Use of Capillary Blood Samples as a New Approach for Diagnosis of Dengue Virus Infection

Abstract

We evaluated the use of capillary blood samples stored on filter papers for diagnosis of dengue virus infection. Venous and capillary blood samples were collected from 130 patients suspected of having dengue fever. We compared the performances of standard reference methods using capillary blood samples absorbed onto filter papers versus venous blood samples. The resulting sensitivity, specificity, and positive predictive value of tests performed on filter paper compared to those performed on venous blood samples were 81.6% (62/76; 95% confidence interval [CI], 74.9% to 88.3%), 90.7% (49/54; 95% CI, 85.7% to 95.7%), and 92.5% (62/67; 95% CI, 86.2% to 98.8%), respectively. During the acute phase of dengue virus infection (day 1 to day 4), the tests performed on capillary blood samples had a sensitivity of 88.5% (95% CI, 82.0% to 95.0%) and a specificity of 93.8% (95% CI, 88.9% to 98.7%). During the convalescent phase of infection, this method allowed the viral serotype to be determined for 4 of 15 (27%) dengue virus-infected patients for whom virological diagnosis using venous samples was negative. Capillary blood samples could therefore be a good alternative for the diagnosis of dengue virus infection in tropical areas. Indeed, these samples are convenient for storage and transport without the need for a cold chain and simplify the collection of samples from children. Moreover, our results suggest that viral particles persist longer in capillary blood than in peripheral blood. Analysis of the viability of viral particles under these conditions may give new insights into the physiopathology of dengue virus infection and the transmission of dengue virus during outbreaks.

Virological Surveillance of Dengue in Saint Martin and Saint Barthélemy, French West Indies, Using Blood Samples on Filter Paper

“…16,17 This sampling procedure allows dengue viral RNA, NS1 viral protein, and specific immunoglobulin M (IgM) to be detected without the logistical and temperature constraints for shipping and storage normally required for biological samples. Dengue viral RNA absorbed onto filter paper remains stable when stored up to 2 months at room temperature.…”

Kinetics of Dengue Non-Structural Protein 1 Antigen and IgM and IgA Antibodies in Capillary Blood Samples from Confirmed Dengue Patients

“…We previously showed the usefulness of collecting capillary blood samples in the field for dengue diagnosis and epidemiological purposes-the simplicity of sample collection and shipment from remote areas and the possibility of using routine techniques for dengue diagnosis. 14,18 However, the kinetics of biological markers of dengue infection, such as NS1 antigen, IgM, and IgA, in the capillary compartment had not been assessed during the time course of the disease. This issue is especially important, because none of these biological markers are sensitive enough in venous samples to diagnose dengue infection during the period of defervescence (days 4-7) frequently associated with clinical complications.…”

“…Therefore, other alternatives for dengue diagnosis based on non-invasive sample collection combined with sensitive, specific, rapid, and cost-effective detection tools are required to identify and manage patients suspected of dengue; such tools would also be useful for field studies in endemic regions. [14][15][16][17] Against this background, we previously showed that capillary blood samples collected from the fingertip by pricking and absorbed onto filter papers could be a promising alternative to venous puncture for dengue diagnosis and epidemiological studies. 14,18 In particular, we showed that this sampling approach allowed the detection of the viral genome, the NS1 antigen, and dengue-specific IgM antibodies without cold chain constraints.…”

“…[14][15][16][17] Against this background, we previously showed that capillary blood samples collected from the fingertip by pricking and absorbed onto filter papers could be a promising alternative to venous puncture for dengue diagnosis and epidemiological studies. 14,18 In particular, we showed that this sampling approach allowed the detection of the viral genome, the NS1 antigen, and dengue-specific IgM antibodies without cold chain constraints. 18 In the present descriptive study, we assessed testing for NS1 antigen and IgM and IgA antibodies in capillary blood samples from dengue patients collected sequentially over the course of the disease.…”

Comparative research of effectiveness of cellulose and fiberglass porous membrane carriers for bio sampling in veterinary and food industry monitoring

“…This method is a good alternative to the classical ones due to relative noninvasiveness, easy realization, simple sample treatment and storage, very low volumes of biomaterials applications [2]. In medical practice this approach was lately effectively adapted for infectious disease diagnostics [3,4], including human immunodeficiency virus [5][6][7][8], hepatitis [9][10][11][12], and flaviviridae [13]. Moreover, this technique is suggested as the major one for creating biobanks of humans [14].…”