Fig 1.
Geographic location of the study site.
Fig 2.
Flow-chart of the study in Panenggo Ede where those tests performed in field or field laboratory were confirmed by DNA analysis at the Eijkman Institute in Jakarta, Indonesia.
Fig 3.
Photographs illustrating visual test outcomes for the G6PD RDT (top) and FST (bottom).
For FST, samples were spotted at time 0, 5 and 10 minutes interval and the dark spots were considered deficient (D) and the bright ones were considered normal (N). RDT with purple color was considered normal (N) and no color was considered deficient (D).
Table 1.
PCR primers and RFLP conditions for G6PD variants common in Southwest Sumba Regency and PCR primers for detecting SAO, HbE and α thalassemia.
Fig 4.
Chart illustrating the rationale for assessing diagnostic performance of qualitative G6PD screening devices in the context of a clinical decision to offer or withhold primaquine therapy in patients with P. vivax malaria.
Each classification (bold font top), clinical outcome (normal font middle), and risk or benefit (italics bottom) of diagnostic performance appears in each box of classification.
Table 2.
Malaria and anemia in the community.
Fig 5.
Variants of G6PD found in Panenggo Ede.
(A) Bar graph showing different variants found in males (blue) and females (red) and (B) showed the boxplot showing the activity of these variants in comparison to normal. VL, VC, CT and CO stands for Vanua Lava, Viangchan, Chatham and Coimbra Shunde variant of G6PD respectively. Black line across each box plot is the median for each group. * Indicated that the group contained homozygous females as well.
Fig 6.
Graphs illustrate diagnostic outcomes for the G6PD RDT (left) and FST (right) among males (top) and females (bottom) across quantitative G6PD activity values for each subject.
A qualitative test classification as deficient is shown in red, and green for normal. Vertical lines within each identify specific diagnostic thresholds (10%, 20%, 30%, 60% and 100%) employed to calculate diagnostic performance characteristics.
Table 3.
G6PD diagnostic tests analyzed in 610 subjects living in Panenggo Ede village, Southwest Sumba, tested against G6PD gold standard test.