# Presentation: 059463

## Preparation of Blood Films for Malaria Detection

## Materials for Preparation of Malaria Smears

- Clean and wrapped slides
- Sterile lancets
- 70% ethanol and water
- Absorbent cotton wool
- Surgical gloves
- Lint-free cotton cloth
- Slide box or cover to exclude flies and dust
- Record form or register
- Soft lead pencil; ball-point pen

## Making the Malaria Smear

- Holding the patient’s left hand, palm upwards, select the third finger from the thumb.
- The big toe can be used with infants.
- The thumb should never be used for adults or children.
- Clean the finger with a piece of cotton wool lightly soaked in 70% ethanol, using firm strokes to remove grease and dirt from the ball of the finger.
- Dry the finger with a clean cotton cloth, using firm strokes to stimulate blood circulation.

## Puncture the ball of the finger with a sterile lancet, using a quick rolling action.
Apply gentle pressure to the finger to express 1st  drop of blood and wipe it away with a dry piece of cotton wool. 
Be sure cotton strands do not remain on the finger and mix with  blood.

- Apply gentle pressure to the finger to express 1st  drop of blood and wipe it away with a dry piece of cotton wool.
- Be sure cotton strands do not remain on the finger and mix with  blood.

**Perform Finger Stick**

## Collecting Blood for Thick Prep

- Working quickly, handling slides by the edges, collect the blood using the following procedure
- Apply further pressure to express more blood and collect two or three larger drops, about this size (circle), on the slide, about 1 cm.
-  Wipe finger with cotton
- Allow the thick film to dry with the slide in a flat, level position, protected from flies, dust and extreme heat.

## Collecting Blood Sample for Thin Prep

- Working quickly, handling slides by the edges, collect the blood using the following procedure
- Apply further pressure to express blood and collect two or three larger drops, about this size (circle), on the slide, about 1 cm.
- Proceed with making (thin) smear as prepared for blood cell identification and enumeration
- Wipe finger with cotton

## Making a Thin Film

- Using a second clean slide as “spreader” and, with the slide with the blood drops resting on a flat, firm surface, touch the small drop with the spreader and allow the blood to run along its edge.
- Firmly push the spreader along the slide, keeping the spreader at an angle of 45.
- Make sure that the spreader is in even contact with the surface of the slide all the time the blood is being spread.

## Making a Thick Film

- Using the corner of the spreader, quickly join the drops of blood and spread them to make an even, thick film.
- The blood should not be excessively stirred but can be spread in circular or rectangular form with 3 to 6 movements.
- The circular thick films should be about 1cm (1/3 inch) in diameter.

## Label the dry thin film with a soft lead pencil by writing across the thicker portion of the thin film the patient’s name or number and the date.
Do not use a ball-point pen for labeling the slide. 
Wrap the dry slide in the patient’s record form and dispatch it to the laboratory as soon as possible.

- Do not use a ball-point pen for labeling the slide.
- Wrap the dry slide in the patient’s record form and dispatch it to the laboratory as soon as possible.

**Labeling the Slide**

## Credit

- Adopted from:
- WHO – Geneva
- Bench Aids For Diagnosis
- of Malaria Infection, 2nd Edition