Dried blood spots as a practical and inexpensive source for human immunodeficiency virus and hepatitis C virus surveillance.
Passive surveillance of infectious diseases with a high percentage of asymptomatic cases or long incubation periods, such as acquired immunodeficiency syndrome (AIDS), does not reflect the current transmission dynamics. Thus, a multi-strategic surveillance, such as the human immunodeficiency virus (HIV) sentinel surveillance proposed by the World Health Organization (WHO), is necessary. The Brazilian HIV sentinel surveillance was started in May 1992 with this purpose. The objectives of this study were to evaluate the feasibility and costs of HIV and hepatitis C virus (HCV) surveillance using dried blood spots (DBS) collected for neonatal screening of metabolic diseases in the state of Minas Gerais, Brazil. This was accomplished through the comparison of HIV and HCV seroprevalence with previous Brazilian studies. From December 2001 to June 2002, 24,905 newborns were tested for HIV and 4211 for HCV. HIV seroprevalence was 0.25% and the 95% confidence interval (CI) was 0.18, 0.31%; and HCV seroprevalence was 0.71% and the 95% CI was 0.46, 0.97%. These numbers are similar to previous Brazilian studies. Cost in this study was approximately USD 3.10 per sample, which was roughly one third of the cost of the same exam at the Brazilian HIV sentinel surveillance. We conclude that it is possible and more cost-effective to use DBS for infectious diseases surveillance, albeit it is still necessary to compare these results with the usual sentinel methodology in a concomitant trial.
Toledo
Antonio Carlos de Castro
AC
Serviço de Doenças Infecciosas, Faculdade de Medicina, Unifenas, Belo Horizonte, MG, Brazil.
Januário
José Nélio
JN
Rezende
Renata Maria Silva
RM
Siqueira
Arminda Lúcia
AL
Mello
Bernardo Freire de
BF
Fialho
Erica Ligorio
EL
Ribeiro
Raquel Andrade
RA
Silva
Hélia Lemos da
HL
Pires
Erika Carvalho
EC
Simões
Taynaná César
TC
Greco
Dirceu Bartolomeu
DB
D001800:Blood Specimen Collection / Q000379:methods*; D001938:Brazil / Q000453:epidemiology; D005240:Feasibility Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D017048:Health Care Costs; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics / Q000379:methods*; D012307:Risk Factors; D018571:Sentinel Surveillance; D016036:Seroepidemiologic Studies