Malaria Diagnosis

symptoms: fever, chills, headache,

malaise, etc.
history of being in endemic area
splenomegaly and anemia as disease
progresses
microscopic demonstration of parasite
in blood smear (distinguish species)

Thin Blood Smear

prepare smear
'fix' and stain
examine 'feathered'
end
parasitemia = %
infected erythrocytes

thick film: more sensitive

thin film: species identification easier

repeat smears every 12 hours for 48

hours if negative
antigen detection dipstick
ParaSight-F, OptiMal, etc

Thick Blood Smear

Differences Between Species

minor life cycle variations
hypnozoite stage (vivax, ovale)
sequestration (falciparum)

host erythrocyte preference

immature erythrocytes (vivax, ovale)
senescent (malariae)
no preference (falciparum)

stain w/o fixation (lyses erythrocytes)

express as parasites/l

disease and clinical manifestations

blood-stage morphology
Additional Species?

parasites/l = parasites counted/# leukocytes X 8000

P. simiovale (~ P. vivax)
P. malariae variants

Plasmodium
falciparum
numerous rings without
mature forms
slightly smaller
marginal forms
trophozoites and schizonts
not normally in peripheral
circulation
severe disease
compact parasite
crescent-shaped
gametocytes

Plasmodium
falciparum
numerous rings without
mature forms
slightly smaller
marginal forms
trophozoites and schizonts
not normally in peripheral
circulation
severe disease
compact parasite
crescent-shaped
gametocytes

Plasmodium
vivax
enlarged erythrocyte
Schffners dots
ameboid trophozoite
many merozoites in
mature segmenter

Plasmodium vivax
enlarged erythrocyte
Schffners dots
ameboid trophozoite
many merozoites in
mature segmenter

Plasmodium falciparum
numerous rings without
mature forms
slightly smaller
marginal forms
trophozoites and schizonts
not normally in peripheral
circulation
severe disease
compact parasite
crescent-shaped
gametocytes

Plasmodium
vivax
enlarged erythrocyte
Schffners dots
ameboid trophozoite
many merozoites in
mature segmenter

Plasmodium
vivax
enlarged erythrocyte
Schffners dots
ameboid trophozoite
many merozoites in
mature segmenter

Schffners dots due to

caveola-vesicle complexes
on erythrocyte surface

Plasmodium
ovale
similar to P. vivax
enlarged erythrocyte
Schffners dots
subtle differences
compact trophozoite
fewer merozoites
elongated erythrocyte

Plasmodium malariae
compact trophozoite
'band' form
8-10 merozoites in
mature schizont
rosette

Plasmodium
malariae

Plasmodium
malariae

compact trophozoite
'band' form
8-10 merozoites in
mature schizont
rosette

compact trophozoite
'band' form
8-10 merozoites in
mature schizont
rosette