Point-of-care G6PD diagnostics for Plasmodium vivax malaria is a clinical and public health urgency

BMC Medicine

Commentary

J. Kevin Baird¹ 

[1] Eijkman-Oxford Clinical Research Unit, Jalan Diponegoro No. 69, Jakarta, Indonesia;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK;

关键词: Plasmodium vivax;    Hypnozoite;    Relapse;    Primaquine therapy;    G6PD deficiency;    Diagnostics;    Acute hemolytic anemia;   

DOI  :  10.1186/s12916-015-0531-0

 received in 2015-11-19, accepted in 2015-11-20,  发布年份 2015

来源: Springer

【 摘 要 】

Malaria caused by Plasmodium vivax threatens over 2 billion people globally and sickens tens of millions annually. Recent clinical evidence discredits the long-held notion of this infection as intrinsically benign revealing an often threatening course associated with mortality. Most acute attacks by this species derive from latent forms in the human liver called hypnozoites. Radical cure for P. vivax malaria includes therapy aimed both at the acute attack (blood schizontocidal) and against future attacks (hypnozoitocidal). The only hypnozoitocide available is primaquine, a drug causing life-threatening acute hemolytic anemia in patients with the inherited blood disorder glucose-6-phosphate dehydrogenase (G6PD) deficiency. This disorder affects 400 million people worldwide, at an average prevalence of 8 % in malaria-endemic nations. In the absence of certain knowledge regarding the G6PD status of patients infected by P. vivax, providers must choose between the risk of harm caused by primaquine and that caused by the parasite by withholding therapy. Resolving this dilemma requires the availability of point-of-care G6PD diagnostics practical for use in the impoverished rural tropics where the vast majority of malaria patients seek care.

【 授权许可】

CC BY   
© Baird. 2015