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Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic disorder characterized by reduced G6PD enzyme levels in the blood. This condition is common in populations exposed to malaria; an acute febrile disease caused by Plasmodium parasites. G6PD-deficient individuals may suffer from acute hemolysis following the prescription of Primaquine, an antimalarial treatment. The population at risk for such a condition includes the Senoi group of Orang Asli, a remote indigenous community in Malaysia. This study aimed to elucidate the G6PD molecular heterogeneity in this subethnic group which is important for malaria elimination. A total of 662 blood samples (369 males and 293 females) from the Senoi subethnic group were screened for G6PD deficiency using a quantitative G6PD assay, OSMMR2000-D kit with Hb normalization. After excluding the family members, the overall prevalence of G6PD deficiency in the studied population was 15.2% (95% CI: 11–19%; 56 of 369), with males (30 of 172; 17.4%) outnumbering females (26 of 197; 13.2%). The adjusted male median (AMM), defined as 100% G6PD activity, was 11.8 IU/gHb. A total of 36 participants (9.6%; 26 male and 10 female) were deficient (<30% of AMM) and 20 participants (5.4%; 4 male and 16 female) were G6PD-intermediate (30–70% of AMM). A total of 87 samples were genotyped, of which 18 showed no mutation. Seven mutations were found among 69 genotyped samples; IVS11 T93C (47.1%; n = 41), rs1050757 (3'UTR +357A>G)(39.1%; n = 34), G6PD Viangchan (c.871G>A)(25.3%; n = 22), G6PD Union (c.1360C>T)(21.8%; n = 19), c.1311C>T(20.7%; n = 18), G6PD Kaiping (c.1388G>A)(8.0%; n = 7), and G6PD Coimbra (c.592C>T)(2.3%; n = 2). Our analysis revealed 27 hemizygote males, 18 heterozygote females, 7 homozygote females, and 2 compound heterozygote females. This study confirms the high prevalence of G6PD deficiency among the Senoi Malaysian Orang Asli, with a significant degree of molecular heterogeneity. More emphasis should be placed on screening for G6PD status and proper and safe use of Primaquine in the elimination of malaria among this indigenous population. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of Plasmodium vivax malaria with 8-aminoquinolines is contraindicated in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals due to the risk of acute haemolytic anaemia. Effective G6PD screening is paramount to avoid adverse drug reactions. This study aimed to evaluate the performance of novel quantitative point-of-care (POC) tests as a new screening method for G6PD deficiency in Malaysia. Materials and Methods: A total of 153 neonatal cord blood, 99 peripheral blood of older children aged between 1 month to 12-years old, and 62 peripheral adult blood were screened for G6PD deficiency using two quantitative POC tests, CareStartTM biosensor (Carestart) and CareStartTM Biosensor 1 (S1). The results were compared with OSMMR2000D kit as a reference assay. Two statistical analyses were performed in this study to evaluate the POC test performances, the Spearman's correlation test and the Cohen's kappa method. Results: Both Carestart and S1 tests showed significant positive correlations to OSMMRS000D with r² = 0.7916 and r² = 0.7467. Their measurement of agreement showed a kappa (κ) value of 0.805 (p<0.001, 95% CI), and 0.795 (p<0.001, 95% CI), respectively. Analysis of the area under the Receiver Operating Curve (ROC) at 60% cut-off illustrated that the Carestart had 90.2% sensitivity, 98.9% specificity, 98.3% positive predictive value (PPV), and 93.8% negative predictive value (NPV). The corresponding values for the S1 were 95.2%, 100%, 100%, and 96.8%, respectively. Conclusion: This study showed that the Carestart and S1 biosensors have high-performance reliability for screening of G6PD deficiency, which can guide safe prescriptions of anti-malaria medications and hence, eradication of Plasmodium vivax malaria. [ABSTRACT FROM AUTHOR]

The disruptive potentials of drones are rapidly growing including for the delivery of blood samples in healthcare. Maintenance of the quality of blood samples is important to ascertain that the drone is a safe mode of transportation, particularly during emergencies and in critical cases. The influence of the drone carriage material on blood samples transportation was investigated in this study. Two phases of drone simulation flights were conducted in Cyberjaya, Malaysia. In Phase 1, the effect of drone carriage material on the internal storage temperature during blood samples transportation was determined. Three types of carriage materials were compared: aluminium, expanded polystyrene (EPS) foam, and polypropylene (PP) plastic. In Phase 2, the quality of drone-transported blood samples was assessed, using the best material from Phase 1 as the drone carriage material. Biochemical and hematological analyses of 60 blood samples were conducted using five parameters. In Phase 1, EPS foam was found to be the best material to maintain a stable and favorable internal storage temperature at mean kinetic temperature ±SD of 4.70 ±1.14°C. Much higher and unfavorable mean kinetic temperatures were recorded for aluminium (11.46 ±0.35°C) and plastic (14.17 ±0.05°C). In Phase 2, laboratory tests show that the quality of blood samples was well maintained, and the mean biochemical and hematological parameters of drone-transported blood samples showed no significant alteration compared to ground controls. Drone carriage material is an important determinant of the quality of blood samples transported by drone, particularly in hot equatorial climates as in Malaysia. The blood storage temperature was best maintained using EPS foam, as evidenced by the favorable average temperature and preservation of hematological and biochemical parameters of the blood samples. [ABSTRACT FROM AUTHOR]

Introduction: The vast advancement of technology and breakthrough in high-tech disciplines created multiple areas of research activities, including the emergence of the medical drone. Malaysia, a rapidly developing country in Southeast Asia is on track to achieving high-income status. However, the stagnant growth of Malaysian maternal healthcare does not run parallel with the aspiration. This review paper assessed and reported narratively the current condition of maternal healthcare in Malaysia, the possible application of drones in improving the sector, exploring in detail several challenges, and providing recommendations for experts in studying the rising technological phenomena. Materials and Methods: A literature search was done from June 2019 to November 2019 with restrictions to the English language. The search was performed in ScienceDirect, PubMed, and EMBASE databases, using a combination of search terms related to drones, Unmanned Aerial Vehicles (UAV), Unmanned Aerial Systems (UAS), maternal, obstetric, healthcare, medical products transportation and Malaysia. A discourse analysis followed and a narrative review was provided on this subject. Results and Discussion: The validated ability of drones in the delivery of blood products is highlighted as a possible application in improving maternal healthcare in Malaysia, particularly in the state of Sabah. Five key challenges are identified: infrastructure, technicalities, regulations, expertise, and social acceptance. Future predictions of drone technology in healthcare were outlined with the suggestion of three principle arms of application. Conclusion: The usage of the medical drone in medical products transportation supports the objectives of WHO MDG 5 for Malaysian maternal health. A study on the impact of drones in reducing the maternal mortality ratio is recommended for further exploration. [ABSTRACT FROM AUTHOR]