Poster Presentation First Malaria World Congress 2018

Performance of CareStart RDT in determining the status of G6PD deficiency in anemic sample (#477)

Hisni Rahmat 1 , Ari Winasti Satyagraha 1
  1. Eijkman Institute for Molecular Biology, Central Jakarta, INDONESIA, Indonesia

Even though point of care Carestart G6PD RDT has been recommended by the WHO as a diagnostic tool for G6PD screening in the field, many still prefer spectrophotometric quantitative G6PD tests instead. One main caveat of using the quantitative tests is that it depends on the concentration of hemoglobin as the denominator in generating G6PD activity. In anemic cases, G6PD activities were higher than normal range resulting in false negative result. Since Carestart G6PD RDT uses visual dye colorization, it may give higher accuracy in determining the G6PD status in anemic cases.  This is a preliminary study to assess the performance of Carestart RDT in various concentration of hemoglobin against spectrophotometric quantitative G6PD test. A broad range of hemoglobin concentration (14.5 to 2.6 g/dL; mean level: 5.8 g/dL) was obtained by diluting the packed red blood cells with its plasma using ratios of 1:1 to 1:10. The blood was taken from 1 normal individual and 1 G6PD-deficient individual and performed 3 times over a range of more than 2 weeks per test. The initial untreated activity of the samples were 8.01 U/g Hb and 1.03 U/g Hb for normal and G6PD-deficient samples. The G6PD-normal sample showed that its activity rose from 8.79 U/g Hb at ratio 1:1 to 10.73 U/g Hb at ratio 1:10. While in G6PD-deficient sample, it was from 1.31 U/g Hb to 3.22 U/g Hb. The result of CareStart RDT assay indicated that the purple color was weakening in higher blood dilution, particularly for normal sample. In G6PD-deficient sample, no color change was detected in any ratios. This result suggested that the Carestart RDT might be more accurate than spectrophotometric assay in determining G6PD status in anemia. This test may prove to be more reliable in intermediate cases, however, more tests should be done to prove otherwise.