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Malaria PCR
Test Code39729
CPT Codes
87798<br>Limited Access Code
Preferred Specimen
4 mL whole blood collected in an EDTA (lavender-top) tube, and
2 thin blood films and 2 thick blood films submitted on clean, grease-free slides in plastic containers
2 thin blood films and 2 thick blood films submitted on clean, grease-free slides in plastic containers
Minimum Volume
1 mL
Instructions
Blood Collection:
1. Invert several times to mix blood.
2. Do not transfer blood to other containers. Send specimen in original tube.
Slide Collection:
1. Ideally, blood films should be made directly from uncoagulated blood acquired via fingerstick. However, EDTA anticoagulated blood is also acceptable.
2. Prepare thin blood films as follows:
a. Prepare a thin film with a "feathered edge" that is no more than a single cell thick.
b. Allow the film to thoroughly air dry and then fix by briefly immersing in either absolute or 95% methyl alcohol.
c. Allow to air dry after fixation.
3. Prepare thick blood films as follows:
a. Place a large drop of blood (approximately the size of a dime and preferably from a fingerstick) on a slide.
b. Using a corner of a second slide, spread the drop in a circular motion while applying firm pressure to literally scratch the blood onto the carrier slide. This technique allows the blood to dry quickly and adhere well to the slide.
Use approximately 20 circular sweeps with the second slide. The drop of blood should be about the size of a quarter when finished.
c. Do not fix. Air dry thoroughly (approximately 45 minutes) before placing in transport container.
1. Invert several times to mix blood.
2. Do not transfer blood to other containers. Send specimen in original tube.
Slide Collection:
1. Ideally, blood films should be made directly from uncoagulated blood acquired via fingerstick. However, EDTA anticoagulated blood is also acceptable.
2. Prepare thin blood films as follows:
a. Prepare a thin film with a "feathered edge" that is no more than a single cell thick.
b. Allow the film to thoroughly air dry and then fix by briefly immersing in either absolute or 95% methyl alcohol.
c. Allow to air dry after fixation.
3. Prepare thick blood films as follows:
a. Place a large drop of blood (approximately the size of a dime and preferably from a fingerstick) on a slide.
b. Using a corner of a second slide, spread the drop in a circular motion while applying firm pressure to literally scratch the blood onto the carrier slide. This technique allows the blood to dry quickly and adhere well to the slide.
Use approximately 20 circular sweeps with the second slide. The drop of blood should be about the size of a quarter when finished.
c. Do not fix. Air dry thoroughly (approximately 45 minutes) before placing in transport container.
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Not established
Refrigerated: 7 days
Frozen: Not established
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Gross lipemia
Methodology
Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization
Setup Schedule
Set up: Daily; Report available: 1-3 days
Reference Range
Negative
Clinical Significance
Detection of Plasmodium DNA and identification of the infecting species
An adjunct to conventional microscopy of Giemsa-stained films, particularly in cases of low percent parasitemia or suboptimal parasite morphology
Detection and confirmatory identification of Plasmodium species: P falciparum, P vivax, P ovale, P malariae, and P knowlesi
This test should not be used to screen asymptomatic patients.
