COMPARATIVE STUDY OF CONVENTIONAL GIEMSA STAIN WITH QBC AND MODIFIED GIEMSA STAIN IN IDENTIFICATION AND SPECIATION OF MALARIAL PARASITE

BACKGROUND In recent years due to the emergence of chloroquine resistance and the serious nature of P.falciparum infection prompt and accurate diagnosis of malaria is essential for reducing morbidity and mortality. The Gold standard conventional Giemsa staining of blood smears is time consuming. In this study, we describe a modification of the conventional Giemsa staining method. The aim of the study was to compare the conventional, and modified Giemsa staining methods with QBC in malaria identification and speciation. METHOD This prospective study included 405 patients suspicious of malaria . Blood samples were collected, Thick and thin smears were prepared and stained by conventional and modified Giemsa staining methods .The samples were examined by QBC method simultaneously. The results were compared in malaria diagnosis and species identification RESULTS Out of 405 cases 40 (9.8) were positive for malaria by both conventional and modified Giemsa methods. Modified Giemsa method was more rapid and speciation was possible in 65 of the thick smear due to clearer background. By QBC 48(11. 8) cases were diagnosed as malaria . As for speciation 25 cases were of P.vivax and 3 cases were found to be of P.falciparum by thick blood smears of modified Giemsa staining method. In QBC precise Speciation between ring stages of P.vivax and P.falciparum was not possible in all cases in our study. CONCLUSION Modified Giemsa is Rapid, can be read easily with training and speciation is possible with thick smear and it is cost effective. Useful in primary health care and resourcepoor settings. QBC method is more sensitive in endemic areas with low level of parasitemia. But it is expensive and correct speciation is not possible in all cases. So Modified Giemsa can be carried out simultaneously along with QBC to improve the diagnosis of malaria .