title: Dried blood spots as a practical and inexpensive source for human immunodeficiency virus and hepatitis C virus surveillance.
abstract: 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.
authors.affiliation: Serviço de Doenças Infecciosas, Faculdade de Medicina, Unifenas, Belo Horizonte, MG, Brazil.
authors.forename: Antonio Carlos de Castro
authors.initials: AC
authors.lastname: Toledo
authors.forename: José Nélio
authors.initials: JN
authors.lastname: Januário
authors.forename: Renata Maria Silva
authors.initials: RM
authors.lastname: Rezende
authors.forename: Arminda Lúcia
authors.initials: AL
authors.lastname: Siqueira
authors.forename: Bernardo Freire de
authors.initials: BF
authors.lastname: Mello
authors.forename: Erica Ligorio
authors.initials: EL
authors.lastname: Fialho
authors.forename: Raquel Andrade
authors.initials: RA
authors.lastname: Ribeiro
authors.forename: Hélia Lemos da
authors.initials: HL
authors.lastname: Silva
authors.forename: Erika Carvalho
authors.initials: EC
authors.lastname: Pires
authors.forename: Taynaná César
authors.initials: TC
authors.lastname: Simões
authors.forename: Dirceu Bartolomeu
authors.initials: DB
authors.lastname: Greco
mesh_terms: 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