DIAGNOSIS MALARIA IN VIETNAM EPIDEMIC REGION

1. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Tropical climate country in asia
ü Biodiversity
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Different types of ecosystems with rich diversity of
species and genetic resources;

2. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Tropical climate country in asia
ü Biodiversity support to PHARMACOGNOSY
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Different types of ecosystems with rich diversity of
species and genetic resources;

3. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Tropical climate country in asia
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PARASITE DIVERSITY

4. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Two main parasite groups in Vietnam
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Malaria
Parasitic worms

5. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
DIAGNOSIS MALARIA
IN VIETNAM EPIDEMIC REGION

6. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Some information of Vietnam malaria epidemic
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7. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
CDC recommendations for traveling
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8. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Go to the main content on this day…

9. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
for epidemiological research and surveys
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GOLD STANDARD
improve management of malaria infections

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GOLD STANDARD
203 million patients tested by
microscopic examination in 2014
A valuable classic test
q Identification of different malaria species
q Monitoring of antimalarial drug efficacy.
q Various parasite stages
q Blood sample
q Using Giemsa/ Wright stain to examination

11. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Giemsa stain / WHO recommendation
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Giemsa is the classical stain used for malaria
microscopy, and diagnosis requires examination of
both thin and thick films from the same patient.

12. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Preparing thin and thick films
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Thin blood smear Thick blood smear

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14. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Thin and thick films
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üThick film
lysed RBCs
good screening test
larger volume
more difficult to diagnose species
üThin film
fixed RBCs, single layer
low density infection can be missed
smaller volume
good species differentiation

15. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
The ideal location for microscopic examination
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the feathered edge

16. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Giemsa stain
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17. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Giemsa stain
ü One acid and one base dye component
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18. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Giemsa stain
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20. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Giemsa stain
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21. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Hoffbrand, A. V., & Moss, P. A. (2015). Hoffbrand's essential haematology (Vol. 38). John Wiley & Sons.
Types of blood cells
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22. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Peripheral blood cell
Hoffbrand, A. V., & Moss, P. A. (2015). Hoffbrand's essential haematology (Vol. 38). John Wiley & Sons.
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Neutrophil
Lymphocyte
Monocyte
Basophil
Platelet
Eosinophil
Erythrocyte
Neutrophil

25. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium spp. life cycle
Microbiology, OpenStax, Rice University
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26. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Human blood stages
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Immature Ring stage
Mature Ring stage
Schizont
Gametocytes

27. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Malaria species
ü Plasmodium falciparum
ü Plasmodium vivax
ü Plasmodium malariae
ü Plasmodium ovale
ü Plasmodium knowlesi
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28. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum - Early trophozoite
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Delicate rings, few/ slight cytoplasm
Chromatin: single/ double/ Triple… minute bead
Adhering to the edge of the infected erythrocyte
Pigment is not visible at this stage
“headphone” form

29. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum - Early trophozoite
ü Multiple infections
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“ring” form “headphone” form“ i letter form”
double/ triple… chromatin dots
“appliqué/accolé form”
Multiple rings in a RBC
ü “Polymorphism”

30. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum - Maturing trophozoites
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Maurer’s clefts
appliqué forms and Maurer’s clefts
mature trophozoites
pigment

31. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum – Schizont
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Mature trophozoite stage and schizont stage
à in microvasculature; rare in peripharal
blood

32. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum – Gametocyte
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Crescent- or banana- shaped; distorting the shape of the erythrocyte
Macrogametocyte/ Female Microgametocyte/ Male
loose nucleus

33. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum – Gametocyte
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Female Male

34. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum thick film
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35. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium falciparum thick film
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WBC
“i form”
gametocyte
chromatin
cytoplasm

36. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium vivax – Early trophozoite
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one vacuole
cytoplasm
chromatin

37. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium vivax - Maturing trophozoite
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chromatin
mature amoeboid trophozoites
pigment
Schüffner’s dots/ stippling
Schüffner’s dots/ stippling
vacuole

38. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium vivax - Check
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Early trophozoite
Mature trophozoite
Brown pigment
Schuffner’s stippling
Larger than non-infected cells

39. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium vivax - Schizont
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Serial mitosis
brown pigment

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41. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium vivax - Gametocyte
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Round to oval; filling most of the erythrocyte.
Male
gametocyte
Female
gametocyte
nucleus is larger, stains
red and diffuse
cytoplasm stains deep
blue, nucleus is small,
red and compact

42. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Plasmodium vivax - Thick film
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Plasmodium spp.

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www.facebook.com/microbiopharm
www.phancanhtrinh.com

46. Faculty of Pharmacy, UMPMicrobiology and Parasitology Dept.
Thanks for your attention!