Using Dried Blood Spots for Global Health Surveillance

Global health surveillance relies on accurate, scalable, and cost-effective methods to monitor disease and population health trends; especially in areas with limited resources. Dried blood spot (DBS) technology is increasingly becoming a vital part of this toolkit. Thanks to its portability, durability, and minimal requirements for storage or transport, DBS sampling makes it possible to gather reliable data even in the most remote locations.

This article explores how dried blood spots are used in global health surveillance programs and why they are uniquely suited to support public health efforts around the world.

Why Surveillance Matters in Global Health

Health surveillance is essential for understanding and controlling diseases, tracking outbreaks, and evaluating health interventions. In global contexts, particularly in low-resource or geographically isolated regions, traditional blood sampling methods can be impractical. Venipuncture requires trained personnel, refrigeration, and quick transport to centralized laboratories. It can also reduce participation rates.

DBS technology overcomes many of these barriers, enabling wider participation in surveillance initiatives and expanding the reach of public health efforts.

Learn More: How Accurate are Dried Blood Spot Kits?

What Makes DBS Ideal for Global Use?

Dried blood spot cards offer several key advantages that make them ideal for global health surveillance:

  • Minimal infrastructure: No need for refrigeration, centrifugation, or specialized lab equipment at the point of collection.
  • Compact and lightweight: Cards are small, easy to store, and simple to mail using standard postal systems.
  • Non-invasive collection: Blood is collected from a simple finger prick, making the process more accessible and acceptable for field workers and participants alike.
  • Stable for weeks: Once dried, the blood sample remains stable at room temperature, even in warm climates, making cold-chain logistics unnecessary.

These attributes allow for effective sample collection from diverse populations, including rural villages, urban slums, and refugee camps: anywhere that traditional phlebotomy isn’t feasible.

How DBS Enables Infectious Disease Monitoring

One of the most common global applications of DBS sampling is in the detection and tracking of infectious diseases. Because a dried blood spot retains antibodies, viral DNA/RNA, and other analytes, it can be analyzed using highly sensitive laboratory methods such as ELISA or PCR.

Global health programs have used DBS to monitor:

  • HIV prevalence and antiretroviral treatment outcomes
  • Hepatitis B and C infections
  • Malaria exposure and transmission rates
  • Congenital infections like syphilis or cytomegalovirus (CMV)

For example, during HIV surveillance campaigns in sub-Saharan Africa, DBS cards have enabled health agencies to test thousands of people without the need for complex cold-chain logistics. This same model is now being applied to emerging diseases and vaccine surveillance.

Population Health and Nutritional Studies

In addition to infectious diseases, DBS sampling plays a growing role in broader population health studies. Biomarkers measurable from dried blood spots can reflect:

  • Micronutrient levels (such as vitamin A, D, iron)
  • Exposure to environmental toxins
  • Inflammatory status
  • Hormonal or metabolic changes

This makes DBS ideal for nutritional surveys, maternal-child health monitoring, longitudinal cohort studies in resource-limited settings, and DHS/MICS surveys (demographic and health surveys/multiple indicator cluster surveys). For example, UNICEF and WHO have partnered with local governments to use DBS samples in mass health surveys, assessing anemia, iodine deficiency, or vitamin D status in children and pregnant women.

Implementation at Scale

Rolling out DBS collection in a global health context involves several logistical and technical considerations:

  • Training: Field workers are trained to collect samples using lancets and standardized filter paper cards.
  • Packaging and storage: Samples are dried thoroughly, packaged with desiccants, and labeled with tracking codes.
  • Shipping: Cards are transported via standard mail or courier to centralized labs, where they undergo validated testing.
  • Data integration: Results are fed into national or global health databases to inform disease modeling and response planning.

Organizations that manufacture DBS kits, like RDA Spot, design materials for rugged field conditions and streamlined logistics, ensuring sample integrity across long distances and varied climates.

Ensuring Accuracy and Consistency

Maintaining analytical accuracy in field-collected DBS samples requires:

  • High-quality collection cards that resist contamination and degradation
  • Clear instructions and support materials to guide proper sample collection
  • Validation of lab methods for dried blood matrices
  • Quality control and proficiency testing at reference laboratories

When these systems are in place, DBS-based testing delivers data comparable in quality to conventional venous samples, making it suitable for regulatory use and high-impact decision-making.

A Global Public Health Game Changer

As the world faces new challenges in pandemic preparedness, antimicrobial resistance, and chronic disease surveillance, DBS technology offers a flexible, cost-effective solution. It makes population-scale testing possible even in environments where laboratory infrastructure is limited, empowering global health programs to act quickly and decisively.

Whether it’s detecting the next outbreak, monitoring vaccination efficacy, or tracking nutritional deficiencies, dried blood spot sampling is helping health systems worldwide reach more people, and generate more reliable data, than ever before.

References

  1. Lim MD. Dried Blood Spots for Global Health Diagnostics and Surveillance: Opportunities and Challenges. Am J Trop Med Hyg. 2018 Aug;99(2):256-265. doi: 10.4269/ajtmh.17-0889. Epub (2018).
  2. Nain, Minu1; Sinha, Abhinav1; Sharma, Amit1,2,. Dried blood spots: a robust tool for malaria surveillance in countries targeting elimination. Journal of Vector Borne Diseases 60(1):p 11-17, (2023).
  3. Jacobson TA, Bae Y, Kler JS, Iyer R, Zhang R, Montgomery ND, Nunes D, Pleil JD, Funk WE. Advancing Global Health Surveillance of Mycotoxin Exposures using Minimally Invasive Sampling Techniques: A State-of-the-Science Review. Environ Sci Technol. (2024).
  4. Tanumihardjo SA, Russell RM, Stephensen CB, Gannon BM, Craft NE, Haskell MJ, Lietz G, Schulze K, Raiten DJ. Biomarkers of Nutrition for Development (BOND)-Vitamin A Review. J Nutr. (2016).