Modified Fluorescent Spot Test for screening G6PD deficiency among malaria patients in remote health care services, northern Thailand
Keywords:
ภาวะพร่องเอนไซม์จีซิกพีดี, ผู้ป่วยมาลาเรีย, มาลาเรียไวแวกซ์, ชุดตรวจ G6PD, มาลาเรียฟัลซิปารัม สำเร็จรูปAbstract
The objective of this study was to apply a standard G6PD screening test in the malaria clinics in remote areas of Mae Hong Son province. Primaquine is now the only one antimalarial drug available in Thailand for radical treatment in P.vivax and kills gametocytes of all malaria parasite species However, severe hemolytic anemia might occur in some patients with G6PD deficiency. Therefore, all malaria patients should be screened for G6PD before taking the drug. Fluorescent Spot Test (FST) for G6PD was a method recommended by the International Committee of Standardization in Hematology (ICSH) as the most acceptable and reliable screening test for G6PD deficiency. But, it needed tools and skills in diagnosis and interpretation of the results. There were 109 malaria patients tested for G6PD by the modified FST G6PD and CareStartTmG6PD RDT. The efficacy and side effects of antimalarial drug were observed carefully. If any evidence of the side effect found, the patient must be referred to the hospital immediately. The result showed that the modified FST G6PD had 100% sensitivity and specificity compared with Methylene blue Oxidation and observation of any side effect of primaquine in malaria patients. There were 109 (95.41%) patients normal G6PD, 4 (3.67%) patients with G6PD deficiency, and 1 (0.91%) patient with partial G6PD deficiency. In contrast, CareStartTmG6PD RDT had 35.78% (39 cases) of invalid results which was unusual as rapid diagnosis test normally simply to use. There were several reasons, one of them was a blood sample might have high hematocrit which resulted in a difficulty to flow through the RDT strip and also the temperature was high. In conclusion, the result of this study clearly indicated that modified FST
G6PD can be used as screening test in remote areas by health worker.
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