Abstract

Paradigm Shift in Malaria Parasite Density Determination to First Principle Protocol

Background: The need for a simple and more accurate malaria diagnosis and parasite density determination cannot be over-emphasized at such a time when there is increased infection prevalence and higher mortality rate as reported by the World Health Organization. Objective: This article highlights the simple novel approach in using the ‘first principle’ protocol on malaria parasite density determination. Methods: The protocol based on the first principle on malaria parasite quantification was used. The diameter of the field of view (dFOV, 0.178 mm) multiplied by 100 fields gives the diameter of the circle of thick blood film required. The volume of blood in the thick film is equal to the diameter of the circle of thick blood film divided by the volume of blood used (8 μL) and further divided by the magnification to give 0.002 μL. When one microlitre was divided by 0.002 μL, it gave 500 as a factor. Results: Results showed (1+) as 5 to 50 parasites/μL of blood; (2+) as 50 to 500 parasites/μL of blood; (3+) as 500 to 5000 parasites/ μL of blood; and (4+) as >5000 parasites/μL of blood. Conclusion: For us to maintain the desired quality assurance in the diagnosis of malaria, we must have to use an automatic pipette to dispense the actual volume of blood (8 μL) required to prepare a thick blood film of a circle within a specified diameter (18 mm). The use of this method has revealed that it is more accurate, quicker, reproducible, sensitive, actual result value, simple, straightforward, and scientifically verified parasitological method.

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