The use of residual blood specimens in seroprevalence studies for vaccine preventable diseases: A scoping review
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Background
Residual blood specimens offer a cost- and time-efficient alternative for conducting serological surveys. However, their use is often criticized due to potential issues with representativeness of the target population and/or limited availability of associated metadata. We conducted a scoping review to examine where, when, how, and why residual blood specimens have been used in serological surveys for vaccine-preventable diseases (VPDs), and how potential selection biases are addressed.
Methods
The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We identified relevant papers published between 1999 and 2022 through a literature search of PubMed, Scopus, Embase, Cochrane, and the WHO IRIS database. Study data were captured using Kobo Toolbox, and findings were summarized using descriptive analytical methods.
Results
A total of 601 articles met the inclusion criteria after title, abstract screening, and full-text review. The most commonly studied VPDs using residual blood specimens were COVID-19 (27%), hepatitis E (16%), hepatitis B (10%), influenza (9%), HPV (7%), and measles (7%). Most studies (81%) aimed to estimate population-level seroprevalence. Residual specimens were primarily sourced from patients (55%) or blood donors (36%). Common strategies to address potential biases included comparing results with published estimates (78%) and performing stratified analyses (71%).
Conclusions
Residual blood specimens are widely used in seroprevalence studies, particularly during emerging disease outbreaks when rapid estimates are critical. However, the review highlighted inconsistencies in how researchers analyze and report the use of residual specimens. To address these gaps, we propose a set of recommendations to improve the analysis, reporting, and ethical considerations of serological surveys using residual specimens.
