• Bailey JW, Williams J, Bain BJ, Parker-Williams J, Chiodini P, General Haematology Task Force. Guideline for laboratory diagnosis of malaria. London (UK): British Committee for Standards in Haematology; 2007. 19 p. [10 references]

This is the current release of the guideline.

Malaria

Diagnosis

Hematology
Infectious Diseases

Clinical Laboratory Personnel
Physicians

To recommend adequate techniques and adequate training and experience that will improve accurate malaria diagnosis

Patients in the United Kingdom with suspected malaria

Primary Testing

1. Thick film microscopy
2. Thin film microscopy
3. Preparation times and temperatures
4. Fixative (acetone, methanol)
5. Stain (Giemsa, Leishman's, Field's, May-Grunwald-Giemsa [MGG], modified Field's)
6. Quantification of parasites
7. Confirmation of diagnosis and species
8. Referral to a reference laboratory
9. Repeat testing
10. Handling high-risk blood samples

Supplementary Testing

1. Rapid antigen detection (immunochromatographic tests) – Binax NOW® and OptiMal-IT
2. Quantitative buffy coat (QBC) blood parasite detection
3. Polymerase chain reaction (PCR)
4. Drug sensitivity (research only)

Quality Control (QC)

1. Internal QC
2. External QC (National External Quality Assessment Scheme)
3. Clinical Pathology Accreditation
4. Reference laboratory confirmation
5. Personnel training

Sensitivity and specificity of test procedures

Searches of Electronic Databases

Not stated

Not stated

Not stated

Not applicable

Review

Not stated

Not stated

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

Not stated

Not applicable

• The routine use of thick and thin films is advised for malaria diagnosis. Thick films should be exposed to acetone for 10 minutes then stained without further fixation, using Giemsa or Field's stain. Thin films should be exposed to acetone for 1 minute and then either stained with a Leishman stain (methanol based) or methanol fixed and stained with a Giemsa stain. Thick films should be examined for an adequate period of time by two observers.
• If thick films are positive, the species should be determined by examination of a thin film. In the case of Plasmodium falciparum infection, the percentage of parasitised cells should be estimated.
• Rapid antigen detection tests (immunochromatographic tests) cannot replace microscopy but are indicated as a supplementary test when malaria diagnosis is being performed by relatively inexperienced staff (e.g., in low prevalence areas and outside normal working hours).

None provided

The type of supporting evidence is not specifically stated for each recommendation.

Accurate qualitative and quantitative diagnosis of malaria

Not stated

An implementation strategy was not provided.

Getting Better
Living with Illness

Effectiveness
Timeliness

• Bailey JW, Williams J, Bain BJ, Parker-Williams J, Chiodini P, General Haematology Task Force. Guideline for laboratory diagnosis of malaria. London (UK): British Committee for Standards in Haematology; 2007. 19 p. [10 references]

Not applicable: The guideline was not adapted from another source.

2007

British Committee for Standards in Haematology - Professional Association

British Committee for Standards in Haematology

Not stated

Authors: J. W Bailey; J. Williams; B. J. Bain; J Parker-Williams; P. Chio

Not stated

This is the current release of the guideline.

None available

None available

This NGC summary was completed by ECRI Institute on March 18, 2008. The information was verified by the guideline developer on April 1, 2008.