This is an ookinete, not found circulating in a patient. Instead, it is usually formed in the stomach of mosquito when an ingested macrogametocyte is fertilized by a microgamete. This is a motile, fusiform stage that resembles a macrogametocyte of P. falciparum. It can be distinguished by the concentration of pigment at one end and not centrally located as in a gametocyte.