MALARIA ROUTINE DIAGNOSIS IN CLINICAL LABORATORIES: THE REALITY & THE ACCESS FOR IMPROVING QUALITY
Ebtehal A.M.S. El-Dessouki
Parasitology Department, Faculty of Medicine, Ain Shams University, Egypt
Background: Light microscopy examination of Giemsa-well stained thick and thin films by a skilled microscopist has remained the "gold standard" for malaria diagnosis. Rapid diagnostic tests based on Plasmodium antigen detection often do not allow for species identification as microscopy does. PCR-based assays are available only for research and epidemiological studies.
Methods: This paper represents a comparison study of three different methods routinely on use for malaria diagnosis by the private sector hospitals, in Jeddah, KSA. Light microscopy, rapid diagnostic tests (RDTs), and automated malaria pigment detection using a hematology analyzer.
Results: Out of 482 patients examined for malaria 18.05%, 16.39%, 12.86%, 16.18%, 12.86%, and 11.83% were detected by light microscopy examination of Giemsa-stained blood smears by an experienced reader, OptiMAL-IT rapid malaria diagnostic test, automated malaria pigment detection using Cell-Dyn 3500 hematology analyzer, light microscopy examination of Field-stained blood smears by an experienced microscopist, and light microscopy examination of Giemsa-stained and Field-stained blood smears by an inexperienced microscopist respectively.
Conclusion: Light microscopy examination of Giemsa-stained thin and thick peripheral blood smears is more sensitive and specific within the hands of an expert microscopist, while RDTs can be an additive tool whenever there's emergency, and unavailable trained parasitologist. Automated malaria pigment detection can't be relied upon as a sole diagnostic test for malaria.