Validating the assessment of glucose 6 phosphate dehydrogenase g6pd
to place dormant forms in the liver called hypnozoites.
These parasites typically cause 3 or more clinical attacks in relatively quick succession in the months after the primary attack, or may do so up to 1 or 2 years later.
Tens of millions of patients diagnosed with vivax malaria cannot safely receive primaquine therapy against repeated attacks caused by activation of dormant liver stages called hypnozoites.
The only drug registered as safe and effective in preventing relapses is primaquine, and it has been in continuous use since 1952.
At therapeutic dosing against relapse, primaquine causes a mild to severe acute hemolytic anemia in patients having an inborn deficiency of G6PD.
The most widely applied technology for G6PD screening—the fluorescent spot test (FST)—is impractical in that setting.
At G6PD activity ≤40% of normal (n = 112), CSG test was not inferior to FST in detecting G6PD deficiency ( = 0.01) specificity, respectively.