Department of Clinical and Research Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Department of Clinical Laboratory, Zhuhai Municipal Maternal and Child Healthcare Hospital, Zhuhai Institute of Medical Genetics, Zhuhai, Guangdong, China.
J Trop Pediatr. 2020 Oct 1;66(5):495-503. doi: 10.1093/tropej/fmaa003.
Previous studies have shown that the CareStart™ G6PD Deficiency rapid diagnostic test has high diagnostic accuracy on G6PD deficiency in Africa and Thailand, but not in China. As there are regional differences of G6PD genotype distribution, we are attending to verify the effectiveness of the kit in Chinese population. The study cohort included 247 newborns admitted to our hospital for jaundice. The quantitative detection of G6PD enzyme activity and G6PD gene mutations analysis was used to classify the status of G6PD deficiency. The performance of CareStart™ assays was verified by calculating the sensitivity, specificity and area under the receiver operating characteristic curve (AUC) based on the corrected G6PD deficiency status. In male newborns, the sensitivity of the CareStart™ assay was 98.9%, the specificity was 94.2% and the AUC was 0.97. In female newborns, the sensitivity was 58.5% when the cutoff value of residual enzyme activity was 100%; however, the sensitivity was 100% when the cutoff value was 60%. Therefore, the CareStart™ test can effectively screen G6PD deficiency in male newborns and female infants with less than 60% residual enzyme activity, female infants with residual enzyme activities of 60-100% are more likely to be missed diagnosed among Chinese newborns.
先前的研究表明,CareStart™ G6PD 缺乏症快速诊断检测在非洲和泰国的 G6PD 缺乏症诊断中具有较高的准确性,但在中国并非如此。由于 G6PD 基因型分布存在区域性差异,我们正在验证该试剂盒在中国人群中的有效性。该研究队列包括 247 名因黄疸而入住我院的新生儿。通过定量检测 G6PD 酶活性和 G6PD 基因突变分析,对 G6PD 缺乏症的状态进行分类。根据纠正后的 G6PD 缺乏状态,通过计算灵敏度、特异性和受试者工作特征曲线下面积(AUC)来验证 CareStart™检测的性能。在男性新生儿中,CareStart™检测的灵敏度为 98.9%,特异性为 94.2%,AUC 为 0.97。在女性新生儿中,当残留酶活性的截断值为 100%时,敏感性为 58.5%;然而,当截断值为 60%时,敏感性为 100%。因此,CareStart™检测可有效筛查男性新生儿和残留酶活性低于 60%的女性婴儿的 G6PD 缺乏症,而残留酶活性在 60-100%之间的女性婴儿更有可能在中国新生儿中漏诊。