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G6PD DeficiencyNCT04033640

Evaluation of a Diagnostic to Identify Glucose-6-phosphate Dehydrogenase (G6PD) Deficiency in Brazil

A study testing SD Biosensor STANDARD G6PD Test, Pointe Scientific Test Kit and HemoCue System in people with G6PD Deficiency, run by PATH at 2 sites in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Th objectives of this study are: To determine the performance of G6PD tests in detecting G6PD activity and hemoglobin (Hb) compared to a reference assay To assess the comprehension of the G6PD test packaging and labelling among intended users To assess the usability of G6PD test result outputs among intended users Read more about this study

Who is it for?
Ages 2 years and olderHealthy volunteers can take part
Conditions the study is for
G6PD Deficiency
What is being tested?
SD Biosensor STANDARD G6PD Test, Pointe Scientific Test Kit and HemoCue System
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,754 participants
Where
2 sitesBrazil
Study dates
27 Jun 2019to 31 Dec 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Febrile patients seeking care at the Manaus or Porto Velho clinics
  • 2 years age or older
  • Willing to provide informed consent
  • Included in previous G6PD surveys and provided consent to be contacted again
  • 2 years of age or older
  • Willing to provide informed consent or assent
Show all 10Show fewer
  • Provides malaria case management at study facility or study site
  • Considered an intended user of quantitative POC G6PD tests
  • Trained and proficient in the use of the POC G6PD test
  • Willing to provide informed consent

Who cannot join

  • Younger than 2 years of age
  • Participants who received a blood transfusion in the last 3 months, self report
  • Unwilling to provide informed consent
  • Participants with known G6PD status
  • Younger than 2 years of age
  • Participants who received a blood transfusion in the last 3 months, self report
Show all 12Show fewer
  • Unwilling to provide informed consent or assent or unavailable during study visit
  • Health workers
  • Does not provide malaria case management at study facility or study site
  • Not considered an intended user of quantitative POC G6PD tests
  • Not trained or not proficient in the use of the POC G6PD test
  • Unwilling to provide informed consent

Trial locations and contacts

2 sites in 1 country.

Brazil2 sites
  • Tropical Medicine Foundation Doctor Heitor Vieira Dourado

    Manaus, Amazonas

  • Centro de Pesquisa em Medicina Tropical de Rondônia

    Porto Velho, Rondônia

Other trials in Brazil

About this study

Official title: Evaluation of a Diagnostic to Identify G6PD Deficiency in Brazil

Th objectives of this study are:

  • To determine the performance of G6PD tests in detecting G6PD activity and hemoglobin (Hb) compared to a reference assay
  • To assess the comprehension of the G6PD test packaging and labelling among intended users
  • To assess the usability of G6PD test result outputs among intended users
Read the detailed description

This is a cross-sectional diagnostic accuracy study that includes both participants and health worker participants.

The participant population will be recruited at clinics and through a household survey using an enriched sample of a population with known G6PD status, established through previous epidemiological studies. Clinic staff will take capillary blood samples and conduct two point of care (POC) tests: 1) HemoCue® hemoglobin test, and 2) the investigational Standard Diagnostics (SD) Biosensor STANDARD POC test for glucose-6-phosphate dehydrogenase (G6PD) deficiency. Venous blood will be collected and transferred to a laboratory where reference assays will be performed on venous samples using the Pointe Scientific G6PD Analyzer and hemoglobin tests.

The health worker participants will include trained intended users of the G6PD tests. Trained health workers will be surveyed to assess product usability through a questionnaire to assess label and packing comprehension as well as results interpretation.

Conditions
G6PD Deficiency
Being tested
SD Biosensor STANDARD G6PD Test, Pointe Scientific Test Kit, HemoCue System, Complete blood count (CBC)
Keywords
G6PD deficiency
Medical subject headings
Glucosephosphate Dehydrogenase Deficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SD Biosensor STANDARD G6PD TestDiagnostic test

    The SD Biosensor G6PD Analyzer is designed to measure the quantitative determination of total hemoglobin concentration and G6PD enzymatic activity in fresh human whole blood specimens based on reflectometry assays in a point-of-care (POC) setting. The test is intended to aid in the identification of people with G6PD deficiency.

    The test is currently not licensed for use in Brazil and is considered an investigational product.

  • Pointe Scientific Test KitDiagnostic test

    The Pointe Scientific test kit will serve as the reference assay to assess G6PD activity. Its intended use is for the quantitative, kinetic determination of G6PD in blood at 340 nm.

  • HemoCue SystemDiagnostic test

    The HemoCue hemoglobin (Hb) 201+ system is designed for quantitative point-of-care whole blood hemoglobin determination in primary care using a specially designed analyzer, the HemoCue Hb 201+ Analyzer, and specially designed microcuvettes, the HemoCue Hb 201+Microcuvettes.

  • Complete blood count (CBC)Diagnostic test

    In Manaus, hemoglobin concentration was determined by CBC using an automated hematology analyzer (Sysmex KX-21N).

Study groups in NCT04033640
Study groupRoleWhat they receive
G6PD Diagnostic TestingOtherParticipants provided whole blood samples as well as finger-stick capillary blood samples. At the clinic site, study staff performed the SD Biosensor STANDARD G6PD test and the POC HemoCue hemoglobin test on finger stick blood samples. At the reference laboratories, G6PD activity was measured from whole blood samples using the SD Biosensor STANDARD G6PD test and the Pointe Scientific G6PD reference assay and hemoglobin was measured using the HemoCue hemoglobin test and by a complete blood count (CBC) using an automated hematology analyzer (Manaus site only).
Receives: Diagnostic Test: SD Biosensor STANDARD G6PD Test; Diagnostic Test: Pointe Scientific Test Kit; Diagnostic Test: HemoCue System; Diagnostic Test: Complete blood count (CBC)
Health WorkersNo interventionParticipants were trained on use of the SD Biosensor STANDARD G6PD test by members of the study team with extensive experience with G6PD diagnostics and the STANDARD G6PD test. Health worker participants were surveyed to assess label and packing comprehension as well as results interpretation.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sensitivity of SD Biosensor STANDARD G6PD Test for Identifying G6PD Deficient Individuals

    For the purposes of this study, an individual was considered G6PD deficient if they tested positive in the Pointe Scientific assay. A true positive was defined as a participant with ≤ 30% of normal G6PD activity in circulating venous blood determined by the Pointe Scientific test.

    Diagnostic sensitivity of the SD Biosensor STANDARD G6PD test is defined as the percentage of participants who tested positive for G6PD deficiency on the reference test who were identified by the test assay as positive, calculated as:

    Number of participants who were both test and true positive / (Number of participants who were test and true positive + Number of participants who were test negative but true positive [ie false negative]) * 100%.

    Sensitivity of the SD Biosensor STANDARD G6PD test was calculated from both venous and capillary blood samples.

    Measured: All samples were collected on study day 1

  2. Sensitivity of SD Biosensor STANDARD G6PD Test for Identifying Women With Intermediate G6PD Activity

    To investigate the performance of the SD Biosensor STANDARD G6PD test to distinguish females with intermediate G6PD activity from females with normal activity, assay sensitivity was determined at a G6PD activity threshold of 70%. A true positive for intermediate G6PD activity in females was defined as G6PD activity between 30 and 70% of normal in circulating venous blood as determined by the Pointe Scientific test.

    Sensitivity of the SD Biosensor STANDARD G6PD test is the percentage of women who tested positive for intermediate G6PD activity on the reference test who were identified by the test assay as positive, calculated as:

    Number of women who were both test and true positive / (Number of women who were test and true positive + Number of women who were test negative but true positive [ie false negative]) * 100%.

    Sensitivity of the SD Biosensor STANDARD G6PD test for identifying females with intermediate G6PD activity was calculated from both venous and capillary blood samples.

    Measured: All samples were collected on study day 1

  3. Specificity of SD Biosensor STANDARD G6PD Test for Identifying G6PD Deficient Individuals

    For the purposes of this study, an individual was considered G6PD deficient if they tested positive by the Pointe Scientific assay. A true negative was defined as > 30% of normal G6PD activity in circulating venous blood as determined by the Pointe Scientific test.

    Specificity is the percentage of participants who tested negative for G6PD deficiency on the reference test who were identified as negative using the test assay, calculated as:

    Number of participants who were both test and true negative / (Number of participants who were test and true negative + Number of participants who were test positive but true negative [ie false positive]) * 100%.

    Specificity of the SD Biosensor STANDARD G6PD test was calculated from both venous and capillary blood samples.

    Measured: All samples were collected on study day 1

  4. Specificity of SD Biosensor STANDARD G6PD Test for Identifying Women With Intermediate G6PD Activity

    To investigate the performance of the SD Biosensor STANDARD G6PD test to distinguish females with intermediate G6PD activity from females with normal activity, the specificity was determined at a G6PD activity threshold of 70%. A true negative for intermediate G6PD activity in females was defined as G6PD activity > 70% of normal in circulating venous blood as determined by the Pointe Scientific test.

    Specificity is the percentage of participants who tested negative for G6PD deficiency on the reference test who were identified as negative using the test assay, calculated as: Number of participants who were both test and true negative / (Number of participants who were test and true negative + Number of participants who were test positive but true negative [ie false positive]) * 100%.

    Specificity of the SD Biosensor STANDARD G6PD test was calculated from both venous and capillary blood samples.

    Measured: All samples were collected on study day 1

Secondary outcomes (6)
  1. Accuracy Between the SD Biosensor STANDARD G6PD Test Assay and the Pointe Scientific Test Kit

    Accuracy between the SD Biosensor STANDARD G6PD test assay and the Pointe Scientific G6PD reference assay was calculated as the percent agreement between both G6PD tests, ie, the percentage of participants with the same diagnosis according to both tests (either deficient, intermediate, or normal G6PD levels).

    Accuracy of the SD Biosensor STANDARD G6PD test was calculated from both venous and capillary blood samples.

    Measured: All samples were collected on study day 1

  2. Accuracy Between the SD Biosensor STANDARD G6PD Test Measure of Hemoglobin and the Reference HemoCue Hemoglobin Test

    Accuracy between the SD Biosensor STANDARD G6PD test measure of hemoglobin and the HemoCue hemoglobin reference assay was calculated as the percentage agreement between both tests, ie, the percentage of participants with the same diagnosis according to both tests (either non/mild anemia, moderate anemia or severe anemia).

    Measured: All samples were collected on study day 1

  3. Accuracy Between the SD Biosensor STANDARD G6PD Test Measure of Hemoglobin and the Hemoglobin Measured in a Complete Blood Count

    Accuracy between the SD Biosensor STANDARD G6PD test measure of hemoglobin and the hemoglobin result from the complete blood count (CBC) reference assay (using an automated hematology analyzer) was calculated as the percentage agreement between both tests, ie, the percentage of participants with the same diagnosis according to both tests (either non/mild anemia, moderate anemia or severe anemia). Complete blood counts were only conducted for participants enrolled at the site in Manaus.

    Measured: All samples were collected on study day 1

  4. Median G6PD Values Measured by the SD Biosensor STANDARD G6PD Test for Venous and Capillary Blood Samples

    Measured: All samples were collected on study day 1

  5. Number of Participants Who Met Acceptance Criteria for Label Comprehension

    After completing training, health worker participants were asked to complete a questionnaire to assess their comprehension of the test label. The questionnaire consisted of 13 multiple-choice questions with mutually exclusive options and a single correct answer focused on aspects of the product label including key warnings, limitations, and restrictions as well as the proper test procedure.

    Acceptance (success) criterion for label comprehension was defined as at least 85% correct responses (11 out of 13 possible points).

    Measured: Day 1

  6. Number of Participants Who Met Acceptance Criteria for Accurate Results Interpretation

    After completing training, health worker participants were asked to complete a questionnaire to assess their ability to interpret the test result outputs. The questionnaire consisted of seven short-answer questions (5 valid results, 2 invalid results) focused on the participant's ability to read the results screen, record the simulated G6PD and hemoglobin quantitative results, and classify the results as normal, intermediate, deficient, or invalid.

    For each valid result, three points were possible: (one for G6PD result transcription, one for hemoglobin result transcription, and one for result interpretation) and for each invalid result, one point was possible, resulting in a total of 17 possible points.

    Acceptance (success) criterion for results interpretation was defined as at least 85% correct responses (15 out of 17 possible points).

    Measured: Day 1

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jul 2019
  2. Study start27 Jun 2019
  3. Primary completion31 Dec 2019
  4. Study completion31 Dec 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,754 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04033640
Sponsor's protocol ID
G6PD Brazil
Status last verified
Sep 2021
First submitted
17 Jul 2019
Last updated
11 Nov 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is no plan to share any IPD with other researchers.

Publications

  • Zobrist S, Brito M, Garbin E, Monteiro WM, Clementino Freitas S, Macedo M, Soares Moura A, Advani N, Kahn M, Pal S, Gerth-Guyette E, Bansil P, Domingo GJ, Pereira D, Lacerda MV. Evaluation of a point-of-care diagnostic to identify glucose-6-phosphate dehydrogenase deficiency in Brazil. PLoS Negl Trop Dis. 2021 Aug 12;15(8):e0009649. doi: 10.1371/journal.pntd.0009649. eCollection 2021 Aug.

    PubMed 34383774
  • Gerth-Guyette E, Adissu W, Brito M, Garbin E, Macedo M, Sharma A, Das S, Lacerda MVG, Pereira D, Talukdar A, Yilma D, Pal S, Zobrist S, Domingo GJ. Usability of a point-of-care diagnostic to identify glucose-6-phosphate dehydrogenase deficiency: a multi-country assessment of test label comprehension and results interpretation. Malar J. 2021 Jul 8;20(1):307. doi: 10.1186/s12936-021-03803-1.

    PubMed 34238299

Questions about this trial

What is this clinical trial studying?

A study testing SD Biosensor STANDARD G6PD Test, Pointe Scientific Test Kit and HemoCue System in people with G6PD Deficiency, run by PATH at 2 sites in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Nov 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sensitivity of SD Biosensor STANDARD G6PD Test for Identifying G6PD Deficient Individuals (time frame: All samples were collected on study day 1). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04033640, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Nov 2021.

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