Diagnosis (Microscopy)
Microscopic examination remains the "gold standard" for laboratory confirmation of malaria in the malaria-endemic world, as well as in the United States.
Technique
A blood specimen collected from the patient is spread as a thick or thin blood smear, stained with a Romanovsky stain (most often Giemsa), and examined with a 100X oil immersion objective. Visual criteria are used to detect malaria parasites and to differentiate (when possible) the various species. (See DPDx specimen preparation) (See DPDx Plasmodium species comparison chart.)
Advantages and Disadvantages
Advantages: Microscopy is an established, relatively simple technique that is familiar to most laboratorians in endemic countries. In such areas, microscopy is a standard technique used for diagnosing other diseases (such as tuberculosis), often by the same laboratorians using the same facilities and equipment.
Disadvantages: In many developing countries, microscopy is not reliable because the microscopists are often insufficiently trained and supervised and are frequently overworked, the microscopes and reagents are of poor quality, and often the supply of electricity is unreliable.
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- Centers for Disease Control and Prevention
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(M-F, 9am-5pm, eastern time). - Emergency consultation after hours, call:
770-488-7100
and request to speak with a CDC Malaria Branch clinician. - malaria@cdc.gov