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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/µl

• disease and clinical manifestations
• blood-stage morphology
Additional Species?

parasites/µl = 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

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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 • Schüffner’s dots • ‘ameboid’ trophozoite • many merozoites in mature segmenter Plasmodium vivax • enlarged erythrocyte • Schüffner’s 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 • Schüffner’s dots • ‘ameboid’ trophozoite • many merozoites in mature segmenter Plasmodium vivax • enlarged erythrocyte • Schüffner’s dots • ‘ameboid’ trophozoite • many merozoites in mature segmenter Schüffner’s dots due to caveola-vesicle complexes on erythrocyte surface 2 .

vivax • enlarged erythrocyte • Schüffner’s 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’ 3 .Plasmodium ovale • similar to P.