Practical Methods to Permit the Analysis of Host Biomarkers in Resource-Limited Settings

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  • 1 Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia;
  • | 2 Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom;
  • | 3 University of Pennsylvania, Philadelphia, Pennsylvania;
  • | 4 Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;
  • | 5 Hospital of the University of Pennsylvania, Philadelphia;
  • | 6 Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;
  • | 7 Department of Medicine, Division of Infectious Diseases, UHN-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada;
  • | 8 Médecins Sans Frontières, New Delhi, India

Host biomarker testing can be used as an adjunct to the clinical assessment of patients with infections and might be particularly impactful in resource-constrained settings. Research on the merits of this approach at peripheral levels of low- and middle-income country health systems is limited. In part, this is due to resource-intense requirements for sample collection, processing, and storage. We evaluated the stability of 16 endothelial and immune activation biomarkers implicated in the host response to infection stored in venous plasma and dried blood spot specimens at different temperatures for 6 months. We found that –80°C storage offered no clear advantage over –20°C for plasma aliquots, and most biomarkers studied could safely be stored as dried blood spots at refrigeration temperatures (4°C) for up to 3 months. These results identify more practical methods for host biomarker testing in resource-limited environments, which could help facilitate research in rural and remote environments.

Author Notes

Address correspondence to Arjun Chandna, Siem Reap, Cambodia. E-mail: arjun@tropmedres.ac

These authors contributed equally to this work.

Financial support: This research was funded by Médecins Sans Frontières (SPOT SEPSIS) and the UK Wellcome Trust [219644/Z/19/Z]. For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. K. C. K. is supported in part by the Canada Research Chair program and a Canadian Institutes of Health Research Foundation grant (FDN-148439).

Authors’ addresses: Arjun Chandna and Paul Turner, Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia, E-mails: arjun@tropmedres.ac and pault@tropmedres.ac. Melissa Richard-Greenblatt, University of Pennsylvania, Philadelphia, PA, E-mail: melissa.richard-greenblatt@pennmedicine.upenn.edu. Richard Tustin III, Children’s Hospital of Pennsylvania, Philadelphia, PA, E-mail: tustinr@chop.edu. Sue J. Lee and Yoel Lubell, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mails: sue@tropmedres.ac and yoel@tropmedres.ac. Kevin C. Kain, Department of Medicine, Division of Infectious Diseases, UHN-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada, E-mail: kevin.kain@uhn.ca. Sakib Burza, Médecins Sans Frontières, New Delhi, India, E-mail: sakib.burza@barcelona.msf.org.

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