Repeatability and reproducibility of a handheld quantitative G6PD diagnostic.


Journal

PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488

Informations de publication

Date de publication:
02 2022
Historique:
received: 20 07 2021
accepted: 17 01 2022
entrez: 17 2 2022
pubmed: 18 2 2022
medline: 26 2 2022
Statut: epublish

Résumé

The introduction of novel short course treatment regimens for the radical cure of Plasmodium vivax requires reliable point-of-care diagnosis that can identify glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. While deficient males can be identified using a qualitative diagnostic test, the genetic make-up of females requires a quantitative measurement. SD Biosensor (Republic of Korea) has developed a handheld quantitative G6PD diagnostic (STANDARD G6PD test), that has approximately 90% accuracy in field studies for identifying individuals with intermediate or severe deficiency. The device can only be considered for routine care if precision of the assay is high. Commercial lyophilised controls (ACS Analytics, USA) with high, intermediate, and low G6PD activities were assessed 20 times on 10 Biosensor devices and compared to spectrophotometry (Pointe Scientific, USA). Each device was then dispatched to one of 10 different laboratories with a standard set of the controls. Each control was tested 40 times at each laboratory by a single user and compared to spectrophotometry results. When tested at one site, the mean coefficient of variation (CV) was 0.111, 0.172 and 0.260 for high, intermediate, and low controls across all devices respectively; combined G6PD Biosensor readings correlated well with spectrophotometry (rs = 0.859, p<0.001). When tested in different laboratories, correlation was lower (rs = 0.604, p<0.001) and G6PD activity determined by Biosensor for the low and intermediate controls overlapped. The use of lyophilised human blood samples rather than fresh blood may have affected these findings. Biosensor G6PD readings between sites did not differ significantly (p = 0.436), whereas spectrophotometry readings differed markedly between sites (p<0.001). Repeatability and inter-laboratory reproducibility of the Biosensor were good; though the device did not reliably discriminate between intermediate and low G6PD activities of the lyophilized specimens. Clinical studies are now required to assess the devices performance in practice.

Sections du résumé

BACKGROUND
The introduction of novel short course treatment regimens for the radical cure of Plasmodium vivax requires reliable point-of-care diagnosis that can identify glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. While deficient males can be identified using a qualitative diagnostic test, the genetic make-up of females requires a quantitative measurement. SD Biosensor (Republic of Korea) has developed a handheld quantitative G6PD diagnostic (STANDARD G6PD test), that has approximately 90% accuracy in field studies for identifying individuals with intermediate or severe deficiency. The device can only be considered for routine care if precision of the assay is high.
METHODS AND FINDINGS
Commercial lyophilised controls (ACS Analytics, USA) with high, intermediate, and low G6PD activities were assessed 20 times on 10 Biosensor devices and compared to spectrophotometry (Pointe Scientific, USA). Each device was then dispatched to one of 10 different laboratories with a standard set of the controls. Each control was tested 40 times at each laboratory by a single user and compared to spectrophotometry results. When tested at one site, the mean coefficient of variation (CV) was 0.111, 0.172 and 0.260 for high, intermediate, and low controls across all devices respectively; combined G6PD Biosensor readings correlated well with spectrophotometry (rs = 0.859, p<0.001). When tested in different laboratories, correlation was lower (rs = 0.604, p<0.001) and G6PD activity determined by Biosensor for the low and intermediate controls overlapped. The use of lyophilised human blood samples rather than fresh blood may have affected these findings. Biosensor G6PD readings between sites did not differ significantly (p = 0.436), whereas spectrophotometry readings differed markedly between sites (p<0.001).
CONCLUSIONS
Repeatability and inter-laboratory reproducibility of the Biosensor were good; though the device did not reliably discriminate between intermediate and low G6PD activities of the lyophilized specimens. Clinical studies are now required to assess the devices performance in practice.

Identifiants

pubmed: 35176015
doi: 10.1371/journal.pntd.0010174
pii: PNTD-D-21-01086
pmc: PMC8853557
doi:

Substances chimiques

Glucosephosphate Dehydrogenase EC 1.1.1.49

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0010174

Subventions

Organisme : Wellcome Trust
ID : 200909/Z/16/Z
Pays : United Kingdom
Organisme : NCATS NIH HHS
ID : TL1 TR001864
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Benedikt Ley (B)

Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.

Ari Winasti Satyagraha (A)

Eijkman Institute for Molecular Biology, Jakarta, Indonesia.

Mohammad Golam Kibria (MG)

International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.

Jillian Armstrong (J)

Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America.

Germana Bancone (G)

Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.

Amy K Bei (AK)

Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America.

Greg Bizilj (G)

PATH, Seattle, Washington, United States of America.

Marcelo Brito (M)

Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Xavier C Ding (XC)

FIND, Geneva, Switzerland.

Gonzalo J Domingo (GJ)

PATH, Seattle, Washington, United States of America.

Michael E von Fricken (ME)

George Mason University, Fairfax, Virginia, United States of America.

Gornpan Gornsawun (G)

Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.

Brandon Lam (B)

Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Didier Menard (D)

Institut Pasteur, INSERM U1201, Paris, France.
Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France.

Wuelton Monteiro (W)

Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.

Sampa Pal (S)

PATH, Seattle, Washington, United States of America.

Lydia Visita Panggalo (LV)

Eijkman Institute for Molecular Biology, Jakarta, Indonesia.

Sunil Parikh (S)

Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America.

Daniel A Pfeffer (DA)

Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.

Ric N Price (RN)

Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Alessandra da Silva Orfano (A)

Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America.

Martina Wade (M)

Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America.

Mariusz Wojnarski (M)

Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

Kuntawunginn Worachet (K)

Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

Aqsa Yar (A)

Institut Pasteur, INSERM U1201, Paris, France.

Mohammad Shafiul Alam (MS)

International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.

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