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Dried Blood Spots for Global Health Diagnostics and Surveillance: Opportunities and Challenges
1Global Health Division, Bill & Melinda Gates Foundation, Seattle, Washington.
Insights
Dried blood spot (DBS) cards offer a cost-effective method for global health surveillance in remote areas. Optimizing DBS collection and handling is crucial for reliable bioanalysis and data accuracy.
Area of Science:
- Biomedical Sciences
- Global Health
- Analytical Chemistry
Background:
- Dried blood spot (DBS) cards are increasingly utilized to expand global health and disease surveillance to underserved populations.
- DBS cards provide a logistically simple and cost-effective approach for blood specimen collection, preservation, and transport in resource-limited settings.
Purpose of the Study:
- To review methods for assessing the reliability of DBS-based bioanalysis.
- To identify optimal conditions for minimizing pre-analytical variability in DBS data.
- To provide examples from newborn screening, drug development, and global health.
Main Methods:
- Literature review of published studies on DBS applications and validation.
- Analysis of factors influencing pre-analytical variability in DBS.
- Examination of case studies where DBS feasibility was assessed.
Main Results:
- Methods for determining DBS reliability and optimizing conditions are described.
- Sources of variability are identified, highlighting the need for evidence-based standard operating procedures.
- Examples illustrate successful and unsuccessful DBS applications.
Conclusions:
- Standardized, evidence-based field-to-laboratory procedures are essential for reliable DBS bioanalysis.
- Careful consideration of DBS card type, handling, and storage is critical for analyte stability and recovery.
- DBS technology may not be feasible for all analytes or use cases due to technological or physiological limitations.
Abstract:
There is increasing interest in using dried blood spot (DBS) cards to extend the reach of global health and disease surveillance programs to hard-to-reach populations. Conceptually, DBS offers a cost-effective solution for multiple use cases by simplifying logistics for collecting, preserving, and transporting blood specimens in settings with minimal infrastructure. This review describes methods to determine both the reliability of DBS-based bioanalysis for a defined use case and the optimal conditions that minimize pre-analytical sources of data variability. Examples by the newborn screening, drug development, and global health communities are provided in this review of published literature. Sources of variability are linked in most cases, emphasizing the importance of field-to-laboratory standard operating procedures that are evidence based and consider both stability and efficiency of recovery for a specified analyte in defining the type of DBS card, accessories, handling procedures, and storage conditions. Also included in this review are reports where DBS was determined to not be feasible because of technology limitations or physiological properties of a targeted analyte.
