title: [Microbiological diagnosis of imported malaria].
abstract: Current diagnosis of malaria is based on the combined and sequential use of rapid antigen detection tests (RDT) of Plasmodium and subsequent visualization of the parasite stained with Giemsa solution in a thin and thick blood smears. If an expert microscopist is not available, should always be a sensitive RDT to rule out infection by Plasmodium falciparum, output the result immediately and prepare thick smears (air dried) and thin extensions (fixed with methanol) for subsequent staining and review by an expert microscopist. The RDT should be used as an initial screening test, but should not replace microscopy techniques, which should be done in parallel. The diagnosis of malaria should be performed immediately after clinical suspicion. The delay in laboratory diagnosis (greater than 3 hours) should not prevent the initiation of empirical antimalarial treatment if the probability of malaria is high. If the first microscopic examination and RDT are negative, they must be repeated daily in patients with high suspicion. If suspicion remains after three negative results must be sought the opinion of an tropical diseases expert. Genomic amplification methods (PCR) are useful as confirmation of microscopic diagnosis, to characterize mixed infections undetectable by other methods, and to diagnose asymptomatic infections with submicroscopic parasitaemia.
authors: Consulta de Enfermedades Importadas y Parasitología Clínica, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España. Electronic address: torrus_die@gva.es.
authors: Diego
authors: D
authors: Torrús
authors: Sección de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
authors: Cristina
authors: C
authors: Carranza
authors: Consulta de Enfermedades Importadas y Parasitología Clínica, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España.
authors: José
authors: J
authors: Manuel Ramos
authors: Sección de Microbiología y Parasitología, Hospital General Universitario de Alicante, Área de Microbiología, Universidad Miguel Hernández, Alicante, España.
authors: Juan
authors: J
authors: Carlos Rodríguez
authors: Laboratorio de Malaria y otras Parasitosis Emergentes, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, España.
authors: José Miguel
authors: JM
authors: Rubio
authors: Laboratorio de Parasitología, Servicio de Microbiología, Hospital Universitario La Paz-Hospital Carlos III, Madrid, España.
authors: Mercedes
authors: M
authors: Subirats
authors: Laboratorio de Malaria y otras Parasitosis Emergentes, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, España.
authors: Thuy-Huong
authors: TH
authors: Ta-Tang
mesh_terms: D000953:Antigens, Protozoan / Q000032:analysis; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005188:False Negative Reactions; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000469:parasitology; D018512:Parasitemia / Q000175:diagnosis / Q000469:parasitology; D010961:Plasmodium / Q000276:immunology / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods; D012698:Serologic Tests / Q000379:methods; D013194:Staining and Labeling / Q000379:methods; D014195:Travel
chemical_list: D000953:Antigens, Protozoan
keywords: Diagnosis; Diagnóstico; Frotis; Gota gruesa; Malaria; PCR; Rapid antigen detection tests; Tests rápidos de detección de antígenos; Thin and thick blood smears