姬姆薩染色法、瑞氏－姬姆薩染色法與劉氏染色法對瘧原蟲鏡檢之探討

瘧疾是不可輕忽且具有生命威脅的急性傳染病，惡性瘧原蟲更是致死率最高的寄生蟲，快速且正確地診斷對於瘧疾治療以及防止感染傳播至關重要。血液抹片的顯微鏡檢查為診斷瘧疾的黃金標準，本文比較姬姆薩染色法（Giemsa stain）、劉氏染色法（Liu's stain）及瑞氏-姬姆薩染色法（Wright-Giemsa stain）三種國際上及我國醫院常使用的血液抹片染色方法的效果，探討其對瘧原蟲寄生在紅血球之形態、細胞核、細胞質、色素、許氏斑點（Schüffner's dots）及茅氏裂縫（Maurer's cleft）鑑別能力之差異。結果顯示，Giemsa stain在識別瘧原蟲的所有形態較佳，但相對較耗時，且並非所有醫院均備有Giemsa染劑。國內普遍使用的Liu's stain及Wright-Giemsa stain簡單且快速，可辨識瘧原蟲形態，其中Liu's stain更能鑑定瘧原蟲種別，幫助臨床醫師快速診斷通報及正確投藥治療。

Malaria continues to be a significant global public health concern, characterized by its severe and life-threatening nature. Plasmodium falciparum, the most dangerous species, can result in cerebral malaria with a mortality rate exceeding 10%. Because of the rapid disease progression and the fatal symptoms, a fast and correct diagnosis is crucial for malaria treatment and the prevention of community-wide transmission.
Microscopy with blood smear has been considered the“gold standard”for malaria diagnosis. In this study, we compared three staining methods, namely Giemsa stain, Liu's stain, and Wright-Giemsa stain, commonly used in domestic and international diagnostic laboratories. We collected blood smears from 16 malaria cases to assess staining characteristics, including features like nuclei, cytoplasm, pigments, parasite morphology within red blood cells, Schüffner's dots, and Maurer's clefts.
We found that Giemsa staining offered the most comprehensive identification of all malaria parasite morphology, but it was relatively time-consuming. However, considering that Taiwan has been malaria-free since 1965, experiencing no local malaria infection, and fewer than ten imported cases were reported in the last decade, not all hospitals maintained the Giemsa staining solution. Instead, Liu's staining and Wright-Giemsa staining methods were commonly preferred due to their simplicity and speed while still enabling species-level identification of Plasmodium parasites. Liu’s stain can better identify Plasmodium to species level and facilitate rapid diagnosis and therapy.