Guideline:
Guideline for laboratory diagnosis of malaria
Bibliographic Source(s)
- Bailey JW Williams J Bain BJ Parker-Williams J Chiodini P General Haematology Task Force. Guideline for laboratory diagnosis of malaria. London (UK): British Committee for Standards in Haematology; 2007. 19 p. [10 references]
Guideline Status
This is the current release of the guideline.
Guideline Category
Diagnosis
Intended Users
Clinical Laboratory Personnel
Physicians
Guideline Objective(s)
To recommend adequate techniques and adequate training and experience that will improve accurate malaria diagnosis
Target Population
Patients in the United Kingdom with suspected malaria
Interventions and Practices Considered
Primary Testing
- Thick film microscopy
- Thin film microscopy
- Preparation times and temperatures
- Fixative (acetone methanol)
- Stain (Giemsa Leishman's Field's May-Grunwald-Giemsa [MGG] modified Field's)
- Quantification of parasites
- Confirmation of diagnosis and species
- Referral to a reference laboratory
- Repeat testing
- Handling high-risk blood samples
Supplementary Testing
- Rapid antigen detection (immunochromatographic tests) – Binax NOW® and OptiMal-IT
- Quantitative buffy coat (QBC) blood parasite detection
- Polymerase chain reaction (PCR)
- Drug sensitivity (research only)
Quality Control (QC)
- Internal QC
- External QC (National External Quality Assessment Scheme)
- Clinical Pathology Accreditation
- Reference laboratory confirmation
- Personnel training
Major Outcomes Considered
Sensitivity and specificity of test procedures
Methods Used to Collect/Select Evidence
Searches of Electronic Databases
Description of Methods used to Collect/Select the Evidence
Not stated
Number of Source Documents
Not stated
Methods Used to Assess the Quality and Strength of the Evidence
Not stated
Rating Scheme for the Strength of the Evidence
Not applicable
Methods Used to Analyze the Evidence
Review
Description of the Methods Used to Analyze the Evidence
Not stated
Methods Used to Formulate the Recommendations
Not stated
Rating Scheme for the Strength of the Recommendations
Not applicable
Cost Analysis
A formal cost analysis was not performed and published cost analyses were not reviewed.
Method of Guideline Validation
Not stated
Description of Method of Guideline Validation
Not applicable
Major Recommendations
- The routine use of thick and thin films is advised for malaria diagnosis. Thick films should be exposed to acetone for 10 minutes then stained without further fixation using Giemsa or Field's stain. Thin films should be exposed to acetone for 1 minute and then either stained with a Leishman stain (methanol based) or methanol fixed and stained with a Giemsa stain. Thick films should be examined for an adequate period of time by two observers.
- If thick films are positive the species should be determined by examination of a thin film. In the case of Plasmodium falciparum infection the percentage of parasitised cells should be estimated.
- Rapid antigen detection tests (immunochromatographic tests) cannot replace microscopy but are indicated as a supplementary test when malaria diagnosis is being performed by relatively inexperienced staff (e.g. in low prevalence areas and outside normal working hours).
Clinical Algorithm(s)
None provided
Type of Evidence supporting the Recommendations
The type of supporting evidence is not specifically stated for each recommendation.
Potential Benefits
Accurate qualitative and quantitative diagnosis of malaria
Potential Harms
Not stated
Description of Implementation Strategy
An implementation strategy was not provided.
IOM Care Need
Getting Better
Living with Illness
IOM Domain
Effectiveness
Timeliness
Bibliographic Source(s)
- Bailey JW Williams J Bain BJ Parker-Williams J Chiodini P General Haematology Task Force. Guideline for laboratory diagnosis of malaria. London (UK): British Committee for Standards in Haematology; 2007. 19 p. [10 references]
Adaptation
Not applicable: The guideline was not adapted from another source.
Source(s) of Funding
British Committee for Standards in Haematology
Guideline Committee
Not stated
Composition of Group that Authored the Guideline
Authors: J. W Bailey; J. Williams; B. J. Bain; J Parker-Williams; P. Chio
Financial Disclosures/Conflicts of Interest
Not stated
Guideline Status
This is the current release of the guideline.
Guideline Availability
Electronic copies: Available from the British Committee for Standards in Haematology Web site.
Print copies: Available from the British Committee for Standards in Haematology; Email: bcsh@b-s-h.org.uk.
Availability of Companion Documents
None available
Patient Resources
None available
NGC STATUS
This NGC summary was completed by ECRI Institute on March 18 2008. The information was verified by the guideline developer on April 1 2008.
COPYRIGHT STATEMENT
This NGC summary is based on the original guideline which is copyrighted by the British Committee for Standards in Haematology. For more information contact the BCSH Secretary 100 White Lion Street London UK N1 9PF; Email: bcsh@b-s-h.org.uk.
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