Malaria (Plasmodium)

Detection of Plasmodium species (malaria)
Microbiology
Serology
○ Whole blood (PCR, serology) ○ Serum (serology) ○ Unstained blood slides (thick and thin)
Other Information
○ Two specimens collected in a 24 hour period at least 6 to 12 hours apart are required for a diagnosis

○ If suspecting active infection, order Microscopy and PCR. Indicate if patient has had recent travel history, fever, hemoglobinuria, intravascular hemolysis, renal failure or immune compromise status. Unstained thick and thin slides and EDTA blood are required.
○ Serologic testing only determines a previous exposure to Plasmodium species and should not be used to diagnose a suspected active malaria infection

○ Genotyping to assess antimalarial resistance is only available when treatment failure is suspected.
○ Whole blood/serum: serum separator tube (clotted blood) (min volume 5 mL) (serology)
○ Whole blood: EDTA-blood tube (lavender top) (microscopy, PCR) (min volume 5 mL)
○ Unstained blood slides: slide mailer

○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood
Refer to section Sample Processing / Delivery
PHOL
○ Up to 24 hours
○ Serology: up to 42 days
416-586-4800 extension 4553
○ NO; but consultation is recommended (especially if genotyping is of interest in cases of suspected treatment failure)
○ Label specimen container and outer biohazard specimen bag with printed electronic laboratory order sticker. For unstained blood slides, place in slide mailer. Place specimens in biohazard bag, seal.

○ Specimens should be stored and transported to the UHN/SH Microbiology Laboratory at room temperature (20-25˚C) immediately after collection.

○ The specimen will be referred to the Public Health Ontario Laboratory for testing. PHOL will refer serology to the NRCP.