Calculating percent parasitemia, which can be used to predict prognosis and monitor response to treatment for patients with malaria
Slides submitted for malaria parasitemia reflex are used for percent parasitemia analysis.
This test may be added to positive LCMAL / Malaria, Molecular Detection, PCR, Varies by physician request only.
Only orderable as a reflex. For more information see LMALP / Malaria PCR with Parasitemia Reflex, Varies.
Giemsa Stain
Malaria
Parasitemia
Plasmodium
Slides submitted for malaria parasitemia reflex are used for percent parasitemia analysis.
This test may be added to positive LCMAL / Malaria, Molecular Detection, PCR, Varies by physician request only.
Varies
Only orderable as a reflex. For more information see LMALP / Malaria PCR with Parasitemia Reflex, Varies.
Specimen Type: Blood films
Container/Tube: Clean, grease-free slides in plastic slide container
Specimen Volume: 2 Thin blood films and 2 thick blood films
Collection Instructions:
1. Blood films should be made from fresh blood using fingerstick or drops of blood from needle following venipuncture. However, EDTA anticoagulated blood is also acceptable.
2. Prepare thin blood films as follows:
a. Prepare a thin film with a "feathered edge" that is no more than a single cell thick.
b. Allow the film to thoroughly air dry and then fix by briefly immersing in either absolute or 95% methyl alcohol.
c. Allow to air dry after fixation.
3. Prepare thick blood films as follows:
a. Place a large drop of blood (approximately the size of a dime and preferably from a fingerstick) on a slide.
b. Using a corner of a second slide, spread the drop in a circular motion while applying firm pressure to literally scratch the blood onto the carrier slide. This technique allows the blood to dry quickly and adhere well to the slide. Use approximately 20 circular sweeps with the second slide. The drop of blood should be about the size of a quarter when finished.
c. Do not fix. Air dry thoroughly (approximately 45 minutes) before placing in transport container.
See Specimen Required
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Refrigerated (preferred) | 7 days | |
Ambient | 7 days |
Calculating percent parasitemia, which can be used to predict prognosis and monitor response to treatment for patients with malaria
Slides submitted for malaria parasitemia reflex are used for percent parasitemia analysis.
This test may be added to positive LCMAL / Malaria, Molecular Detection, PCR, Varies by physician request only.
Malaria is a potentially life-threatening disease caused by Plasmodium species. Diagnosis is traditionally performed by microscopic examination of Giemsa-stained thick and thin blood films. However, polymerase chain reaction (PCR) testing can also be used for sensitive and specific detection. When positive, PCR results should be followed by calculation of percent parasitemia from blood film examination. The degree of parasitemia is used to predict prognosis as well as monitor response to treatment for patients with malaria.
Only orderable as a reflex. For more information see LMALP / Malaria PCR with Parasitemia Reflex, Varies.
A percent parasitemia is provided following a positive result for LMALP / Malaria PCR with Parasitemia Reflex, Varies.
The percentage of parasitemia represents the percentage of infected red blood cells. This is calculated from representative microscopic fields on the thin blood film. Plasmodium gametocytes are not included in the calculation since they are not infectious to humans and are not killed by most antimalarial drugs.
Since the degree of parasitemia may change rapidly due to natural parasite replication and administration of anti-malarial therapies, it is most useful to calculate the percentage of infected cells immediately after the blood is drawn and parasites are detected. A percent parasitemia calculated more than 8 hours after the blood is drawn will not accurately reflect the patient's current state of parasitemia.
Calculation of the percent parasitemia may not be possible if the parasites are degraded or have altered morphology due to age of the specimen or suboptimal transportation conditions.
In some cases of very low parasite burden, a specimen may be polymerase chain reaction positive, but no organisms are present on the thin film, and therefore it will not be possible to determine the percentage of infected red blood cells.
1. Centers for Disease Prevention and Control (CDC). Malaria. CDC. Updated August 19, 2022. Accessed November 17, 2022. Available at www.cdc.gov/malaria/
2. Swan H, Sloan L, Muyombwe A, et al. Evaluation of a real-time polymerase chain reaction assay for the diagnosis of malaria in patients from Thailand. Am J Trop Med Hyg. 2005;73(5):850-854
3. World Health Organization (WHO). Malaria. WHO. Updated July 26, 2022. Accessed November 17, 2022. Available at www.who.int/news-room/fact-sheets/detail/malaria
The percentage of infected cells (percent parasitemia) is calculated by counting the number of infected red blood cells among 3000 to 100,000 red blood cells on the thin blood film. The result is expressed as a percentage (% parasitemia = number of infected red blood cells/total number of red blood cells counted x 100).(Unpublished Mayo method)
Monday through Friday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
87207
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
MALCT | Plasmodium Percent Parasitemia Rflx | 53556-7 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
MALCT | Plasmodium Percent Parasitemia Rflx | 53556-7 |