Validation of mailed &lt;i&gt;via&lt;/i&gt; postal service dried blood spot cards on commercially available HIV testing systems

Hayashida, Tsunefusa; Takano, Misao; Tsuchiya, Kiyoto; Aoki, Takahiro; Gatanaga, Hiroyuki; Kaneko, Noriyo; Oka, Shinichi

doi:10.35772/ghm.2021.01105

Cited by 3 publications

(3 citation statements)

References 12 publications

(19 reference statements)

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“…Late diagnosis in Japan is attributed to multiple factors, including HIV public health policies (access to ART still requires a CD4 count <500 cells/mm 3 ) as well as high levels of stigma that make people reluctant to test, even though testing is anonymous and free. Although self-sampling at home is available commercially, this requires people to mail dried blood spots, which has not been legally approved, so it is challenging to publicly advocate this option [40]. HIV testing is still not routinely included in sexual health tests, even when other STIs are diagnosed, so cases are missed in both clinics and hospitals [41].…”

Section: Late Diagnosis In Japanmentioning

confidence: 99%

Late diagnosis of HIV in 2022: Why so little change?

Collins¹,

Namiba

Sparrowhawk³

et al. 2022

HIV Medicine

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Background: The proportion of people who are diagnosed late is a key metric to measure the public health response to HIV. But this percentage remains stubbornly high in nearly every country. Delays in accessing antiretroviral therapy affects both (i) individual health, due to a higher risk of mortality, and (ii) population-based health, due to continued risk of transmission. Despite huge efforts to increase testing, late diagnosis continues to be an indication of a public health failure.Outline: This short review includes community perspectives on why late diagnosis continues and how it may be reduced. We discuss both structural barriers that prevent people from testing earlier and personal reasons why some people still refuse testing when offered. We note that late diagnosis is reported in all countries and in all demographic groups and that sex, gender, age, and sexuality all affect these rates. However, even in groups with high HIV awareness, such as in gay and bisexual men in the UK, more than one in three people with HIV continue to be diagnosed late. Fears and prejudice about HIV based on outdated information are still common among both health workers and people using health services. For example, testing is still not offered in primary or emergency care settings, and even free testing might not be accepted if someone fears the outcome might jeopardize their resident status, employment, relationship, or health.Summary: In addition to developing targeted projects to reach the highest-risk groups, a positive mainstream public campaign could make testing more acceptable at a broad population level across all demographics. This could challenge and repair the media campaigns from the 1980s that still contribute to the stigma that frightens people away from testing now. We hope that an effective approach in one country might also help others.

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Section: Late Diagnosis In Japanmentioning

confidence: 99%

Late diagnosis of HIV in 2022: Why so little change?

Collins¹,

Namiba

Sparrowhawk³

et al. 2022

HIV Medicine

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show abstract

“…Most studies that utilize DBS prepared them from capillary or venous blood drawn in clinic settings, which limits their widespread utilization. However, self-collected DBS samples have been successfully used for the detection of hepatitis C [12] and HIV [13,14], and for the monitoring of haemoglobin A1c [15] and various drug and vitamin levels [16][17][18][19][20][21]. This same technique could be applied to study malaria, making it more accessible in areas without health clinics, and allowing for more frequent sampling.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of community at-home dried blood spot collection combined with pooled reverse transcription PCR as a viable and convenient method for malaria epidemiology studies

Hergott

Owalla²,

Balkus

et al. 2022

Malar J

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Background Many Plasmodium infections in endemic regions exist at densities below the limit of detection of standard diagnostic tools. These infections threaten control efforts and may impact vaccine and therapeutic drug studies. Simple, cost-effective methods are needed to study the natural history of asymptomatic submicroscopic parasitaemia. Self-collected dried blood spots (DBS) analysed using pooled and individual quantitative reverse transcription polymerase chain reaction (qRT-PCR) provide such a solution. Here, the feasibility and acceptability of daily at-home DBS collections for qRT-PCR was studied to better understand low-density infections. Methods Rapid diagnostic test (RDT)-negative individuals in Katakwi District, northeastern Uganda, were recruited between April and May 2021. Venous blood samples and clinic-collected DBS were taken at enrollment and at four weekly clinic visits. Participants were trained in DBS collection and asked to collect six DBS weekly between clinic visits. Opinions about the collection process were solicited using daily Diary Cards and a Likert scale survey at the final study visit. Venous blood and DBS were analysed by Plasmodium 18S rRNA qRT-PCR. The number of participants completing the study, total DBS collected, and opinions of the process were analysed to determine compliance and acceptability. The human internal control mRNA and Plasmodium 18S rRNA were evaluated for at-home vs. clinic-collected DBS and venous blood to assess quality and accuracy of at-home collected samples. Results One-hundred two adults and 29 children were enrolled, and 95 and 26 completed the study, respectively. Three individuals withdrew due to pain or inconvenience of procedures. Overall, 96% of participants collected ≥ 16 of 24 at-home DBS, and 87% of DBS contained ≥ 40 µL of blood. The procedure was well tolerated and viewed favourably by participants. At-home collected DBS were acceptable for qRT-PCR and showed less than a one qRT-PCR cycle threshold shift in the human control mRNA compared to clinic-collected DBS. Correlation between Plasmodium falciparum 18S rRNA from paired whole blood and DBS was high (R = 0.93). Conclusions At-home DBS collection is a feasible, acceptable, and robust method to obtain blood to evaluate the natural history of low-density Plasmodium infections by qRT-PCR.

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“…However, DBS continue to be mainly used for sample collection in clinic and field settings by trained healthcare professionals. Nevertheless, DBS have been used successfully for self-collection of samples for a variety disease conditions such as HIV ( 48 , 49 ), hepatitis ( 50 ), and diabetes ( 51 ).…”

Section: A Strategy For More Frequent Cost-effective Testing To Avoid...mentioning

confidence: 99%

Rethinking detection of pre-existing and intervening Plasmodium infections in malaria clinical trials

Owalla¹,

Hergott²,

Seilie³

et al. 2022

Front. Immunol.

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Pre-existing and intervening low-density Plasmodium infections complicate the conduct of malaria clinical trials. These infections confound infection detection endpoints, and their immunological effects may detract from intended vaccine-induced immune responses. Historically, these infections were often unrecognized since infrequent and often analytically insensitive parasitological testing was performed before and during trials. Molecular diagnostics now permits their detection, but investigators must weigh the cost, complexity, and personnel demands on the study and the laboratory when scheduling such tests. This paper discusses the effect of pre-existing and intervening, low-density Plasmodium infections on malaria vaccine trial endpoints and the current methods employed for their infection detection. We review detection techniques, that until recently, provided a dearth of cost-effective strategies for detecting low density infections. A recently deployed, field-tested, simple, and cost-effective molecular diagnostic strategy for detecting pre-existing and intervening Plasmodium infections from dried blood spots (DBS) in malaria-endemic settings is discussed to inform new clinical trial designs. Strategies that combine sensitive molecular diagnostic techniques with convenient DBS collections and cost-effective pooling strategies may enable more thorough and informative infection monitoring in upcoming malaria clinical trials and epidemiological studies.

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Validation of mailed <i>via</i> postal service dried blood spot cards on commercially available HIV testing systems

Cited by 3 publications

References 12 publications

Late diagnosis of HIV in 2022: Why so little change?

Late diagnosis of HIV in 2022: Why so little change?

Feasibility of community at-home dried blood spot collection combined with pooled reverse transcription PCR as a viable and convenient method for malaria epidemiology studies

Rethinking detection of pre-existing and intervening Plasmodium infections in malaria clinical trials

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