ACROSS Study: Populations at risk of malaria and drug induced haemolysis

ACROSS Study
APMEN health Care facility & community assessment to determine populations at Risk Of malaria and primaquine-induced haemolysiS

Aim:

To identify populations and individuals at risk of malaria and drug induced hemolysis. Evaluating the utility of novel diagnostics. 

Rationale:

In the Asia-Pacific region an increasing proportion of malaria is due to Plasmodium vivax since it is harder to eliminate than Plasmodium falciparum. P. vivax can form dormant liver stages that can relapse weeks to months after an initial infection. The only widely available drug to kill the liver stages is primaquine, but this can cause drug induced hemolysis in patients with a common enzyme deficiency known as Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency.

To promote the safe and effective use of primaquine radical cure for malaria, we need to have a better understanding of which populations are at greatest risk of malaria and know prevalence and variants of G6PD deficiency in these populations. In the last five years, great gains have been made in developing novel point-of-care diagnostics that can diagnose patients with P. vivax malaria and identify those with G6PD deficiency. The utility of these diagnostics in a clinical setting need to be explored both by quantitative and qualitative surveys. The aim of the ACROSS surveys is to provide a standardized approach to field testing so that a range of data can be gathered for each location, but can also be pooled for a comprehensive analysis.

Implications for policy and practice:

The study is designed to inform local policy makers on the local burden of malaria and G6PD deficiency, how well novel diagnostics perform in their country and identify key bottlenecks in patient and caregiver perceptions that may impede their widespread use.