Despite the potential benefit of primaquine in reducing Plasmodium falciparum transmission and radical cure of
Plasmodium vivax and Plasmodium ovale infections, concerns over risk of hemolytic toxicity in individuals with
glucose-6-phosphate dehydrogenase deficiency (G6PDd) have hampered its deployment. A cross-sectional survey
was conducted in 2014 to assess the G6PDd prevalence among 631 children between 6 and 59 months of age in
southwestern Uganda, an area where primaquine may be a promising control measure. G6PDd prevalence was
determined using three detection methods: a quantitative G6PD enzyme activity assay (Trinity Biotech®
G-6-PDH
kit), a qualitative point-of-care test (CareStart
G6PD rapid diagnostic test [RDT]), and molecular detection of the
G6PD A G202A allele. Qualitative tests were compared with the gold standard quantitative assay. G6PDd
prevalence was higher by RDT (8.6%) than by quantitative assay (6.8%), using a < 60% activity threshold. The
RDT performed optimally at a < 60% threshold and demonstrated high sensitivity ( 90%) and negative predictive
values (100%) across three activity thresholds (below 60%, 30%, and 40%). G202A allele frequency was 6.4%,
7.9%, and 6.8% among females, males, and overall, respectively. Notably, over half of the G202A homo-
/hemizygous children expressed  60% enzyme activity. Overall, the CareStart
G6PD RDT appears to be a viable
screening test to accurately identify individuals with enzyme activities below 60%. The low prevalence of G6PDd
across all three diagnostic modalities and absence of severe deficiency in our study suggests that there is little barrier
to the use of single-dose primaquine in this region.