Thick vs Thin film comparison

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Relative merits of thick or thin films in malaria diagnosis

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  Thin film appearances P.falciparum

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  Thick film appearances P.falciparum

There is no single correct choice of staining, essentially the thin film has many advantages in terms of ease of preparation, staining and identification. In contrast the thick malarial film offers a single but significant advantage: that of superior sensitivity for parasite detection.< It is important to appreciate these strengths and weaknesses.

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TABLE: A COMPARISON OF THICK AND THIN FILMS

1. Sensitivity for detection
Thick film: Higher - can detect lower levels of parasitaemia ~5–10 parasites/µL
Thin film: Lower - generally requires ~50 parasites/µL for reliable detection
2. Species Identification
Poor: poor - red cell morphology is lost and species-specific features may not be seen
Thin film: Good - both parasite morphology and RBC characteristics are assessed
3. Quantification of parasite number
Difficult: red cells are not seen so requires estimation and is therefore imprecise
Easier: parasites can be counted counted directly and assessed as a proportion of red cells
4. Preparation and staining considerations
Less easy: requires air drying and careful spreading and staining to minimise any artefact
Easier: films are fixed and stained immediately with clearer morphology of parasites and red cells

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