Marlanka A Zuur1, Herman Veenhof1, Alena Aleksa2, Natascha Vanʼt Boveneind-Vrubleuskaya3, Endang Darmawan4, Md Golam Hasnain5,6, Scott K Heysell7, Erwin M Jongedijk8, Remco A Koster8,9, Cecile Magis-Escurra10, Nilza Martinez11, Gladys Molinas11, Dinesh Mondal5, Ully A Mulyani12, Dyah A Perwitasari4, Andrej Tsivunchyk2, Daan J Touw1,8, Jan-Willem C Alffenaar1,13,14. 1. Department Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, the Netherlands. 2. Department of Phthisiology and Pulmonology, Grodno State Medical University, Grodno, Belarus. 3. Department of TB Control, Metropolitan Public Health Service Haaglanden, The Hague, the Netherlands. 4. Faculty of Pharmacy, Ahmad Dahlan University, Yogyakarta, Indonesia. 5. Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka, Bangladesh. 6. Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health (SMPH), Faculty of Health and Medicine, The University of Newcastle (UoN), New South Wales, Australia. 7. Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia. 8. Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Clinical Pharmaceutical and Toxicological Laboratory, Groningen. 9. PRA Health Sciences Bioanalytical Laboratory, Assen. 10. Department of Respiratory Diseases, Radboud University Medical Center-TB Expert Centre Dekkerswald, Nijmegen-Groesbeek, the Netherlands. 11. Instituto Nacional de Enfermedades Respiratorias y del Ambiente, Asunción, Paraguay. 12. Indonesia Agency for Health Research and Development, Ministry of Health, Jakarta, Indonesia. 13. University of Sydney, Faculty of Medicine and Health, Sydney Pharmacy School, Sydney. 14. Westmead Hospital, Sydney, Australia.
Abstract
BACKGROUND: Dried blood spot (DBS) sampling is a blood collection tool that uses a finger prick to obtain a blood drop on a DBS card. It can be used for therapeutic drug monitoring, a method that uses blood drug concentrations to optimize individual treatment. DBS sampling is believed to be a simpler way of blood collection compared with venous sampling. The aim of this study was to evaluate the quality of DBSs from patients with tuberculosis all around the world based on quality indicators in a structured assessment procedure. METHODS: Total 464 DBS cards were obtained from 4 countries: Bangladesh, Belarus, Indonesia, and Paraguay. The quality of the DBS cards was assessed using a checklist consisting of 19 questions divided into 4 categories: the integrity of the DBS materials, appropriate drying time, blood volume, and blood spot collection. RESULTS: After examination, 859 of 1856 (46%) blood spots did not comply with present quality criteria. In 625 cases (34%), this was due to incorrect blood spot collection. The DBS cards from Bangladesh, Indonesia, and Paraguay seemed to be affected by air humidity, causing the blood spots not to dry appropriately. CONCLUSIONS: New tools to help obtain blood spots of sufficient quality are necessary and environmental specific recommendations to determine plasma concentration correctly. In addition, 3% of the DBS cards were rejected because the integrity of the materials suggesting that the quality of plastic ziplock bags currently used to protect the DBS cards against contamination and humidity may not be sufficient.
BACKGROUND: Dried blood spot (DBS) sampling is a blood collection tool that uses a finger prick to obtain a blood drop on a DBS card. It can be used for therapeutic drug monitoring, a method that uses blood drug concentrations to optimize individual treatment. DBS sampling is believed to be a simpler way of blood collection compared with venous sampling. The aim of this study was to evaluate the quality of DBSs from patients with tuberculosis all around the world based on quality indicators in a structured assessment procedure. METHODS: Total 464 DBS cards were obtained from 4 countries: Bangladesh, Belarus, Indonesia, and Paraguay. The quality of the DBS cards was assessed using a checklist consisting of 19 questions divided into 4 categories: the integrity of the DBS materials, appropriate drying time, blood volume, and blood spot collection. RESULTS: After examination, 859 of 1856 (46%) blood spots did not comply with present quality criteria. In 625 cases (34%), this was due to incorrect blood spot collection. The DBS cards from Bangladesh, Indonesia, and Paraguay seemed to be affected by air humidity, causing the blood spots not to dry appropriately. CONCLUSIONS: New tools to help obtain blood spots of sufficient quality are necessary and environmental specific recommendations to determine plasma concentration correctly. In addition, 3% of the DBS cards were rejected because the integrity of the materials suggesting that the quality of plastic ziplock bags currently used to protect the DBS cards against contamination and humidity may not be sufficient.
Authors: Herman Veenhof; Job Frank Martien van Boven; Anna van der Voort; Stefan Philip Berger; Stephanus Johannes Leonardus Bakker; Daniël Johannes Touw Journal: Br J Clin Pharmacol Date: 2020-02-28 Impact factor: 4.335
Authors: Bibie N Said; Scott K Heysell; Getnet Yimer; Rob E Aarnoutse; Gibson S Kibiki; Stellah Mpagama; Peter M Mbelele Journal: Int J Mycobacteriol Date: 2021 Oct-Dec
Authors: Marith I Francke; Laura E J Peeters; Dennis A Hesselink; Sanne M Kloosterboer; Birgit C P Koch; Herman Veenhof; Brenda C M de Winter Journal: Ther Drug Monit Date: 2022-05-23 Impact factor: 3.118