Giemsa stain test

Giemsa stain is performed to determine the presence of malarial parasite in a person’s blood and to diagnose malaria.

Your doctor may order this test if you have the following symptoms:

• Chills
• Fever
• Sweats
• Headache
• Nausea and vomiting
• Fatigue 
• Body ache 

The symptoms of malaria are quite similar to those of other infections. It may start with flu-like illness though the severity of the symptoms may vary depending on the following:

• Your general health
• Your age
• The type of malarial parasite you have

Rarely, the disease can cause impaired neurological function, seizures or loss of consciousness and may lead to death.

It usually takes 7-30 days for symptoms to appear after the initial infection. Malaria symptoms may occur in cycles, with episodes of fever and other indications.

The following people are at a considerably higher risk of getting infected with malaria:

• Children under five years of age
• Individuals with HIV/AIDS
• Pregnant women
• Non-immune migrants, travellers and mobile populations

Also, you may be asked to get this test done if you show symptoms of lymphatic filariasis, babesiosis or trypanosomiasis in a person. 

Some of the signs and symptoms of lymphatic filariasis are as follows:

• Lymphoedema (improper functioning of lymphatic system leading to swelling and fluid accumulation in the tissues)
• Hydrocele in men (swelling of the scrotum), especially due to W. bancrofti
• Elephantiasis (hardening and thickening of the skin)
• Tropical pulmonary eosinophilia syndrome (increased levels of disease-fighting white blood cells called eosinophils, commonly seen in the people of Asia)

Some people develop the following non-specific symptoms of babesiosis:

• Fever
• Headache
• Chills
• Sweats
• Loss of appetite
• Body ache
• Nausea 
• Fatigue 
• Haemolytic anaemia (a type of anaemia leading to jaundice and dark urine)

A person with African trypanosomiasis initially has symptoms such as headaches, muscle and joint aches and swollen lymph nodes. The disease may progress to the central nervous system, affect the brain, and may lead to coma and death.

Additionally, Giemsa stain is used in haematology to distinguish different types of blood cells such as the different white blood cells. It can also stain chromosomes and is used to identify chromosomes with a process called G-banding.

If you are on anticoagulants like warfarin, you may have an increased risk of bleeding when a blood sample is drawn. Also, certain medicines may interfere with the results of this test. So, before the test, tell your doctor about all the medications you are taking.

For malaria, a blood film is required for diagnosis. A laboratory technician will use a sterile syringe to withdraw the required amount of blood from a vein in your arm.

You may feel a sharp pain when the needle is inserted, but this will fade quickly. 

Also, some people tend to feel temporary dizziness or lightheadedness after the test.

Normal results:

Normal results for Giemsa stain are reported as negative for blood parasites like Plasmodium, Babesia, Trypanosoma species and microfilaria parasite.

Both thick and thin films (from the sample) are made to diagnose malaria. Thinner films are easier for diagnosis, but thick films have 50 times more volume of blood, and thus both the films are used.

Abnormal results: 

Abnormal results are reported as positive for the parasite. They indicate that the given blood sample had the parasitic organism it was being tested for. 

Once Plasmodium is detected in your blood, the species of Plasmodium will be identified, and parasitaemia will be calculated. Parasitaemia is a measure of the number of parasites per microlitre of blood. It can also be expressed as a percentage of red blood cells that have malaria parasites. Parasitaemia indicates the severity of the infection. Although microscopy is easy and quick to perform, the accuracy of the results depends on the skill of the technician, the staining technique and the quality of reagents used.

Microfilariae of organisms causing filariasis are also stained by Giemsa stain, which helps determine the species of the organism depending on the different characteristics of each.

Babesiosis can be diagnosed by observing the species in the red blood cells in a stained blood smear under the microscope.

Trypanosoma species also are stained with Giemsa to reach a diagnosis of trypanosomiasis.

The doctor will consider your travel history, clinical symptoms and physical examination findings when interpreting the test results.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.