Inter-test reliability of the anti-RESA indices based on ELISA tests using eluates from whole blood spots dried on filter paper

The ring-infected erythrocyte surface antigen (RESA), is one of the falciparum malaria vaccine candidates rarely studied in Brazil. Fieldwork logistics to conduct serology studies is simplified when eluates from whole blood dried on filter paper can be used. Therefore, this study aimed to assess the inter-test reliability for the anti-RESA ELISA-based indices using eluates from filter paper and from serum samples. The study population consisted of 210 individuals (Brazil) from whom matched samples were collected. Anti-RESA ELISA-based index means (+/- S.D.) were 15.29% (+/-28.13%) for filter paper and 11.79% (+/-23.67%) for serum samples. The intra-class correlation coefficient was estimated to be 82.38%, indicating high test reliability. However, there was a significant tendency for filter paper test results to have higher values than serum sample test results (P < 0.001). Explanations for this finding may be the presence of haemoglobin in the eluates from filter paper, which may interfere with ELISA testing.