1. The laboratory Assistant in Primary Health Centre should be provided with a separate room equipped fully with worktables, schools, racks, stains, chemical reagents. etc.. Needed for staining. Cleaning and examination of slides and for maintaining returns, records and wall charts. It is preferable to provide artificial lighting for microscopic examination.
2. The Lab, Assistant will receive blood smears together with MF-2 reports for collected under active, passive, contact, mass, confirmatory and follow-up agents receipt of these smears should be entered first in MF-8 register for receipt and examination blood smears which should be maintained Health Sub Centre – wise.
- All the blood smears received by him should be stained with JSB stain on the same as far as possible. No smears should be kept unstained for more than 2 days . only thick smears need to be stained for routine examination.
- The Lab. Assistant should observe the correct technique of blood examination and avoid common errors in the use of microscope.
- The general rule must be strictly observed to examine 100 microscopic fields in cash thick smear in five minutes time before declaring the slide negative.
- A minimum of 50 thick film microscopic fields of the positive slide should be examined before a definite species diagnosis is made.
- After 50minutes of constant examination. it is advisable to interrupt the examinations 10 minutes doing some other work which does not stain the eyes.
- Ordinarily, a microscopic should not examine more than 50 blood films a day with a monthly out turn of 1250 blood films. This workload can be increased to 60 to 70 *day for cleaning heavy backlog in examination.
- The Lab. Assistant must record for each positive slide, the Parasite species and the stage by using the following symbols,
Rings - r
Trophozoites - t P. Falciparum – Fr Fg
Schizonts - S p. vivax - Vr., Vt,Vs
Gametocytes - g
- In case of P. Falciparum, he must record the parasite density as follows:
§ For 1-10 Parasites per 100 thick film fields.
§ For 11-100 Parasites per 100 thick film fields.
§ For 1-10 Parasites per one thick film field.
§ For 11-100 Parasites per one thick film field.
From this record of parasite density a very approximate estimate of parasitic
Per Cmm blood can be made as follows:
- equals to 5-50 Parasites Per Cmm
- equals to 55-500 Parasites Per Cmm
- equals to 505-5000 Parasites Per Cmm
- equals to 5500-50000 Parasites Per Cmm and more.
11. On completion of blood slide examination, he should complete the relevam MF2* received in triplet. In filling column (9) stages of parasite as given in section 9* entered for P. falciparum and mixed cases.
12. He should give a progressive number (P.No.) for each positive case and enter the P.No of the case in column (10) of the MF-2 report.
13. He should return one copy of MF-2 to the MPHA/VHN and one copy to the MPHS and retain one copy at the PIIC Laboratory, which should be field HSC-Wise.
14. He should Keep the positive and negative slides separately packed the negative slides should be sorted out according to serial number ending 0,1,2,3,4,5,6,7,8,9 and kept together in respective pigeon-holes with number 0-9 HSC – wise.
15. All the negative blood smears should be packed neatly according to 0-9 HSC-Wise and to be sent to the respective Dy.director of Health Services at the end of each month. The Dy. Director of Health Services will arrange for sending the negative blood smears to zonal Entomological Team and R.D.
16. The Lab. Assistant should maintain the following forms and registers.
I. HSC-Wise Mf-2 forms of blood smears indicating case number against the positives.
II. MF-8 registers for blood smears receipt and examination.
III. MF-7 register of HSC-Wise detail of positive cases and remedial measures.
IV. MF-9 Master Register of Epidemiological Evaluation Hsc – Wise and village –Wise.
V. Running stock register
17. He should also maintain the following charts:
I. Area map showing jurisdiction and headquarters of HSCs, Passive agencies and indicator villages in API-2 and above HSC.
II. HSC-Wise Master Chart based on epidemiological evaluation master register.
III. Passive agency-Wise and month-wise showing new cases, fever cases, blood slides collected and positive deducted. FTDS if collecting slides will be considered as passive agency. This information will be based on the report (MF-10) received from the passive agencies or the fever treatment depots on malaria.
IV. Backlog of unexamined blood slides along with number of positives as ladder chart.
V. Backlog of Radical Treatment along with positive ladder chart.