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The diagnosis of blood parasites depends on making high-quality blood films, using the correct stain, recognising the characteristic morphological features and estimating a parasitaemia when appropriate. UK NEQAS Parasitology distributes a wide range of specimens in order to challenge participants in their diagnostic techniques. These specimens are pre-stained and the purpose is for identification of parasites. Some specimens are also sent to test the participants’ parasitaemia calculation techniques as parasitaemia calculations can have potential clinical impact.

High quality blood films

It is essential to make high quality thick and thin blood films in order to be able to see the parasites in relation to the surrounding red cells and the background.


Correct stain

The correct stain must be used in order to see the stippling and recognise characteristic features in a blood film containing malaria species and the sheath in microfilariae species.

Morphological features

Recognising the morphological features in blood parasites is essential for the correct diagnosis, i.e. whether the red blood cell is enlarged or not, whether the red cells contain stippling or fimbriation, whether a microfilaria possesses a sheath or whether there are nuclei at the tip of the tail.

Percentage parasitaemia

Counting of red blood cells infected with parasites of Plasmodium falciparum is essential and the percentage parasitaemia should always be reported as this has implications for prognosis and the pattern of treatment employed. Where relevant, UK NEQAS Parasitology distributions award score for correct parasitaemia reporting.


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