Utility of dried blood spots in detecting helicobacter pylori infection

Purpose: Identifying infectious pathogens by collecting intravenous blood (IVB) is a well-established procedure, however, the collection of IVB in field epidemiological study is challenging. The dried blood spot (DBS) as an alternative to IVB has been introduced, although, there is a limited study to demonstrate the utility of DBS stored at various storage conditions and transported at different periods. This is an observational study, which evaluates the effectiveness of DBS in field epidemiological studies to identify infectious pathogens. Materials and Methods: A total of 264 paired DBS samples prepared from IVB, stored at 4 degrees C, -20 degrees C after period 24, 48 and 72 h. Serologically, enzyme-linked immunosorbent assay [ELISA] IgG antibody detected against Helicobacter pylori infection from DBS and compared with IVB. Results: Quantitatively, IgG antibody reactivity showed >87% correlation between IVB and DBS samples stored at 4 degrees C or -20 degrees C within 48 h of transport duration. DBS stored at 4 degrees C shows, equal sensitivity 87.5% and specificity 95% before 48 h of transport duration, while at -20 degrees C storage similar sensitivity 87.5% observed but slightly less specificity 86.36% observed as compared to 24 h of transport duration. One-way analysis of variance showed, nonsignificant difference at both (-20 degrees C and 4 degrees C) the stored condition with P value (P > 0.851) and (P > 0.477). Kappa values showed good inter-rater reliability between DBS and IVB in a range (0.77-0.81). Conclusion: No significant difference was observed in detecting H. pylori when ELISA was conducted using IVB or DBS stored at 4 degrees C and transported even after 48 h. This confirms that DBS collected even in compromised conditions in the field can be used for detecting infection.