficient. Sensitivity of the BinaxNOW G6PD to detect deficient subjects was 54.5% (6 of 11), and specificity was 100% (345 of 345). Room temperatures inadvertently falling outside the range required to perform the rapid test (18-25°C) together with subtlety of color change and insufficient training could partially explain the low sensitivity found. Ensuring safe use of 8-aminoquinolines depends on additional development of simple, highly sensitive G6PD deficiency diagnostic tests suitable for routine use in malaria-endemic areas.

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