Test: Malaria Exam, Blood 
  Synonym: Parasite Exam, Blood; Giemsa Stain for Malaria 
  Method: Stain, microscopic exam 
  Availability: Daily, results available within 24 hours or by STAT request 
  Specimen: Blood 
  Collection Device: One 5.0 mL EDTA (Lavender) tube or 5 thick and 5 thin slides.  
  Volume: 5.0 mL whole blood (slides may also be prepared by fingerstick blood) 
  Storage/Transport: After collection, transfer the blood tube to the laboratory at ambient temperature. If > 1 hour, prepare five thin blood smears (use the technique done to prepare a differential count) and 5 thick blood smears (prepared by dropping 10 - 20 µl of blood onto the slide and spreading into a dime-sized area with a wooden or plastic applicator). Slides can be dried at a temperature no greater than 37 °C. Do not stain or fix the slides. Label the slides with the patient's name, hospital number, and date/time of preparation. Transfer slides to the laboratory after the slides have dried at room temperature in a covered container. 
  Unacceptable: Frozen or refrigerated samples, blood tube or prepared slides > 24 hours old, blood tube or slides without the time of collection indicated 
  Specimen Stability: Slides and tubes are stable at ambient air for up to 24 hours 
  Reference Interval: Negative 
  Reportable Disease: Detection of malarial parasites in blood is reportable 
  Comments: Requests for malarial smears should also include the following historical information:
i) patient's travel history and date of return to or arrival in the US
ii) history of prophylaxis or treatment for malaria
iii) history of transfusions or shared needles
iv) past history of malaria in the patient

Blood containing malaria parasites is infectious, and universal precautions should be strictly followed when handling specimens. One negative set of blood smears does not rule out malaria. 
  Revised: 2/13/2012