Journal
PATHOGENS
Volume 12, Issue 5, Pages -Publisher
MDPI
DOI: 10.3390/pathogens12050650
Keywords
P. vivax; G6PD testing; radical cure; malaria elimination; policy; treatment guidelines; implementation; point of care diagnostics
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Plasmodium vivax malaria continues to be a significant burden in various regions. The use of 8-aminoquinoline drugs is necessary for the complete removal of the parasite, but it can cause severe haemolysis in G6PD deficient patients. The implementation of routine G6PD testing in malaria endemic countries is still lacking, and there are challenges in training healthcare staff, quality control of diagnostics, and communication with affected communities.
Plasmodium vivax malaria continues to cause a significant burden of disease in the Asia-Pacific, the Horn of Africa, and the Americas. In addition to schizontocidal treatment, the 8-aminoquinoline drugs are crucial for the complete removal of the parasite from the human host (radical cure). While well tolerated in most recipients, 8-aminoquinolines can cause severe haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. G6PD deficiency is one of the most common enzymopathies worldwide; therefore, the WHO recommends routine testing to guide 8-aminoquinoline based treatment for vivax malaria whenever possible. In practice, this is not yet implemented in most malaria endemic countries. This review provides an update of the characteristics of the most used G6PD diagnostics. We describe the current state of policy and implementation of routine point-of-care G6PD testing in malaria endemic countries and highlight key knowledge gaps that hinder broader implementation. Identified challenges include optimal training of health facility staff on point-of-care diagnostics, quality control of novel G6PD diagnostics, and culturally appropriate information and communication with affected communities around G6PD deficiency and implications for treatment.
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