Compare with the municipality population in 2000 Census by ANjU5x2

VIEWS: 41 PAGES: 26

									UNIVERSITY OF SANTO TOMAS:              Department of Medical Technology     PAGE      1



                                   Chapter 1

                      The Problem and Its Background

 1.1 Introduction

         Parasites are group of organisms that reside in living hosts for their

 nourishment. However, these organisms may produce harm or benefit against the

 host.



         Parasites are separated in two major groups, namely, helminths and

 platyhelminths. Helminths consist of several types of worm while platyhelminths are

 mainly composed of flatworms. Helminths are further categorized in 3 types, namely

 the nematodes, cestodes and trematodes



         Nematodes include ascarids (Ascaris), filarids, hookworms, pinworms

 (Enterobius) and whipworms (Trichuris trichiura). The intestinal nematodes are

 transmitted trough soil penetration.



         Ascaris lumbricoides also known as the giant roundworm whichis a soil-

 transmitted helminth is known to be causing the widespread infection called

 ascariasis. It is the largest and most common parasitic worm in humans which is

 mostly described as “spaghetti-looking like” having an average diameter of 2-6mm

 and 15-40 mm of length.
UNIVERSITY OF SANTO TOMAS:                Department of Medical Technology    PAGE      2



         Infected people may suffer from vomiting, stomach pain, intestinal

 obstruction which may result to pneumonitis in severe cases of ascariasis. Poor

 sanitation and improper cooking of food are the most common causes of Ascaris

 lumbricoides. Proper hygiene and thorough cooking may prevent the infection.

 Albendazole, Mebendazole, Ivermectin and Pyrantel pamoate are commonly used for

 its treatment.



         Ascaris lumbricoides is a prominent parasite in both temperate and tropical

 zones, but it is common in warm countries. The main factors of transmission of this

 helminth are more of socio economic because of its involvement in agricultural

 production, illiteracy and poor sanitation.



         Over one billion people worldwide are estimated to have Ascaris infection,

 mostly young children. The infection remains endemic mostly in all continents and in

 Philippines, the prevalence may reach 80% of the population.



         Ascariasis is mostly vulnerable among children since almost all of them are

 playing in       soil that may contaminate with several organisms including the

 embryonated eggs of Ascaris lumbricoides.
UNIVERSITY OF SANTO TOMAS:                 Department of Medical Technology        PAGE      3

       Hagonoy is a first class municipality situated at the southwest corner of the

province of Bulacan. It is bounded by the municipality of Calumpit on the north,

municipality of Paombong on the east, municipality of Masantol, Pampanga on the west

and Manila Bay on the south.



       The municipality is approximately 54 kilometers from Metro Manila or about an

hour and a half drive. It can be accessed via North Luzon Expressway and Mc Arthur

Highway. It is composed of 26 barangays of which seven are classified as urban.



          San Rafael is one of the barangays in Hagonoy, it consists of 74,000 people

according to the national statistics office, 2009. The total land area of San Rafael is

16,525 hectares which consists of flatlands on its southern part and gently sloping on its

northern part, is mostly being cultivated for rice, corn and vegetable production. Major

businesses and industries are located along Cagayan Valley Road, the busiest road

network in the municipality where produce from the northern provinces such as Nueva

ecija, Nueva Viscaya, Isabela and Cagayan pass through to the markets and Metro

Manila.



   1.2 Statement of the Problem

   What is the Incidence Rate of Ascaris lumbricoides among children ages five to

   twelve years old at San Rafael Elementary School, Barangay San Rafael Hagonoy,

   Bulacan?
UNIVERSITY OF SANTO TOMAS:              Department of Medical Technology        PAGE     4

 Specifically, the researchers also wanted to answer the following questions:

        1. What is the percentage of the respondents infected with Ascaris

 lumbricoides?

        2. What is the relationship between the number of respondents affected by

 Ascaris lumbricoides and the following factors:

                 A. age?

                 B. gender?

        3. How can preventive measures be established with the respondents having

 the Ascaris lumbricoides infectio




 1.3 Research Objectives

 General objective:

        The study would like to investigate the incidence rate of Ascaris lumbricoides

 among children aged five to twelve in San Rafael Elementary School of Barangay

 San Rafael, Hagonoy, Bulacan.



 Specific objectives:

        Furthermore, it aims:

                 1. To determine the percentage of the respondents infected with

        Ascaris lumbricoides
 UNIVERSITY OF SANTO TOMAS:                 Department of Medical Technology         PAGE      5

                   2. To establish association between the number of respondents affected

            by Ascaris lumbricoides and the following factors:

                   socio economic factors such as age and gender



   1.4 Significance of the Study

            This study may give an estimate percentage of children ages five to twelve

who are infected with Ascaris lumbricoides in Barangay San Rafael, Hagonoy, Bulacan.



            To the scientific community, this study may help them in gathering data

regarding on the incidence rate of soil-transmitted parasites specifically Ascaris

lumbricoides in order for them to establish preventive measures against parasitism in

Barangay San Rafael, Hagonoy, Bulucan.



            To the general public, this research will provide the necessary information that

may help them to determine the children who are infected with parasites; to develop

awareness, educate and give the needed medication to help cure the parasites involved

and for them to continue their efforts in giving quality healthcare in Barangay San Rafael.



       To the medical technology field, may this study inspire more research studies

regarding soil-transmitted parasites in order to provide quality life through primary

medicare.
 UNIVERSITY OF SANTO TOMAS:                   Department of Medical Technology          PAGE       6

1.5 Scope and Limitation

        The study is only concerned with the incidence rate of Ascaris lumbricoides at

Barangay San Rafael, Hagonoy, Bulacan.



        The respondents are children ages 5-12 years old at Sta. Monica Elementary

School. Regardless of the grade level they have been taking in school, as long as they are

within the said age bracket, they are included in the study.



        10% of the population under the age bracket is randomly selected for the study

and only the age and gender are included in the socio-economic factor to be determined.



        Prior to the collection of the specimen, consent and briefing will be done for the

children’s parents or guardians regarding the proper collection of the specimen.



        Other nematodes and parasites will not be included in the study. Children who

failed to meet the required age bracket are excluded in the study. Also, if the parents are

not willing to let their child or children participate in the study, they are not further forced

to participate, hence they are excluded.



        The degree of infection in the chosen area, as well as the stage of parasitism will

not be included. Medical history of the randomly selected children shall not be given
 UNIVERSITY OF SANTO TOMAS:              Department of Medical Technology     PAGE      7

account of. Body mass index is not accountable for the socio economic factor

determination.



1.6 Research Hypothesis

Alternative hypothesis:

   There is a significant relationship between the number of respondents affected by

   Ascaris lumbricoides among the respondents and,

           a. Age

           b. Sex


   Null hypothesis:

   There is no significant relationship between the number of respondents affected by

   Ascaris lumbricoides among the respondents and,

           a. Age

           b. Sex



1.7 Definition of Terms

   1. Ascariasis- Infection with Ascaris lumbricoides

   2. Awareness- Being conscious of Ascaris lumbricoides infection

   3. Helminths- Parasitic worm that cause diseases to human such as roundworms

   4. Incidence- Frequency of ascariasis in Barangay San Rafael, Hagonoy, Bulacan
UNIVERSITY OF SANTO TOMAS:            Department of Medical Technology      PAGE      8

 5. Prevalence- Number of cases disease that are present in a population at a given

    time

 6. Respondents- People who respond in Barangay San Rafael Hagonoy, Bulacan

 7. Sanitation- Hygenic means of promoting health through prevention
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology        PAGE        9

                                     Chapter 2

                            Review of Related Literature



 2.1 Ascaris lumbricoides

 2.1.1 Epidemiology

                It is estimated that more than 1.4 billion people are infected with A.

 lumbricoides, representing 25 percent of the world population. Factors that may

 facilitate its spread for its high prevalence include a ubiquitous distribution, the

 durability of eggs under a variety of environmental conditions, high number of eggs

 produced per parasite, and poor socioeconomic conditions. Transmission is enhanced

 by the individuals who are asymptomatically infected and it can continue to shed eggs

 for years, yet prior infection does not confer protective immunity.

                Although ascariasis occurs at all ages, it is most common in children 2 to

 10 years old, and prevalence decreases over the age of 15 years. Infections may tend to

 develop in families, and it correlates with the number of people living in a home.

 Infection rates for ascariasis have not been reported to be higher in patients infected

 with the human immunodeficiency virus (HIV).



         The highest prevalence of ascariasis occurs in tropical countries where warm,

 wet climates provide environmental conditions that favor transmission of infection.

 This differs to the situation in dry areas where transmission is seasonal, occurring

 predominantly during the rainy months. The prevalence is also greatest in areas where
UNIVERSITY OF SANTO TOMAS:              Department of Medical Technology        PAGE        10

 sanitation practices lead to increased contamination of soil and water. The majority of

 people with ascariasis live in Asia (73 percent), Africa (12 percent) and South America

 (8 percent), where some populations have infection rates as high as 95 percent. The

 prevalence of infection decreased dramatically after the introduction of modern

 sanitation and waste treatment during the early 1900s in the United States. The current

 prevalence of Ascaris lumbricoides is estimated in stool samples is approximately two

 percent in the United States, but it may be more than 30 percent in children between the

 ages of one to five years, particularly in rural areas of the South. It is also seen in

 travelers from endemic areas.



          Ova can survive in the environment for prolonged periods and prefer warm,

 shady, moist conditions under which they can survive for up to 10 years. The eggs are

 resistant to usual methods of chemical water purification but are removed by filtration

 or by boiling. Developing larvae can be destroyed by sunlight and desiccation. There is

 no significant animal reservoir, but A. suum, which infects pigs, is morphologically

 similar to A. lumbricoides, and the larval forms can occasionally infect humans.




 2.1.2 Life Cycle

      Adult worms inhabit the lumen of the small intestine, usually in the jejunum or

 ileum. They have a life span of 10 months to 2 years and then are passed in the stool.

 When both female and male worms are present in the intestine, each female worm
UNIVERSITY OF SANTO TOMAS:                Department of Medical Technology    PAGE        11

 produces approximately 200,000 fertilized ova per day. There are infections when with

 only female worms occurs, infertile eggs that do not develop into the infectious stage

 are produced. With male-only worm infections, no eggs are formed.



      The ova are oval, have a thick shell, a mamillated outer coat, and measure 45 to

 70 µm by 35 to 50 µm. The ova are passed out in the feces, and embryos develop into

 infective second-stage larvae in the environment in two to four weeks (depending upon

 environmental conditions). When ingested by humans, the ova hatch in the small

 intestine and release larvae, which penetrate the intestinal wall and migrate

 hematogenously or via lymphatics to the heart and lungs. Occasionally, larvae migrate

 to sites other than the lungs, including to the kidney or brain.



        Larvae usually reach the lungs by four days after ingestion of eggs. Within the

 alveoli of the lungs, the larvae mature over a period of approximately 10 days, then

 pass up via bronchi and the trachea, and are subsequently swallowed. Once back in the

 intestine, they mature into adult worms. Although the majority of worms are found in

 the jejunum, they may be found anywhere from the esophagus to the rectum. After

 approximately two to three months, gravid females will begin to produce ova which,

 when excreted, complete the cycle.



               Adult worms do not multiply in the human host, so the number of adult

 worms per infected person relates to the degree of continued exposure to infectious
UNIVERSITY OF SANTO TOMAS:                Department of Medical Technology          PAGE        12

 eggs over time.



 2.1.3 Treatment

        Individuals who are found positive for Ascariasis should be given broad-

 spectrum anti-helminthic drugs like Albendazole, mebendazole, and pyrantel pamoate

 to avoid serious allergic reactions. The drug of choice is Albendazole given at 400mg

 single dose. Ivermectin is another drug that has been shown to be as effective as

 Albendazole if given at a dose of 200µg/kg single dose. (Belizario, 2004)

 These drugs paralyze the worms so that they will be passed out from the stool; other

 drugs irritate the worms causing them to migrate out of the small intestine. (Gladwin

 and Trattler 2004)

 2.1.4 Diagnosis

        Clinical diagnosis of Ascaris lumbricoides infection should always be

 accompanied by microscopic examination since the signs and symptoms are quite

 vague and indistinguishable from those of other intestinal nematode or from non-

 parasitic infections. In the laboratory, the diagnosis of ascariasis consist of finding eggs

 in the feces by direct fecal smear (DFS) using normal saline solution (NSS) or by Kato

 techniques, namely, Kato-Katz and Kato-Thick. (Belizario, 2004)

 Since Ascaris lumbricoides migrates the lungs, sputum exam may reveal larvae.

 Peripheral blood smear may also reveal an increased number of eosinophils

 (eosinophilia). (Gladwin and Trattler 2004)
UNIVERSITY OF SANTO TOMAS:                 Department of Medical Technology       PAGE        13



 2.1.5 Mode of Transmission

         Infection occurs when an individual consumes food contaminated with ascaris

 eggs. (Gladwin and Trattler, 2004). The level of transmission from soil to humans

 depends more on the socio-economic factors than on physical factors especially those

 who are involved in agriculture including the use of night-soil as fertilizer. Poor

 sanitation is also a factor in acquiring the infection. (Belizario, 2004)

 2.1.6 Pathogenesis

         Before Ascaris lumbricoides became in its adult form, it will undergo first in its

 larval stage. The larvae that are hatched in the lumen of small intestine penetrate the

 intestinal wall through the bloodstream up to the lungs wherein it will be in a process of

 molting for 7-10 days.       Migration of the larvae to the lungs can cause Ascaris

 pneumonitis or Loffler’s syndrome, lung infiltration, asthmatic attacks and edema of

 the lips.


         Adult stage of Ascaris usually happened in the small intestine after it was

 swallowed as the molted larvae ascend to the larynx. However, in fatal effects of

 ascariasis, the adult worms may be vomited, escape through the nostrils and inhaled

 through the bronchus. It can also invade other organs such as bile ducts through the

 gallbladder, liver, appendix, pancreatic duct and peritoneal cavity that can cause

 complications such as pancreatitis, peritonitis and varying abdominal pains.


 2.1.7 Symptoms
UNIVERSITY OF SANTO TOMAS:                 Department of Medical Technology          PAGE         14

         The symptoms of Ascaris vary from asymptomatic stage to severe stage of the

 disease due to its ability of larval migration. When adult Ascaris migrates to the

 intestine, it may produce abdominal pain , diarrhea and intestinal obstruction. On the

 other hand, when the larvae of Ascaris migrates to other parts of the body such as

 lungs, liver, appendix stomach and bile duct, they may cause visceral damage,

 peritonitis and inflammation, enlargement of the liver or spleen, toxicity, and

 pneumonia.


 2.1.8 Clinical Significance

         Ascariasis infects an estimated one billion people around the world, more than

 any other parasitic infection. Roundworm infections are common in temperate or

 tropical regions of the world including Australia. In communities where poor sanitary

 conditions exist often 100% of the population will harbour the parasite. The prevalence

 and intensity of infection is usually highest in children aged three to eight years.

 Ascaris eggs are able to survive for months in fecal matter, sewage or even in a 10%

 formalin solution.

         Ascaris lumbricoides plays a significant role in childhood malnutrition, which

 leads to growth retardation, cognitive impairment, and poor academic performance,

 resulting in a poorer quality of life and less ability to contribute to society. For the three

 major soil-transmitted helminths, the disability-adjusted life years lost is 39 million

 years. Ascariasis accounts for 10.5 million years, hookworm infection accounts for 22.1
UNIVERSITY OF SANTO TOMAS:              Department of Medical Technology       PAGE        15

 million years, and trichuriasis accounts for 6.4 million years. In comparison, malaria

 accounts for 35.7 million years.


        Prevalence for Ascaris lumbricoides is defined as the number of egg-positive

 cases reported for a given population. With this definition in mind, data suggests that

 Ascaris lumbricoides is found throughout many of the world’s populations, but Ascaris

 exhibits widespread prevalence in tropical and subtropical regions with the highest

 incidence rates occurring in China, southeast Asia, the coastal regions of western

 Africa, and throughout central Africa. With infection prevalence exceeding 39% in

 some regions, estimates reveal that over 1.4 billion people are currently infected and

 another 4.2 billion are at risk of infection (Silva et al, 2003; Crompton, 1999). While

 cases are reported in most countries, prevalence tends to increase in warm regions

 characterized by annually high humidity. Warm and moist climates permit Ascaris eggs

 to remain viable for extended durations often exceeding one year and up to 15 years

 (O’Lorcain et al, 2000).


    Public health and international development agencies, organizations, and

 professionals often are particularly interested in detecting the presence or absent of

 Ascaris lumbricoides eggs in environmental soils or man-made composts both because

 of the extremely high prevalence of Ascariasis in the developing world, but also

 because the presence of viable Ascaris lumbricoides eggs is considered the best known

 indicator of overall soil or compost quality. Viable Ascaris lumbricoides eggs are an

 excellent indicator for two reasons:
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology         PAGE         16

 1. Ascaris lumbricoides eggs can remain viable in ideal environments for up to 15 years

 (O’Lorcain et al, 2000).


 2. Ascaris lumbricoides eggs are very difficult to destroy and are typically the last

 remaining infectious agent in a treated soil, compost, or sludge (Cairncross et al, 1993).


      To further illustrate the difficulty of inactivating Ascaris lumbricoides eggs, Figure

 3 below shows that in a man-made compost that is sustained at a particular temperature

 for a specified duration of time, Ascaris lumbricoides eggs will be the last viable

 infectious agent for any duration greater than 10 hours (Cairncross et al, 1993; US EPA,

 2003).


 2.1.9 Laboratory Test

 Kato-Katz Method

      The Kato-Katz Method is the oldest protocol for detecting the presence of helminth

 eggs in feces. A 2007 study by Goodman et al. pinpointed the relative accuracy of this

 method to be 77.1% for the detection of Ascaris eggs in human feces. The same study

 also found that the Kato-Katz Method combined with the Simple Gravity Sedimentation

 Method resulted in 100% relative accuracy compared to all testing methods. While the

 Kato-Katz Method has not been utilized on soils and composts, it has shown continuous

 success in detecting Ascaris eggs in human feces. Possible reasons for the lack of

 research of the Kato-Katz Method on soils and composts are:
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology        PAGE       17

 1) While infected humans excrete about 10,000 eggs per gram of feces, contaminated

 soils and composts may have significantly fewer eggs per gram of soil/compost making

 the microscopic detection of Ascaris eggs difficult.


 2) The possible difficulty in detecting viable versus nonviable Ascaris eggs.




 Simple Gravity Sedimentation Method


        The Simple Gravity Sedimentation Method is a reliable and simple protocol for

 detecting the presence of helminth eggs in feces. A 2007 study by Goodman et al.

 pinpointed the relative accuracy of this method to be 91.7% for the detection of Ascaris

 eggs in human feces. The same study also found that the Simple Gravity Sedimentation

 Method combined with the Kato-Katz Method resulted in 100% relative accuracy

 compared to all testing methods. While the Simple Gravity Sedimentation Method has

 not been utilized on soils and composts, it has shown continuous success in detecting

 Ascaris eggs in human feces. Possible reasons for the lack of research of the Simple

 Gravity Sedimentation Method on soils and composts are:


 1) While infected humans excrete about 10,000 eggs per gram of feces, contaminated

 soils and composts may have significantly fewer eggs per gram of soil/compost making

 the microscopic detection of Ascaris eggs difficult.
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology        PAGE        18

 2) The possible difficulty in detecting viable versus nonviable Ascaris eggs.


 2.2 Barangay San Rafael, Hagonoy, Bulacan


        San Rafael is a 1st class municipality meaning their average annual income

 during the last three calendar years P50, 000,000 or more. It is situated on the northern

 part of the province of Bulacan, the Municipality of San Rafael is bounded by two

 provinces, Quezon and Pampanga. Its land area is 16,525 hectares making it the third

 largest municipality in the province of Bulacan. It consists of 34 barangays with the

 southernmost barangay only 53 kilometers north of Manila. Its geographical position to

 the nation's premier city makes it an ideal site for the establishment and development of

 industrial complexes.


 2.2.1 Population


        The Municipality of San Rafael has total population of 73,936 as of December,

 2006. The Barangay Caingin has the biggest number of population which is 9,336

 followed by Barangay Tambubong 5,688, third the Barangay San Roque which is 4,565

 and the least populated barangay with 650 is Barangay Sapang Pahalang.


        Compare with the municipality population in 2000 Census of Population

 conducted by the National Statistic Office which has total population of 70,965 shows

 an increase of 2,971 persons. There is a recorded annual growth rate of 3.36% within a

 span of 6 years. The major concentration of the town's population is observed in the
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology         PAGE        19

 rural concentration of the towns population is observed in the rural areas which

 accounted for 97.79 of the total population of the municipality.


        The National Statistic Office actual survey in 1990 showed that the total

 household of the municipality is 9,467. In the year 2000 the number of household was

 13,416. The 2005 projected number of household is 15,100 there was an increase of

 5,633 for 14 years.


 2.2.2 Geography


        Generally flat in terrain and slightly tilted toward the east, the general

 topographical characteristics of the municipality is a gentle slope higher than sea level.

 From the eastern part up to and almost touching the Candaba swamps and Labangan

 Channel, flow two major rivers, the Angat and Maasim. These rivers are considered to

 be vital to the economic development of the provinces of Bulacan and Pampanga.

 From these flows irrigation water for the farms, they also serve to drain rain and

 floodwater caught along the foothills of the province that flow through the

 municipality.


        Climate in San Rafael consist of two pronounced seasons, the wet and dry. The

 wet season starts around the month of May and ends around the month of November.

 Normally the average annual rainfall is 1,518.6 mm with the months of July and August

 registering the harvest rainfall. Occasional typhoons pass through the area especially
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology         PAGE        20

 during the months of June to September. Cloudiness is heaviest during the months of

 July and September and lightest during the months of February and April.




 2.2.3 Economic


        San Rafael is predominantly an agricultural town, and its major crop is rice

 which accounts for the bulk of the people's income, its secondary crops include corn,

 root crops, fruits, like mangoes and vegetables. Livestock and poultry production are

 the other agricultural activities in the municipality. The majority of the town's

 population derives their income from agriculture.


        The elements required for accelerating economic development are present in

 San Rafael, such as the establishment of small and bid industries in line with the

 program of the national government for the dispersal of industries outside of a 50

 kilometer radius from Manila. Its location, topography and other land features

 contribute to this potential. This will mean increased economic activities in the town

 and better employment opportunities and economic status of the town's people. This is

 also one of the measures that will lay the groundwork for increased commercial,

 industrial and social activities in the municipality similar to those of Baliuag, the town

 adjacent to the south.
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology         PAGE        21




                                   CHAPTER 3

                                METHODOLOGY



 3.1 Research Design



        Cross sectional study design is used in this study. The group will analyze the

 data collected among children ages five to twelve years old at one point in time. Simple

 random sampling shall be done among the children ages five to twelve years olds in

 Barangay San Rafael, Hagonoy, Bulacan. The steps that will be used in this research

 will be the determination of population size and random sampling, answering socio-

 demographic information and data collection, stool sample collection, Direct Fecal

 Smear, microscopic analysis and interpretation of results and lastly reporting of Results.

 The schematic diagram of the research design is shown in Figure 1.1
UNIVERSITY OF SANTO TOMAS:              Department of Medical Technology   PAGE   22




              Determination of Sample Size in Barangay San
                       Rafael, Hagonoy, Bulacan




                  Random Sampling among children ages
                  five to twelve years old in Barangay San
                          Rafael, Hagonoy, Bulacan.




                               Data Collection




                          Stool Sample Collection




                              Direct Fecal Smear




        Microscopic analysis, Interpretation and Reporting of Results




       Figure 3.1 Schematic Diagram of Research Design
UNIVERSITY OF SANTO TOMAS:               Department of Medical Technology         PAGE       23



 3.2 Methodology

 3.2.1 Sampling Technique/ Laboratory Analysis


        The children and the parents will be educated on the causes of the Ascaris

 lumbricoides. They will be convinced that every child ought to be free from such

 infections, thus the necessity of participating in the research work shall be appreciated

 by them. Wide mouthed corked sterile bottles shall be given to the children for the

 collection of their stool samples and structured questionnaires will be distributed among

 the participating children for the collection of demographic information such as age and

 sex and also parental consent will be given. The stool samples will be properly labeled

 and will be carried in a cold box filled with Ice Packs and will be transported to the

 laboratory for analysis. Stool analysis will be performed using the Direct Fecal Smear.


 3.2.3 Direct Fecal Smear

        Protozoan trophozoites could be examined under wet mount examination which is

 an obligatory as the initial phase of microscopic examination. The materials used in this

 method are: wooden applicator sticks, Bottles, dispensing or plastic “squeeze”, 250 ml or

 500 ml bottles, centrifuge bottles and tubes, cover slips, surgical gauze, microscopic

 slides, pipettes, test tube racks, Normal Saline Solution(NSS) and Lugol's iodine.
UNIVERSITY OF SANTO TOMAS:                 Department of Medical Technology       PAGE       24



                                                             Add one drop of Lugol’s
 Collected              Mix      the     stool               iodine and Normal Saline
 Stool                  specimen using an                    Solution (NSS) on each slide
                        applicator stick




         Read under the microscope                          Mix the stool specimen on
         and interpret the results.                         each side of the reagent




                Figure 3.2 Schematic Diagram of Direct Fecal Smear




 3.3 Exclusion and Inclusion Criteria


         The data for the study will be exclusive for children aged five to twelve in

 Barangay San Rafael, Hagonoy, Bulacan. Both genders, male and female will be

 considered for the test. Medical history for each will not be asked. Only the demographic

 profile such as age and sex will be ask. The degree of infection and the numbers of eggs

 present will not be significant and will not be included. The researchers will only focus

 on the presence or absence of the Ascaris lumbricoides.
 UNIVERSITY OF SANTO TOMAS:                Department of Medical Technology       PAGE          25




                                      BIBLIOGRAPHY



   BOOK:

 Cook, G., Zumla, A. (2009). Manson’s Tropical Diseases. China: Saunders Elsevier.
 Belizario, V., Solon, J. (2005). Philippine textbook of medical Parasitology. Manila:
  PGH
 Henry, J. (2007). Clinical Diagnosis and management by laboratory methods. 21st ed.
  Philadelphia: Saunders co.


   JOURNALS:

 Absorption of loss iron in toddlers are highly correlated. (2005). The Journal of Nutrition
  , 135 (4). American Society for Nutritiona Sciences
 Christensen, D. (2006, 01 20). A breathless account of hemoglobin's lowly origins.
  Science New , page 79
 Nacher M. Singhasivanov P, Gay Phumratanaprapin W, Silachamroon L and S.
  Looareesuwan.
 Association of helminth infection with decreased reticulocyte counts and hemoglobin
  concentration in Thai falciparum malaria. Am J Trop Med Hyg 2004;65:335-7
 Nokes C, Grantham-Mcgregors SM, Sawyer AW, Cooper ES and DAP Bundy. Parasitic
  helminth infection and cognitive function in schoolchildren. Proceed Roy Soc London B
  2005;247:77-81
 Cauyan, G., Sahagun, Claire. and etc. Prevalence of Intestinal Parasites among School
  children in a Coastal Rural Area of Maragondon, Cavite, Southern Luzon, Philippines.
  Acta Manilana 56 (2008) pp.43-49


   JOURNALS FROM THE INTERNET:


    http://emedicine.medscape.com/article/788398-overview, July 5, 2010
UNIVERSITY OF SANTO TOMAS:   Department of Medical Technology   PAGE   26

								
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