MIS 2010
Laboratory procedures
Introduction
• During the MIS patients are tested for Anemia
• using a hem cure 201+
• Malaria parasites using
• RDTs (ICT Mal Pf)
• Thick blood films stained in Geimsa 3%
• Dried spots will be used
• to resolve on discordant results
• Serology testing for malaria transmission
intensity
• Other molecular amplification methods like
LAMP
Tests per client
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Hemoglobin estimation
RDTs test for P.falciparum
Thick blood film
Blood spot on a filter paper
Requirements for the four tests
• General
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Un used gloves
Alcohol swab, Lancet
Sharp disposal box
General disposal bucket with a bin liner
• Anemia
• Hemocue analyzer, Microcuvette
• Malaria Testing by RDTs
• Testing device, Sucking blood
• Malaria testing by blood film
• Microscope slide
• Slide box carrier
• Slide making template
• Serology and molecular analysis
• Filter paper
• Descant
• Medicine pack
Blood collection procedure
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Clean the ring finger appropriately with an alcohol swab
Using a sterile lancet gently prick the finger
Put two normal drops on the centre of slide
From the same finger stick put a drop of blood on each
circle/square on the provided filter paper
• From the microscope slide
• Fill the microcuvette for HB estimation
• Suck the blood using the provided sucking bulb for RDTs testing in
the kit to the right first mark
• The remaining blood on the slide is spread evenly using the
provided template to make an even thick film
How to make a finger stick
• Assemble all the requirements for the four tests
• Hb,malaria test (RDTs &BF), serology testing and molecular
analysis (PCR & Lamp)
• Put on new un-used gloves
• Clean the ring finger with an alcohol swab let it
air dry
• Open a new un-opened sterile lancet from the
RDT kit and use it to make a finger stick
• Without putting it on the floor or table discard it
directly in the sharp box.
Blood collection
• Label the microscope slide, RDT testing
device, medicine pack and filter paper with
the client ID.
• Put two drops of blood on the centre of the
microscope slide.
• Put additional drops of blood on each of
the circles/squares on the filter paper.
Hemoglobin testing
• Turn on the Hemocue
• Open the sample rack
• Fill first the microcuvette from the two
drops on the microscope slide
• Clean the microcuvette and put it in the
Hemocue
• Read and report the results when
displayed.
Malaria testing-RDTs
• Suck blood from the centre of the
microscope slide to the first mark of the
sucking bulb in the RDT kit
• Dispense the sucked blood on the sample
well by touching-blotting
• Add five drops of buffer on the buffer well
• Wait for 15 minutes
• Read, and report the results
• Keep the used RDT cassette for QC
Malaria testing-BF
• From the remaining blood after anemia and
RDTs testing,
• Spread it over the area as indicated by the slide
making template
• Keep it on a flat surface to air dry
• Store air dried blood films in the slide carrier
box.
• Blood films should be stored properly following
the patient name, IDs ,dates and enumeration
areas
Blood spots
• Let each drop of blood on each circle
completely air dry for a day protected from
the dust and insects in the slide carrier box
• Puck them in a well labeled with client IDs
medicine pack with a descant
• Enter or tick the specimens successfully
collected on the specimen sheet provided.
• Ensure that this is verified by all team
members
How to do lab procedures
• Follow Hemocue manufacture instructions
• Follow RDTs instructions sheets
Specimen dispatching
• All the specimens will received by one of the four
laboratory supervisors only.
• No one should just leave the specimens with anyone
without verification and signing in the specimen receiving
register for each laboratory supervisors.
• All the four specimens (slide, RDT, filter paper, anemia
test result) will be checked for labeling ,presence or
absence and collect collection.
• Each enumeration area will have its own slide carrier
and all the specimens bundled together with the daily
specimen collection sheets in one place.
Specimen Storage
• Slides will be stained at NMCC
• Examined and results report at NMCC
• Filter papers will be stored at 4 degree
Celsius before molecular and serology
analysis at a selected institution.