Malaria Exam, Blood  

IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.


Test: Malaria Exam, Blood  
Synonym: Parasite Exam, Blood; Giemsa Stain for Malaria 
Method: Stain, microscopic exam  
Availability: Daily, results available within 24 hours or by STAT request  
Specimen: Blood  
Collection Device: One 5.0 mL EDTA (Lavender) tube or 5 thick and 5 thin slides.  
Volume: 5.0 mL whole blood (slides may also be prepared by fingerstick blood)  
Storage/Transport: After collection, transfer the blood tube to the laboratory at ambient temperature. If > 1 hour, prepare five thin blood smears (use the technique done to prepare a differential count) and 5 thick blood smears (prepared by dropping 10 - 20 µl of blood onto the slide and spreading into a dime-sized area with a wooden or plastic applicator). Slides can be dried at a temperature no greater than 37 °C. Do not stain or fix the slides. Label the slides with the patient's name, hospital number, and date/time of preparation. Transfer slides to the laboratory after the slides have dried at room temperature in a covered container.  
Unacceptable: Frozen or refrigerated samples, blood tube or prepared slides > 24 hours old, blood tube or slides without the time of collection indicated  
Specimen Stability: Slides and tubes are stable at ambient air for up to 24 hours  
Reference Interval: Negative  
Reportable Disease: Detection of malarial parasites in blood is reportable 
Comments: Requests for malarial smears should also include the following historical information:
i) patient's travel history and date of return to or arrival in the US
ii) history of prophylaxis or treatment for malaria
iii) history of transfusions or shared needles
iv) past history of malaria in the patient

Blood containing malaria parasites is infectious, and universal precautions should be strictly followed when handling specimens. One negative set of blood smears does not rule out malaria. 
Revised: 2/13/2012 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.