The laboratory diagnosis of malaria

Audits of malaria diagnosis in the UK have revealed shortcomings. The use of recommended procedures should improve the standard of malaria diagnosis, Both thick and thin films should be examined. Thick films should be stained unfixed with a Giemsa or modified Field's stain. Thin films should be fixed and stained with a Giemsa or a Leishman stain. All films should be examined for an adequate period of time by two observers. In the case of P. falciparum infection parasites should be quantified. Microscopy may be supplemented by an immunological or fluorescence-based method. Slides from all cases in which a diagnosis of malaria is made should be sent to a reference centre for verification, Laboratories should participate in a relevant NEQAS scheme and should take steps to ensure that all those carrying out malaria diagnosis maintain their skills.