Highlight on tropical medicine: Malaria

     I gingerly pick up the microscope slide and set it on the microscope stage. Training my eyes on the tiny specimen beneath the magnifying viewer I focus it back and forth until the purple-pink blood cells come into clear focus. Then, I carefully place a drop of oil on the slide to go to the next level of magnification and look again. There, everywhere on the slide, are miniscule pink dots with purple rings inside the red blood cells. Malaria.

Some of you may remember that I myself had malaria back in 2015 when I was training in the lowlands near the coast. It can certainly be dangerous if untreated and where I work it constitutes a significant portion of the patients that I help treat. In the tropics (especially lowland and coastal areas) malaria is a common ailment and where I live there are a few types that are common. It used to be that the mosquito that carried the malaria parasite was only found in the lowlands but we are starting to have an increasing incidence of malaria in the highlands. Most expats that live in tropical areas take medication to help prevent malaria infection but sometimes they can still be infected with malaria parasites.

The dark pink/purple dots are the malaria parasites

So, what does malaria look like you may ask. He’s a picture of malaria under the microscope (see left). We do two different kinds of slides to see if malaria is present in the blood (people generally only have symptoms when the infection levels are high in their blood). First we look at a slide where all of the red blood cells have been ruptured (a thick film) and just the contents of the cells are visible. This gives us a higher potential concentration of malaria so that we can more easily see if it is present. The second type of slide we do is one where we’ve prepared the slide so that the cells are suspended in a fixed state (a thin film) and then we can see if there are parasites in the red blood cells and we can also see what type of parasites are present (there are at least 3 types of malaria present here). As you can see, one type of malaria has a classic ring-like pattern that occurs inside the red blood cells. Other types of malaria have other distinctive forms that help people like me to identify what type they are and how to best treat the patients that have contracted these types of malaria.

The purple dots connected by a "ring" are the malaria parasites

Every day I am learning something new about tropical medicine. It can be frustrating and overwhelming but it can also be exciting and exhilarating. So, for each new slide I examine and each new disease I tackle and try to learn to recognize and treat I thank God that He is helping me to grow and to help the people around me.