St. Maria soledad (Repaired).docx

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ST. LOUIS HIGHER INSTITUTE OF
MEDICAL STUDIES, DOUALA
HIGHER NATIONAL DIPLOMA
DEPARTMENT OF MEDICAL LABORATORY
SCIENCE
A CLINICAL INTERNSHIP CARRIED OUT AT
THE ST MARY HOSPITAL FROM THE 4TH
OF
JULLY TO THE 19TH
OF AUGUST
AN INTERNSHIP REPORT SUBMITTED IN PARTIAL
FUFILMENT OF THE REQUIREMENT FOR THE AWARD
OF A HIGHER NATIONAL DIPLOMA (HND) IN MEDICAL
LABORATORY SCIENCE
PRESENTED BY:
AZUAH KINGSLY NDANGA
MLS/21/0010
2022/2023
REPUBLIC OF CAMEROON
***************
PEAC-WORK-FATHERLAND
***************
MINISTRY OF HIGHER EDUCATION
******************
REPUBLIQUE DU CAMEROON
***************
PAIX-TRAVIAL-PATRIE
***************
MINISTERE DE L’ENSEIGNMENT SUPERIEUR
******************

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DEDICATION
We dedicate this work to God almighty for His unfailing grace and protection
He granted to us during our internship period.

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ACKNOWLEGEMENT
We acknowledge the teachers of St Louis school of health sciences Douala
together with the staff of St. Maria Soledad Hospital Alakuma, together with
our parents and benefactors and all who made it possible for us to carry out this
internship successfully.

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Contents
DEDICATION................................................................................................................. ii
ACKNOWLEGEMENT................................................................................................... iii
List of tables................................................................................................................. v
LIST OF FIGURES.......................................................................................................... vi
List of abbreviation..................................................................................................... vi
1.0 Definition of an internship.....................................................................................1
1.1 Rational, goals and objectives. ..............................................................................1
1.2 Location of the internship with Public Health and geography area in
accordance...................................................................................................................1
1.3 History of the mankon people:..............................................................................1
1.4 Cultural values of the Mankon people (customs, socials, economy, delicacies,
and language). .............................................................................................................2
THE HEALTH INSTITUTION AND THE LABORATORY.....................................................4
2.0. The Health Institution...........................................................................................4
2.1.3 Staff Strength......................................................................................................6
2.1.4 Bed Capacity .......................................................................................................7
2.2 THE LABORATORY..................................................................................................7
2.2.1 Structure and Organization of the Laborator .....................................................7
2.2.2 Laboratory Staff Strength ...................................................................................9
LABORATORY SPECIMEN FLOW CHART.....................................................................10
2.2.5 Analytical Runs in the Laboratory.....................................................................14
CHAPTER THREE.........................................................................................................15
2.2.5.1 Reception.....................................................................................................15
2.2.5.2 COLLECTION BENCH.......................................................................................15
2.2.5.3 Hematology bench.......................................................................................19
2.2.5.4 Bacteriology bench ........................................................................................23
2.2.5.6 Parasitology bench.........................................................................................26
2.2.5.5Serology bench ...............................................................................................27
2.2.5.6 Biochemistry bench .......................................................................................35
QUALITY CONTROL IN THE LABORATORY AND WASTE MANAGEMENT ...................38
Statistics of the three most prevalent diseases.........................................................39
CHAPTER FOUR..............................................................................................................42

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RESULT ANALYSIS AND INTERPRETATION .................................................................42
SUMMARY, DISCUSION, CONCLUSION AND RECOMMENDATION............................42
SWOT ANALYSIS ...................................................................................................43
OPPORTUNITIES ..............................................................................................44
List of tables
Table I Three most prevalent diseases in 2018...................................................36
Table II Three most prevalent diseases in 2019..................................................37
Table III Three most prevalent diseases in 2020................................................38
Table IV Three most prevalent diseases during our internship period..............38

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LIST OF FIGURES
Figure 1 The pie chart shows the percentage prevalence of the three most
prevalence diseases in the year 2018..................................................................39
Figure 2 The pie chart shows the three most prevalent diseases in the year 2019.........40
Figure 3 The pie chart shows the three most prevalent diseases in the year 2020.........40
Figure 4 The three most prevalent diseases during our internship period .....................41
List of abbreviation
SMSCH.................................St Maria Soledad Catholic Hospital
HOD......................................Head of Department
RBC......................................Red Blood Cells
WBC.....................................White Blood Cells
ASLO...................................Anti-streptolysin O antigen
RF.........................................Rheumatoid Factor
CRP......................................C-Reactive Proteins
ESR.....................................Erythrocyte Sedimentation Rate
VDRL.................................Venereal Disease Research Laboratory
TPHA..................................Treponema Pallidum Hemagglutination Assay
HIV.....................................Human Immunodeficiency Virus

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CHAPTER ONE
INTRODUCTION
1.0 Definition of an internship.
An internship is a period when professional students leave their study area to study and practice
under supervision in other institutions for a particular period of time.
1.1 Rational, goals and objectives.
 To blend theory with practical
 To acquire new skills on the different lab benches
 To improve on previously acquired skills
 To learn lab communication and socialization.
1.2 Location of the internship with Public Health and geography area in
accordance.
St. Maria Soledad Catholic Hospital (SMSCH) is an institution built on the estate situated at
Alakuma, Mankon, Bamenda Central Sub Division. It covers the Alakuma Health Area as
demarcated by the Regional Delegation of Public Health, the latter being one of the 19 Health
Areas of the Bamenda Health District. It has a total population of 22,758 as per the 2019
population census. It is located along the Bamenda –Bafut high way and about 3km from the
Bamenda Regional Hospital.
It is bounded to the North by the Bafut Health Area, to the South by the Azire Health Area, to
the East by the Mulang Health Area and to the west by the Alabukam Health Area.
1.3 History of the mankon people:
Mankon, (“ma” meaning mother and “nkon” meaning wave or long line in the mankon
language) is a cosmopolitan town located in the northwest region of Cameroon at an average
altitude of 1000meters above sea level, found in latitude 5.962 and longitude10.113 and is made
up of an elevated area of plateau and hills which makes up part of Cameroon’s grass fields.

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About fifteen ethnic groups contributed in the foundation of Mankon. They came from all
directions and in particular from the Mbam valley and the widikum region. According to one of
the many oral traditions, which are at times contradictory, several of the mankon groups were
originally based in the Mbam valley, the land of the Tikar, situated north-east of the foumban.
As a result of war in the fourteenth and fifteenth centuries, these groups emigrated to the west,
toward the region now known as Wimbum situated in the Nkambe plateau. Due to conflict with
other groups made the Mankon people migrate southward to the Bamunkumbit in the Ndop
plane, where they stayed for some time before crossing to the Bamileke region from Babadjou
to Bangwa via Dschang. They then reached Ntarinkon forest in the widikum region where they
stayed for a short time. During their travel from the east known as sa’nyom (where the sun
rises).This is why the Mankon language resembles that of the Bamumkumbit, Babadjou,
Dschang and Bangwa, but different from their original Widikum people. Due to the hostility of
the forest and lack of rich hunting ground, they finally moved eastward reaching Ala’nkyi “the
water logged land”. The king of Mankonat that time was Fon Ndehmagha VI also called
Mbangnuzhy who was a courageous fighter and a good leader. One of the princes; Bihmagha,
feared that the people of Mankon were been led into danger and took some indigenes
southward, settled forming the present day Pinyin. The initial tribes of the mankon and the
Chomba, Nsongwa, Akum, Mbatu,Ndzong, mundum I and II, and Alatening grouped
themselves into a more consolidated unit called the Nguemba, which made them capable of
withstanding any enemy . The Nguemba tribe is ruled by the Fon of Mankon. In 1891,
following an attack brought by Dr Zintgraff, the German explorer and trader, this group was
divided. The present Fon of the mankon people is Fon Angwafo III.
REFERENCE; Quarter head of Alakuma
1.4 Cultural values of the Mankon people (customs, socials, economy,
delicacies, and language).
Interms of socials, the kwifo or ngumba and the Fon are at the head of Mankon people. The Fon
is the secular and spiritual leader of the Mankon people and at the same time the Tatsey, the
head of “nto”, the royal clan. He also presides over religious rituals like the “Nusa” where the
Fon and the quarter heads use prayer blocks that they scratch with knives placing them over
different kinds of leaves and herbs brought by the citizens present asking their gods to chase

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away evil spirits, diseases and to foster fertility, he also preside over the war council and the
council of “bukum” consisting of notable’schosen by the king himself as determined by their
lineage. Succession to the throne is passed down from father to son: only when a Fon dies can
his son succeed him and once enthroned, the Fon can never abdicate the throne and the eldest
son cannot succeed his father, this can happen if he has no brothers. The traditional meal is
Achu which is prepared on the 2nd
country Sundays of the 8 days in the week and is eaten
throughout the week till the next country Sunday. The traditional dance of the mankon people is
called the “mbagalum”. It is the commonest dance during traditional gathering and funerals.
The Fondom shares it boundary with the Nkwen, Bafut, Mendankwen, Nsongwa and the
Chomba people.

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CHAPTER TWO
THE HEALTH INSTITUTION AND THE LABORATORY
2.0. The Health Institution.
This health institution was approved by the ministerial orderNo.1487/AMSP/SG/DOST/SDSSP
of June 2004 as the St Maria Soledad Catholic Health Center and was opened to the
Cameroonian public. It was then upgraded to the level of a full flesh hospital on the 13th
of
February 2014 by a ministerial order No. 0156/A/MINSANTE/SG/DOSTS/SDSSP/SVDS by
the then Minister of Public Health, Dr. Andre Mama Fouda
2.1 Background History of the Hospital
St Maria Soledad Catholic Hospital is run by the congregation of the Sisters Servants of Mary,
Ministers to the Sick. They were founded in the year 1851 by Sister Maria Soledad Torres
Accosta with the motto “I was sick and you visited me”
They are the servants of Mary consecrated to the service of God and the church, aspire after
perfect charity and continuing Christ’s mission of salvation to the public by providing health
care. The live in a community and dedicate their lives to the love of God; providing diligent
nursing care and graciously caring for the sick, in their homes and in the hospital.
They also have branches in Widikum in Momo Division of the North West Region and Dschang
in the Menoua Division of the West Region of Cameroon. The hospital administration is headed
by a director who is under the supervision of a Mother Superior. The present director is Sr.
Carmen Rodriguez who has been the director from the creation of the hospital.

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2.1.1 BAMENDA ORGANIGRAM OF ST MARIA SOLEDAD ALAKUMA

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2.1.2 Functional Departments of the Hospital
 Out Patient Consultation
 Pharmacy
 Laboratory
 Diabetic Clinic
 Hospitalization
 Maternity
 Theatre
 Treatment Center
 Infant Welfare clinic
 Laundry
2.1.3 Staff Strength
 05 Medical Doctors
 01 Visiting Internist
 01 Gynecologist
 48 Nurses and Midwives
 08 Laboratory Personnel
 04 Pharmacy Technicians
 04Administrative and Financial Assistants
 06 Janitors
 03 Laundry Personnel
 04 Security Guards.
 01 Driver
The Hospital also receives human resource support from the Doctors without Borders Team
who are resident in the hospital to provide emergency health care to victims of the socio
political crisis and other expanded health care assistance to the needy around the town of
Bamenda.

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2.1.4 Bed Capacity.
It has a total bed capacity of 104 beds spread out in the surgical, male, female, children,
gynecological, private wards and the maternity section.
2.2 THE LABORATORY
2.2.1 Structure and Organization of the Laboratory.

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THE STRUCTURE OF THE LABORATORY
ENTRANCE TO ROOM TWO
MAIN ENTRANCE
REGISTRATION
TABLE
COLLECTION
BENCH
BACTERIOLOGY
BENCH
HAEMATOLOGY
BENCH
BLOOD BANK
REFRIGERATOR
SEROLOGY
BENCH
BIOCHEMISTRY
BENCH
PARASITOLOGY
BENCH
VAGINAL
SMEAR
ROOM
WASHING
AND
STAINING
BENCH
CENTRIFUGATION AND STERILIZATION

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2.2.2 Laboratory Staff Strength
The laboratory has personnel strength of nine (9);
 07 Medical laboratory Scientists
 04 Medical Laboratory Technicians
 03 Assistant Medical Laboratory Technicians.
The laboratory is headed by a Head of Department who is a medical laboratory scientist and
supervised by a Reverend Sister who is a medical laboratory technician and is responsible for
the management and supplies of the laboratory. The HOD is assisted by an Assistant HOD who
is an Assistant Medical laboratory technician. The various benches in the laboratory are
supervised by various staff who is appointed by the HOD.
The laboratory operates 24hours/7days and has two working shifts;
 Morning shift……….8am – 5pm
 Night shift…………..5pm – 8am

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LABORATORY SPECIMEN FLOW CHART
FROM THE DOCTOR
CASH OFFICE
LABORATORY
AFTER
COLLECTION
OFSAMPLE
GO FOR RESULTS

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2.2.4 Major Equipment in the Laboratory
 The Microscope
 Hematology Analyzer
 Spectrophotometer
 Blood Bank Refrigerator
 Hematocrit centrifuge
 Incubator
 PIMA machine
 ichroma machine
 Electrophoresis machine
 Urine analyzer
 Fridge (for storing of reagents and specimens).
1. The Microscope.
The microscope was used to observe various stained slides and wet mount slides for
various tests such as Gram reaction, malaria parasite, urine sediment, WBC counting
chamber, thin films for differential white cell count, vaginal and urethral wet mounts
and skin scrapping slides. The stained slides are observed under the oil immersion
objective, and the wet mounts are observed under the 10X and 40X objectives.
Quality control of the microscope is done daily with the use of positive and negative
control slide. The eye piece is cleaned weekly to remove dust and other debris.
2. Hematology analyzer. (The Mindray 20BC ).
Principle: The method of counting cells by the Full blood count machine is based on
electrical impedance (Coulter Principle). It states that particles passing through an orifice
(with an electric current) will produce an increase in impedance, due to the displacement of
electrolytes caused by the presence of the particle. Whole blood is passed between two

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electrodes through a narrow aperture that only one cell can pass through at a time. The
change in impedance is proportional to the volume of the particle.
Use: It is a 3 part hematology analyzer that measures RBC, WBC and Platelet
parameters. EDTA anticoagulated blood was used to automatically carry out the
cytometry. The results were printed out and recorded in the register.
3. Spectrophotometer
Principle: The principle is based on Beer-Lambert’s law which states that the quantity of
light that is absorbed by a substance dissolved in a fully transmitting solvent is directly
proportional to the concentration of that substance and the path length of the light through
the solution. Each substance will therefore absorb or transmit light over a certain range of
wavelength.
Use: use to measure the concentration of; sodium, potassium, chloride, magnesium,
calcium, creatinine, urea, uric acid, cholesterol, protein, antibodies (IgM and IgG).
4. Blood Bank Refrigerator.
The refrigerator stores fresh blood from screened donors in blood bags at a temperature
range of 2-8 0
C. Blood can be store in this refrigerator for up to 35days before expiry. The
temperature is monitored and chatted twice daily: in the morning and evening.
5 Hematocrit centrifuge
Principle: The centrifuge works on the principle of sedimentation, where the centrifugal
acceleration causes denser substances and particles to move outward in the radial direction
and those that are less dense are displaced and move to the center.
Use: it is used to determine Packed cell volume (PCV) or Hematocrit (Hct).
6. Incubator.
It is used to inoculate microbial cultures. It has a fairly constant temperature range of 37-
400
C.
7. PIMA Machine.

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Principle: The PIMA test has a disposable PIMA test cartridge containing dried reagents
and the PIMA analyzer. A low sample volume (approximately 25ul) of blood (venous or
capillary) is collected into the test cartridge, which is then capped. The PIMA test
cartridge is inserted into the analyzer and the sample sealed within the cartridge is
processed. During the course of the procedure data is recorded, analyzed and interpreted
using an inbuilt software in the analyzer. The results are displayed on the screen.
Use: The PIMA machine is a cytometer that is used for the analysis of a PIMA test
cartridge for the counting of CD4 cells in HIV infection cases.
8. The ichroma Machine.
Principle: It is based on antigen- antibody reaction and fluorescent technology. The
reader uses a semiconductor diode laser as the excitation light source for illuminating
the test cartridge membrane , thereby triggering fluorescence from the flourochrome
molecules present on the membrane.
The fluorescent light is collected together with the scattered laser light. Pure
fluorescence is filtered from the mixture of the scattered and fluoresced light. Intensity
of the fluorescent is scanned and converted into an electric signal which is proportional
to the intensity of the fluorescence produced on the test cartridge membrane. The on-
board microprocessor computes concentration of the analyte in the clinical specimen
based on a pre-programmed calibration. The computed and converted result is displayed
on the display screen of the ichroma reader.
Use: It is a portable fluorescence scanning instrument used for measuring the
concentration of analystes in human blood, urine and other specimens. The
immunoassay can be for screening, monitoring, and/or routine physical examinations.
Some of the analytes whose concentrations are measured are: Prostate Specific Antigen
(PSA), Thyroid Stimulating Hormone (TSH), Thyroxin (T4), Tri-iodothyronine(T3),
Progesterone, and Glycated hemoglobin( HbA1C).
9. Electrophoresis Machine.
Principle: Charged particles under the influence of a liquid media placed in an electric
field will migrate to the electrode of the opposite charge. Positive ions (cations) will

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migrate to the cathode which is the negative electrode. Negative ions (anions) will
migrate to the anode, the positive electrode.
Use: It is used to screen for Sickle cell disease by detecting HbSS (sickle cell disease),
HbAS (sickle cell trait) or HbAA (normal hemoglobin).
10. Urine Analyzer.
Principle: The measurement principle is the Dual Wavelength Reflectance photometry:
objects that have different reflectance ratios at two lasers wavelengths may be classified
based on this spectral ratio, independent of the area of those objects in the laser beam.
Use: it is used for the biochemical analyses of fresh urine specimens. It measures and
analyses the following parameters; glucose, ascorbic acid, ketones, bilirubin,
urobilinogen, protein, specific gravity, blood, leukocytes, nitrite and pH values.
11. Fridge
It is used to store reagents and specimens. It has both the freezing and refrigerating
compartments. Refrigerating temperatures ranges from 2-80
C and freezing temperatures
go below 00
C. The temperature is monitored twice daily.
2.2.5 Analytical Runs in the Laboratory.
The laboratory carries out routine procedures and assays on the following benches as outlined
below.
 Reception and registration of clients.
 Collection of specimens.
 Erythrocyte sedimentation rate
 Hemoglobin measurement
 Hematocrit(Packed cell volume)
 Full blood count
 White blood cell count and white blood cell differential count

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 Widal,CRP,ASLO ,RF,VDRL,TPHA ,BG and CROSS MATCH, HIV, HbsAg, HCV,H.
pylori, PT, Chlamydia and Toxoplasma gondi ,RDT and microscopy for malaria
parasite
 Hb electrophoresis
 Culture from vaginal smear, CSF, pleural fluid ,stool, urine
 Skin snip ,skin scrapping, urinalysis and stool analysis,
 Electrolytes[Na+,K+,CL-,Mg2+,Ca2+],urea , creatinine, uric
acid,PSA,HbA1c,T4,T3and TSH
CHAPTER THREE
2.2.5.1 Reception
After consultation, patients who had to do laboratory tests were welcome in the lab and their
cards were check if they had paid for the tests. If not, they were send to the cash office to pay
and the cards were placed into a Catton, they were asked to wait outside on the bench to be
called in order of arrival. The cards were register into the registration book as follows;
 Bed number for in patients
 Lab number or code(assigned by the registrar)
 Patients name
 Receipt number
 Sex
 Age
 Test requested and lab results (after analyzing the sample).
After registration, the cards were then send to the collection bench for specimen collection.
2.2.5.2 COLLECTION BENCH.
The following specimens were collected on the collection bench;
 Capillary and venous blood collection

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 Vaginal and urethral smears,
 Skin scrapping
a) Capillary blood collection.
Materials and reagents:
 Cotton, 70% alcohol, pair of glove and a lancet.

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Procedure:
 The client was welcomed and the procedure was explain to the client seeking his or her
consent.
 The index finger was massaged and was disinfected with 70% alcohol cotton swab.
 A sterile lancet was used to prick the air dried finger and a dry cotton swab was used to
wipe off the first drop of blood.
 Slow pressure was applied on the finger to collect the required volume of blood.
b) Venous blood collection.
Materials:
A pair of glove, 70% alcohol, cotton, syringe and needle, tourniquet, dry tube, purple cap tube,
amongst others.
Procedure:
 After setting the workstation with the necessary materials, the client was called in,
welcomed, and was asked to sit down. The procedure was explained to him seeking his
concern.
 Gloves were won and the tube labeled with the client’s name and the lab number or
code. A new syringe was removed from it containing water proof bag and the needle was
fitted tightly in to it with the bevel facing up and the plunger was aspirated to check for
air tightness.
 A good puncture site was chosen from the upper limbs, the tourniquet was tied a few a
centimeters from the puncture site, and the client was asked to make a fist.
 A cotton swab wetted with 70% alcohol was used to disinfect the chosen puncture site in
a circular manner and was allowed to air dry.
 The syringe was held at an angle of 45o
with the bevel facing up to enter the chosen vein.
When a back flow was observed in the syringe, the plunger was pulled backward slowly
while supporting the needle with the other hand until the required volume of blood was
collected.
 The tourniquet was removed and the client was asked to release the fist.

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 A dry cotton swab was placed on the punctured site and the syringe was removed from
the vein .The client was instructed to apply pressure on the punctured site with the dry
swab until the blood had stop and was put into an infectious waste container.
 The collected sample was filled into the labeled tube and was sent to the appropriate
bench for analysis.
c) Vaginal smear collection.
Materials
A pair of glove, a sterile speculum, sterile swab and clean grease-free slides.
Procedure:
The procedure was explained to the client seeking her consent. She was then asked to
undress and climb on the collection bed and was positioned in the lithotomic position. Gloves
were done.
 A sterile speculum was opened and inserted into the vagina and screwed.
 A sterile swab was opened and the swab was inserted in the vagina and was rotated
at an angle of 3600
on the vaginal wall to obtain the specimen.
 The swab and the speculum were then removed respectively.
 The sample collected was used to prepare a smear for Gram staining and saline wet
mount for microscopy.
d) Urethral smear collection.
Materials
Pair of glove, clean grease-free slides, a sterile swab, physiological saline and cotton.
Procedure
 Cotton moistened with physiological saline was used to clean the surrounding of the
urethral opening.
 Gentle massage was done on the urethra from above downward, and the discharge that
came out of the urethra was collected using the sterile swab.

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 A smear was done on the clean grease free slide for Gram staining.
e) Skin scrapping.
Materials
A pair of gloves clean grease-free slide, cover slip, potassium hydroxide (KOH)
solution, cotton, a new blade, 70% alcohol.
Procedure
 The work materials were set and the client was sent to buy a clean razorblade.
 The infected site (neck, hands amongst others) was disinfected using 70% alcohol swab.
 The rash was scraped using a new unused razorblade into a clean slide and KOH was put
onto the scrapped material and the setup was covered with a cover slip and was taken for
microscopy for fungal infection.
2.2.5.3 Hematology bench
The following tests were performed in the hematology bench;
ESR, Hb electrophoresis, hematocrit, FBC, WBC count, WBC differential count, CD4 count,
Hb measurement (using hemiglobinometer).
a. Erythrocyte Sedimentation Rate
Principle: when blood in a vertically positioned westergreen pipette is left undisturbed, red
cells aggregate, stick together to form a rouleaux and sediment through plasma. ESR is the rate
at which the sedimentation occurs in one hour and indicated by the length of the column of clear
plasma above the red cell measured in mm.
Materials and reagent
 Westergreen ESR pipette
 Westergreen stand
 EDTA anticoagulant blood

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Procedure
The westergren pipette was filled with EDTA anticoagulant blood and was kept on the ESR
stand.
The timer was set at 60minutes and the starting time recorded on a piece of paper together with
the stand number and the stop time. After one hour interval, the ESR was read as the length of
the clear plasma above the red cells in millimeter per hour (mm/hr). The blood was then
discarded into the sink and the tube was washed and kept in a stand to air dry.
Interpretation of ESR test results
Normal values:
 Men: up to 10mm/hr
 Women: up to 15mm/hr
 Elderly: up to 20mm/hr.
b) Hb Electrophoresis.
Principle: This test is used as a screening test to screen for and identify variant and abnormal
hemoglobin. The various hemoglobin separate at different rates due to differences in their
surface electrical charges as determined by their amino acid structure.
Materials and reagent:
Distilled water, EDTA anticoagulant blood, control samples (HbAA, HbAS, HbSS), a pair of
glove, cellulose acetate paper, electrophoresis chamber.
Procedure:
 The work station was set and gloves done.
 The blood was lysed in distilled water.
 The buffer was placed into the two opposite spaces of the electrophoresis chamber.

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 The samples that is the controls; HbAA, HbAS, HbSS, and the patient’s sample (lysed
blood) were applied at one end of the cellulose acetate paper respectively at the same
distant.
 The cellulose paper was then transferred into the electrophoresis chamber with its two
ends immersed into the buffer.
 The chamber was then closed and the power was switch on and the setup was left
undisturbed for 20minutes for the various samples to migrate in the cellulose paper due
to electric current.
 After 20minutes the power was switched off and the distance moved by the various
bands and the number of bands in the patients sample was observed and compared with
control samples to give the final results.
 The buffer and the nitrocellulose paper were then removed and stored back in the fridge.
Hematocrit:
Principle: Anticoagulated blood in a glass capillary of specified bore size, and wall thickness is
centrifuged in a microhaematocrit centrifuge at 12000-15000xg for 3-5 minutes to obtain
constant packing of the red cells. The PCV value is read from the scale of a microhaematocrit
reader or calculated by dividing the height of the red cell column by the height of the total
column of blood.
Heparinized capillary tube, capillary blood, micro hematocrit centrifuge, sealant and micro
hematocrit reader, a pair of glove.
Procedure:
 A finger prick was done to collect capillary blood.
 A heparinized capillary tube was three quarter filled with capillary blood.
 The unfilled end of the capillary tube was sealed with a sealant (soap).
 The sealed capillary tube was placed in one of the numbered slots of the micro
hematocrit rotor with the rim end against the rim gasket corresponding to the lab number
and was balanced with another tube.

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 The sample was centrifuged for 5 minutes at 12000 xg.
 After centrifugation, the tube was checked for any leakage and the PCV was read using
a hand held hematocrit reader by placing the base of the red cell column (above the
sealant) on the zero mark and the top of the plasma column on the 100 line mark.
 The capillary tube was then discarded into the infectious waste container.
D) WBC count:
Principle: whole blood is diluted 1 in 20dilution in an acid reagent which haemolyses the red
cells, leaving the white cells to be counted microscopically using an improved Neubauer
counting chamber and the number of WBC per micro liter calculated.
EDTA anticoagulant blood, improved Neubauer counting chamber, cover slip, Pasteur pipette,
light microscope, Turk’s fluid, and glove.
Procedure:
 380ul of Turks fluid was transferred into a clean tube and 20ul of whole blood was
added onto it and mixed.
 After a few minute, a clean dropper was used to charge the Neubauer counting chamber
with the diluted blood.
 The chamber was mounted on the microscope and was focused with 10x objective and
the cells were counted in the four corner squares and the number of WBC per micro liter
was calculated and reported.
 The counting chamber was then removed and wiped with a clean tissue paper and was
stored in it box while the tissue paper was discarded in to infectious waste container.
E) WBC differential count:
Principle: A well-made thin blood film, fixed with 95% alcohol and stained with the
appropriate Romanowsky stain was allowed to air dry and observed under 100x
objective using immersion oil to count the different types of white blood cells present in

23
the peripheral blood of the individual. The percentage of each white cell counted in
100WBCs was reported.
A pair of glove, a clean glass slide, blood sample, 95% alcohol, spreader, field stains
,AandB,microscope.
Procedure:
 A well-made thin film was made and kept in to a hot air oven to dry.
 The dried film was fixed with 95% alcohol and was kept to air dry.
 The dried thin film was stained with field stain (the film was put in to field stain A for
about one minute, rinsed and deep in to field stain B and washed immediately).
 The stained film was put in to a hot air oven to dry.
 Immersion oil was put on the dried film and was focused using 100x objective to count
the different type of white blood cells present and were reported in percentage.
F) Hemoglobin measurement using the hemoglobin meter:
The measurement of total Hb concentrations is defined as the sum total of oxygenated
hemoglobin, deoxygenated hemoglobin, carboxyhaemoglobin and methaemoglobin. It is done
to detect anemia and its severity.
2.2.5.4 Bacteriology bench.
The following tests were performed on the bacteriology bench;
 Gram staining
 Preparation of culture media (blood agar, mac conkey agar ,saborauddextrose agar,
nutrient agar, salmonella -shiegella agar, cystein lactose electrolyte deficient agar).
 Culture of stool, urine, CSF, pleural fluid, vaginal smear and urethral smear samples,
wound swab and antimicrobial sensitivity testing.

24
Gram staining:
Principle: The cell wall of both gram negative and gram positive bacteria are permeable to the
primary stain; gentian violet which stains the bacteria purple, the color is intensified using
lugol’siodine. Upon decolorization using 95% alcohol, the gram positive bacteria retain the
primary stain due to its thicker peptidoglycan layer, while the gram negative bacteria loose the
primary stain and picks up the color of the counter stain; diluted carbolfuschin, hence appearing
pink or red.
Materials and reagents: Gentian violet,lugol’s iodine, 95% alcohol, tap water, and diluted
carbolfuschin
Procedure:
 A well dried smear was fixed with 95% alcohol and kept to air dry.
 The fixed air dried smear was covered with gentian violet and stained for 30seconds
 The slide was then washed with water from a cup .The smear was then covered with
lugols iodine and left to stain for 2minutes.
 The slide was washed and covered with 95% alcohol for about 5seconds.
 The slide was washed and covered with diluted carbolfuschin and left to stain for
30seconds.
 The slide was washed and kept in a hot air oven to dry.
 ///////////////////The stained air dried smear was observed using the oil immersion objective
for the presence of purple stained gram positive bacteria or pink gram negative bacteria
or other non-bacterial bodies like epithelial cells, yeast cells and fungal hyphae.
Preparation of culture media:
Materials required: dehydrated powder of the different culture media, blood, hot air oven,
electronic balance, distilled water, Petri dishes gloves and face mask.

25
Procedure:
 The mass of the various culture media were measured using the electronic
balance from already calculated values.
 Each of the measured mass of the media were dissolved in 100ml of distilled
water each and covered with aluminum foil and swirled to dissolve.
 The dissolved media were sterilized in a hot air oven; the oven was set at 200o
c
and the dissolved media were put in to the hot air oven until it boil and was
timed for 1hour.
 After one hour, the media were removed and kept to cool.
 For blood agar, the calculated volume of blood was added on to the nutrient agar
to be used.
 The cooled prepared culture media were pour-plated and covered to gel and were
stored in the refrigerator and were removed from there and dried in the incubator
before use.
Culture of stool, CSF, urine, vaginal and urethral smear, pleural fluid and wound swab:
All the samples for culture were inoculated in SSA, BA, MCA, CLED and SDA and incubated
overnight.
The culture plates were observed for growth and the different colonies present if growth
occurred. Gram’s staining was done on the different colonies present and antimicrobial
sensitivity was set for any significant bacterial growth observed in a nutrient agar plate.
Antimicrobial sensitivity testing:
 Commercially prepared antibiotic disc were used.
 The desired colony was taken and spread on nutrient agar plate.
 The various antimicrobial discs were placed on different position in the culture media
plate.

26
 The culture plate was incubated overnight and sensitivity was observed as zone of
clearance around the antimicrobial disc, in which the wider the zone of clearance the
more sensitive the bacteria is to that antibiotic and no clearance indicates resistance to
the antibiotics.
2.2.5.6 Parasitology bench
Thick film for malaria parasite, urine analysis, stool analysis, skin scrapping, RDT for
Plasmodium falciparum were carried out.
Malaria testing:
RDT for plasmodium falciparum: 5 microliter of whole blood was placed on the new cassette
using a dropper from the cassette and three drops of the buffer solution added .The results were
observed for 20 minutes and reported, positive when the control and the patient line appeared,
negative when only the control line appeared and invalid when no line appeared or line on
patient and not on control.
Malaria parasite
Procedure;
A clean grease-free slide was taken and a drop of blood was placed on it and smeared,
then dried in the hot air oven.
Stained with field stain A for 5 seconds and wash with tap water, then field stain B for one
1 second and wash again with tap water, dry and observed microscopically.
It was observed with 100X objectives ,for the presence of malaria parasite.
 Results were recorded as (+),(++), (+++) depending on the number of parasites present
per field.
Urine analysis
The sample was collected and was centrifuged, the supernatant was removed and the
sediment was placed on labelled clean grease –free slide and cover slipped.
The slide was mounted on the microscope and was focused with 10X objective.

27
The 40X objectives was used to confirm for the presence of epithelial cells, blood cells,
spermatozoa, yeast cells, Trichomonas vaginalis.
Stool analysis
 The stool sample was prepared on a labelled clean glass slide using one drop each of
both normal saline and lugol’s iodine on the same slide.
Using a spoon found in the stool container stool was emulsified on the different reagent
and cover slip starting from the saline to iodine.
Then was observed microscopically for the presence of any parasites such as yeast cells,
Giardialamblia, Entamoeba coli, motile bacteria.
2.2.5.5Serology bench
H. pylori, ASLO, RF, ABO blood group test, HIV test, HCV test, HBsAg test, Widal, C-
Reactive Protein (CRP), PSA test, TPHA, PT, VDRL, test,T3, T4, TSH, HbA1C.
H. pylori test
Principle; This is a rapid test that employs gene recombination.H.pylori antigen together with
the principle of gold immune filtration assay to indirectly detect antibody in human serum. The
nitro-cellular membrane is immobilized with H.pylori antigen and H.pylori antigen is
conjugated to colloidal gold particles at the test region. The conjugated particle then migrates
chromatographically to react at the test region.
Procedure
 After blood was centrifuged, plasma from wet tube was obtained and serum from dry
tube was also used in place of plasma.
 The test was removed from the sealed pouch and placed on a clean, level surface and the
patient’s identity was labeled on it.
 One drop of serum or plasma was pipetted using the pipette coming directly from the
pouch and was inserted in the well of the test and one drop of buffer placed in the test
well.
 The serum or plasma migrated till the end of the test line.

28
 The test was left for 20 minutes and if a red line appeared on the Test region, therefore
the test was reported as Positive and if no line appeared on Test region, therefore the test
was reported as Negative.
ASLO
Principle; The ASLO reagent is a suspension of polystyrene latex particles coated with
stabilized Streptolysin O .The reagent has been adjusted in the way that the presence of an Anti-
Streptolysin O titre of IU/mL or higher in the serum gives a visible agglutination of Latex
particles without previous sample dilution.
Procedure
 Reagent and the specimen were bought at room temperature.
 A drop of test reagent was place on the dark side of a clean dry tile.
 Equal drops of serum was added on the same spot of the reagent.
 A sticker was used to mix the two drops well.
 The tile was placed on the oscillator for two minutes
 ASLO was reported as negative when no observable agglutination was seen.
Rheumatoid Factor
Principle; The Rheumatoid Factor latex particles are coated with specifically purified human
gamma globulin. When the latex suspension is mixed with serum containing elevated
rheumatoid Factor levels on the tile, clear agglutination is seen within two minutes.
Procedure
 Reagent and the specimen were brought at room temperature.
 A drop of test reagent was placed on the dark side of a clean dry tile.
 Equal drops of serum was added on the same spot of the reagent.

29
 The tile was placed on the oscillator for two minutes.
 Rheumatoid Factor was reported as positive when any observable agglutination was
seen.
 Rheumatoid Factor was reported as negative when no observable agglutination was
seen.
ABO grouping
Principle; It is based on specific agglutination reaction between Antigen on red cell and IgM
antibodies in the patients serum.
Procedure
 The reagents were removed from the fridge and were placed on a clean table for it to
reach the room temperature for 20-30 minutes.
 The reagents were mixed well before use.
 A clean dry tile was taken and a drop of each anti-serum; Anti-A, Anti-B, Anti-AB and
Anti-D was dropped on it.
 A drop of patient’s whole blood was placed onto each reagent.
 Applicator sticks were used to mix well the blood and the Ant-sera.
 Tile was rugged for two minutes and scored for agglutination.
HIV Test
Principle; Determine TM
HIV-1/2 is an immuno chromatographic test for the qualitative
detection of antibodies to HIV-1 and HIV-2 sample is added to the sample pad. As the sample
migrates through the conjugate pad, it reconstitutes and mixes with the selenium colloid-
Antigen conjugate. This mixture continues to migrate through the solid phase to the
immobilized recombinant antigen and synthetic peptides at the patient window site.

30
Procedure
 A strip test of HIV-1/2 was placed on a clean, level surface and the patient’s identity
was labeled on it.
 Two drops of the patient’s serum was dropped on the determine TM
HIV-1/2 and two
drops of buffer solution of HIV was added too.
 The sample migrated till the end of the strip and a red line appeared on the Control line.
The strip was left undisturbed for 15 minutes and read.
 If a red line appeared on the Test region, therefore the test was reported as Positive and
if no line appeared on Test region, therefore the test was reported as Negative.
HCV Test
Principle; The one step HCV test strip is a qualitative membrane based immunoassay for the
detection of antibodies to HCV in serum or plasma. The test line of the membrane is coated
with recombinant HCV antigens. When the specimen is applied, it migrates upward by
capillary action and combines with the antigens to generate a red line.
Procedure
 The strip was remove from the pouch and placed on a clean, level surface and the
patient’s identity was labeled on it.
 Three drops of patient’s serum was dropped on the strip.
 The serum migrated crossing the Test and Control regions.
 A redline appeared on the Control region and the strip was left for 15 minutes, after
which result was observed.
 If a red line appeared on the Test region, therefore the test was reported as Positive and
if no line appeared on Test region, therefore the test was reported as Negative.
HBsAg Test
Principle; The HBsAg rapid test strip is a qualitative immunoassay for the detection of HBsAg.
The membrane is pre-coated with anti HBsAg antibodies on the test line region on the strip.
When specimen is applied on the specimen pad, the specimen reacts with the anti HBsAg

31
antibodies conjugate particles. The mixture migrates upward on the membrane by capillary
action and reacts with anti HBsAg antibodies on the membrane and generates a colored line.
Procedure
 The test strip was removed from a sealed pouch, placed on a peeled test card
 1 to 2 drops of patient’s serum was dropped on the specimen pad on the strip
 The timer was set for 10 to 15 minutes and read.
 Presence of two coloured lines in the test and control indicative of the presence of
HBsAg antibodies in patient’s serum or plasma.
 Presence of only one line at the control region indicates the absence of HBsAg
antibodies in patient’s serum or plasma.
Syphilis test (TPHA)
Principle; The syphilis ultra-rapid test strip is a qualitative membrane based immunoassay for
the detection of Treponema pallidum antibodies in plasma or serum. When the sample is
applied on the sample pad, it reacts with the pre-coated syphilis antigens on the sample pad. The
mixture migrates by capillary action and interacts with the immobilized syphilis antigens on the
test line producing a colored line.
Procedure
 The test strip was removed from a sealed pouch, placed on a peeled test card
 1 to 2 drops of patient’s serum was dropped on the specimen pad on the strip
 The timer was set for 10 to 15 minutes and read
 Presence of two colored lines on the control and test band indicates the presence of
antibodies to Treponema pallidumin patient’s plasma or serum.
 Presence of one colored line on the control band indicates the absence of antibodies to
Treponema pallidumin patient’s plasma or serum
Pregnancy test
Principle; It is based on the identification of HCG (Human Chorionic Gonadotropin) in urine
with the use of a strip incorporated with anti- HCG.

32
Procedure
 The strip was removed from the pack and labeled
 The strip was then dipped in the urine container containing urine.
 The presence of a double line indicated the presence of the HCG in the urine for a
positive test.
 The presence of a single line indicated the absence of the HCG hormone for a negative
test.
Widal test
Principle; The bacterial antigen test is a slide and tube agglutination test for the quantitative
and the semi-quantitative detection of antibodies: anti salmonella, in human serum. The
reagents, standardized suspensions of killed and stained bacteria agglutinate when mixed with
samples containing homologous antibody.
Procedure
 Reagents were brought to room temperature and suspended
 The reagents were then respectively dropped on a tile with eight circles with the O, AO,
BO, CO, H, AH, BH, CH antigens.
 Patient’s serum was dropped on to each of the circles
 This was then mixed using an applicator stick to fill the entire circle
 The mixture was then rocked for 2 minutes using a rotator and observed for
agglutination
 Agglutination indicates the presence of antibodies to salmonella in patient’s serum. 1/80
= insignificant, 1/160 = mild, 1/320 = moderate, 1/640 = severe.
 No agglutination indicates absence of antibodies to salmonella in patient’s serum.
CRP
Principle; The C - reactive protein latex is a slide agglutination test for the quality and semi-
quantitative detection of C - reactive protein in human serum. Latex particles coated with goat
anti-human CRP are agglutinated when mixed with samples containing CRP.

33
Procedure
 Reagent and the specimen were bought at room temperature.
 A drop of test reagent was place on the dark side of a clean dry tile.
 Equal drop of serum was added on the same spot of the reagent.
 The tile was placed on the oscillator for two minutes.
 CRP was reported as positive when any observable agglutination was seen.
 CRP was reported as negative when no observable agglutination was seen.
T3 Test
Principle; Uses a competitive immuno-detection method. In this method, the target material in
the sample binds to the fluorescent labeled detecting antibody in detection buffer, to form the
complex as sample mixture. The complex is loaded to migrate onto the Nitro-cellulose matrix,
where the covalent couple of T3and Bovine Serum Albumin is immobilized on a test strip and
interferes with binding of target material exists in blood; the less detecting antibody is
accumulated, resulting in the less fluorescence signal.
Procedure
 75 micro liters of the sample was transferred in to the tube containing solution A.
 It was well mixed by pipetting the solution up to 10 times.
 75 microliters of solution B was added to the tube containing the sample and solution.
 The two solutions and the sample were well mixed with the lid well closed.
 The tube was incubated after mixing at room temperature for 08 minutes.
 75 microliters of the mixture form the tube and loaded in the sample well on the
cartridge.
 The cartridge was inserted into the slot of the chamber.
 The cartridge was seen immediately after the 08 minutes and the results were displayed
on the screen of the ichroma machine and was recorded and printed.

34
T4 Test
Principle; Uses a competitive immuno-detection method. In this method, the target material in
the sample binds to the fluorescent labeled detecting antibody in detection buffer, to form the
complex as sample mixture. The complex is loaded to migrate onto the Nitro-cellulose matrix,
where the covalent couple of T4 and Bovine Serum Albumin is immobilized on a test strip and
interferes with binding of target material exists in blood; the less detecting antibody is
accumulated, resulting in the less fluorescence signal.
Procedure
 75 microliters of the sample was transferred in to the tube containing solution A.
 The tube was incubated after mixing at room temperature for 08 minutes.
 75 microliters of the mixture form the tube and loaded in the sample well on the
cartridge.
 The cartridge was inserted into the slot of the chamber.
 The cartridge was seen immediately after the 08 minutes and the results were displayed
on the screen of the Ichroma machine and was recorded and printed.
TSH
Principle; It is a FIA (Fluorescent Immuno-Assay) for the quantitative determination of TSH in
serum or plasma. The test is a Sandwich Immuno-detection method; the detector antibody in
buffer binds to antigen in the sample, forming antibody-antigen complex and migrate onto the
nitro-cellulose matrix to be captured by the other immobilized antibody on the test strip. The
greater in quantity of antigens in the sample, the more anti body-antigen complex and leads to
stronger intensity of fluorescence signal on detector antibody which is processed by instrument
for Ichroma test to show TSH concentration in sample.

35
Procedure
 150 microliters of sample to a mixing tube.
 The lid was closed and the mixture well shaken 10 times.
 75microliters of the solution was pipetted and loaded in the cartridge.
 The cartridge was incubated at room temperature for 12 minutes.
 After incubation, the cartridge was inserted in the chip that was inserted in the machine.
PSA (Prostate Specific Antigen) Test
Principle; It is a FIA (Fluorescent Immuno-Assay) for the quantitative detection of PSA in
serum, plasma or whole blood. The test is a Sandwich Immuno-detection method; the detector
antibody in buffer binds to antigen in the sample, forming antibody-antigen complex and
migrate onto the nitro-cellulose matrix to be captured by the other immobilized antibody on the
test strip. The greater in quantity of antigens in the sample, the more anti body-antigen complex
and leads to stronger intensity of fluorescence signal on detector antibody which is processed by
instrument for Ichroma test to show PSA concentration in sample.
Procedure
 75 microliters of the sample was transferred in to the tube containing solution A.
 The tube was incubated after mixing at room temperature for 15 minutes before
scanning.
 After scanning, results appeared on the screen and was recorded by printing the results
from the machine
2.2.5.6 Biochemistry bench
The following assays are carried out on the biochemistry bench: SGOT, SGPT, creatinine, urea,
uric acid, Ca2+
, Mg2+
, K+
, Na+
,Cl-
, Total protein, Tryglyceride, cholesterol.

36
SGOT.
It is a cellular enzyme found in high concentrations in the heart muscles, liver cells, and skeletal
muscle cells. Its measurements accesses malfunction in heart muscles, liver and skeletal muscle
disorders.
Principle: AST (Aspartate aminotransferase) or SGOT catalyses the reversible transfer of an
amino group from aspartate to alpha ketoglutarate forming glutamate and oxaloacetate. The
oxaloacetae produced is reduced to malate by malate dehydrogenase and NADH.
Procedure: This reaction is kinetic since it measures the rate of decrease in concentration of
NADH.
 1000uL of the working reagent was mixed with 100uL of the serum sample, mixed and
incubated for 1minute.
 The concentration was then read using the semi-automated spectrophotometer.
 It was then recorded on the register.
Normal values: up to 38U/L.
SGPT
It is a cellular enzyme found in highest amounts in the liver and kidney. It is used in diagnosis
of liver diseases.
Principle: ALT (alanine aminotransferase) or SGPT catalysis the reversible transfer of an
amino group from alanine to alpha ketoglutarate forming glutamate and pyruvate. Pyruvate is
then reduced to lactate by lactate dehydrogenase and NADH.
Procedure: This reaction is kinetic since it measures the rate of decrease in concentration of
NADH.
 1000uL of the working reagent was mixed with 100uL of the serum sample, mixed and
incubated for 1minute.
 The concentration was then read using the semi-automated spectrophotometer.
 It was then recorded on the register.

37
Normal value: up to 40U/L.
Creatinine.
Creatinine is the result of the degradation of creatine in the muscles. Creatinine is excreted by
the kidneys. In case of renal failure, creatinine together with urea and uric acid are retained in
the blood.
Principle: it is based on the reaction of creatinine and sodium picrate. A red complex is formed.
The intensity of the color formed is proportional to the creatine concentration in the sample.
Procedure:
 The working reagent (WR) was prepare by mixing equal volumes of R1 (picric acid) and
R2 (sodium hydroxide).
 1000mL of WR was measured into 3 tubes labeled blank, standard and sample.
 100ul each of standard and sample was measured into their respective tubes and mixed.
 The semi-automated analyzer was then set to measure to measure the concentrations of
blank, standard and sample.
 The results were then registered.
Normal values: men 0.7-1.4mg/dL.
Women 0.6-1.4mg/dL.
Urea.
Urea in blood appears as a result of protein metabolism. It is the final product of protein
metabolism. High levels in blood may cause renal diseases, heart failure, GIT hemorrhage, renal
obstruction and dehydration.
Principle: urea in blood is hydrolyzed to ammonia and carbon dioxide in the presence of urease
enzyme. The ammonia reacts with the salycilate and hydrochloride in the presence of the
nitroprusside to form a green indophenols whose color intensity is proportional the
concentration of the the urea in the blood.

38
 The working reagent (WR) was prepared by dissolving the urease enzyme (R3) in one
bottle of the buffer (R1).
 3 tubes were labeled blank, standard and sample.
 The tubes were filled with 1000ul of WR each.
 10ul of the standard and sample was pipette into their respective tubes.
 It was mixed and incubated at 370
C for 5minutes.
 The analyzer was then set to measure the concentrations and the results were recorded.
Normal value: 15-45mg/dL.
QUALITY CONTROL IN THE LABORATORY AND WASTE MANAGEMENT.
Both internal and external quality controls were done in the laboratory.
Internal quality control was done on newly opened lab reagents using prepared lab samples
(positive and negative samples). The results were charted in to the internal quality control chart
together with the reagent lot number and the name and signature of the lab personnel was also
charted.
External quality control samples were received from an external laboratory and were tested and
recorded and the results were sent back to the external laboratory for confirmation.
All waste generated in the laboratory were segregated in to the different waste bins that is,
infectious waste were put in to an infectious bin, all non infectious waste and plastics were put
in to a non-infectious waste container while all sharp objects were put in to the sharp container.

39
Statistics of the three most prevalent diseases
Table 1 the three most prevalent diseases in 2018
Disease Total tested Positive cases Percentage
positive
Percentage
prevalence
Malaria 2983 428 14.3 10.8
Typhoid 621 365 58.8 9.2
Gastritis 354 64 18.1 1.6
Total 3958
Figure 1The pie chart shows the percentage prevalence of the three most prevalence
diseases in the year 2018
Table II the three most prevalent diseases in 2019
Diseases Total tested Positive cases Percentage
positive
Percentage
prevalence
Malaria 2462 434 17.6 10.4
Typhoid 1268 820 64.7 19.7
Gastritis 430 194 45.1 4.7
Total 4160
MALARIA
TYPHOID
GASTRITIS

40
Figure 2 The pie chart shows the three most prevalent diseases in the year 2019
Table III the three most prevalent diseases in the year 2020
Diseases Total tested Positive cases Percentage
positive
Percentage
prevalence
Malaria 3590 344 9.6 5.7
Typhoid 1954 1312 67.1 21.8
Gastritis 482 280 58.1 4.6
Total 6026
Figure 3 The pie chart shows the three most prevalent diseases in the year 2020
MALARIA
TYPHOID
GASTRITIS
MALARIA
TYPHOID
GASTITIS

41
Table IV The three most prevalent diseases during our internship period.
Disease Total tested Positive cases Percentage
positive
Percentage
prevalence
Malaria 633 155 24.5 15.9
Typhoid 235 164 69.8 16.9
Gastritis 102 51 50.0 5.2
Total 970
Figure 4 The three most prevalent diseases during our internship period
MALARIA
TYPHOID
GASTRITIS

42
CHAPTER FOUR
RESULT ANALYSIS AND INTERPRETATION
4.0. General statement.
From the data obtain above in chapter three; it can be observed that;
In the year 2018, malaria had the highest percentage prevalence of 10.8, typhoid had a higher
percentage prevalence of 9.2 and gastritis had a high percentage prevalence of 1.6. These were
the three most prevalent diseases in 2018.
In the year 2019, typhoid had the highest percentage prevalence of 19.7, malaria had a higher
percentage prevalence of 10.4, and gastritis had a high percentage prevalence of 4.7.
In the year 2020, typhoid had a percentage prevalence of 21.8, malaria had a percentage
prevalence of 5.7, and gastritis had a percentage prevalence of 4.6.
During our internship period from the 13th
of Apri8 to the 4th
of May 2021, we had typhoid as
the disease with the highest percentage prevalence, malaria as the disease with the higher
percentage prevalence and gastritis with the high percentage prevalence.
SUMMARY, DISCUSION, CONCLUSION AND RECOMMENDATION.
5.0 Summary
The data was collected from the lab registers by counting the total number of clients tested for
the three mentioned diseases together with the number of positive cases for each of the diseases.
The percentage prevalence was then calculated by dividing the number of positive cases for
each disease by the total number of people tested for the three diseases and multiplying by one
hundred.
5.1 Discussion
The highest prevalence of typhoid could be attributed to some of the following reasons during
our internship period:
 Poor quality of tap water and the use of wells by some of the inhabitants.
 The method of diagnosis (widal test)
Malaria was the disease with the higher prevalence and could be attributed to the following
reasons:

43
 Our internship period was during the rainy season which favors the survival of
mosquitoes in the surrounding bushes.
 The blockage of gutters due to the piling of waste on the streets leads to stagnant water
which provides a favorable breeding area for mosquitoes.
Gastritis was the disease with the high prevalence and this could be attributed to the following
reasons:
 Poor quality of drinking water.
 Poor hygiene as a result of overcrowding in homes.
This result however does not exclusively show the condition of the Alakuma health area since
the hospital also receives clients from other health areas due its accessibility.
5.2 Conclusion
75% of our objectives were obtained in some of the benches.
However, some of our objectives were not obtained since we were not allowed to carry out
certain procedures in some benches such as the biochemistry.
SWOT ANALYSIS
Strengths
The hospital was really encouraging as they were ready to listen to what we were to give out to
them and we were also ready to gain from them too
Competent workers which are willing to sacrifice their all for their patients.
Team work and relation between health center and the sick was really encouraging and good.
Proper time management and waste disposal
The presence of few and organized staff at the hospital
Answer all question relating to health.
Weaknesses

44
We were not able to meet up with some of our objectives because we were not granted the
permission to use some machines for instance at the biochemistry section.
No running taps at specific junctions of the hospital for the washing of hands to maintain perfect
hygiene.
Some people in the hospital lack knowledge about the possible solution to maintain perfect
hygiene and sanitation
OPPORTUNITIES
The hospital’s location is just perfect, the area looks secure and calm.
Equipment and materials are available for learning not forgetting the improvisions made by the
practitioners at the hospital.
The departments are well equipped and functional.
We were opportune to gain more knowledge and experiences
We were able to create new relationships with other interns of different schools, the nurses,
cleaner
Proper communication was made or established with the reasoning of the community, trying to
understand their believes
The hospital provided us with so many opportunities to know how primary health care is managed
at the level of the hospital, data collection is carried out and interpreted at the hospital.
Provided us with knowledge on how the hospital and community function together and also the
understanding of the culture and believes of the people.
THREATS
Due to the lack of specialist in certain domain in the St Maria Soledad hospital there were some
cases that the hospital could not handle, so were transferred to the Bamenda general hospital for
treatment.

45
RECOMMENDATION
Base on my findings and experience in the hospital during my internship
period, I was lacking in so many things. In my working skills due to lack of being
given the chance from the school, to have much opportunities for internships in each
semester.
 So I recommend that more opportunities should be given by the school to
Students to carry out more of practical than theory for that is the key to
medical laboratory science.
 I recommend at least 2 internship per semester to improve on our knowledge
and working skills.
 I also recommend that more practical sessions should be done in our school
labs in order for the Students to be familiar with medical terms, materials Etc.
in other not to be surprise when expose to real life situation.
 Health personnel should develop and master good ethical norms in regard to
their profession so as to have an accident free working environment.
 Control teams should be sent frequently to the hospital to check some of the
difficulties faced by both patient and staff, and also to educate workers
standard practices.

46
REFERENCE
1) Internship period according to : www.prospects.ac.uk.internships
2) SWOT Reference to:
S- Strengths
W-Weaknesses,
O –Opportunities
T-Threats
3) According to www.inveSt.opedia.com>terms>swot
4) Sterilization according to: CDC
www.cdc.gov>disinfection>St.erilization

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