Field trials of a rapid test for G6PD deficiency in combination with a rapid diagnosis of malaria

A rapid single-step screening method for detection of glucose-6-phosphate d ehydrogenase (G6 PD) deficiency was evaluated on Halmahera Island, Maluku P rovince, Indonesia, and in Shan and Mon States, Myanmar, in combination wit h a rapid diagnosis of malaria by an acridine orange staining method. Sever e deficiency was detected by the rapid test in 45 of 1126 volunteers in Ind onesia and 54 of 1079 in Myanmar, but it was difficult to distinguish blood samples with mild deficiency from those with normal activity 89 of 99 seve rely deficient cases were later confirmed by formazan ring method in the la boratory but 5 with mild and 5 with no deficiency were misdiagnosed as seve re. Of the samples diagnosed as mild and no deficiency on-site, none was fo und to be severely deficient by the formazan method. Malaria patients were simultaneously detected on-site in 273 samples on Halmahera island and in 2 77 samples from Shan and Mon States. In Mon State, primaquine was prescribe d safely to G6 PD-normal malaria patients infected with Plasmodium vivax an d/or gametocytes of P. falciparum. The new rapid test for G6 PD deficiency may be useful for detecting severe cases under field conditions, and both r apid tests combined are can be useful in malaria-endemic areas, facilitatin g early diagnosis, prompt and radical treatment of malaria and suppression of malaria transmission.