Examination of blood for parasites

Timing

Whenever possible, specimens should be collected before treatment is initiated. When malaria and babesiosis are suspected, blood smears should be obtained and examined without delay. Since the parasitemia may fluctuate, multiple smears might be needed. These can be taken at 8 to 12-hour intervals for 2 to 3 days.

 Microfilariae exhibit a marked periodicity depending on the species involved, therefore the time of specimen collection is critical. If a filarial infection is suspected, the optimal collection time for demonstrating microfilariae is:

  • Loa loa—midday (10 AM to 2 PM)
  • Brugia or Wuchereria—at night, after 8 PM
  • Mansonella—any time
  • Onchocerca—any time

Procedure

  1. Label collection tubes and pre-cleaned slides (preferably frosted-end) with the patient’s name (or other identifier) and date and time of collection.
  2. Clean the site well with alcohol; allow to dry.
  3. Collect the venous blood in a vacuum tube containing anticoagulant (preferably EDTA); alternatively, collect the blood in a syringe and transfer it to a tube with anticoagulant; mix well.
  4. Prepare at least 2 Thick smear and 2 Thin smear as soon as possible after collection.
  5. Then observe under microscope. 
 

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