Rapid Fire Presentation 8th International Conference on Plasmodium vivax Research 2022

Operational feasibility of integrating glucose-6-phosphate dehydrogenase point-of-care testing into malaria case management: evidence from Vietnam and Lao PDR (#322)

Emily Gerth-Guyette 1 , Sarah Cassidy-Seyoum 2 , Huyen Nguyen 3 , Sengkeo Vongviengxay 2 , Keoboupaphone Chindavongsa 4 , Viengxay Vanisaveth 4 , Phuc Quang Bui 5 , Mai Thi Tuyet Dang 5 , Timothy Finn 2 , Spike Nowak 3 , Adam Bennett 1 , Gonzalo Domingo 1
  1. PATH, Seattle, WA, United States
  2. Malaria Elimination Initiative , University of San Francisco , Vientiane , Laos PDR
  3. PATH, Hanoi, Vietnam
  4. Center of Malariology, Parasitology and Entomology, Vientiane, Lao PDR
  5. National Institute of Malariology, Parasitology and Entomology, Hanoi, Vietnam

Introduction: For patients with Plasmodium vivax, screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency can improve health outcomes, align diagnosis and treatment options in remote settings with globally recommended clinical practices, and reduce transmission through the expanded use of radical cure treatments. Until recently, widespread use of G6PD testing has been limited, in part due to concerns around test usability. Malaria control programs and research partners in Vietnam and Lao PDR have undertaken operational research studies to assess the operational feasibility of integrating G6PD point-of-care testing into routine care.

Methods: A measurement framework was developed and implemented to assess operational feasibility across multiple dimensions including adherence to a revised case management algorithm that includes G6PD classification, assessments of health care provider knowledge, an evaluation of training, a cost analysis, and a qualitative exploration of barriers and facilitators that impact G6PD testing. Primary endpoints include the proportion of patients who are correctly diagnosed and treated, and the number of patients who report an adverse event, including drug-induced acute hemolytic anemia. Qualitative data collection and health worker observations took place at baseline, midline, and endline.

Results and conclusions: G6PD testing was used as part of malaria case management across 23 district hospitals and health centers in malaria-endemic areas from September 2020 to December 2021.192 P. vivax patients and 33 health workers in Laos, and 27 P. vivax patients and 31 health workers in Vietnam, were enrolled into the study. The proportion of patients who were appropriately tested, treated, and followed up with will be reported. Scores from health worker assessments over time will be presented, as well as costs and qualitative user perceptions and experiences. These data provide insights into what changes to routine care, training, and supervision will be needed to successfully integrate G6PD testing into case management and expand radical cure treatment.