Skip to main content
Log in

The modified G6PD deficiency screening test

  • General Paper
  • Published:
Accreditation and Quality Assurance Aims and scope Submit manuscript

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, which involves the mutation of the G6PD gene on the X chromosome, is the most common enzyme defect in humans. G6PD produces nicotinamide adenine dinucleotide phosphate (NADPH) for red blood cell protection from oxidative stress. Oxidative stress-induced red blood cell hemolysis in G6PD-deficient patients leads to anemia, jaundice, acute renal failure, and kernicterus in newborns. Currently, the fluorescent spot test (FST) is widely used for G6PD deficiency screening. This test detects NADPH production under UV light. This study purposed to modify the G6PD deficiency screening test based on NADPH production and the ability to detect the results of the color change in the color of the reaction. Blood samples of 60 subjects were collected and screened for G6PD deficiency using FST method. All samples were tested with the modified G6PD screening test and the quantitative assay kit. The results from the modified test showed the color red for normal cases, whereas the color brown indicated G6PD deficiency cases. The cutoff value of G6PD activity detected by the quantitative method was less than 2.9 U/gHb for G6PD deficiency. The precision of this study was 100 %. The results of sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of the modified test were 100 %, 96.7 %, 100 %, and 96.7 %, respectively. The modified G6PD screening test can be used for the screening of G6PD deficiency in newborns, for support through providing more information, and for self-protection from oxidative stress.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Stanton RC (2012) Glucose-6-phosphate dehydrogenase, NADPH, and cell survival. IUBMB Life 64(5):362–369

    Article  CAS  Google Scholar 

  2. Tang HY, Ho HY, Wu PR, Chen SH, Kuypers FA, Cheng ML, Chiu DT (2015) Inability to maintain GSH pool in G6PD-deficient red cells causes futile AMPK activation and irreversible metabolic disturbance. Antioxid Redox Signal 22(9):744–759

    Article  CAS  Google Scholar 

  3. Nobrega-Pereira S, Fernandez-Marcos PJ, Brioche T, Gomez-Cabrera MC, Salvador-Pascual A, Flores JM et al (2016) G6PD protects from oxidative damage and improves healthspan in mice. Nat Commun 7:10894

    Article  CAS  Google Scholar 

  4. Van den Broek L, Heylen E, Van den Akker M (2016) Glucose-6-phosphate dehydrogenase deficiency: not exclusively in males. Clin Case Rep 4(12):1135–1137

    Article  Google Scholar 

  5. Gomez-Manzo S, Marcial-Quino J, Vanoye-Carlo A, Serrano-Posada H, Ortega-Cuellar D, González-Valdez A et al (2016) Glucose-6-phosphate dehydrogenase: update and analysis of new mutations around the world. Int J Mol Sci 17(12):2069

    Article  Google Scholar 

  6. Ley B, Thriemer K, Jaswal J et al (2017) Barriers to routine G6PD testing prior to treatment with primaquine. Malar J 16:329

    Article  Google Scholar 

  7. Satyagraha AW, Sadhewa A, Elvira R, Elyazar I, Feriandika D, Antonjaya U et al (2016) Assessment of point-of-care diagnostics for G6PD deficiency in malaria endemic rural Eastern Indonesia. PLoS Negl Trop Dis 10(2):e0004457

    Article  Google Scholar 

  8. Mbanefo EC, Ahmed AM, Titouna A, Elmaraezy A, Trang NTH, Phuoc Long N et al (2017) Association of glucose-6-phosphate dehydrogenase deficiency and malaria: a systematic review and meta-analysis. Sci Rep 7:45963

    Article  CAS  Google Scholar 

  9. Von Fricken M, Weppelmann T, Eaton W, Masse R, Madsen VE, De Rochars B et al (2014) Performance of the carestart glucose-6-phosphate dehydrogenase (G6PD) rapid diagnostic test in Gressier, Haiti. Am J Trop Med Hyg 91:77–80

    Article  Google Scholar 

  10. Osorio L, Carter N, Arthur P, Bancone G, Gopalan S, Gupta SK et al (2015) Performance of BinaxNOW G6PD deficiency point-of-care diagnostic in P. vivax-infected subjects. Am J Trop Med Hyg 92(1):22–27

    Article  Google Scholar 

  11. Esperanza Espino F, Bibit JA, Beulah Sornillo J, Tan A, von Seidlein L, Ley B (2016) Comparison of three screening test kits for G6PD enzyme deficiency: implications for its use in the radical cure of vivax malaria in remote and resource-poor areas in the Philippines. PLoS ONE 11(2):e0148172

    Article  Google Scholar 

  12. Markic J, Krzelj V, Markotic A, Marusic E, Stricevic L, Zanchi J, Sapunar A (2006) High incidence of glucose-6-phosphate dehydrogenase deficiency in Croatian island isolate: example from Vis island. Croat Croat Med J 47(4):556–570

    PubMed  Google Scholar 

  13. Rawat DK, Hecker P, Watanabe M, Chettimada S, Levy RJ, Okada T et al (2012) Glucose-6-phosphate dehydrogenase and NADPH redox regulates cardiac myocyte L-type calcium channel activity and myocardial contractile function. PLoS ONE 7(10):e45365

    Article  CAS  Google Scholar 

  14. Obasa T, Mokuolu O, Ojuawo A (2011) Glucose 6 phosphate dehydrogenase levels in babies delivered at the University of Ilorin teaching hospital. Niger J Paediatr 38(4):165–169

    Google Scholar 

  15. Obasa TO, Adesiyun OO, Mokuolu OA, Ojuawo AI (2012) Comparative analysis of glucose-6-phosphate dehydrogenase levels in pre-term and term babies delivered at University of Ilorin Teaching Hospital. Pediatr Rep 4(1):e7

    Article  Google Scholar 

  16. Mukherjee MB, Colah RB, Martin S, Ghosh K (2015) Glucose-6-phosphate dehydrogenase (G6PD) deficiency among tribal populations of India-Country scenario. Indian J Med Res 141(5):516–520

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Elella SA, Tawfik M, Barseem N, Moustafa W (2017) Prevalence of glucose-6-phosphate dehydrogenase deficiency in neonates in Egypt. Ann Saudi Med 37(5):362–365

    Article  Google Scholar 

  18. Charoenkwan P, Tantiprabha W, Sirichotiyakul S, Phusua A, Sanguansermsri T (2014) Prevalence and molecular characterization of glucose-6-phosphate dehydrogenase deficiency in northern Thailand. Southeast Asian J Trop Med Public Health 45(1):187–193

    CAS  PubMed  Google Scholar 

  19. Phompradit P, Kuesap J, Chaijaroenkul W, Rueangweerayut R, Hongkaew Y, Yamnuan R et al (2011) Prevalence and distribution of glucose-6-phosphate dehydrogenase (G6PD) variants in Thai and Burmese populations in malaria endemic areas of Thailand. Malar J 10:368

    Article  CAS  Google Scholar 

  20. Dombrowski JG, Souza RM, Curry J, Hinton L, Silva NRM, Grignard L et al (2017) G6PD deficiency alleles in a malaria-endemic region in the Western Brazilian Amazon. Malar J 6(1):253

    Article  Google Scholar 

  21. LaRue N, Kahn M, Murray M, Leader BT, Bansil P, McGray S et al (2014) Comparison of quantitative and qualitative tests for glucose-6-phosphate dehydrogenase deficiency. Am J Trop Med Hyg 91(4):854–861

    Article  CAS  Google Scholar 

  22. Nantakomol D, Paul R, Palasuwan A, Day NPJ, White NJ, Imwong M (2013) Evaluation of the phenotypic test and genetic analysis in the detection of glucose-6-phosphate dehydrogenase deficiency. Malar J 12:289

    Article  Google Scholar 

  23. Neill JM (1925) Studies on the oxidation reduction of hemoglobin and methemoglobin: III. The formation of methemoglobin during the oxidation of autoxidizable substances. J Exp Med 41(4):551–560

    Article  CAS  Google Scholar 

  24. Santana MS, de Lacerda MVG, Barbosa MdGV, Alecrim WD, Alecrim MdGC (2009) Glucose-6-phosphate dehydrogenase deficiency in an endemic area for malaria in Manaus: a cross-sectional survey in the Brazilian Amazon. PLoS ONE 4(4):e5259

    Article  Google Scholar 

  25. AlSaif S, Ponferrada MB, AlKhairy K, AlTawil K, Sallam A, Ahmed I et al (2017) Screening for glucose-6-phosphate dehydrogenase deficiency in neonates: a comparison between cord and peripheral blood samples. BMC Pediatr 17(1):159

    Article  Google Scholar 

  26. Luzzatto L, Seneca E (2014) G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications. Br J Haematol 164(4):469–480

    Article  CAS  Google Scholar 

  27. Domingo GJ, Satyagraha AW, Anvikar A, Baird K, Bancone G, Bansil P et al (2013) G6PD testing in support of treatment and elimination of malaria: recommendations for evaluation of G6PD tests. Malar J 12:391

    Article  Google Scholar 

Download references

Acknowledgements

This work has been supported by the Graduate Scholarship for Outstanding Students (Grant number 07/2560 and 07/2562) and the Institute of Research and Innovation, Walailak University, under grant number WU_IRG61_18.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Orawan Sarakul.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krithong, R., Nuinoon, M., Pramtong, S. et al. The modified G6PD deficiency screening test. Accred Qual Assur 25, 121–126 (2020). https://doi.org/10.1007/s00769-019-01421-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00769-019-01421-8

Keywords

Navigation