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DBS specimens can be transported with very low infectious risk by routine postal systems without specialized biohazard shipping containers. These characteristics make DBS sampling attractive for specimens collected in remote and/or resource-limited settings.
Before every baby goes home from the nursery, he/ she has a small amount of blood taken from his/her heel. The babys blood is collected in five circles on the newborn screening card. This is called a heel- stick or dried blood spot (also called DBS) sample. The DBS is used to test for a specific group of condi- tions.
In general, DBS samples may be stored at room temperature for many weeks, months, or years. However, samples that contain unstable compounds should be stored at a lower temperature in order to enhance stability.
Systematic reviews have reported 98% sensitivity and 100% specificity for HBsAg screening on DBS compared to 88.9% sensitivity and 98.4% specificity using HBsAg RDT (Amini et al., 2017; Lange et al., 2017a).
There is evidence that the Hepatitis B virus might be transmitted for a few days from dried blood if there is direct contact of flakes of the blood with an open wound or the moist membranes of the eyes, nose or mouth.
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Dried blood spot testing (DBS) is a form of biosampling where blood samples are blotted and dried on filter paper. The dried samples can easily be shipped to an analytical laboratory and analysed using various methods such as DNA amplification or HPLC.
Disadvantages of DBS include the hematocrit effect, which is related to the viscosity of the blood affecting its spread on to the filter paper, causing a major source of error when assessing concentrations, and the possibility of low DNA volume.
Dried blood spot analysis offers the advantage of collecting a small sample volume, which is easily transported. However, this also means that the concentration of the target analyte is potentially quite low (e.g. less than 1 ng/L), requiring a sensitive and specific assay for detection and quantification.

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