Confirming Malaria Diagnosis:

The patient with suspected malaria (uncomplicated or severe) requires laboratory investigations (i.e. microscopy or rapid diagnostic test for MP) to confirm the diagnosis.

Microscopy is cost effective, fairly sensitive and highly specific. Microscopic examination of blood smear for MP, where found feasible, is still considered a gold standard for diagnosing malaria. Microscopy can estimate parasite density and differentiates between parasites and its species, provides information about platelets and leukocytes and help diagnose many other conditions. Giemsa stained thick and thin blood smears should be examined in all malaria suspected patients. A thick smear should be examined in all suspected cases of malaria because of its ability to detect parasites even with the low parasitemia. A thin film is used for identification of species and stages of parasites. High parasitemia, growing stages of parasites (trophozoites and schizonts) and pigment-laden neutrophils indicate poor prognosis. If any of the above are detected the doctor should be informed to help in making the decision about referral of the patient to hospital. In case of uncertainty of identification of parasite species in severe malaria patients, it should always be considered as P. falciparum.

The laboratory staff examines the blood smear for malaria parasite (MP) and records the results in the laboratory register. On the same day he/she reports the results to the doctor on the patient OPD ticket. The result is reported on OPD ticket as follows:

1.       Plasmodium vivax seen.

2.       Plasmodium falciparum seen.

3.       Plasmodium vivax and falciparum seen.

4.       Malaria parasite not seen.

Rapid diagnostic tests (RDT) for diagnosing malaria are fairly sensitive and specific. These tests are fast and simple. The rapid diagnostic tests are based on detection of parasite-derived proteins circulating in the whole blood. They are particularly helpful in diagnosing partially treated cases and those with very low parasitemia, when the microscopy is negative, or microscopy services are not available or not reliable. The rapid diagnostic tests are able to detect the presence of plasmodium falciparum and vivax in malaria patients.