Prevalence of facemask use among general public when visiting wet market during Covid-19 pandemic: An observational study. (Preprint)

2020 ◽  
Author(s):  
Gobi Hariyanayagam ◽  
Sera Selvanthan Sundram Gunasekaran ◽  
Shargunan Selvanthan Gunasekaran ◽  
Nur Syafina Insyirah Zaimi ◽  
Nor Amirah Abdul Halim
Keyword(s):  
High Risk ◽  
General Population ◽  
Binary Logistic Regression ◽  
Final Analysis ◽  
High Risk Population ◽  
Binary Logistic Regression Model ◽  
Chi Square ◽  
Hygiene Measures ◽  
Wet Market ◽  
Medical Grade

BACKGROUND In late December 2019, an outbreak of a novel coronavirus disease (COVID-19; previously known as 2019-nCoV) was epidemiologically linked to seafood and wet animal market in Wuhan, Hubei, China. This event has instigated negative stigma among the general population to view the wet market as a high-risk location for potential transmission of coronavirus. OBJECTIVE This study investigated the prevalence of facemask use among general population visiting the wet market as well as factors contributing to unacceptable facemask practice. Setting The visitors to a district wet market selling range of live or freshly slaughtered animals during COVID-19 pandemic outbreak was observed for facemask practice. METHODS All Individuals visiting the market were observed for the type, category and practice of wearing facemas. Subjects were categorized into two groups of acceptable and unacceptable facemask practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting and Binary Logistic regression model was used in the multivariate setting. Main outcome measure Prevalence, acceptance practice and odds ratio of unacceptance of facemask use. RESULTS Among 1697 individuals included in the final analysis, 1687 (99.7%) was observed wearing facemask with 1338 (78.8%) using medical-grade facemask. Among them, 1615 (95.7%) individuals facemask practice was acceptable while the reaming 72 (4.3%) individuals were observed with unacceptable facemask practice. Individuals using medical-grade facemask and high-risk age group are 6.4 times (OR=6.40; 95% CI, 2.00-20.43; p=.002) and 2.06 times practice (OR=2.06; 95% CI, 1.08-3.94; p=.028) more likely to have unacceptable facemask practice respectively. CONCLUSIONS High saturation of facemask among the general population is an adequate indicator of public hygiene measures strategy which can help to mitigate the COVID-19 epidemic impact. Alarmingly, the unacceptable facemask practice among high-risk population raises the need for a targeted approach by healthcare authorities to ensure satisfactory facemask use.

scholarly journals Prevalence of facemask use among general public when visiting wet market during Covid-19 pandemic: An observational study.

2020 ◽  
Author(s):  
Gobi Hariyanayagam Gunasekaran ◽  
Sera Selvanthan Sundram Gunasekaran ◽  
Shargunan Selvanthan Gunasekaran ◽  
Nur Syafina Insyirah Zaimi ◽  
Nor Amirah Abdul Halim
Keyword(s):  
High Risk ◽  
General Population ◽  
Observational Study ◽  
Final Analysis ◽  
High Risk Population ◽  
Wholesale Market ◽  
Binary Logistic Regression Model ◽  
Hygiene Measures ◽  
Wet Market ◽  
Medical Grade

Background In late December 2019, an outbreak of a novel coronavirus disease (COVID-19; previously known as 2019-nCoV) was epidemiologically linked to seafood and wet animal wholesale market in Wuhan, Hubei, China. This has instigated stigma among the general population as the wet market is viewed as a high-risk location for getting infected with coronavirus. Objective This study investigated the prevalence of facemask use among general population visiting the wet market. This study also investigated the demographic factors contributing to unacceptable facemask practice. Setting This prospective observational study was done among visitor to a district wet market selling range of live or freshly slaughtered animals during COVID-19 pandemic outbreak. Methods Individuals entering through dedicated entry point were observed for the type, category and practice of wearing personal protective equipment. Inclusion criteria for this study were any individuals entering the wet market. Subjects were categorized into two groups of acceptable and unacceptable facemask practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting and Binary Logistic regression model was used in the multivariate setting. Main outcome measure Prevalence, acceptance practice and odds ratio of unacceptance of facemask use. Results Among 1697 individuals included in the final analysis, 1687 (99.7%) was observed wearing facemask with 1338 (78.8%) using medical-grade facemask. Among them, 1615 (95.7%) individuals facemask practice was acceptable while the reaming 72 (4.3%) individuals were observed with unacceptable facemask practice. Individuals using medical-grade facemask and high-risk age group are 6.4 times (OR=6.40; 95% CI, 2.00-20.43; p=.002) and 2.06 times practice (OR=2.06; 95% CI, 1.08-3.94; p=.028). More likely to practice unacceptable facemask use respectively. Conclusion High saturation of facemask among the general population is an adequate indicator of public hygiene measures strategy which can help to mitigate the COVID-19 epidemic impact. Alarmingly, the unacceptable facemask practice among high-risk population raises the need for a targeted approach by healthcare authorities to ensure satisfactory facemask use.

scholarly journals Prevalence and Acceptance of Face Mask Practice among Individuals Visiting Hospital during COVID-19 Pandemic: An Observational Study

2020 ◽  
Author(s):  
Gobi Hariyanayagam Gunasekaran ◽  
Sera Selvanthan Sundram Gunasekaran ◽  
Shargunan Selvanthan Gunasekaran ◽  
Fouzia Hanim Binti Abdul Halim
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Odds Ratio ◽  
Binary Logistic Regression ◽  
Final Analysis ◽  
Face Mask ◽  
High Risk Population ◽  
Binary Logistic Regression Model ◽  
Hygiene Measures ◽  
Entry Points

Background: The COVID-19 transmission has been established to occur through respiratory droplets from coughing and sneezing. Health agencies have strongly recommended the use of facemask as a precaution from cross-transmission. Objective: This study investigated the prevalence of facemask use among visitors to the hospital. This study also investigated the demographic factors contributing to unacceptable facemask practice. Setting: This prospective observational study was done among hospital visitors to a district specialist hospital during COVID-19 pandemic outbreak. Methods: Individuals entering through dedicated entry point were observed for the type, category and practice of wearing personal protective equipment. Inclusion criteria for this study were any individual's ≥ 2 years old entering the treatment facility from selected entry points. Patients were categorized into two groups of acceptable and unacceptable facemask practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting and Binary Logistic regression model was used in the multivariate setting. Main Outcome Measure: Prevalence, acceptance practice and odds ratio of unacceptance of facemask use. Results: Among 1652 individuals included in the final analysis, 1574 (96.9%) was observed wearing facemask with 1269 (72.0%) of individuals worn medical-grade facemask. However, among them, only 1397 (88.8%) individuals' facemask practice was acceptable while the reaming 177 (11.2) individuals were perceived with unacceptable facemask practice. Male individuals, Malay ethnic and high risk age group are 1.47 times (Odds Ratio: OR=1.47; 95% CI, 1.06-2.06; p=.023), 2.18 times (OR=2.18; 95% CI, 1.55-3.08; p<.001) and 1.99 times (OR=2.18; 95% CI, 1.42 - 2.77; p<.001) more likely to exhibit unacceptable facemask practice respectively. Conclusion: Extensive use of facemasks coupled with environmental hygiene measures is a public health strategy which can help to mitigate the COVID-19 epidemic impact. However, a targeted comprehensive strategy to improve compliance to proper facemask practice among the high-risk population is needed to achieve maximal protective benefit.

scholarly journals Prevalence and acceptance of glove wearing practice among general population when visiting high risk are during local COVID-19 outbreak

2020 ◽  
Author(s):  
Gobi Hariyanayagam Gunasekaran ◽  
Sera Selvanthansundram Gunasekaran ◽  
Shargunan Selvanthan Gunasekaran ◽  
Fouzia Hanim Bt Abdul Halim ◽  
Nur Syafina Insyirah Binti Zaimi ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
General Population ◽  
Public Health Education ◽  
Entry Point ◽  
Risk Area ◽  
High Risk Area ◽  
Entry Points ◽  
Wet Market ◽  
Medical Grade

AbstractBackgroundHealthcare authorities have generally advised against wearing glove by the general population. However, the use of gloves has become a common sight in public places raising the question of the necessity of glove wearing practice by the general populationObjectiveThis study aims to investigate the prevalence and types of glove used as well as the acceptance of the glove practice by individuals visiting the high-risk area during Covid-19 pandemic.SettingThis prospective observational study was conducted among individuals visiting a wet market and district specialist hospital During Covid-19 pandemic. The required data was recorded based on observation by trained data collectors who were stationed at the strategic entry point.MethodsIndividuals entering through dedicated entry point were observed for the type, category and practice of wearing personal protective equipment. Inclusion criteria for this study were any individuals entering the facilities from entry points without respiratory symptoms. Exclusion criteria for this study were individuals less than 2 years old, visiting the emergency department, facility staff, individuals who are suspected of multiple entry and individuals who are exiting the treatment facility entrance. Patients were categorized into two groups of acceptable and unacceptable glove practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting.Main outcome measurePrevalence, acceptance of glove wearing practice.ResultsA total of 75 individuals (2.3%) compromising of 45 (60.0%) individuals from hospitals and 30 (40.0%) individuals from wet markets were seen wearing glove amongst 3322 individuals observed during the data collection period. A higher proportion of individuals visiting wet market (30.0%) were observed with unacceptable glove practice compared to individuals visiting the hospital (8.9%), χ2 (1) = 5.60, p = .018. Similarly, a Higher proportion of glove use among non-Malay (53.3%) compared to Malay (46.7%) was observed in hospital compared to a higher proportion of glove use among Malay compared to non-Malay (16.7%) visiting wet market, χ2 (1) = 10.20, p = .001. As for glove use, we found that male were using more medical-grade glove (78.8%) compared to non-medical grade glove (21.2%) while an equal amount of medical (50.0%) and non-medical grade glove (50.0%) was used among female, χ2 (1) = 6.546, p = .011. Besides, we found that higher proportion of individual using medical-grade glove was using medical grade facemask (68.3%) which was similar to the proportion of individuals using non-medical glove was using non-medical facemask (66.7%), χ2 (1) = 5.25, p = .022.ConclusionWe present the prevalence and characteristics of glove wearing practice in high-risk location during the current COVID-19 outbreak in Malaysia. Facing a worldwide public health emergency with limited effective clinical treatment, the role of glove-wearing in mitigating COVID-19 transmission is questionable. If needed, the compliance to proper glove-wearing could be improved through targeted public health education

Predictive Factors for Patients’ Failure to Show for Initial Outpatient Physical Therapist Evaluation

2021 ◽  
Author(s):  
Matthew Briggs ◽  
Christine Ulses ◽  
Lucas VanEtten ◽  
Cody Mansfield ◽  
Anthony Ganim ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Employment Status ◽  
Physical Therapist ◽  
Demographic Data ◽  
Binary Logistic Regression ◽  
Final Analysis ◽  
Outpatient Setting ◽  
Binary Logistic Regression Model ◽  
Number Of Patients ◽  
Payer Source

Abstract Objective The objective of this study was to xamine primary factors which may predict patients’ failure to show at initial physical therapist evaluation in an orthopedic and sports outpatient setting. Methods A retrospective analysis of patients’ demographic data for physical therapist evaluations between January 2013 and April 2015 was performed. A binary logistic regression model was used to evaluate the odds of a no-show at evaluation. Demographic variables of age, employment status, days waited for the appointment, payer source, and distance traveled to clinic were analyzed. Independent variables were considered significant if the 95% Cis of the odds ratios did not include 1.0. Results A total of 6971 patients were included in the final analysis with 10% (n = 698) of the scheduled patients having a no-show event for their initial evaluation. The following factors increased the odds of patients having a no-show event: days to appointment (OR = 1.058; 95% CI = 1.042 to 1.074), unemployment status (OR = 1.96; 95% CI = 1.41 to 2.73), unknown employment status (OR = 3.22; 95% CI = 1.12 to 8.69), Medicaid insurance (OR = 4.87; 95% CI = 3.43 to 6.93), Medicare insurance (OR = 2.22; 95% CI = 1.10 to 4.49), unknown payer source (OR = 262.84; 95% CI = 188.72 to 366.08), and distance traveled ≥5 miles (OR = 1.31; 95% CI = 1.01 to 1.70). Female sex [OR = 0.73; 95% CI = 0.57 to 0.95) and age ≥ 40 years (OR = 0.44; 95% CI = 0.33 to 0.60) decreased the odds of a no-show event. Conclusion Results from this study indicate there may be some demographic factors that are predictive of patients failing to attend their first physical therapist visit. Impact Understanding the predictive factors and identifying potential opportunities for improvements in scheduling processes might help decrease the number of patients failing to show for their initial physical therapy appointment, with the ultimate goal of positively influencing patient outcomes.

scholarly journals Appraisal of Issues Influencing Soil-Steps Application for Sustainable Farmland Management in High-Potential District, Ethiopia

2018 ◽  
Vol 7 (3) ◽  
pp. 102
Author(s):  
Mehretie Belay
Keyword(s):  
Smallholder Farmers ◽  
Group Discussion ◽  
Household Head ◽  
Binary Logistic Regression ◽  
Northwest Ethiopia ◽  
Study Data ◽  
High Potential ◽  
Binary Logistic Regression Model ◽  
Chi Square ◽  
Chi Square Test

Soil damage by moving water is a somber predicament on farmlands in highland Ethiopia. Sizeable number of trial in farmland preservation has been executed to handle the crisis during the last tens of years. However, the attempts have not been vibrant to trim-down the danger to an attractive extent. This paper evaluates factors contributing to application of soil-steps (bunds) as sustainable farmland management technology (SFLMT) by smallholder farmers in one of the high-potential districts of northwest Ethiopia named Dangila Woreda (District). Mixed method triangulation designs involving concurrent acquisition and interpretation of quantitative and qualitative data were used in the study. Data were acquired from randomly chosen 201 farming households during the harvest seasons of 2011 and 2012. Ordered questionnaire, participatory field observation, key informant interview and focus group discussion were mechanisms employed during the data acquisition. Descriptive statistics (means, standard deviations and percentiles), Chi-square test, t-test and the binary logistic regression model were used to analyze the quantitative data. The qualitative information was textually narrated to augment the quantitative results. Findings of the investigation confirm that age of the household head, the number of household members, slope of the farmland, the size of the farmland held, households’ participation in indigenous labour-sharing activities and the number of farm tools owned were significantly increasing the building of soil-steps as SFLMT in the study district. Involvement in off-farm activities and pest invasions were considerably hindering farmers from building soil-steps on their farmlands. The results in general indicated that households’ access to livelihood assets are key promoters for farmers’ implementation of soil-steps on their farmlands. Local resource preservation and improvement trials should thus ponder on convalescing farmers’ material endowments to improve their capability to use soil-steps as SFLMT in their farming activities.

scholarly journals Assessment of General Populations Knowledge, Attitude, and Perceptions Toward the Coronavirus Disease (COVID-19): A Cross-Sectional Study From Pakistan

2021 ◽  
Vol 8 ◽  
Author(s):  
Saadullah Khattak ◽  
Maqbool Khan ◽  
Tahir Usman ◽  
Johar Ali ◽  
Dong-Xing Wu ◽  
...  
Keyword(s):  
General Population ◽  
Binary Logistic Regression ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Social Media Platforms ◽  
General Populations

Background: Coronavirus disease 2019 (COVID-19) is a global health threat and caused a universal psychosocial impact on the general population. Therefore, the knowledge, attitude, and perceptions (KAPs) of the general population are critical for the development and effective implementation of standard operating procedures (SOP) to contain the contagion and minimize the losses. Therefore, the current study was conducted to understand and evaluate the KAPs of Pakistani populations toward the COVID-19.Methods: An online cross-sectional study was carried out among participants from 1 May to 30 July 2020 in different areas of Pakistan. The respondents of the study were the general population with age ≥ 18 years. The poll URL was posted on several channels after a call for participation. Other social media platforms such as WeChat, WhatsApp, Facebook, Twitter, Instagram, Messenger, and LinkedIn were engaged to maximize general population engagement. The questionnaire included details about sociodemographic, knowledge about COVID-19, perceptions toward universal safety precautions of COVID-19, and beliefs attitude toward the COVID-19. The obtained data were exported into a Microsoft Excel spreadsheet and SPSS software version 21 for windows. The descriptive statistics values were presented in frequencies and percentages. Binary logistic regression, Chi-square test, and one-way ANOVA were applied to analyze the participants' socio-demographic characteristics and variables related to KAPs. P-value < 0.05 was recorded as significant.Results: A total of 1,000 participants were invited of which 734 participated in this study. The response rate was 73.4% (734/1,000). The gender, marital status, education, and residence showed a significant association with the knowledge score. The majority of the study participants were thinking that COVID-19 may be more dangerous in elderly individuals 94.5% (n = 700), and individuals with chronic diseases or severe complications 96.7% (n = 710) (p = 0.00). More than half of the participants 52.5% (n = 385) showed their concern that either they or their family members might get the infection. More than 98% (n = 703), (P-value = 0.00) of the participants held that COVID-19 would be successfully controlled in Pakistan by following the standard SOPs and government guidelines.Conclusion: This study showed that the general population of Pakistan has good awareness and reasonable attitudes and perceptions toward the full features of the COVID-19. The current study suggests that mass-level effective health education programs are necessary for developing countries to improve and limit the gap between KAP toward COVID-19.

scholarly journals Middle East respiratory syndrome coronavirus (MERS-CoV) neutralising antibodies in a high-risk human population, Morocco, November 2017 to January 2018

2019 ◽  
Vol 24 (48) ◽  
Author(s):  
Anass Abbad ◽  
Ranawaka APM Perera ◽  
Latifa Anga ◽  
Abdellah Faouzi ◽  
Nhu Nguyen Tran Minh ◽  
...  
Keyword(s):  
High Risk ◽  
Middle East ◽  
General Population ◽  
Arabian Peninsula ◽  
Middle East Respiratory Syndrome ◽  
Zoonotic Transmission ◽  
World Health ◽  
High Risk Population ◽  
Global Public Health ◽  
Neutralising Antibodies

Background Middle East respiratory syndrome coronavirus (MERS-CoV) remains a major concern for global public health. Dromedaries are the source of human zoonotic infection. MERS-CoV is enzootic among dromedaries on the Arabian Peninsula, the Middle East and in Africa. Over 70% of infected dromedaries are found in Africa. However, all known zoonotic cases of MERS have occurred in the Arabian Peninsula with none being reported in Africa. Aim We aimed to investigate serological evidence of MERS-CoV infection in humans living in camel-herding areas in Morocco to provide insights on whether zoonotic transmission is taking place. Methods We carried out a cross sectional seroprevalence study from November 2017 through January 2018. We adapted a generic World Health Organization MERS-CoV questionnaire and protocol to assess demographic and risk factors of infection among a presumed high-risk population. ELISA, MERS-CoV spike pseudoparticle neutralisation tests (ppNT) and plaque neutralisation tests (PRNT) were used to assess MERS-CoV seropositivity. Results Serum samples were collected from camel slaughterhouse workers (n = 137), camel herders (n = 156) and individuals of the general population without occupational contact with camels but living in camel herding areas (n = 186). MERS-CoV neutralising antibodies with ≥ 90% reduction of plaque numbers were detected in two (1.5%) slaughterhouse workers, none of the camel herders and one individual from the general population (0.5%). Conclusions This study provides evidence of zoonotic transmission of MERS-CoV in Morocco in people who have direct or indirect exposure to dromedary camels.

scholarly journals Prevalence of SARS-CoV-2 Antibodies in Multiple Sclerosis: The Hidden Part of the Iceberg

2020 ◽  
Vol 9 (12) ◽  
pp. 4066
Author(s):  
Nicola Capasso ◽  
Raffaele Palladino ◽  
Emma Montella ◽  
Francesca Pennino ◽  
Roberta Lanzillo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Cross Sectional Study ◽  
Low Risk ◽  
High Risk Population ◽  
Chi Square ◽  
Cross Sectional ◽  
Risk Population ◽  
Exact Test ◽  
Chi Square Test

Background. We compared the prevalence of SARS-CoV-2 IgG/IgM in multiple sclerosis (MS), low-risk, and high-risk populations and explored possible clinical correlates. Methods. In this cross-sectional study, we recruited MS patients, low-risk (university staff from non-clinical departments), and high-risk individuals (healthcare staff from COVID-19 wards) from 11 May to 15 June 2020. We used lateral flow immunoassay to detect SARS-CoV-2 IgG and IgM. We used t-test, Fisher’s exact test, chi square test, or McNemar’s test, as appropriate, to evaluate between-group differences. Results. We recruited 310 MS patients (42.3 ± 12.4 years; females 67.1%), 862 low-risk individuals (42.9 ± 13.3 years; females 47.8%), and 235 high-risk individuals (39.4 ± 10.9 years; females 54.5%). The prevalence of SARS-CoV-2 IgG/IgM in MS patients (n = 9, 2.9%) was significantly lower than in the high-risk population (n = 25, 10.6%) (p < 0.001), and similar to the low-risk population (n = 11, 1.3%) (p = 0.057); these results were also confirmed after random matching by age and sex (1:1:1). No significant differences were found in demographic, clinical, treatment, and laboratory features. Among MS patients positive to SARS-CoV-2 IgG/IgM (n = 9), only two patients retrospectively reported mild and short-lasting COVID-19 symptoms. Conclusions. MS patients have similar risk of SARS-CoV-2 infection to the general population, and can be asymptomatic from COVID-19, also if using treatments with systemic immunosuppression.

scholarly journals 1195. Where You Live Matters: United States Region as a Significant Predictor of Mortality for ESBL Infection Based on a Descriptive Study Using NIS Database

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S361-S362 ◽  
Author(s):  
Elizabeth George ◽  
Sarah Aurit ◽  
Christopher Destache ◽  
Renuga Vivekanandan
Keyword(s):  
Case Fatality ◽  
Binary Logistic Regression ◽  
Multidrug Resistant ◽  
Inpatient Setting ◽  
Continuous Variables ◽  
Binary Logistic Regression Model ◽  
Chi Square ◽  
The Us ◽  
Resistant Infection ◽  
Prolonged Hospital

Abstract Background Extended-spectrum β-lactamase (ESBL) enzymes are produced by multidrug-resistant (MDR) pathogens and confer resistance to β-lactam antibiotics. Infections due to MDR organisms, particularly those ESBL producing pathogens, are of major concern worldwide and are associated with prolonged hospital stay and increased case-fatality rate. Carbapenems are the treatment of choice for severe infections however overuse of this class of antibiotics is leading Carbapenemase-producing pathogens. Variations have been observed in the prevalence of ESBL strains from different US regions; however, it is unclear whether morbidity and mortality follow a similar pattern. This study was conducted to explore the incidence of ESBL infections in the inpatient setting and factors that affect morbidity/mortality. Methods The National Inpatient Sample (NIS) was used to identify all hospitalizations during 2002 to 2014; all primary and secondary diagnoses were searched to identify-resistant infection that utilized the ICD-9 code “V091.” All hospitalizations were stratified based on the indication of resistant infection, and comparisons were made with the chi-square test and linear regression for categorical and continuous variables, respectively. A multivariable binary logistic regression model was used to examine survival for those with ESBL infection. All analyses were conducted with SAS version 9.4; P &lt; 0.005 was considered significant. Results The analysis identified 320,888,511 hospitalizations with 17,732 identified with ESBL infection. Significant differences for those with and without an ESBL infection were found based on the US region with the pertinent results as follows; Northeast: 19.95% vs. 23.30%, Midwest: 14.71% vs. 16.81%, South: 25.14% vs. 40.53%, and West: 40.20% vs. 19.35%; P &lt; 0.001. Results indicated the US region as a significant predictor of mortality for those with ESBL infection. Regions identified in Figure 1. Conclusion Notable findings from this study include a statistically significant variation in mortality risk between US regions. Comparatively lower risk of mortality as related to ESBL infection was noted in the Midwest region when compared with the West region. A greater understanding of the regional epidemiology of β-lactamases is needed to clarify why this disparity exists. Figure 1 Disclosures All authors: No reported disclosures.

scholarly journals Glucose-6-phosphate dehydrogenase deficiency neonatal screening: preliminary evidence that a high percentage of partially deficient female neonates are missed during routine screening

2000 ◽  
Vol 7 (1) ◽  
pp. 46-51 ◽  
Author(s):  
G.J. Reclos ◽  
C.J. Hatzidakis ◽  
K.H. Schulpis
Keyword(s):  
High Risk ◽  
General Population ◽  
Enzymatic Activity ◽  
G6pd Deficiency ◽  
Preliminary Evidence ◽  
High Risk Population ◽  
Quantitative Test ◽  
Glucose 6 Phosphate Dehydrogenase ◽  
Semiquantitative Method ◽  
Athens Area

Objectives To provide preliminary evidence that the currently employed semiquantitative method of screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency can only detect infants who are totally deficient for G6PD and misses all cases of partial G6PD deficiency. Setting General population: 2150 randomly selected blood samples from the Blood Donation Department, Speliopouleion General Hospital, Athens, Greece. Neonate population: 2000 samples from neonates (50% male; 50% female) in maternity hospitals in the greater Athens area. High risk population: a total of 545 individuals from 133 families in the Athens area, the minimum acceptance criteria being the parents and any brother or sister. Method Blood specimens from neonates or adults were collected and either spotted and dried on special filter paper (Schleicher and Schull 2992, Darmstadt, Germany) or used in tubes after being heparinised. For the quantitative evaluation of G6PD enzyme activity, the Quantase G6PD screening kit (Quantase Limited, Perth, UK) was used. Quantase G6PD controls (Quantase Limited) were used at three levels of G6PD. These controls are rated at 24, 30, and 37°C. Alternatively, we used the Sigma G6PDH controls (Sigma Chemical Company, St Louis, USA) which are rated at 30 and 37°C. The assay was performed according to the instructions included in the kit with the modification for haemoglobin normalisation. Results General population: 36 females who were classified as having normal enzymatic activity with the semiquantitative test, were classified as partially deficient with the quantitative test. Neonate population: using the quantitative test, the percentage of G6PD deficient neonates in this population was 5.5%, compared with 3.17% reported in routine screening using the semiquantitative method. High risk population: the quantitative method detected 28 cases of total or partial G6PD deficiency in sisters of males with known total deficiency. The semiquantitative method only detected 32% (nine out of 28) of these cases. Conclusions A considerable amount of partially G6PD deficient female neonates (heterozygotes) are undetected and classified as having normal enzymatic activity using the semiquantitative method, which uses a cut off of 2.1 U/g haemoglobin (Hb). The use of a fully quantitative G6PD screening kit is proposed, employing the automated haemoglobin normalisation and a cut off of 6.4 U/g Hb. Any neonate with an activity below this mark should be regarded as G6PD deficient, and all preventive measures should be taken.

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