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Table 3 Key research priorities

From: Review of key knowledge gaps in glucose-6-phosphate dehydrogenase deficiency detection with regard to the safe clinical deployment of 8-aminoquinoline treatment regimens: a workshop report

1.

Exploration of safe yet efficacious doses of 8-aminoquinolines for the radical cure of vivax malaria and the reduction of falciparum transmission.

2.

Definition of the relationship between genotype, enzyme activity and co-factors.

3.

Understanding of the relationship between 8-aminoquinoline dose and risk of haemolysis in G6PD normal and deficient individuals.

4.

Determining the correlation between enzyme activity and the severity of haemolysis.

5.

Definition of a threshold of G6PD activity that stakeholders, including regulatory agencies consider sufficient to administer safely standard 8-aminoquinoline regimens.

6.

Consensus on the degree of haemolysis (i e, proportion of red cell lysis) that constitutes an unacceptable clinical risk to the patient.

7.

Investigation of the mean level of haemolysis in uncomplicated malaria without primaquine treatment.

8.

What are acceptable test characteristics (e g, sensitivity and specificity) of rapid tests in various populations and field conditions?

9.

High resolution mapping of G6PD deficiency and haemolysis risks across major malaria endemic settings.

10.

Analysis of the cost-effectiveness of G6PD deficiency tests and the risk benefit of deploying or withholding primaquine regimens for P. vivax infections.