Diagnostic Accuracy of Dried Blood Spots Collected on HemaSpot HF Devices Compared to Venous Blood Specimens To Estimate Measles and Rubella Seroprevalence

Christine Prosperi, Ojas Kaduskar, Vaishali Bhatt, Alvira Z. Hasan, Jeromie W.Vivian Thangaraj, Muthusamy S. Kumar, R. Sabarinathan, Saravana Kumar, Augustine Duraiswamy, Gururaj Rao Deshpande, Ullas Padinjaremattathil Thankappan, Sanjay L. Chauhan, Ragini N. Kulkarni, Avi Kumar Bansal, Itta K. Chaaithanya, Neha R. Salvi, Sandeep Sharma, William J. Moss, Lucky Sangal, Nivedita GuptaManoj V. Murherkar, Sanjay M. Mehendale, Gajanan N. Sapkal, Kyla Hayford

Research output: Contribution to journalArticlepeer-review


Fingerprick blood spotted onto filter paper offers an alternative to venous blood for use in population-based surveillance because it is comparatively inexpensive, acceptable, and easy to manage in the field. Prior studies have shown excellent agreement for immunoglobulin G (IgG) antibody detection from dried blood spots (DBS) and venous blood samples. However, much of this evidence is from high-income settings or laboratories where the samples were unlikely to be exposed to extreme temperatures and humidity, factors known to degrade DBS. We report the diagnostic accuracy of DBS collected using HemaSpot HF devices against venous sera in measuring measles and rubella-specific IgG antibodies in a household serosurvey conducted in two districts in India. Paired serum and DBS samples collected by fingerprick were collected from women aged 15 to 50 years enrolled in a serosurvey in Palghar District of Maharashtra and Kanpur Nagar District of Uttar Pradesh in India. Specimen quality and volume were assessed in the laboratory. Samples were tested for antimeasles and antirubella IgG antibodies by an enzyme-linked immunosorbent assay (ELISA) (Euroimmun). Sensitivity of antibody detection by DBS was greater than 98%, and specificity was 90% and 98%, for measles and rubella IgG, respectively. Antibody concentrations were strongly correlated between paired specimens with adequate volume (measles R2 = 0.94; rubella R2 = 0.89). Although correlation was poor if DBS specimens had lower volumes, impact on qualitative results was minimal. This study showed DBS collected with HemaSpot HF devices can generate highly accurate results of measles and rubella-specific IgG compared to sera in community-based surveys when protocols are optimized for DBS specimens.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
Issue number4
StatePublished - Aug 2021


  • India
  • diagnostic accuracy
  • dried blood spots
  • measles
  • rubella
  • serology

ASJC Scopus subject areas

  • Microbiology
  • Molecular Biology


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