17 results on '"Bancone, Germana"'
Search Results
2. A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border
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Saito, Makoto, Carrara, Verena I., Gilder, Mary Ellen, Min, Aung Myat, Tun, Nay Win, Pimanpanarak, Mupawjay, Viladpai-nguen, Jacher, Paw, Moo Kho, Haohankhunnatham, Warat, Konghahong, Kamonchanok, Phyo, Aung Pyae, Chu, Cindy, Turner, Claudia, Lee, Sue J., Duanguppama, Jureeporn, Imwong, Mallika, Bancone, Germana, Proux, Stephane, Singhasivanon, Pratap, White, Nicholas J., Nosten, François, and McGready, Rose
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- 2021
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3. G6PD deficiency in malaria endemic areas of Nepal
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Marasini, Baburam, Lal, Bibek Kumar, Thapa, Suman, Awasthi, Kiran Raj, Bajracharya, Bijay, Khanal, Pratik, Neupane, Sanjeev, Jha, Shambhu Nath, Acharya, Sanjaya, Iama, Smriti, Koirala, Madan, Koirala, Dinesh, Bhandari, Suresh, Mahato, Ram Kumar, Chaudhary, Arun, Ghimire, Pramin, Magar, Rahachan Gharti, Bhattarai, Rajan Kumar, Gornsawun, Gornpan, Penpitchaporn, Pimsupah, Bancone, Germana, and Acharya, Bhim Prasad
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- 2020
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4. Vivax malaria in pregnancy and lactation: a long way to health equity
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Brummaier, Tobias, Gilder, Mary Ellen, Gornsawun, Gornpan, Chu, Cindy S., Bancone, Germana, Pimanpanarak, Mupawjay, Chotivanich, Kesinee, Nosten, François, and McGready, Rose
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- 2020
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5. Molecular characterization and mapping of glucose-6-phosphate dehydrogenase (G6PD) mutations in the Greater Mekong Subregion
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Bancone, Germana, Menard, Didier, Khim, Nimol, Kim, Saorin, Canier, Lydie, Nguong, Chea, Phommasone, Koukeo, Mayxay, Mayfong, Dittrich, Sabine, Vongsouvath, Malavanh, Fievet, Nadine, Le Hesran, Jean-Yves, Briand, Valerie, Keomany, Sommay, Newton, Paul N., Gorsawun, Gornpan, Tardy, Kaelan, Chu, Cindy S., Rattanapalroj, Orpreeya, Dong, Le Thanh, Quang, Huynh Hong, Tam-Uyen, Nguyen, Thuy-Nhien, Nguyen, Hien, Tran Tinh, Kalnoky, Michael, and Nosten, Francois
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- 2019
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6. Primaquine-induced haemolysis in females heterozygous for G6PD deficiency
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Chu, Cindy S., Bancone, Germana, Nosten, François, White, Nicholas J., and Luzzatto, Lucio
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- 2018
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7. A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border.
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Makoto Saito, Carrara, Verena I., Gilder, Mary Ellen, Aung Myat Min, Nay Win Tun, Pimanpanarak, Mupawjay, Viladpai-nguen, Jacher, Moo Kho Paw, Haohankhunnatham, Warat, Konghahong, Kamonchanok, Aung Pyae Phyo, Cindy Chu, Turner, Claudia, Lee, Sue J., Duanguppama, Jureeporn, Imwong, Mallika, Bancone, Germana, Proux, Stephane, Singhasivanon, Pratap, and White, Nicholas J.
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RANDOMIZED controlled trials ,MOSQUITO nets ,MALARIA ,TREATMENT failure ,PREGNANT women ,PLASMODIUM vivax - Abstract
Background: Artemisinin and artemisinin-based combination therapy (ACT) partner drug resistance in Plasmodium falciparum have spread across the Greater Mekong Subregion compromising antimalarial treatment. The current 3-day artemether-lumefantrine regimen has been associated with high treatment failure rates in pregnant women. Although ACTs are recommended for treating Plasmodium vivax malaria, no clinical trials in pregnancy have been reported.Methods: Pregnant women with uncomplicated malaria on the Thailand-Myanmar border participated in an open-label randomized controlled trial comparing dihydroartemisinin-piperaquine (DP), artesunate-mefloquine (ASMQ) and a 4-day artemether-lumefantrine regimen (AL+). The primary endpoint for P. falciparum infections was the PCR-corrected cure rate and for P. vivax infections was recurrent parasitaemia, before delivery or day 63, whichever was longer, assessed by Kaplan-Meier estimate.Results: Between February 2010 and August 2016, 511 pregnant women with malaria (353 P. vivax, 142 P. falciparum, 15 co-infections, 1 Plasmodium malariae) were randomized to either DP (n=170), ASMQ (n=169) or AL+ (n=172) treatments. Successful malaria elimination efforts in the region resulted in premature termination of the trial. The majority of women had recurrent malaria (mainly P. vivax relapses, which are not prevented by these treatments). Recurrence-free proportions (95% confidence interval [95% CI]) for vivax malaria were 20.6% (5.1-43.4) for DP (n=125), 46.0% (30.9-60.0) for ASMQ (n=117) and 28.7% (10.0-50.8) for AL+ (n=126). DP and ASMQ provided longer recurrence-free intervals. PCR-corrected cure rates (95% CI) for falciparum malaria were 93.7% (81.6-97.9) for DP (n=49), 79.6% (66.1-88.1) for AMSQ (n=55) and 87.5% (74.3-94.2) for AL+ (n=50). Overall 65% (85/130) of P. falciparum infections had Pfkelch13 propeller mutations which increased over time and recrudescence occurred almost exclusively in them; risk ratio 9.42 (95% CI 1.30-68.29). Among the women with falciparum malaria, 24.0% (95% CI 16.8-33.6) had P. vivax parasitaemia within 4 months. Nausea, vomiting, dizziness and sleep disturbance were more frequent with ASMQ. Miscarriage, small-for-gestational-age and preterm birth did not differ significantly among the treatment groups, including first trimester exposures (n=46).Conclusions: DP was well tolerated and safe, and was the only drug providing satisfactory efficacy for P. falciparum-infected pregnant woman in this area of widespread artemisinin resistance. Vivax malaria recurrences are very common and warrant chloroquine prophylaxis after antimalarial treatment in this area.Trial Registration: ClinicalTrials.gov identifier NCT01054248 , registered on 22 January 2010. [ABSTRACT FROM AUTHOR]- Published
- 2021
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8. Methods for the field evaluation of quantitative G6PD diagnostics: a review.
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Ley, Benedikt, Bancone, Germana, von Seidlein, Lorenz, Thriemer, Kamala, Richards, Jack S., Domingo, Gonzalo J., and Price, Ric N.
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GLUCOSE-6-phosphate dehydrogenase deficiency , *QUINOLINE derivatives , *POINT-of-care testing , *ULTRAVIOLET spectrophotometry , *HEMOLYSIS & hemolysins , *PRIMAQUINE , *PLASMODIUM vivax , *DIAGNOSIS , *THERAPEUTICS - Abstract
Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at risk of severe haemolysis following the administration of 8-aminoquinoline compounds. Primaquine is the only widely available 8-aminoquinoline for the radical cure of Plasmodium vivax. Tafenoquine is under development with the potential to simplify treatment regimens, but point-of-care (PoC) tests will be needed to provide quantitative measurement of G6PD activity prior to its administration. There is currently a lack of appropriate G6PD PoC tests, but a number of new tests are in development and are likely to enter the market in the coming years. As these are implemented, they will need to be validated in field studies. This article outlines the technical details for the field evaluation of novel quantitative G6PD diagnostics such as sample handling, reference testing and statistical analysis. Field evaluation is based on the comparison of paired samples, including one sample tested by the new assay at point of care and one sample tested by the goldstandard reference method, UV spectrophotometry in an established laboratory. Samples can be collected as capillary or venous blood; the existing literature suggests that potential differences in capillary or venous blood are unlikely to affect results substantially. The collection and storage of samples is critical to ensure preservation of enzyme activity, it is recommended that samples are stored at 4 °C and testing occurs within 4 days of collection. Test results can be visually presented as scatter plot, Bland-Altman plot, and a histogram of the G6PD activity distribution of the study population. Calculating the adjusted male median allows categorizing results according to G6PD activity to calculate standard performance indicators and to perform receiver operating characteristic (ROC) analysis. [ABSTRACT FROM AUTHOR]
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- 2017
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9. Genotypic and phenotypic characterization of G6PD deficiency in Bengali adults with severe and uncomplicated malaria.
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Plewes, Katherine, Soontarawirat, Ingfar, Ghose, Aniruddha, Bancone, Germana, Kingston, Hugh W. F., Herdman, M. Trent, Leopold, Stije J., Haruhiko Ishioka, Faiz, Md. Abul, Anstey, Nicholas M., Day, Nicholas P. J., Hossain, Md. Amir, Imwong, Mallika, Dondorp, Arjen M., and Woodrow, Charles J.
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GLUCOSE-6-phosphate dehydrogenase deficiency ,BENGALI (South Asian people) ,MALARIA prevention ,PHENOTYPES ,QUINOLINE ,DISEASES ,THERAPEUTICS - Abstract
Background: Control of malaria increasingly involves administration of 8-aminoquinolines, with accompanying risk of haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Few data on the prevalence and genotypic basis of G6PD deficiency are available from Bangladesh, where malaria remains a major problem in the South (Chittagong Division). The aim of this study was to determine the prevalence of G6PD deficiency, and associated G6PD genotypes, in adults with falciparum malaria in southern Bangladesh. Methods: G6PD status was assessed via a combination of fluorescent spot testing (FST) and genotyping in 141 Bengali patients admitted with falciparum malaria to two centres in Chittagong Division from 2012 to 2014. In addition, an analysis of genomic data from 1000 Genomes Project was carried out among five healthy Indian subcontinent populations. Results: One male patient with uncomplicated malaria was found to have G6PD deficiency on FST and a genotype associated with deficiency (hemizygous Orissa variant). In addition, there were two female patients heterozygous for deficiency variants (Orissa and Kerala-Kalyan). These three patients had a relatively long duration of symptoms prior to admission compared to G6PD normal cases, possibly suggesting an interaction with parasite multiplication rate. In addition, one of 27 healthy local controls was deficient on FST and hemizygous for the Mahidol variant of G6PD deficiency. Examination of 1000 Genomes Project sequencing data across the Indian subcontinent showed that 19/723 chromosomes (2.63%) carried a variant associated with deficiency. In the Bengali from Bangladesh 1000 Genomes population, three of 130 chromosomes (2.31%) carried deficient alleles; this included single chromosomes carrying the Kerala-Kalyan and Orissa variants. Conclusions: In line with other recent work, G6PD deficiency is uncommon in Bengalis in Bangladesh. Further studies of particular ethnic groups are needed to evaluate the potential risk of wide deployment of primaquine in malaria control efforts in Bangladesh. [ABSTRACT FROM AUTHOR]
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- 2017
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10. Neonatal Hyperbilirubinemia in a Marginalized Population on the Thai-Myanmar Border: a study protocol.
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Thielemans, Laurence, Trip-Hoving, Margreet, Bancone, Germana, Turner, Claudia, Simpson, Julie A., Hanboonkunupakarn, Borimas, van Hensbroek, Michaël Boele, van Rheenen, Patrick, Moo Kho Paw, Nosten, François, McGready, Rose, Carrara, Verena I., and Paw, Moo Kho
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NEONATAL jaundice ,HEALTH of immigrants ,GLUCOSE-6-phosphate dehydrogenase deficiency ,DISEASE prevalence ,GESTATIONAL age ,DISEASE risk factors ,DIAGNOSIS of developmental disabilities ,DEVELOPMENTAL disabilities ,LONGITUDINAL method ,RESEARCH protocols ,NOMADS ,PHOTOTHERAPY ,REFUGEES ,RESEARCH funding ,DISEASE incidence ,SEVERITY of illness index ,CASE-control method ,DIAGNOSIS ,THERAPEUTICS - Abstract
Background: This study aims to identify risk factors and the neurodevelopmental impact of neonatal hyperbilirubinemia in a limited-resource setting among a refugee and migrant population residing along the Thai-Myanmar border, an area with a high prevalence of glucose-6-phosphate dehydrogenase-deficiency.Methods: This is an analytic, observational, prospective birth cohort study including all infants of estimated gestational age equal to or greater than 28 weeks from mothers who followed antenatal care in the Shoklo Malaria Research Unit clinics. At birth, a series of clinical exams and laboratory investigations on cord blood will be carried out. Serum bilirubin will be measured in all infants during their first week of life. All the infants of the cohort will be clinically followed until the age of one year, including monitoring of their neurodevelopment.Discussion: The strength of this study is the prospective cohort design. It will allow us to collect information about the pregnancy and detect all infants with neonatal hyperbilirubinemia, to observe their clinical response under treatment and to compare their neurodevelopment with infants who did not develop neonatal hyperbilirubinemia. Our study design has some limitations in particular the generalizability of our findings will be limited to infants born after the gestational age of 28 weeks onwards and neurodevelopment to the end of the first year of life.Trial Registration: ClinicalTrials.gov ID NCT02361788 , registration date September 1st, 2014. [ABSTRACT FROM AUTHOR]- Published
- 2017
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11. The challenges of introducing routine G6PD testing into radical cure: a workshop report.
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Ley, Benedikt, Luter, Nick, Espino, Fe Esperanza, Devine, Angela, Kalnoky, Michael, Lubell, Yoel, Thriemer, Kamala, Baird, J. Kevin, Poirot, Eugenie, Conan, Nolwenn, Chong Chee Kheong, Dysoley, Lek, Wasif Ali Khan, Dion-Berboso, April G., Bancone, Germana, Hwang, Jimee, Kumar, Ritu, Price, Ric N., von Seidlein, Lorenz, and Domingo, Gonzalo J.
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MALARIA treatment ,GLUCOSE-6-phosphate dehydrogenase deficiency ,PRIMAQUINE ,DRUG accessibility ,BLACKWATER fever ,KNOWLEDGE gap theory - Abstract
The only currently available drug that effectively removes malaria hypnozoites from the human host is primaquine. The use of 8-aminoquinolines is hampered by haemolytic side effects in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. Recently a number of qualitative and a quantitative rapid diagnostic test (RDT) format have been developed that provide an alternative to the current standard G6PD activity assays. The WHO has recently recommended routine testing of G6PD status prior to primaquine radical cure whenever possible. A workshop was held in the Philippines in early 2015 to discuss key challenges and knowledge gaps that hinder the introduction of routine G6PD testing. Two point-of-care (PoC) test formats for the measurement of G6PD activity are currently available: qualitative tests comparable to malaria RDT as well as biosensors that provide a quantitative reading. Qualitative G6PD PoC tests provide a binomial test result, are easy to use and some products are comparable in price to the widely used fluorescent spot test. Qualitative test results can accurately classify hemizygous males, heterozygous females, but may misclassify females with intermediate G6PD activity. Biosensors provide a more complex quantitative readout and are better suited to identify heterozygous females. While associated with higher costs per sample tested biosensors have the potential for broader use in other scenarios where knowledge of G6PD activity is relevant as well. The introduction of routine G6PD testing is associated with additional costs on top of routine treatment that will vary by setting and will need to be assessed prior to test introduction. Reliable G6PD PoC tests have the potential to play an essential role in future malaria elimination programmes, however require an improved understanding on how to best integrate routine G6PD testing into different health settings. [ABSTRACT FROM AUTHOR]
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- 2015
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12. Epidemiology of forest malaria in Central Vietnam: the hidden parasite reservoir.
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Thanh, Pham Vinh, Van Hong, Nguyen, Van Van, Nguyen, Van Malderen, Carine, Obsomer, Valérie, Rosanas-Urgell, Anna, Grietens, Koen Peeters, Nguyen Xuan Xa, Bancone, Germana, Chowwiwat, Nongnud, Tran Thanh Duong, D'Alessandro, Umberto, Speybroeck, Niko, and Erhart, Annette
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MALARIA diagnosis ,EPIDEMIOLOGY ,MALARIA prevention ,PUBLIC health ,MICROSCOPY ,POLYMERASE chain reaction - Abstract
Background: After successfully reducing the malaria burden to pre-elimination levels over the past two decades, the national malaria programme in Vietnam has recently switched from control to elimination. However, in forested areas of Central Vietnam malaria elimination is likely to be jeopardized by the high occurrence of asymptomatic and submicroscopic infections as shown by previous reports. This paper presents the results of a malaria survey carried out in a remote forested area of Central Vietnam where we evaluated malaria prevalence and risk factors for infection. Methods: After a full census (four study villages = 1,810 inhabitants), the study population was screened for malaria infections by standard microscopy and, if needed, treated according to national guidelines. An additional blood sample on filter paper was also taken in a random sample of the population for later polymerase chain reaction (PCR) and more accurate estimation of the actual burden of malaria infections. The risk factor analysis for malaria infections was done using survey multivariate logistic regression as well as the classification and regression tree method (CART). Results: A total of 1,450 individuals were screened. Malaria prevalence by microscopy was 7.8% (ranging from 3.9 to 10.9% across villages) mostly Plasmodium falciparum (81.4%) or Plasmodium vivax (17.7%) mono-infections; a large majority (69.9%) was asymptomatic. By PCR, the prevalence was estimated at 22.6% (ranging from 16.4 to 42.5%) with a higher proportion of P. vivax mono-infections (43.2%). The proportion of sub-patent infections increased with increasing age and with decreasing prevalence across villages. The main risk factors were young age, village, house structure, and absence of bed net. Conclusion: This study confirmed that in Central Vietnam a substantial part of the human malaria reservoir is hidden. Additional studies are urgently needed to assess the contribution of this hidden reservoir to the maintenance of malaria transmission. Such evidence will be crucial for guiding elimination strategies. [ABSTRACT FROM AUTHOR]
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- 2015
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13. Assessment of therapeutic responses to gametocytocidal drugs in Plasmodium falciparum malaria.
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White, Nicholas J., Ashley, Elizabeth A., Recht, Judith, Delves, Michael J., Ruecker, Andrea, Smithuis, Frank M., Eziefula, Alice C., Bousema, Teun, Drakeley, Chris, Chotivanich, Kesinee, Imwong, Mallika, Pukrittayakamee, Sasithon, Prachumsri, Jetsumon, Chu, Cindy, Andolina, Chiara, Bancone, Germana, Hien, Tran T., Mayxay, Mayfong, Taylor, Walter R. J., and von Seidlein, Lorenz
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PLASMODIUM falciparum ,MALARIA prevention ,GERM cells ,PRIMAQUINE ,GLUCOSE-6-phosphate dehydrogenase ,THERAPEUTICS - Abstract
Indirect clinical measures assessing anti-malarial drug transmission-blocking activity in falciparum malaria include measurement of the duration of gametocytaemia, the rate of gametocyte clearance or the area under the gametocytaemia-time curve (AUC). These may provide useful comparative information, but they underestimate dose-response relationships for transmission-blocking activity. Following 8-aminoquinoline administration P. falciparum gametocytes are sterilized within hours, whereas clearance from blood takes days. Gametocytaemia AUC and clearance times are determined predominantly by the more numerous female gametocytes, which are generally less drug sensitive than the minority male gametocytes, whereas transmission-blocking activity and thus infectivity is determined by the more sensitive male forms. In choosing doses of transmission-blocking drugs there is no substitute yet for mosquito-feeding studies. [ABSTRACT FROM AUTHOR]
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- 2014
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14. Review of key knowledge gaps in glucose-6-phosphate dehydrogenase deficiency detection with regard to the safe clinical deployment of 8-aminoquinoline treatment regimens: a workshop report.
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von Seidlein, Lorenz, Auburn, Sarah, Espino, Fe, Shanks, Dennis, Cheng, Qin, McCarthy, James, Baird, Kevin, Moyes, Catherine, Howes, Rosalind, Ménard, Didier, Bancone, Germana, Winasti-Satyahraha, Ari, Vestergaard, Lasse S., Green, Justin, Domingo, Gonzalo, Yeung, Shunmay, and Price, Ric
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MALARIA prevention ,GLUCOSE-6-phosphate dehydrogenase deficiency ,QUINOLINE derivatives ,PLASMODIUM falciparum ,CLINICAL pathology ,PRIMAQUINE ,INFECTIOUS disease transmission ,THERAPEUTICS - Abstract
The diagnosis and management of glucose-6-phosphate dehydrogenase (G6PD) deficiency is a crucial aspect in the current phases of malaria control and elimination, which will require the wider use of 8-aminoquinolines for both reducing Plasmodium falciparum transmission and achieving the radical cure of Plasmodium vivax. 8-aminoquinolines, such as primaquine, can induce severe haemolysis in G6PD-deficient individuals, potentially creating significant morbidity and undermining confidence in 8-aminoquinoline prescription. On the other hand, erring on the side of safety and excluding large numbers of people with unconfirmed G6PD deficiency from treatment with 8-aminoquinolines will diminish the impact of these drugs. Estimating the remaining G6PD enzyme activity is the most direct, accessible, and reliable assessment of the phenotype and remains the gold standard for the diagnosis of patients who could be harmed by the administration of primaquine. Genotyping seems an unambiguous technique, but its use is limited by cost and the large range of recognized G6PD genotypes. A number of enzyme activity assays diagnose G6PD deficiency, but they require a cold chain, specialized equipment, and laboratory skills. These assays are impractical for care delivery where most patients with malaria live. Improvements to the diagnosis of G6PD deficiency are required for the broader and safer use of 8-aminoquinolines to kill hypnozoites, while lower doses of primaquine may be safely used to kill gametocytes without testing. The discussions and conclusions of a workshop conducted in Incheon, Korea in May 2012 to review key knowledge gaps in G6PD deficiency are reported here. [ABSTRACT FROM AUTHOR]
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- 2013
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15. The reality of using primaquine.
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Burgoine, Kathy L., Bancone, Germana, and Nosten, François
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PRIMAQUINE , *PLASMODIUM vivax , *GLUCOSE-6-phosphate dehydrogenase deficiency , *CHLOROQUINE , *MALARIA treatment - Abstract
Background: Primaquine is currently the only medication used for radical cure of Plasmodium vivax infection. Unfortunately, its use is not without risk. Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency have an increased susceptibility to haemolysis when given primaquine. This potentially fatal clinical syndrome can be avoided if patients are tested for G6PD deficiency and adequately informed before being treated. Case presentation: A 35-year old male presented to our clinic on the Thai-Burmese border with a history and clinical examination consistent with intravascular haemolysis. The patient had been prescribed primaquine and chloroquine four days earlier for a P. vivax infection. The medication instructions had not been given in a language understood by the patient and he had not been tested for G6PD deficiency. The patient was not only G6PD deficient but misunderstood the instructions and took all his primaquine tablets together. With appropriate treatment the patient recovered and was discharged home a week later. Conclusions: Whilst primaquine remains the drug of choice to eradicate hypnozoites and control P. vivax transmission, the risks associated with its use must be minimized during its deployment. In areas where P. vivax exists, patients should be tested for G6PD deficiency and adequately informed before administration of primaquine. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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16. Impact of protective haemoglobins C and S on P. falciparum malaria transmission in endemic area.
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Gouagna, Louis C., Bancone, Germana, Yao, Frank, Costantini, Carlo, Ouedraogo, Jean-Bosco, and Modiano, David
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MALARIA - Abstract
An abstract of the article "Impact of protective haemoglobins C and S on P. falciparum malaria transmission in endemic area" that was presented at a conference titled "From Parasite to Prevention: Advances in the understanding of malaria" held in Edinburgh, Great Britain on October 20-22, 2010, is presented.
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- 2010
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17. G6PD testing in support of treatment and elimination of malaria: recommendations for evaluation of G6PD tests.
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Domingo GJ, Satyagraha AW, Anvikar A, Baird K, Bancone G, Bansil P, Carter N, Cheng Q, Culpepper J, Eziefula C, Fukuda M, Green J, Hwang J, Lacerda M, McGray S, Menard D, Nosten F, Nuchprayoon I, Oo NN, Bualombai P, Pumpradit W, Qian K, Recht J, Roca A, Satimai W, Sovannaroth S, Vestergaard LS, and Von Seidlein L
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- Antimalarials therapeutic use, Female, Humans, Male, Plasmodium falciparum, Plasmodium vivax, Thailand, Antimalarials adverse effects, Drug-Related Side Effects and Adverse Reactions prevention & control, Glucosephosphate Dehydrogenase Deficiency diagnosis, Malaria, Falciparum drug therapy, Malaria, Vivax drug therapy, Mass Screening methods, Mass Screening organization & administration
- Abstract
Malaria elimination will be possible only with serious attempts to address asymptomatic infection and chronic infection by both Plasmodium falciparum and Plasmodium vivax. Currently available drugs that can completely clear a human of P. vivax (known as "radical cure"), and that can reduce transmission of malaria parasites, are those in the 8-aminoquinoline drug family, such as primaquine. Unfortunately, people with glucose-6-phosphate dehydrogenase (G6PD) deficiency risk having severe adverse reactions if exposed to these drugs at certain doses. G6PD deficiency is the most common human enzyme defect, affecting approximately 400 million people worldwide.Scaling up radical cure regimens will require testing for G6PD deficiency, at two levels: 1) the individual level to ensure safe case management, and 2) the population level to understand the risk in the local population to guide Plasmodium vivax treatment policy. Several technical and operational knowledge gaps must be addressed to expand access to G6PD deficiency testing and to ensure that a patient's G6PD status is known before deciding to administer an 8-aminoquinoline-based drug.In this report from a stakeholder meeting held in Thailand on October 4 and 5, 2012, G6PD testing in support of radical cure is discussed in detail. The focus is on challenges to the development and evaluation of G6PD diagnostic tests, and on challenges related to the operational aspects of implementing G6PD testing in support of radical cure. The report also describes recommendations for evaluation of diagnostic tests for G6PD deficiency in support of radical cure.
- Published
- 2013
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