2017 · Journal of the International AIDS Society · open access
Routine viral load monitoring in HIV-infected infants and children in low- and middle-income countries: challenges and opportunities
Arpadi et al.
The finding, in our words
The authors contend that dried blood spot specimens are necessary for equitable access to HIV viral load monitoring in infants and children where paediatric venipuncture capacity is constrained in low- and middle-income countries. They emphasise that patient-centric microsampling is critical given lower pediatric viral suppression rates, adherence challenges and limited antiretroviral formulations.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This review establishes that microsampling across blood, saliva, urine and stool matrices offers validated workflows and regulatory recognition for human biomonitoring comparable to conventional methods. It finds that these decentralised approaches enhance participant acceptability and enable screening in remote or low-resource settings.
Among 1242 asymptomatic children in a remote Congolese district, dried blood spot sampling identified 53% as Plasmodium falciparum-positive. No validated artemisinin-resistance mutations were found, but a lumefantrine-susceptibility marker was present in 15% of samples, demonstrating that community-based microsampling can generate actionable resistance surveillance data to guide decentralised malaria treatment strategies.
The study found low SARS-CoV-2 seropositivity in unvaccinated children and young adults in British Columbia, with higher rates in South Asian participants and young infants. Many infections were undetected, highlighting the value of patient-centric microsampling for more accurate, decentralised surveillance.
Patient-collected dried blood spot specimens for phenylketonuria monitoring showed significant quality variability across ten UK laboratories, with rejection rates rising from a median of 4.0% under existing local criteria to 21.9% under proposed national guidelines, most commonly because spots were too small or multi-spotted. The authors estimate that accepting poor-quality specimens could lead to approximately 12,410 incorrect results annually in England, and recommend ongoing training for patients and carers to prevent distress from higher rejection rates.
The study found that congenital cytomegalovirus infection is significantly associated with asymmetric bilateral and profound sensorineural hearing loss in children, based on retrospective analysis of dried blood spot testing. This supports the use of decentralised microsampling for early identification of at-risk children, enabling timely intervention.