This part of the site is strictly dedicated to healthcare professionals practicing in malarial endemic areas

MALARIA NEWS

Information and Training


Submit Advanced search
     


General | Diagnostic tools | Diagnostic strategy | The blood smear test | Thick blood film technique | The QBC-malaria test ® | Detection of the HRP2 antigen | Staining techniques | Identification of parasites

[08/25/2004]
 Thick blood film technique

The thick blood film technique developed by Ronald Ross in 1903, enables a relatively large quantity of blood (3 to 5 micro-liters) to be examined on a 1 cm surface. This leads to a concentration of the parasites: the test positivity threshold is evaluated at 10 to 20 parasite-infected red blood cells per micro-liter (HPM).  

But this advantage is counter-balanced by a number of drawbacks, linked as much to the technical performance as to the interpretation of the examination:



The sample must be taken  from the finger tip, for a sample on an anticoagulant (EDTA) makes it more difficult to create the thick film.

Before coloring a thick film, it must either be allowed to dry for 24 hours at ambient temperature, or, at worst, at least two hours at 37°C. This fact is hardly compatible with an emergency examination. Certain technical features do facilitate accelerated drying, but they involve material constraints (use of a micro-wave oven). 

The major drawbacks appear at the moment of reading: in fact, the morphology of the parasites is modified and the infected red blood cells, whose morphology is very useful for the diagnosis of species, are lyzed. Furthermore, nor is it possible to count the infected RBCs. Only a very rough evaluation of the parasitemia can be envisaged in terms of a parasite/leukocyte ratio. 
Thus, the thick film technique would seem to be a well tried enrichment technique, which is only viable and sensitive when read by highly trained technicians, but which even in the hands of experts, cannot be used in an emergency context and does not provide a rapid answer to the three questions posed to the biologist:

is Plasmodium evidenced by the examination?
is it a Plasmodium falciparum ?
if it is a Plasmodium falciparum, what is the parasitic density? 

It will perhaps be necessary to recommend once again a wide use of this method if the announced disappearance of the QBC Malaria Test® is effective, before other techniques, with a low detection threshold, are developed.  

 

© Copyright sanofi-aventis 2002-2008 all rights reserved
Disease information about malaria:the parasite, the symptoms, prevention and treatment options, atlas of malaria, etc.