Quick answer: On a malaria blood film, the plus signs show how many malaria parasites the lab saw. One plus (+) means a small number, and each extra plus means roughly ten times more. Any positive result with fever needs treatment prescribed by a doctor, but the number of plus signs alone doesn't tell you how sick you are.
What the plus signs mean
Many labs in Nigeria report malaria parasites using the plus system on a thick blood film:
| Result | What the lab saw |
|---|---|
| MP seen + | 1 to 10 parasites in 100 microscope fields |
| MP seen ++ | 11 to 100 parasites in 100 fields |
| MP seen +++ | 1 to 10 parasites in every field |
| MP seen ++++ | More than 10 parasites in every field |
| No MP seen | No parasites found on the film |
Some labs count parasites per microlitre of blood instead, which is more precise. The report may also name the type of malaria. In Nigeria it is almost always Plasmodium falciparum.
I have MP +. Do I need treatment?
If you have fever, body aches, chills or headache and the film shows parasites, you should be treated, even with a single plus. Low counts can rise quickly. Our doctors prescribe the right antimalarial and the right dose for you.
A small number of parasites in someone who feels completely well can happen in places where malaria is common. A doctor will decide whether to treat, based on your symptoms and history.
My result says no MP seen, but I still have fever
A negative film is reassuring, but it doesn't always end the search. Parasites can be missed if you took antimalarials before the test, or if the count is very low. Fever can also come from typhoid, a urine infection, a throat or chest infection, or a viral illness. See a doctor rather than taking more malaria drugs on your own.
Blood film or rapid test?
A rapid test (RDT) gives a quick yes or no from a finger-prick, but it can stay positive for weeks after you're cured. A blood film shows how many parasites there are and helps check that treatment is working. We do both. Read more: malaria blood film vs rapid test.
Warning signs
Go to the nearest hospital now if you or someone else has malaria with confusion, fits, very drowsy behaviour, repeated vomiting, difficulty breathing, yellow eyes, very dark urine or bleeding. These can be signs of severe malaria. Mascot Healthcare doesn't handle emergencies.
Get tested in Akoka
Malaria tests are available by appointment at Mascot Healthcare, 52 Sholanke Street, off Chemist Junction, Akoka, Lagos, Monday to Saturday, 9 AM to 5 PM. See the malaria and typhoid test, or book a consultation for malaria treatment. Current prices are on our price list.
This article is general information, not a diagnosis.
Book your visit at Mascot Healthcare
52 Sholanke Street, off Chemist Junction, Akoka (Yaba), Lagos. Open Monday to Saturday, 9am–5pm, by appointment only.