Analysis index

Pathogen demonstration: 2 ml EDTA-blood for blood smears and thick drop

Antigen demonstration: 1 ml EDTA-blood for malaria-antigen quick test

In the antigen demonstration, plasmodium falciparum (M. tropica), plasmodium vivax or ovale (M. tertiana) or plasmodium malariae (M. quartana) are detected.

Antibody demonstration: 1 ml serum

Antibody demonstration is not suitable for the diagnosis of acute malaria and does not allow a statement about immunity. Serology may be useful in case of patients who have received initial treatment.

PCR: 1 ml EDTA-blood

(P. falciparum, vivax, malariae and ovale) External services for clarification of unclear findings.

Antibody demonstration:

Malaria IgG: < 0,8 – 1,0 ratio

Captured are antibodies against P. falciparum, P. ovale, P. vivax, P. malariae and P. knowlesi.

Fever following a stay in endemic areas.

In accordance with §7, paragraph 3 IfSG, the laboratory has to inform the Robert-Koch institute of any direct and indirect pathogen detection, where possible with specification of species, without patient name.

Malaria tropica (Plasmodium falciparum) is an infectiological emergency! Diagnosis and commencement of therapy should start immediately!

In case of clinical suspicion (clinical picture, matching travel history) but negative microscopic result, repeat tests (3x within 24 hours, in regular intervals) are recommended. Currently, the following types are distinguished: M. tropica (Plasmodium falciparum), M. tertiana (Plasmodium vivax, Plasmodium ovale), M. quartana (Plasmodium malariae), Southeast Asian zoonotic malaria (Plasmodium knowlesi);

1. tropica: Incubation period: 7 – 15 days, fever spells: irregular, life-threatening clinical symptoms without treatment.
2. tertiana: Incubation period: 12 – 18 days, in individual cases also considerably longer, hepatic types may persist for several months, occasionally years, and lead to recurrences. Fever spells of 3 – 4 hours, fever free intervals of one day each. Mostly benign course.
3. quartana: Incubation period: 3 – 6 weeks, fever spells of 4 – 5 hours, fever free intervals of two days. Recurrences possible after decades.

Southeast Asian zoonotic malaria: Clinical symptoms are similar to those of malaria tropica;

Latest recommendations of the WHO or the German society for tropical medicine (DTG) should be observed as to prophylactic measures when travelling to risk areas and current treatment recommendations, travel medical consultation after prior arrangement by telephone. In patients with known or suspected glucose-6-phosphate dehydrogenase deficiency, primaquine may lead to hemolytic episodes.  

Further information can be found at: www.rki.de

MVZ Labor PD Dr. Volkmann und Kollegen Karlsruhe