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Test Code LMALP Malaria PCR with Parasitemia Reflex, Varies

Useful For

Detection of Plasmodium DNA and identification of the infecting species, with reflex percent parasitemia calculated using thin blood films for positive cases

 

An adjunct to conventional microscopy of Giemsa-stained films

 

Detection and confirmatory identification of Plasmodium species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi

 

This test should not be used to screen asymptomatic patients.

Testing Algorithm

If positive, the percent parasitemia will be performed at an additional charge.

 

For more information see Malaria Laboratory Testing Algorithm.

Method Name

Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization

Reporting Name

Malaria PCR with Parasitemia Reflex

Specimen Type

Varies


Ordering Guidance


1. When monitoring percent parasitemia for patient response to therapy, order MAL / Rapid Malaria/Babesia Smear, Varies (conventional blood film exam) instead of this test.

2. This test is not performed on a STAT basis and, therefore, should not be used as a primary screening test for malaria.

3. This test is used primarily to confirm a presumptive malaria diagnosis and to determine infecting Plasmodium species, particularly when the parasite morphology on traditional blood films is suboptimal.

4. Clients in the Rochester, MN area who are seeking a primary test for malaria and who can deliver the specimen within 4 hours of collection should order MAL / Rapid Malaria/Babesia Smear, Varies.

5. Laboratories that are unable to deliver a specimen within 4 hours of collection should perform an initial screen for malaria and other blood parasites in their laboratory prior to sending a specimen to Mayo Clinic Laboratories.



Shipping Instructions


Label all slides and place dry slides in a labeled slide box. Rubber band labeled slide box and labeled EDTA tube together and send to lab refrigerate.



Specimen Required


Both blood specimens and slides are required.

 

Specimen Type: Blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 3 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send whole blood specimen in original tube. Do not aliquot.

 

Specimen Type: Blood films

Container/Tube: Clean, grease-free slides in plastic slide container

Specimen Volume: 2 Thin blood films and 2 thick blood films

Collection Instructions:

1. Blood films should be made from fresh blood using fingerstick or drops of blood from needle following venipuncture. 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.


Specimen Minimum Volume

Blood: 1 mL
Slides: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Ambient  7 days

Reference Values

Negative

Interpretation

A positive result indicates the presence of Plasmodium nucleic acid, and the melting curve analysis indicates the infecting species.

Clinical Reference

1. Global Health, Division of Parasitic Diseases and Malaria: Malaria. CDC; Updated March 28, 2023. Accessed March 29, 2023. Available at www.cdc.gov/malaria/

2. Swan H, Sloan L, Muyombwe A, et al: Evaluation of a real-time polymerase chain reaction assay for the diagnosis of malaria in patients from Thailand. Am J Trop Med Hyg. 2005 Nov;73(5):850-854

3. World Health Organization (WHO). Malaria. WHO; Updated December 8, 2022. Accessed March 29, 2023. Available at www.who.int/news-room/fact-sheets/detail/malaria

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798

87207 (if applicable)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LMALP Malaria PCR with Parasitemia Reflex 47260-5

 

Result ID Test Result Name Result LOINC Value
37116 Malaria PCR w/ Parasitemia 47260-5

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
MALCT Plasmodium Percent Parasitemia Rflx No No