A
clinician who faces a case of fever would need answers to the following questions:
- Is it malaria?
- If yes;
- What is the species?
- Is it severe?
- Is it new/ recurrence?
- Is it active?
At present, ONLY the peripheral smear can
provide answers to ALL these questions on a single test. With trained technicians, blood
smear remains the gold standard for detection, for speciation, for parasite count and for
identification of different forms of the parasites. Therefore, rely ONLY peripheral smear
for speciation, parasite count and identification of parasite forms. The QBC test
performed by trained personnel could match a thick blood smear for detection of malaria.
The RDTs cannot be used as reliable tools for diagnosis of malaria.
| Clinical Features and MP Test |
|
| Clinical
and MP Test Positive |
Clinical
and MP Test Negative |
No
Clinical, MP Test Positive |
 |
|
|
| Malaria |
Malaria
less likely; Repeat MP Test |
Consider
the following possibilities before treating |
|
|
|
|
| Treat |
If
repeatedly negative, do consider non-malarial illness |
?
False positive |
|
|
?Atypical
malaria |
|
Do
administer presumptive antimalarial treatment in endemic areas |
?
Carrier - Presence of gametocytes |
|
|
?Treated/prophylaxis |
| |
Interpretation of Pre-Treatment MP Test |
<3-4 Days (Early infection) |
7-10
Days (Advanced infection) |
 |
 |
 |
|
Positive (Rings)
Treat |
Positive (Gametocytes)
Old infection Consider Recurrence
Look for splenomegaly |
Negative
Administer presumptive treatment in endemic areas
Repeat if febrile |
Positive (Rings/gametocytes)
Treat |
|
|
|
