Validating the assessment of glucose 6 phosphate dehydrogenase g6pd Dating game video free cam 2 cam roulette sex sites
The combination of them explains more than 50 years without access to G6PD screening, which in turn accounts for the lack of access to primaquine therapy against vivax malaria for almost all those patients.We consider this deceptively simple problem the likely basis of most clinical attacks of vivax malaria and attendant burdens of morbidity and mortality.One of the most widely recommended and used has been the fluorescent spot test (FST) described in 1966 by hematologist and pioneering G6PD scientist Ernest Beutler.It has seen several decades of practical and safe use in the developed world, but finds almost no routine application where most patients with malaria live.The most widely applied technology for G6PD screening-the fluorescent spot test (FST)-is impractical in that setting.We evaluated a new point-of-care G6PD screening kit (Care Start G6PD, CSG) against FST using graded Cu Cl treatments to simulate variable hemizygous states, and varying proportions of Cu Cl-treated RBC suspensions to simulate variable heterozygous states of G6PD deficiency.This extraordinarily diverse and complex X-linked trait occurs most frequently where there is endemic malaria transmission, as it may confer some protection against the onset of severe and threatening malaria.
We optimized Cu Cl inhibition of G6PD in normal red blood cells (RBCs) to assess G6PD diagnostic technologies suited to point of care in the impoverished rural tropics.
In experiments double-blinded to Cu Cl treatment, technicians reading FST and CSG test (n = 269) classified results as positive or negative for deficiency.
At G6PD activity ≤40% of normal (n = 112), CSG test was not inferior to FST in detecting G6PD deficiency (P = 0.003), with 96% vs 90% (P = 0.19) sensitivity and 75% and 87% (P = 0.01) specificity, respectively.
The CSG test costs less, requires no specialized equipment, laboratory skills, or cold chain for successful application, and performs as well as the FST standard of care for G6PD screening.
Such a device may vastly expand access to primaquine therapy and aid in mitigating the very substantial burden of morbidity and mortality imposed by the hypnozoite reservoir of vivax malaria.
The most widely applied technology for G6PD screening—the fluorescent spot test (FST)—is impractical in that setting.