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Abstract

In this work, we intend to estimate the prevalence of G6PDd and the relative frequency of deficient variants in the states that comprise the Legal Amazon and conduct a cost-effectiveness analysis of the use of rapid test to detect G6PDd in patients with P. vivax malaria in an endemic malaria area in the Amazon, Brazil.

For this, a cross-sectional study will be conducted, with cluster sampling, involving all municipalities of the Legal Amazon with active transmission of malaria. Males will be investigated by fluorescent spot test test for phenotyping G6PD deficiency. Those with deficient phenotype will be genotyped using the RFLP technique for the search of the main mutations found in Brazil (African and Mediterranean).

For the second goal, it will be constructed a decision-analysis model for the use of rapid tests for detecting G6PDd, in an endemic area for malaria, compared with "no test" in routine malaria program. This work will also allow for determining the costs of introducing the rapid test for the detection of cases of G6PDd in an endemic area for malaria and the ratio of incremental cost-effectiveness in case of deficiency detected by comparing the different tests available to current routine Malaria Program .

This study will fulfill the complex task of characterizing the distribution and diversity of G6PD variants in order to contribute to health policy based on evidence for the use of primaquine. In addition, it will generate important evidence for the incorporation of the rapid test for detecting G6PDd among patients with malaria in the National Program for Malaria Control, from the cost-effectiveness results, identifying priority scenarios for its incorporation