Evaluation of distilled water as buffered water replacement during 3% Giemsa’s solution preparation in Malaria diagnosis
Malaria is a life-threatening disease which has claimed many lives. Giemsa's stain is the gold standard method in malaria diagnosis. Generally, Giemsa's stain is diluted with buffered water. However, sometimes, it produces poor staining of the blood smears, in which can create a major challenge in detecting and identifying positive malaria parasites in a peripheral blood smear. This can lead to misdiagnosis and mistreatment to a patient. The present study examined the effect of replacing the buffered water to distilled water during the preparation of 3% Giemsa's solution. Blood specimens were collected from selected positive (n=80) and negative (n=300) malaria cases in EDTA tube. The modified method employed distilled water and different concentrations of buffered water for diluting Giemsa’s solution stock. The microscopy observation was performed on each set of blood film stained by both modified and standard Giemsa staining methods by two WHO’s qualified technicians. All Giemsa solutions with different diluents were comparable in detecting malaria parasites in the blood films. There was no difference between distilled water and different concentrations of buffered water. Furthermore, distilled water produced homogeneous staining and clearer background of the blood films, which enables different species of malaria to be identified. The present study demonstrates that the modified staining using distilled water in malaria parasites identification is comparable to the gold standard method. In addition, the modified method is rapid, easily available, cost-effective, and reliable.