What Cell count defines malaria?

by

QUESTION

What Cell count defines malaria??

ANSWER

If you are referring to the cell count for diagnosis, then really the answer is that if ANY malaria parasites are observed in a blood film, then the slide should be considered positive for malaria. Of course, some people can have low levels of parasite in their blood, which are not easily detected under a microscope, using a blood slide. These people are also obviously positive for malaria, but have less severe symptoms or indeed may not have any symptoms at all. If they have symptoms, they may need to seek an alternative form of diagnosis, such as a rapid diagnostic test (RDT) or PCR (polymerase chain reaction).

Multiple Malaria Infections Each Year

by

QUESTION

My name is Olumide and I live in Nigeria. I have had malaria too frequently and it’s giving me a lot of concern. I had one last August 2012 and am having another one this October as I am speaking with you. If I should count it, I’ll be having nothing less than 6 occurrences in a year. It’s always an headache induced malaria whereby after using the ACT combination recommended by WHO, two days after, am still having headache, am asthmatic though and can’t use more than Paracetamol. I am tired of all these and need your help.

ANSWER

One of the key things you should check is how you are being diagnosed with malaria—the symptoms of malaria are very general, such as headache, chills and fever. I have seen cases where people assume they have malaria and so take ACTs without getting properly diagnosed, and so they never actually go to the doctor to have their real illness diagnosed. Therefore, next time you feel sick, you should go to the doctor or to a clinic and make sure they do a proper malaria test. This will either be via taking your blood and looking at it on a slide under a microscope, or by using a drop of the blood in a rapid diagnostic test (RDT). I believe that in some parts of Nigeria, you can even buy the RDT in local pharmacies, and do the test yourself at home. Only if you test positive for malaria should you take ACTs; if the test is negative, you should go to a doctor and ask about other possible illnesses with similar symptoms (such as flu, pneumonia, etc).

At the same time, it could be that you are suffering from repeated malaria attacks, in which case you will need to improve your personal protection in order to prevent future attacks. Sleeping under a long-lasting insecticide treated bednet is crucial; you should also wear long-sleeved clothing at night and at the evening since this is when malarial mosquitoes in Africa are usually most active. You may also want to consider indoor residual spraying; this coats the inside walls of your house with insecticide, further reducing the number of mosquitoes that may bite you inside your home. For more information, please see our Malaria Prevention overview page: http://www.malaria.com/overview/malaria-prevention

Repeated Malaria

by

QUESTION

Since January 2011 I got three times malaria. Is it come regularly? Last week also I got maleria and I took medicine but still I have mild headache and sweating feeling tiredenes in between..

ANSWER

The timing of the repeated malaria episodes you have experienced means that it could be recrudescence (where treatment does not completely kill all the malaria parasites in your blood), relapse (where the malaria goes dormant in your liver, then comes back—this is only caused by Plasmodium vivax and Plasmodium ovale malaria) or even re-infection.

However, first of all, the most important thing is to make sure you are properly diagnosed with malaria and secondly, that you receive the right type of treatment for the kind of malaria that you have.

The symptoms of malaria are very general (fever, chills, nausea, tiredness, aches) and can also be caused by many other illnesses and diseases. As such, in order to confirm you actually have malaria, you should have a blood test (thick and thin blood smear, looked at under the microscope by a trained technician, or a rapid diagnostic test (RDT). In some places you can buy these RDTs from local pharmacies and do the test yourself at home).

Depending on where you live, there may be different types of malaria present; in this case, if you do have malaria, it is important to find out which one you have.

P. falciparum is the most common kind in sub-Saharan Africa and first-line treatment is an artemisinin-based combination therapy, such as Coartem – most areas have P. falciparum that is resistant to chloroquine, so this is not appropriate as treatment, nor are sulfadoxine and pyrimethamine combinations (such as Fansidar).

If you have P. vivax or P. ovale, chloroquine may be used, again depending on where you are and whether resistance is known from your area or not. In addition, you might also talk to your doctor about taking primaquine to prevent future relapse and recurrence of the infection.

Repeated re-infection can be prevented by protecting yourself more thoroughly against getting bitten by an infected mosquito. For example, you should sleep under a long-lasting insecticide treated bednet, screen your windows and doors and wear long-sleeved clothing at night and in the evenings. Indoor residual spraying, which coats your walls with insecticide, can also prevent mosquitoes from persisting inside your home.

Late Malaria Confirmation

by

QUESTION

I was given a field diagnosis of malaria 1 1/2years ago and was treated. Can I still get a blood test to confirm if I truly had malaria?

ANSWER

That’s a very interesting question, and the answer is: it depends. Since you were treated, you will no longer have the parasites in your blood stream, and so you cannot use a traditional blood film, looked at under a microscrope, which is the standard diagnostic method in many places.

However, there are other blood tests which look for the presence of antibodies against specific malaria proteins. These antibodies can remain in the blood for a long time after the malaria infection – probably months, but perhaps even years, though the exact length of time may vary from person to person, as well as between antibodies. If you wanted, you could inquire in your hospital whether it would be possible to get a serology test for malaria (serology tests look for antibodies) – if they tell you the brand they use then you could also contact the manufacturer to ask if they have done tests on the length of time the antibodies stay in the blood.

Malaria Detection

by

QUESTION

what’s the newest form of malaria detection?

ANSWER

While the traditional form of malaria detection has been through microscopy of a blood film slide, two new technologies have recently emerged. The first is the use of reagent strips, which are impregnated with molecules that bind to various other proteins present in the blood during a malaria infection. These reagent strips are usually manufactured as part of a rapid diagnostic test (RDT) kit, whereby a patient only has to provide a single drop of blood, and the result can be read within minutes, a bit like a pregnancy test. The other new method which has emerged is based on PCR (polymerase chain reaction) technology. This method looks for malaria DNA directly in the patient’s blood, using specific sequences of DNA that are unique to the malaria parasite. This method is expensive and takes several hours at minimum, but is very sensitive, and even very low levels of malaria can be detected.

Diagnosing Malaria

by

QUESTION

Where in Malaysia (Kuala Lumpur) can I diagnose malaria? Is it possible within 24 hours?

ANSWER

Given that malaria is endemic in Malaysia (though not usually found in Kuala Lumpar) you should be able to get a malaria test at most clinics or hospitals. The most common test is a thick and thin blood film, read under the microscope by a qualified technician—in some places, clinics are also using rapid diagnostic tests (RDTs). Both of these methods are rapid to prepare and analyse—microscopy may take a couple of hours, depending on the business of the medical staff, whereas an RDT should be ready in about half an hour. In some areas, you can also buy RDTs over the counter at a pharmacy for self-testing.

Malaria Test for Infant

by

QUESTION

What can I do if my infant (6-12 months) gets malaria and how can I tell if they have it?

ANSWER

Your infant can easily be diagnosed by a blood test, so visit a clinic, doctor or hospital immediately. The diagnosis will either be done by looking at a thick and thin blood film under a microscope, or by a rapid diagnostic test.

It is important that a blood test is done in addition to a clinical diagnosis—the symptoms of malaria are very similar to many other infections but the treatment may vary. If found to be positive for malaria, the doctor will recommend appropriate treatment and dosage for the type of malaria they have and their weight/age.

If you live in a malarial area, it is also important to take measures to prevent malaria, such as having your child sleep under a long-lasting insecticide treated bednet, and perhaps spraying your rooms in the evening with insecticides to reduce the number of mosquitoes.

Will Malaria Test Work with No Symptoms Present?

by

QUESTION

I believe my fiance who lives in Kenya has malaria but refuses to go for a test. She has headaches and now flu like symptoms. I am returning in late December, if the symptoms have gone can I still take her for a blood test to see if malaria is still present even if the symptoms subside?

ANSWER

Most malaria diagnosis in Kenya is done by looking at a small sample of the patient’s blood under the microscope. Unfortunately, using this method, it is almost impossible to detect malaria that is non-symptomatic. In this case, one option would be to use a rapid diagnostic test which looks for antibodies in the blood against malaria – as these antibodies can sometimes persist after the infection has subsided, it can sometimes tell you whether that person recently had malaria. These rapid diagnostic tests are available in most of the main cities in Kenya, in larger pharmacies, and maybe even in some big supermarkets like Nakumatt. However, given how rapidly malaria can progress and how serious is can become, I would highly recommend that your girlfriend goes to a clinic or doctor and has a malaria test! That way she can receive treatment early, before her symptoms get worse.

How to Take BFMP Specimen for Malaria

by

QUESTION

How to take a bfmp specimen?

ANSWER

BFMP, when relating to malaria, refer to blood films for malaria parasites. Usually, fingerprick or venous blood is collected from the patient and used to create both a thin and a thick blood film. If using venous blood, the sample should be mixed with an anticoagulant in a vacuum tube. For both thin and thick films, a drop of blood is first placed on a clean glass microscope slide. For the thin smear, take a second “spreader” slide, and place the short end at the edge of the drop of blood. Wait for the blood to seep along the whole edge of the spreader slide, then push the droplet forward quickly and smoothly to spread it thinly across the rest of the slide. For the thick film, take the corner of a second slide and use it to smear the droplet of blood into a circle of 1-2 cm diameter.

You should be able to read newsprint through it, but it should not be so large as to risk dropping off the edge of the slide. When both films have completely dried, thin films are fixed in 100% methanol before staining; thick films are not fixed. A variety of different stains can be used for detection of malaria parasites, though commonly used ones include Giemsa or eosin.

Post Malaria Symptoms

by

QUESTION

My girlfriend had malaria in Uganda. It was detected 2nd of October, it was mild form, she felt dizzy, temperature was little higher. She got Artefan, forth day she was in hospital for review, they told her from blood test that its not malaria anymore.

We came home (Slovakia) but week ago she had suddenly the same symptoms like she had had the first time—dizziness, pain in head, temperature. Rapid test showed her she has no malaria. But she is still feeling weak, once in five days she suddenly feels dizzy, sometimes temperature 37,3 Celsius (yesterday last time). Doctors found nothing. Could it be some post-malaria symptom or she might have some other infection? Is it normal?

ANSWER

Rapid tests for malaria are usually quite accurate, especially if the patient is experiencing symptoms. Moreover, the cycles of malaria infection are usually shorter, with patients experiencing fever and dizziness every other day (for Plasmodium falciparum, which is the most common kind in Uganda). I would recommend trying a second rapid test, preferably of a different brand, just to check—make sure it detects ALL kinds of malaria and not just Plasmodium falciparum, as while it is the most common and dangerous kind, there are other types in Uganda, such as P. ovale, which might not show up on a P. falciparum-only test.

If you have access to a travel clinic or hospital that has experience in tropical diseases, you could also see if they could do a blood slide and check for the presence of malaria parasites in your girlfriend’s red blood cells.

If a second rapid diagnostic test is negative, or there is no sign of visible malaria parasites in her blood, then I suspect she has some other infection, as continued symptoms are not usually a side effect of successful malaria treatment.