Oral Presentation First Malaria World Congress 2018

Diagnostics for Plasmodium vivax case management (#168)

Gonzalo Domingo 1 , James McCarthy 2 , Francois Nosten 3
  1. PATH, Seattle, WASHINGTON, United States
  2. QIMR Berghofer Medical Research Institute, Brisbane, Australia
  3. Shoklo Malaria Research Institute, Mae Sot, Thailand

Infection with Plasmodium vivax presents unique diagnostic challenges to case detection and then if confirmed to case management.  Case detection is complicated by the ability of the P. vivax parasites to sequester in the liver, as well as by the low parasite densities in patients presenting with symptoms. Case management is complicated by the need to administer 8-aminoquinoline based drugs such as primaquine to achieve radical cure of liver stage parasites. These drugs can cause severe hemolysis in patients with deficiency in glucose-6-phosphate dehydrogenase (G6PD), a common genetic condition in some populations exposed to malaria.  Limitations of current diagnostics for P. vivax case detection are discussed in context of biomarker availability and dynamics, as well as recent developments to address these limitations. Progress in the availability of diagnostic tests for G6PD deficiency that address safety concerns and thus provide access to curative treatment options for both G6PD deficient patients and women with intermediate G6PD activity levels is provided. Specifically performance data for a novel quantitative diagnostic test for G6PD deficiency is presented. Importantly the relative impact of the performance of current tests for case detection, and the contribution of G6PD deficiency, to access to radical cure is discussed.