Other Commensal Amoeba (Part 2)

Prof. Julius T. Capili, RMT, MPH, DPASMAP | March 7, 2021

Trans by: Azurin, Columna, Lugo, Quirino, Tumamao
 Relationship of parasites to RBCs could not be
considered
Notes: RESISTANCE
 Duffy factor (Fya) inheritance
 Marker for African black urine. lt is also the receptor for
attachment of P. vivax : and P. knowlesii.
 It aIso contribute to the invasiveness of both species.
 Makes patient Susceptible.
 All stages of malaria are seen in P. yivax. P. ovale and p.
malariae while only ring- form and gametocytes (no schizont
and merozoites) seen in P. falciparum
 Morr 's dots/ Stephen
 Cristopher's dots are seen in P. falciparum
 Ring forms of P. falciparum are applique or accole in form
 Red blood cells affected by P. ovale becomes fimbriated,
enlarged, and serrated
 Sickle cell anemia, Hemoglobinopathies (HbSS) and G6PD
makes patient resistant to malaria
IV. FACTORS AFFECTING SUSCEPTIBILITY TO THE
PERIPHERAL BLOOD SMEAR
III. DIAGNOSIS 
 No. of gametocytes present in circulating blood
Q
uantitative Buffy Coat (QBC):  1 P. falciparum gametocyte/ 200 wbc
 Fluorochrome: Acridine Orange  1 P. malariae gametocyte/ 330 wbc
 Para sight F test  1 P. vivax gametocyte/ 1,000 wbc
 Dipstick test for the simple and rapid diagnosis of P.  Age of gametocyte
falciparum  Young and overripe gametocytes don't develop in the
 Serologic test (IFA) mosquito
 Cannot distinguish between current and past infection, V. RELAPSE
therefore not helpful in establishing diagnosis of an acute  Recurrence/ True Relapse
infection.  Reappearance of infection after a significant period during
 OPTIMAL Assay-pLDH (all species) which the parasites had been absent in the blood.
 MalaQuick  This is due to subsequent EE cycle in the liver cells and
 HRP2 (P. falciparum only) reactivation of hypnoloites.
 Blood Film  Seen only in P. vivax and P. ovale
1. THIN SMEAR  Due to reactivation of Hypnozoites in delayed schizogony
 For specie identification, fixed with methanol and stained  Hypnozoites
with Giemsa  Dormants sporozoites
 Not active
 One- celled thick with the cellular element (including the
RBCs) lying flat on the glass surface  Recrudescence
 Cellular less elements are foxed (remain intact &  Due to increase in the surviving population of malaria in the
recognizable) before staining. blood which started with low count thereby not causing any
sign/ symptom.
 ADVANTAGES:
 Permits the study of the morphology of parasites and  It is common in P. falciparum
conditions of RBCs VI. REFERENCES
 Provides more reliable morphologic differentiation and
their relation to RBCs
 Doc Capili’s Lecture
 Used for specific specie identification
 DISADVANTAGES:
 Amount of blood in the sample is very small so that very
light malarial infection may not be detected.

2. THICK SMEAR
 Which is screening, dehemoglobinized, stain in Giemsa
 Many- celled thick and contains 6-20x as much blood as
the thin film
 Should not be fixed before staining because RBCs must
be dehemoglobinized or lyzed during the procedure
 ADVANTAGES:
 Yields must higher concentration of parasites than in thin
blood smear
 For rapid diagnosis when parasites are few or thin fim is
negative.
 DISADVANTAGE:

Trans # 4.2 Other Commensal Amoeba (Part 2) 1 of 1