Detection of Pathogens of Acute Febrile Illness Using Polymerase Chain Reaction from Dried Blood Spots

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  • 1 Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia;
  • | 2 International Vaccine Institute, Seoul, Republic of Korea;
  • | 3 Swiss Tropical and Public Health Institute, Basel, Switzerland;
  • | 4 University of Basel, Basel, Switzerland;
  • | 5 Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom;
  • | 6 Institut Supeìrieur des Sciences de la Population, University of Ouagadougou, Burkina Faso;
  • | 7 Faculty of Medicine, University of Gezira, Wad Medani, Sudan;
  • | 8 University of Antananarivo, Antananarivo, Madagascar

Quantitative polymerase chain reaction (qPCR) of dried blood spots (DBS) for pathogen detection is a potentially convenient method for infectious disease diagnosis. This study tested 115 DBS samples paired with whole blood specimens of children and adolescent from Burkina Faso, Sudan, and Madagascar by qPCR for a wide range of pathogens, including protozoans, helminths, fungi, bacteria, and viruses. Plasmodium spp. was consistently detected from DBS but yielded a mean cycle threshold (Ct) 5.72 ± 1.6 higher than that from whole blood samples. A DBS qPCR Ct cutoff of 27 yielded 94.1% sensitivity and 95.1% specificity against the whole blood qPCR cutoff of 21 that has been previously suggested for malaria diagnosis. For other pathogens investigated, DBS testing yielded a sensitivity of only 8.5% but a specificity of 98.6% compared with whole blood qPCR. In sum, direct PCR of DBS had reasonable performance for Plasmodium but requires further investigation for the other pathogens assessed in this study.

Author Notes

Address correspondence to Brian Grundy, Division of Infectious Diseases and International Health, University of Virginia, 345 Crispell Drive, Charlottesville, VA 22908. E-mail: bsg3md@hscmail.mcc.virginia.edu

Financial support: This work was supported by the National Institutes of Health (NIH; K24AI102972 to E. H.). B. G. is supported by the NIH (T32 AI007046). The Bill & Melinda Gates Foundation provided financial support for the TSAP study (OPP1127988).

Authors’ addresses: Brian Grundy, Jie Liu, Suzanne Stroup, and Eric Houpt, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, E-mails: bsg3md@hscmail.mcc.virginia.edu, jl5yj@virginia.edu, ses8d@virginia.edu, and erh6k@hscmail.mcc.virginia.edu. Ursula Panzner, Justin Im, Frank Konings, Vera von Kalckreuth, Gi Deok Pak, Ligia Maria Cruz Espinoza, and Florian Marks, International Vaccine Institute, Seoul, Republic of Korea, E-mails: upanzner@ivi.int, justin.im@ivi.int, fkonings@gmail.com, vera.vkalckreuth@web.de, gdpak@ivi.int, lcruz@ivi.int, and fmarks@ivi.int. Hyon Jin Jeon, Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK, E-mail: hjj32@cam.ac.uk. Abdramane Soura Bassiahi, Institut Supérieur des Sciences de la Population, Ouagadougou, Burkina Faso, E-mail: bassiahi@gmail.com. Nagla Gaslmelseed, Faculty of Medicine, University of Gezira, Wad Medani, Sudan, E-mail: nag_la@yahoo.com. Raphaë¨l Rakotozandrindrainy, University Antananarivo, Antananarivo, Madagascar, E-mail: rakrapha13@gmail.com.

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