Published: 2017-09-28

Comparison of diagnostic methods of malaria by peripheral smear, centrifuged buffy coat smear and rapid antigen detection test

Bhavnaben A. Vora, Rajan S. Bindu


Background: Malaria is common, life threatening infection in endemic area and presents diagnostic challenge to laboratories in most endemic areas. A rapid and accurate diagnosis is a pre requisite for effective treatment, especially for potentially fatal cases of falciparum infection.

Methods: Total 200 patients presented with fever and chills, were taken for study and performances of peripheral blood and centrifuged buffy coat smear were compared against the result of rapid antigen detection test (standard method).

Results: out of 200 cases, 55 were positive by rapid detection test.30 of P. vivax, 24 of P. falci and 1 was mixed infection. Peripheral smear had 85.5% sensitive and 100% specific compared to RDT which was 100 % sensitive and specific whereas centrifuged buffy coat was 92.7% sensitive and 99.3% specific.

Conclusions: Easy, rapid, most sensitive and specific diagnostic method will help in early diagnosis and lead to decrease in morbidity and mortality.


Centrifuged buffy coat smear, Malaria, Peripheral smear, Rapid detection kit

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WHO. World Malaria Report, 2013. Geneva, Switzerland. Available at

Park K. Malaria. In: Park’s textbook of social and preventive medicine.18th edn; Banarsidas Bhanot: Jabalpur; 2004:201-203.

White NJ, Breman JG. Malaria. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, ed. Harrison’s principles of internal medicine. 18th ed. McGraw Hill, New York; 2012:1688-1705.

Bhandari PL, Raghuveer CV, Rajeev A, Bhandari PD. Comparative study of peripheral blood smear, quantitative buffy coat and modified centrifuged blood smear in malaria diagnosis. Indian J Pathol Microbiol. 2008;51:108-12.

Tangpukdee N, Duangdee C, Wilairatana P, Krudsood S. Malaria diagnosis: a brief review. Korean J Parasitol. 2009;47(2):93-102.

Paniker CKJ. Malaria and Babesia. In: Ghosh S, ed. Textbook of medical parasitology. 7th edn. New Delhi: Jayapee Brothers Medical Publishers; 2013:63-83.

Akhtar S, Maimoon S, Wilkinson A, Gowardhan V, Mahore S. Feasible choices in diagnostic methods of malaria. J Vector Borne Dis. 2010;47:151-4.

Azikiwe CCA, Ifezulike CC, Siminialayi IM, Amazu LU, Enye JC, Nwakwunite OE. A comparative laboratory diagnosis of malaria: microscopy versus rapid diagnostic test kits. Asian Pacific Journal Tropical Biomedicine. 2012:307-10.

Vyas S, Puwar B, Patel V, Bhatt G, Kulkarni S, Fancy M. Study on validity of a rapid diagnostic test kit versus light microscopy for malaria diagnosis in Ahmedabad city, India. East Mediterr Health J. 2014;20(4):236-41.

Kumar KR, Sudarshan KS. Clinical evaluation of a rapid diagnostic kit (Para check Pf) for diagnosis of Plasmodium falciparum. Indian J Prev Soc Med. 2004;35(1):10-4.

Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH. A review of malaria diagnostic tools: microscopy and rapid diagnostic test. Am J Trop Med Hyg. 2007;77(6):119-27.

Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH. A review of malaria diagnostic tools: microscopy and rapid diagnostic test. Am J Trop Med Hyg. 2007;77(6):119-27.

Ujah IOA, Ikeh EI, Glew RH. Evaluation of the Optimal test for rapid diagnosis of malaria. African Journal Clinical Experimental Microbiol. 2003:4(1):14-7.

Kuladeepa VA, Sukesh. Quantitative buffy coat (QBC) test and other diagnostic techniques for diagnosing malaria: review of literature. National J Med Res. 2012;2(3):386-8.

Kakkilaya BS. Malaria site- all about malaria. (Monograph on internet) India; 2009. Available at URL:http:/

Mckenzie FE, Sirichaisinthop J, Miller RS.Gasser RA, Wongsrichanalai C. Dependence of malaria detection and species diagnosis by microscopy on parasite density. Am J Trop Med Hyg. 2003;69(4):372-6.

Duangdee C, Tangpukdee N, Krudsood S, Wilairatana P. Use of buffy coat thick films in detecting malaria parasites in patients with negative conventional thick films. Asian Pac J Trop Biomed. 2012;2:301-3.

Davis R, Flanigan T, Wilson E. Passive gravitational sedimentation of peripheral blood increases the sensitivity of microscopic detection of malaria. Asian Pacific J Tropical Med. 2013:552-5.

Aubouy A, Dechavanne S, Dasseya R, Massougbodji A. Value of rapid tests for diagnosis of malaria in Benin. Med Trop (Mars). 2010;70(5-6):485-9.