A TECHNICAL REPORT ON STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME

(SIWES)

AT
ECWA COMPREHENSIVE HEALTH INITIATIVE MEDICAL LABORATORY

BY

GODSWILL UWEM

FSC/BIO/20/1086

SUBMITTED TO:

DEPARTMENT OF BIOLOGICAL SCIENCE FACULTY OF LIFE SCIENCES

FEDERAL UNIVERSITY DUTSE, JIGAWA STATE.

IN PARTIAL FULFILMENT FOR THE AWARD OF BACHELOR OF SCIENCE (B.Sc)

DEGREE IN BIOLOGY

SUPERVISED

BY

DR. MUNIR GARBA

FROM

JULY 2024 TO JANUARY 2025

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 DEDICATION

I dedicate this report to Almighty God for His love and mercy, to my family for
their unwavering support; and to the people of my country, whose resilience,
innovation, and unwavering spirit continue to inspire progress and innovation.

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 ACKNOWLEDGEMENT

I would like to express my heartfelt gratitude to the entire staff of The ECWA
COMPREHENSIVE HEALTH INITIATIVE KANO (ECHI) for their invaluable
guidance, support, and encouragement throughout the preparation of this report.
Their expertise and insights were instrumental in shaping the direction and quality of
this work.
Special thanks to of The ECWA COMPREHENSIVE HEALTH INITIATIVE
KANO for providing the necessary resources, infrastructure, and environment that
facilitated the successful completion of this report.
I am also deeply appreciative of my colleagues and peers for their constructive
feedback, collaborative spirit, and inspiring discussions, which enriched the
outcomes of this study. To the dedicated individuals at my SIWES placement.
I extend my sincere thanks to my family and friends for their unwavering support
and understanding during this process.
A special mention to Mallam Garba, my SIWES supervisor, whose guidance I
deeply appreciate.

Lastly, my heartfelt gratitude to my level coordinator, Mallama Murjanat, the HOD

of my department, our examination officer, Dr. Munir, and all the lecturers and
staffs, both academic and non-academic. Your efforts in shaping my academic
journey are greatly appreciated.

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 ABSTRACT

This report presents a detailed account about my Student Industrial Work

Experience Scheme (SIWES) undertaken at ECWA Medical Laboratory. The
program aimed to bridge theoretical knowledge with practical skills in medical
laboratory science, encompassing various units such as Hematology, Microbiology,
Biochemistry, Immunology, and Blood Group Serology. Over the twenty four
weeks period, the student participated in critical diagnostic procedures, including
sample collection, processing, and analysis, while gaining hands-on experience in
routine testing, quality control, and laboratory safety practices.

The report outlines key activities, such as blood glucose estimation, bacterial culture
sensitivity, HIV testing, and blood grouping, and describes the operational
principles of advanced equipment like centrifuges and spectrophotometers.
Challenges such as inadequate equipment, reagent shortages, and power outages
were encountered, but practical solutions were implemented to mitigate their
impact.

The SIWES experience provided valuable exposure to real-world laboratory

operations, enhancing the student's technical skills, professional competence, and
problem-solving abilities. Recommendations for laboratory improvements,
including equipment upgrades, better inventory management, and staff training, are
also highlighted to enhance operational efficiency and diagnostic accuracy.

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 TABLE OF CONTENTS

COVER PAGE..........................................................................................................1
TITLE PAGE….........................................................................................................2

DEDICATION..........................................................................................................3

ACKNOWLEDGEMENT….....................................................................................4

ABSTRACT...............................................................................................................5

TABLE OF CONTENTS...........................................................................................6

CHAPTER ONE........................................................................................................8
INTRODUCTION.....................................................................................................8
1.1 INTRODUCTION.........................................................................................8

1.2 STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME (SIWES)

BACKGROUND

1.3 OBJECTIVES of SIWES..............................................................................8

1.4 BODIES INVOLVED IN THE MANAGEMENT OF SIWES....................8

CHAPTER TWO.......................................................................................................9
BACKGROUND OF COMPANY/ORGANIZATION............................................9
2.1 INTRODUCTION.........................................................................................9

2.2 HISTORY.....................................................................................................9

2.3 STRUCTURE OF THE ORGANIZATION.................................................9

2.4 ORGANOGRAM..........................................................................................9

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 2.5 OTHERS DEEMED NECESSARY.............................................................9

CHAPTER THREE..................................................................................................10
THE PROCESS, COMPONENTS & DESCRIPTION...........................................10
3.1 INTRODUCTION......................................................................................10

3.2 PROJECTS CARRIED OUT......................................................................10

3.3 SUPERVISORY WORKS..........................................................................10

CHAPTER FOUR...................................................................................................11
WORKING EXPERIENCE....................................................................................11
4.1 INRODUCTION.........................................................................................11

4.2 PROBLEMS ENCOUNTERED.................................................................11

4.3 PROBLEMS SOLVED...............................................................................11

CHAPTER FIVE.....................................................................................................12
SUMMARY, RECOMMENDATION AND CONCLUSION................................12
5.1 INTRODUCTION...........................................................................................12

5.2 SUMMARY....................................................................................................12

5.3 RECOMMENDATION..................................................................................12

5.4 CONCLUSION...............................................................................................12

REFERENCES........................................................................................................13
APPENDIX

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 CHAPTER ONE
1.1 INTRODUCTION
A clinical lab or medical laboratory in a hospital setting deals with clinician samples
to fetch information about a patient for Diagnosis or prognosis.
Diagnosis results to finding the causative agent of a disease and the type of disease
while prognosis monitors the treatment of a disease, this revealed that diagnosis and
prognosis are the main tools for monitoring disease treatment especially during
disease outbreak.
Actually, the decision of disease treatment depends on the laboratory diagnosis by
which 85% - 90% decision should be based on lab diagnosis. Medical lab has only
four main branches which includes:
Hematology & BGS (the process which analyzes blood, blood related diseases,
blood screening, blood grouping, blood genotype, blood transfusion compatibilities
and cross matching).
i. Medical Microbiology lab: This lab diagnoses mainly microorganisms that
cause a disease in a medical samples & the appropriate Antibiotics will be
recommended.)
ii. Histology: The Medical lab that diagnose tissue samples, It's a laboratory
designated for surgical purpose.)
iii. Chemical Pathology: The lab that deal with chemicals and analyze
Biomolecules and Diagnosis of human body fluid e.g. Blood Glucose level,
Chloride level, Potassium, Urea and Creatinine level. these gives the normal
stability estimation of kidney, livers and other internal organs functioning.
And they also validate the symptoms of some certain diseases such as
Insulinoma, Liver diseases and Diabetes etc.)
iv. Immunology lab: This lab helps in the diagnoses of the presence of HIV/AIDs
virus in human system by using the HIV/AIDs test Algorithm.
In brief, Medical samples are collected base on the type of samples and each samples
have a specific container has stated in WHO regulations e.g. Urine samples in a
Universal container and Swabs sample in a swabs container and others.
In short, Medical lab brings about surety of disease presence in human system and
appropriate treatment for disease through the recommendation of antibiotics, That's
Medical laboratory have 90% impact in human lives savior.

1.2 STUDENT INDUSTRIAL WORK EXPERIENCE

SCHEME (SIWES)

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The Students Industrial work experience scheme (SIWES) is a mandatory program
for all science students in Nigeria specifically life science student, aimed at bridging
the gap between theoretical knowledge and practical skills. The program is designed
to provide students with hands-on experience in laboratory setting e.g. Medical lab,
enabling student to apply theoretical knowledge to real world.
Medical laboratory science is a critical component of healthcare delivery Involving
the analysis of biological and medical samples to diagnose and monitor diseases. The
accuracy and reliability of laboratory results depends on the competence and skills of
Medical lab scientists, Therefore It's essential for students of life and Medical
science to undergo practical training to develop the necessary skills and
competencies.
The SIWES program in Medical laboratory science is structured to provide students
with a comprehensive understanding of laboratory operations, Including Samples
collection, processing and analysis. Students are attached to medical laboratories,
where they work under the supervision of an experienced Medical laboratory
scientist. The program is designed to last for minimum of Six months, during which
students are expected in various laboratory activities, Including routine testing,
quality control and research project.
This report documents my experience during the SIWES program in ECWA Medical
laboratory department, highlighting the skills, knowledge and competence I
acquired, Challenges faced and lesson learned.

1.3 BACKGROUND
The Student Industrial Work Experience Scheme (SIWES) is a program in Nigeria
designed to provide students in tertiary institutions with practical experience in their
chosen fields of study.
SIWES was initiated in 1973 by the Industrial Training Fund (ITF), a body
established by the Federal Government of Nigeria in 1971. The scheme was created
to address the gap between theoretical education in institutions and the practical
skills required in industries.
The primary aim was to enhance students' employability by exposing them to real-
world working environments. It was observed that most graduates lacked the hands-
on experience required by employers, particularly in technical and professional
disciplines like engineering, sciences, technology, and agriculture.
Initially, SIWES was restricted to engineering and technology-based courses but
later expanded to include other disciplines such as agriculture, management sciences,
and education. The program generally lasts for 3-6 months, depending on the
institution and program requirements.

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SIWES is funded by the Nigerian government through the ITF, which reimburses
students and institutions for participation. Academic supervisors visit students at
their workplaces to assess their progress and ensure compliance with the scheme's
objectives.
SIWES remains a critical component of Nigeria's educational framework,
contributing significantly to workforce development and the employability of
graduates.
1.2 OBJECTIVESOF SIWES
 To gain practical experience in Medical Laboratory Science procedures and
technique
 To apply theoretical knowledge in a real world setting
 To develop skills in lab safety, quality control and quality assurance
 To understand the procedures of various test in all units of the medical lab
(Hematology, ANC medical lab, Blood Group serology, Immunology,
Microbiology and Chemical pathology lab unit) and the interpretation of
the tests results.
 To master techniques of blood collection, processing and analysis
 To learn the method of parasitology examination in medical samples i.e
Urine, swabs, sputum and discharge etc.
 To understand the principles and procedures of Microbiological tests
 To gain experience in the use of lab equipment and instruments

• To develop skills in results interpretation and reporting.

1.3 BODIES INVOLVED IN THE MANAGEMENT OF SIWES

Students Industrial work experience scheme in Nigeria is managed by several bodies

and organization. Here are the key players:
 The Federal Government of Nigeria: Provides funding for the scheme
through federal ministry of industrial trade and investment.
 The ITF (Industrial Trading Fund): Formulate policies and guidelines for
SIWES, organizes orientation programs and disburses allowance to
students.

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 National University Commission (NUC): Supervises SIWES in
universities.
 National Board for Technical Education (NBTE): oversees SIWES in
polytechnics and mono technics
 National Commission for College of Education (NCCE): manages SIWES
in college of education in Nigeria.
 Institution of Higher Learning: Participate in SIWES by providing students
for the program and ensuring that students meet the requirements for
participation
 Employers of Labor: Provides placement opportunities for students and
supervise them during SIWES program.

1
0
 CHAPTER TWO
BACKGROUND OF ECWA COMPREHENSIVE HEALTH INITIATIVE

2.1INTRODUCTION
ECWA Comprehensive Health Initiative is one of the leading healthcare facilities
in Kano State, Nigeria, serving as a critical center for medical care in the region.
The hospital plays a vital role in providing accessible, affordable, and quality
healthcare services to the surrounding communities. Established to cater to the
diverse medical needs of the population, it is structured to deliver both general
and specialized care.

2.2 HISTORY
The Evangelical Church Winning All (ECWA) was found in the year 1893 and was
first found in Badagary Lagos in the year 1893.
ECWA as an organization started with the SIM (SUDAN INTERIOR MISSION) by
the following men:
1. Rowland Benham
2. Thomas Ken
3. Walter Gowans
Their mission was to meet up to all black people through; health care services,
educational services and also lot of service.
ECWA comprehensive health center formally known as ECWA DISPENSARY was
brought to Kano in the year 1933 by a British man called Mr Becham who renders
both primary and secondary services to people all over the world. This services
includes:
1. Lab services
2. Consultation services
3. Scanning services
4. Surgery services
5. Immunization services
6. Antenatal services

2.3 STRUCTURE OF THE ORGANIZATION

2.4 ECWA Community Health initiative Kano (founded in 1933), is a mission church under
Evangelical Church Winning All (ECWA). It started as a 5 bed hospital with only two
doctors. Over the years it has evolved to a 35 bed capacity hospital with 2 consultant
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 doctors, 5 Resident doctors, 2 surgeons, 10 staff nurses, 5 Community Health Extension
Workers (CHEW), 6 Administrative/Account staff, 5 laboratory staff, 2 chaplaincy staff
and 10 supportive staff that provide a wide range of supportive care services.
2.5 Its physical structure consists of 3 consultation rooms, a standard laboratory, 5 general
wards, 5 private wards, a reception, record keeping room, 2 injection rooms, a pharmacy,
store, and 6 conveniences.
2.6 The hospital has evolved from the provision of basic services to that of highly specialized
services. It is second to none in sophistication and the provision of quality services with
the possession of standard equipment’s through collaborations with several entities.
2.7
2.8 ORGANOGRAM

2.9 OTHERS DEEMED NECESSARY

Ecwa Comprehensive Health Initiative (ECWA), where the SIWES program was
conducted, serves as a vital healthcare institution in Kano state. The hospital is
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equipped with specialized departments, including the Medical Laboratory
Department, which plays a significant role in diagnosing, monitoring, and treating
diseases.

The Medical Laboratory Department is structured to handle diverse diagnostic needs,

focusing on hematology, microbiology, immunology, chemical pathology, and blood
serology. Each unit is well-organized to cater to specific tests and investigations,
providing students with exposure to routine and advanced laboratory practices.

The hospital operates under a collaborative healthcare model, incorporating qualified

medical laboratory scientists, technicians, and auxiliary staff. This ensures quality
diagnostic services while fostering a conducive learning environment for SIWES
students.

Furthermore, the hospital’s integration into community healthcare delivery highlights

its importance in addressing public health challenges in the region. By engaging in
this program, students not only gain practical skills but also contribute to improving
healthcare outcomes for the local population.

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 CHAPTER THREE
THE PROCESS, COMPONENTS & DESCRIPTION

3.1 INTRODUCTION
This technical report is a detailed documentation of the Student Industrial Work
Experience Scheme (SIWES) conducted at ECWA Comprehensive Health
Initiative (Kano), Medical Laboratory Department. The program aimed to bridge
the gap between theoretical knowledge and practical application in medical
laboratory science, a crucial aspect of healthcare service delivery. This report
encapsulates the hands-on experience gained in various laboratory procedures,
including hematology, microbiology, immunology, and chemical pathology. It
outlines the practical skills acquired, such as sample collection, diagnostic testing,
and results interpretation, while also discussing the challenges faced and lessons
learned during the training.

The focus of the SIWES program was to prepare students for real-world
professional environments by immersing them in routine laboratory operations and
research activities. Through this initiative, the knowledge gained in academic
settings was applied to actual medical practice, enhancing professional competency
and understanding of laboratory science's role in patient care

3.2 PROJECTS CARRIED OUT

During my SIWES program, I was able to participate in eight different

Medical laboratory units of ECWA Hospital, some of the lab have
special time for lecturing student while some doesn't because some
laboratories are always busy with works. Fortunately, we are not only
taught about how to carry out tests in various lab but also the principles,
Procedure, safety precaution of each tests were noted.
The set of laboratories includes:
I. Antenatal care laboratory
II. Hematology lab
III.Microbiology lab
IV. Blood Group Serology lab

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 V. Chemical pathology lab
VI. Reception lab and side lab
Below are the full descriptions of the tests and lectures learned in each laboratory:

3.3 ANTENATAL CARE LABORATORY

This is the lab set apart in a hospital to diagnose the pregnant women medical
samples for the monitoring and detection of infection. The tests in the lab include;
PCV (PACK CELL VOLUME), URINALYSIS and RDT.

3.3.1 PCV TEST

Material needed: methanol or spirit, cotton wool, gloves, lab coat, Micro
hematocrit machine, Capillary tube, Sealer, lancets and PCV reader.
Procedure
a. Methanol or spirit is used to clean the index finger of the patient
b. The lancets is used to prick the finger
c. The blood flowing out is collected into a capillary tube
d. The capillary tube is sealed with a sealer semi-liquid, and get transferred or
arranged inside the Micro hematocrit machine, by which the sealed side
touches the wall of the Micro hematocrit plate.
e. The machine is covered and spin for five minutes
f. After the timing reach, PCV reader is then used to read the result of the Red
blood cells limit in the capillary tube

PCV range:
 Low PCV: <37% for females and <40% for males, Indicating Anemia or blood
loss.
 Normal PCV: 37% - 48% for females and 40% - 54% for males, indicating
healthy red blood cells count.
 High PCV: >48% for females and >54% for males, Indicating dehydration and
others conditions.

3.3.2 URINALYSIS TEST

Urine can be examined by using microscope, color, odor and Re-agent test strip
(Combi-9). however, Combi-9 or Combi-2 is used to analyze urine sample in ANC
lab.
Combi-9 is a medical strip that contains 9 biomolecules and biochemical reagent
that react with the urine sample to diagnose the presence of certain biomolecules,
Infection or disease. This includes:

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  Blood: Yellow (negative)
 PH: Red (negative)
 Glucose: Green (negative)
 Ketones: Chocolate (negative)
 Bilirubin: Yellow (negative)
 Protein: Lemon (negative)
 Nitrogen: Yellow (Negative)

Combi-9 Test strip interpretation

If any of these react with the urine sample, Their color will change and it indicates
infection e.g. if there's too much sugar in the blood, The glucose will change from
green to another color etc. while combi-2 only have protein and glucose as the
biomolecules in the test strip.

16
 Three methods of analyzing Urine sample

3.3.3 RDT TEST (RAPID DIAGNOSTIC TEST)

Material needed: RDT test kit, Test cassette or strip, buffer solution, lancets,
Gloves and lab coat.
Procedure
 Sample collection: Blood is collected from the patient through finger prick.
 Sample preparation: 1 to 2 drops of blood is placed onto the test cassette or
strip and then 1drop of buffer solution is added.

17
  Duration (waiting period): fifteen minutes.
 Results Interpretation:
✓Negative Result: only control line appears.
✓Positive Result: Both the control and test line appear.
✓Invalid Result: No line appear on both control and test line

3.4 HAEMATOLOGY LABORATORY

Hematology is the study of composition, formation, function, diseases and
Investigation of blood. There are four main components of blood namely Red
blood cells, White blood cells, Platelets and Plasma. Also the formation of blood
occur in spleen, bone marrow and liver.
Investigation of blood in hematology lab There are three main investigation of
blood, These are :
1. Hb Genotype.
2. ESR and
3. Full blood count

3.4.1 Hb Genotype
Blood genotype is examined by the use of haemoglobin, However, haemoglobin is
situated inside the red blood cells. Hb Genotype is a genetic constituent or material
inside the red blood cells of a human system.
We have Normal and Abnormal haemoglobin:
1) Normal: A1, A2 Hb in Adults, and F Hb in fetal
2) Abnormal: S, C, D, E, G, H, I, J and K haemoglobin
In Nigeria, we only have A, F and S haemoglobin.

3.4.2 Hb Genotype test

Material needed: cellulose acetate paper, Tris buffer (8.2 - 8.6PH), Electrophoresis
machine, Chamber or electrophoresis tank, Applicator or pipette, Test tube or
Microwave plate, Dilute water, filter paper and blood sample.
Procedure:
a. Using pipette, take a small portion of blood sample and transfer it into a
plain container or a microwave plate depending on the volume.
b. Lyse the blood by adding dilute water.
c. Mix well until the blood lyse perfectly.
d. Gently take the cellulose paper out of its package.
e. Blot the paper with filter paper to make it dry.
f. Use an applicator to apply small portion of the lyse blood onto the cellulose
acetate paper sheet origin.
g. Then, Pour the Tris buffer solution into the chamber or electrophoresis tank.
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 h. Set the acetate paper into the chamber by which the point of haemoglobin
applied is at the negative side of the chamber.
i. Cover the chamber and connect the machine into an electric current (200 -
220volts).
j. Time the setting for 15 - 20 minutes.

Interpretation of Genotype results

3.4.3 ESR (ELECTROCYTE SEDIMENTATION RATE)

ESR is a medical test that is use to determine the rate at which red blood cells
sediment below plasma. the two main purpose of ESR test is to assist in monitoring
the treatment of some diseases e.g. tuberculosis, and it's used in accessing the
degree of inflammation.
Many factors can intervene with the validity of ESR results e.g. vibration,
temperature, time (normal range is 1hour), haemolysis, clot, air bubbles and
Improper position (it must stand 100% vertically).
Two methods of ESR test
Wintrobe method: this method has a tube with two graduations (ascending and
descending order), also it has an anticoagulant Double oxalate, because of the
presence of two oxalate (Ammonium oxalate and sodium oxalate).
Western Green method: western Green has a tube that is longer than wintrobe tube
but it has only single graduation, also it uses sodium citrate as it's anticoagulant.

3.4.4 ESR TEST

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Material needed: ESR tube, Standing rack, Anticoagulant, and blood samples.
Procedure
a. Blood sample is collected into a plain container being ensure that the blood
doesn't clot, haemolyse or have air bubbles.
b. Open the Anticoagulant container and add 2ml of blood sample into the
anticoagulant inside the container to make it 2.5ml.
c. Gently insert the ESR tube into the anticoagulant container top layer by
breaking the first and second layer.
d. Set the ESR tube 100% vertical on the standing rack for 1hour and rea the
result after the timing
e. The result is read at the tube graduation in which the red blood cell
sedimentation limit reach in the plasma.
Normal ESR range : 1 - 15mm/hr
3.4.5 Full blood counts
Full blood counts is a long time process blood analysis that contains 8 different
blood tests together. The tests are listed below:
 Hb genotype
 Pack cell volume
 White Blood cell count
 Red blood cell count
 Mean cell volume count
 Mean cell Hb
 Mean cell concentration
 Differential cell

3.6 MICROBIOLOGY LABORATORY

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Microbiology is the study of microorganisms. In this section of the lab I learned
about the Microbiological medical test and staining in the lab, these includes:
A. Microscopy culture and Sensitivity
B. Acid fast bacillus smear microscopy.
C. Semen Fluid Analysis
D. Gram Staining
E. GeneXpert

3.6.1 Microscopy culture and sensitivity

MC/S is a test use to determine the causative agent of a disease and the right
antibiotics which is bacterial infection. Since mc/s deals with bacteria, bacteria has
some characteristics which involves:
Colonial characteristics:
Size, colour, odour, consistency, opacity, shape, haemolysis, elevation, edge, and
pigmentation (all abbreviated as SCOCOSHEEP).
Also, Haemolytic bacteria (bacteria that can decompose blood) are three: a. Alpha
Haemolytic bacteria (partial) b. Beta hemolytic bacteria (complete) and c. Gamma
Haemolytic bacteria (Non - Haemolytic bacteria).
Moreover, to culture a microorganism, there's a need of agar, therefore preparation
of Agar is essential e.g. Nutrient agar, Mackonkey agar, Chocolate agar and Blood
agar preparation. The difference between chocolate agar and blood agar is the
addition of blood to the chocolate agar.
3.6.2 Blood Agar preparation
Materials Needed: Blood agar base (e.g., trypticase soy agar, chocolate agar or
Columbia agar), Sterile distilled water, Blood samples, Autoclave, Inoculation
loop, Incubator.
Preparation Procedure
a. Weighing the Agar Base: Weigh out the appropriate amount of blood agar
base according to the manufacturer's instructions.
b. Adding Distilled Water: Add the required amount of sterile distilled water to
the agar base.
c. Mixing and Heating: Mix the agar base and water thoroughly, then heat the
mixture until the agar is fully dissolved.
d. Autoclaving: Autoclave the agar mixture at 121°C (250°F) for 15-20
minutes to sterilize it.
e. Cooling: Allow the autoclaved agar mixture to cool to around 45-50°C (113-
122°F).
f. Adding Blood: Add 5-10% v/v sterile blood to the cooled agar mixture. Mix
gently to avoid creating air bubbles.
g. Pouring into Plates or petri dish: Pour the blood agar mixture into sterile
21
 petri dishes, making sure to cover the entire surface.
h. Allowing to Solidify: Allow the agar to solidify at room temperature or in a
refrigerator.
i. Incubation: Incubate the plates at 35-37°C (95-98.6°F) for 24 hours before
use.
To know the exact volume measurement of the blood needed, the formula RV/O is
followed.
Where R = Required volume, V= Given volume and O= Original volume (100%)

Precautions
- Handle the blood agar mixture and plates aseptically to prevent contamination.
- Wear gloves and work in a laminar flow hood or biosafety cabinet when handling
blood and agar.
- Follow proper autoclaving and sterilization procedures to ensure the agar is
properly. sterilized.
3.6.3 Sensitivity Test on Microbial Culture
Materials needed: cultured media, swab stick, forceps, Antibiotics disk, gloves lab
coat and incubator.
Procedure
a. Using a swab stick to pick the bacteria from a given media.
b. Then, make a thoroughly culture on another media i.e. chocolate agar media.
c. By the means of forceps, pick the antibiotics disk and insert it on the culture
media.
d. Incubate for 24 hours at 37°C (body temperature).

Disc diffusion Method

3.6.4 AFB (ACID FAST BACILLI SMEAR MICROSCOPY)

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AFB is a bacterial that results decolonization with acid-alcohol, it has a shape
known as bacilli, AFB test is used for the diagnosis and prognosis of Tuberculosis
disease.
Tuberculosis is an airborne disease causes by a causative agent namely
mycobacterium tuberculosis which also known as mycobacterium complex for
medical personnel. There are two classes of TB base on side of residence in human
body: a. Pulmonary TB (Tuberculosis that affect the lungs) and b. Extrapulmonary
TB (Tuberculosis that affects other part of the body e.g. Pleural cavity). Also there
are two types of TB patient:
i. Follow up patient: Test duration is 48-hrs.
ii. Diagnosis patient: Test duration is 24-hrs.

3.6.5 AFB staining or ZEL-NELSON staining

Material needed: Slide, Cotton wool, Microscope, Primary stain (carbon Fuxin),
secondary stain (methylene blue), decolorizer (alcohol), burden burner, dilute
water, lab coat, lab face mask and hand gloves.
Procedure
a. Prepare a smear on a slide.
b. Heat fix the smear, the reason is make the microorganisms become harmless
and to let them attached firmly to the slide.
c. Apply primary stain carbon Fuxin(pink)
d. Heat until steam is observe, and cool for five minutes.
e. Decolorize with 3% alcohol.
f. Washes with dilute water to rinse away excess stain.
g. Apply secondary stain methylene blue, and then rinse again with water.
h. Wipe the back of the slide, let it dry and prepare for TB microscopy
observation.

3.6.6 Microscopy Test

This is a test to diagnose parasitic infection, Microscopy tests samples are HVS
(High Vagina Swab), stool, Urine, and Sputum. Below are the examples of cells
and microorganisms that can be seen in Microbiological samples.
 Urine: There are mainly six urine samples namely; mid-stream, clear catch,
catheter, Random, 24-hours and Early morning urine sample. Actually, early
morning urine sample are interested to Microbiologists, also boric acid is
used to preserve the urine if motile cells are concerned.
 Urine cells and microorganisms include: pus cell, Red blood cells, Epithelial
cell, Bacterial cell, yeast sperm cell, Cacti (granular, waxy, hyaline, and
cellular), crystal ( including CA+ oxalate, Triple phosphate, Uric acid etc.),
T.vaginalis and schistosoma haematobium and others.
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 Sputum: there are five types of sputum samples, these include mucoid,
prullent, mucopurulent, and salivary. Examples of microbes that can be seen
in sputum samples involves paragomania westermania, Ascaris limbricoides
and others.
 Stools microbes are Hookworms (Acyclostomata duodenoid, Necarto
Americanus, Giardia lamblia, Taenia saginata, Taenia solium and
strongyloides stercolaris.
 HVS (High Vagina Swab) have microorganisms like Trichomonas Vaginalis
and others

URINE MICROORGANISMS AND CELLS

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3.6.7 Semen Fluid Analysis(SFA)TEST
Semen is a fluid consisting of sperm cells and seminal fluid. Sperms cells is also
known as germs cell. The main primary advantage of SFA test is to diagnose and
analyze the infertility of semen. It's a 2 - 3hours test, and SFA sample include
swab, Aspirate and sputum.
There are three methods of semen samples collect, which are coitus interruption,
Masturbation and usage of laboratory condom. Aspermia is a phenomenon use for
males that can't produce semen.
3.6.8 Gram - Staining
Gram staining is a differential staining that is use to distinguish between gram
positive and gram negative bacteria, Gram positive has a cell wall that's made up of
peptidoglycan layer and it absorb only the primary stain during gram staining. The
staining techniques were discovered by Hans Christian Gram. There are two types
gram staining: a. Direct staining (staining of smear directly from the sample) & b.
Indirect staining (staining from the isolate after culture).
There will be nothing like gram staining if there's absence of smear. Smear is
classified into two based on phase, we have liquid smear (smear that doesn't
require addition of normal saline e.g. urine, semen and sputum samples smear) &
solid smear (smear from solid substance and it requires addition of normal saline
e.g. swab and others).
Material needed and procedures for Gram - Staining
Materials needed: slide, sample, bunsen burner, primary stain (crystal violet),
modet (Lugol iodine), decolorizer (95% acetone), timer, secondary stain (safrarin),
dilute water, cotton wool, microscope, Lab coat and gloves.
Procedures
a. Prepare the smear (Thin or Thick).
b. Heat-fix the smear.
c. Cover the smear with the primary stain (crystal violet) for 10 minute to stain
gram positive.
d. Add Lugol’s iodine for one minute, Lugol’s iodine is a modet that function
in crosslinking of the primary stain across the gram positive bacteria cell
wall.
e. Then, Add or cover the smear with decolorizer (95% of acetone).
f. Cover it with safranin (secondary stain) for 5 minutes to stain gram negative
bacteria and washes with dilute water.
g. Wipe the back of the glass, and prepare for microscopy.
25
3.6.9 Gene Expert
This is a test use in the diagnosis of Tuberculosis and early impact of HIV both in
infants and Adult.
Duration: 2-hours
Samples: sputum, stool, urine and aspirate.
GeneXpert Test
Materials Needed: GeneXpert instrument, GeneXpert cartridges, Sample reagent
buffer (SRB), Sample collection tubes, Pipettes and pipette tips, Gloves, Lab coat,
Biosafety cabinet (optional)

GeneXpert Test Procedure

a. Sample Collection: Collect a sample from the patient, such as sputum,
blood, or tissue.
b. Sample Preparation: Prepare the sample for testing by adding a sample
reagent buffer (SRB) to the sample.
c. Cartridge Preparation: Remove a GeneXpert cartridge from the refrigerator
and allow it to reach room temperature.
d. Sample Addition: Add the prepared sample to the cartridge.
e. Cartridge Loading: Load the cartridge into the GeneXpert instrument.
f. Test Initiation: Initiate the test using the GeneXpert software.
g. Result Interpretation: Interpret the results based on the GeneXpert software
output
SKIN SNIFF TEST
This is a test that is used to determined tissue parasite e.g Wuchereria bancrofti,
Dracunculus medinensis and loa loa. It's a 48hours test.

3.7 BGS (BLOOD GROUP SEROLOGY) LAB

In BGS medical laboratory, no test is conducted rather it's called screening, these
screening involves blood screening, blood grouping & Cross-matching for blood
transfusion compatibility, and lastly bleeding of blood.
3.7.1 Grouping of Blood
Materials needed: Applicator or pipette, White tiles, Antiserals (A, B & O or
Rhezoids D).
 Antiserum A: Blue Antisera.
 Antiserum B: Yellow Antisera.
 Antiserum O: white Antisera.

Procedures
a. Put a drop of blood sample on the white tiles in three separate points.
b. Apply the Antiserums onto the separate blood points consecutively.
26
 c. Mix the setting very well with the aid of an applicator.
d. Rock the mixture for 2 to 3 minutes. Analyze the result for agglutination.
Agglutination is the reaction between the antigen (Antiserums) and Antibodies
(blood sample) that leads to the clotting of blood.
Interpretation of Blood Grouping Results
There are A+, A-, B+, B-, O+, O-, AB+ & AB-. Below is the pictorial illustration
of the Blood grouping results interpretation:

Blood Groping results interpretation

27
 : No Agglutination. : Indicating Agglutination.

3.7.2 Blood screening

In BGS lab, There's screening of blood for certain diseases, to ensure that the blood
donor doesn't transmit any disease into the recipient during blood transfusion.
There's screening of blood sample for diseases like Hepatitis B & C, HIV and
syphilis.
Blood screening materials and procedures
Materials needed : HbAgs A,B and C test strip, HIV determine strip, syphilis test
strip, Buffer solution, Applicator or pipette, blood sample, Hand gloves and lab
coat.
Procedures
a. With the aid of an applicator l, apply a drop of blood onto the HbAgS A, B
&C test strip, Syphilis Test strip and HIV determine strip.
b. Apply the buffer solution onto each of the test determine to move the blood
through the strip.
c. Read the results.

Interpretation of Hepatitis B and C results

28
3.8 CHEMPATHOLOGY LABORATORY
This is a medical laboratory also regarded as a clinical chemistry or a biochemistry
laboratory that deals with the analysis of bodily fluids such as urine and blood to
monitor certain diseases.
In a chemical pathology laboratory, there are 6 main Medical test, However 5 are
conducted in my presence namely :
i. Blood Glucose Estimation
ii. Potassium Estimation
iii. Chloride Estimation
iv. Urea Estimation
v. Creatinine Estimation
These test are combined together to know the function of certain organs in the
body system e.g liver and kidney.
3.8.1 Blood Glucose Estimation
This test analyze the level of glucose in blood, be it elevated or decreased which
can lead to series of diseases e.g diabetes mellitus,Insulinoma, and certain liver
diseases. Blood glucose test samples is collected into a specific container called
flouride oxalate(yellow cap), which function as an inhibitor. Due to this container
nature it consist of two chemical compounds which are sodium fluoride and
potassium oxalate, Sodium flouride serve as an anticoagulant while potassium
oxalate serve as an enzyme inhibitor (ENOLASE).
There are four ways of collecting samples for blood glucose estimation, These are:
1. Fasting Blood Collection (FBC): a patient must fast for about 8 - 12 hours
before sample collection, The essence of this FBC is when a clinicial wish to
know the Blood glucose level in vascular system.
2. Random Blood Collection (RBC): an Individual or patient must eat before
the collection of sample, and the blood sample can be collect at any time. the
reason of this RBC is when the clinicial wish to know the actual level of
glucose within muscular system.
3. 2-HOURS Post Parandial (2hpp): these are mostly done after the FBC and
RBC collection, and the blood sample is usually collected from the patient
immediately two hours after the patient eat a Parandial food. The reason of
this blood collection is tk know the function of liver and pancreas.
4. Oral Glucose Tolerance Test(OGTT): this is mainly use as blood collection
path for pregnants that have complaints of high glucose level in their
Random Blood Collection result.OGTT is done at Antenatal care lab in wich
the patient is administered to take glucose D tablet and it's administered base
on the weight of the patient,Then the patient is allowed to rest for 30munites
29
 before the collection of the sample.Now after the glucose estimation is done
on the OGTT sample, It will be compared to the first results from RB
Collection.these comparison can be interpreted in three ways (a. If the
OGTT results is higher than the first RBC results, It's normal diabetic, b. If
the OGTT results is equal to the first RBC results, It's due to pregnancy and
c. When the OGTT results is lower than the first RBC results, it's due to an
infection e.g pancreatic insufficient or liver impairment e.t.c.).

3.8.2 Blood Glucose Estimation Procedure

Materials needed: Micropipette, Reagents(Glucoronic acid, phenol and 4-
aminophenozone), Distilled water, Incubator, Spectrophotometer and test tube.

Blank(optional) Standard Sample

Glucose working 1000μl 1000μl 1000μl

reagent
Standard 10μl
Sample 10μl
The sample need is either Blood plasma or serrum which can be get after
centrifuging the blood.
Mix and Incubate at 37°C for 10minute, Read the absorbance of the standard and
sample against reagent blank at 490-550nm.
Calculation:
Blood glucose utilise this following formula to calculate the level of glucose in the
blood: (Absorbance of Sample × Standard Concentration) ÷ Absorbance of
Standard
=>Glucose concentration standard = 5.6mmol/l
Normal Range of Blood Glucose Estimation :
 Fast Blood Sugar: ( 3.3 to 6.1)mmol/l.
 Random Blood sugar: (3.0 to 8.0) mmol/l.
3.8.3 Chloride Estimation
Materials Needed: Heparinized tube, Centrifuge, Test tubes, Silver nitrate
solution, Potassium chromate solution and Spectrophotometer.
Procedure:
a. Collect a blood sample in a heparinized tube.
b. Centrifuge the sample to separate the plasma.
c. Add 1 mL of plasma to a test tube.
d. Add 1 mL of silver nitrate solution to the test tube.
e. Mix well and allow to stand for 5 minutes.
f. Add 1 mL of potassium chromate solution to the test tube.
30
 g. Mix well and measure the absorbance at 460 nm using a spectrophotometer.
Calculation:
Chloride (mmol/L) = (Absorbance x 100) / (Slope x 1000)
Safety Precautions:
 Wear gloves and lab coat when handling blood samples.
 Use a fume hood when handling silver nitrate and potassium chromate
solutions.
 Avoid skin contact with silver nitrate and potassium chromate solutions.

Centrifuging machine Spectrophotometry machine

3.8.4 Potassium Estimation

Materials Needed:Heparinized tube, Centrifuge, Test tubes, Potassium ISE
solution and Potassium ISE analyzer

Procedure:
a. Collect a blood sample in a heparinized tube.Centrifuge the sample to
separate the plasma.
31
 b. Add 1 mL of plasma to a test tube.
c. Add 1 mL of potassium ion-selective electrode (ISE) solution to the test
tube.
d. Mix well and measure the potential using a potassium ISE analyzer.
Calculation:
Potassium (mmol/L) = (Measured potential x Slope) + Intercept

Safety Precautions:
 Wear gloves and lab coat when handling blood samples.
 Use a fume hood when handling potassium ISE solution.
 Avoid skin contact with potassium ISE solution.

3.8.5 Urea Estimation

Materials Needed:Heparinized tube, Centrifuge, Test tubes, Urease solution,
Phenol hypochlorite solution and Spectrophotometer.
Procedure:
a. Collect a blood sample in a heparinized tube.
b. Centrifuge the sample to separate the plasma.
c. Add 1 mL of plasma to a test tube.
d. Add 1 mL of urease solution to the test tube.
e. Mix well and incubate at 37°C for 5 minutes.
f. Add 1 mL of phenol hypochlorite solution to the test tube.
g. Mix well and measure the absorbance at 550 nm using a spectrophotometer.

Calculation:
Urea (mmol/L) = (Absorbance x 100) / (Slope x 1000)

Safety Precautions:
 Wear gloves and lab coat when handling blood samples.
 Use a fume hood when handling urease and phenol hypochlorite solutions.
 Avoid skin contact with urease and phenol hypochlorite solutions.

3.8.6 Creatinine Estimation

Materials Needed: Heparinized tube, Centrifuge, Test tubes, Alkaline picrate
solution, Spectrophotometer.
Procedure:
a. Collect a blood sample in a heparinized tube.
b. Centrifuge the sample to separate the plasma.
c. Add 1 mL of plasma to a test tube.
d. Add 1 mL of alkaline picrate solution to the test tube.
32
 e. Mix well and incubate at 37°C for 5 minutes.
f. Measure the absorbance at 520 nm using a spectrophotometer.

Calculation:
Creatinine (μmol/L) = (Absorbance x 100) / (Slope x 1000)

Safety Precautions:
 Wear gloves and lab coat when handling blood samples.
 Use a fume hood when handling alkaline picrate solution.
 Avoid skin contact with alkaline picrate solution.

3.9 RECEPTION AND SIDE LAB

These sections of lab in a hospital deal with the diagnosis samples from emergency
patient and massive of patients, Mainly they conducted five test on medical
samples, These medical test are Malaria parasite test, Urinalysis, Pregnancy test,
Pack Cell Volume test and Widal test.In these section, I will report on Three tests,
these are Malaria Parasite test, Widal test and Pregnancy test.

3.9.1 Malaria Parasite Test

A malaria parasite test is a diagnostic procedure used to detect the presence of
malaria parasites in a patient's blood. The test helps in diagnosing malaria and
determining the type of Plasmodium species causing the infection (e.g.,
Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium
ovale, or Plasmodium knowlesi).

Malaria has affected humans for thousands of years. The earliest records date back
to ancient Chinese texts (2700 BCE) and Greek medical literature.Charles Louis
Alphonse Laveran discovered malaria parasites in 1880, earning a Nobel Prize in
1907.Giovanni Batista Grassi established the role of Anopheles mosquitoes in
malaria transmission in the late 19th century.

Malaria is most prevalent in tropical and subtropical regions, especially in sub-

Saharan Africa, Southeast Asia, South America, and parts of the Middle
East.Countries near the equator with warm climates and stagnant water bodies are
hotspots for malaria transmission.
Treatment depends on the species of Plasmodium and the severity of the infection.
Common Antimalarial Drugs:
Chloroquine: Effective against sensitive strains of P. vivax and P. ovale.
Artemisinin-based combination therapies (ACTs): Recommended for P.
falciparum.
33
Primaquine: Used to eliminate liver-stage parasites of P. vivax and P. ovale.
Quinine: Used for severe malaria.

Prevention:Mosquito Control[Use insecticide-treated bed net(ITNs)], Preventive

Medications(Chemoprophylaxis for travelers to malaria-endemic areas), Personal
Protective Measures(Wear long-sleeved clothing&Use mosquito repellents).
Vaccination
The RTS,S/AS01 (Mosquirix) vaccine offers partial protection against P.
falciparum.

Procedure of Malaria Parasite Staining

Materials Needed: Glass microscope slides, Giemsa stain (stock solution),
Buffered water (pH 7.2), Methanol (for fixation), Microscope with oil
immersion lens, Immersion oil, Staining rack or tray, Clean cotton or tissues.

Steps for Staining

a) Thin Blood Smear Preparation:Spread a drop of blood evenly on a
microscope slide to create a thin layer.
b) Thick Blood Smear Preparation:Place a larger drop of blood and spread it
into a thicker layer.
c) Fixation (For Thin Smears): Fix the thin smear by dipping it in methanol.
Avoid fixing thick smears.
d) Staining:Use Giemsa stain, which is specific for staining malaria parasites.

Reagent Preparation
Giemsa Stain:Prepare a 10% working solution using Giemsa stock solution and
buffered water (pH 7.2).

Staining Procedure
a. Place the blood smear on a staining rack.
b. Flood the slide with Giemsa stain (diluted).
c. Allow the stain to act for 10–20 minutes.
d. Rinse the slide gently with buffered water.
e. Air-dry the slide without blotting.

Microscopy Observation
Examine the stained slide under an oil immersion lens (100x objective).
Identify malaria parasites based on their morphological features, such as rings,
trophozoites, schizonts, and gametocytes

34
 Plasmodium. Falciparum stages.

P.falciparum and P.vivax stages

3.9.2 Widal Test

The Widal test is a serological test used to diagnose typhoid fever. It detects
specific antibodies (agglutinins) in the patient's blood against the Salmonella typhi
and Salmonella paratyphi antigens.

35
 WIDAL TEST ON BLOOD SAMPLES

Causative Agent of Typhoid:Typhoid fever is caused by the bacterium

Salmonella enterica serotype Typhi. A similar illness, paratyphoid fever, is caused
by Salmonella enterica serotypes Paratyphi A, B, and C.
Typhoid fever has been known since ancient times and was widespread before
improved sanitation practices.

The Widal test was developed by Georges-Fernand-Isidore Widal in 1896. It

became a standard method for typhoid diagnosis.
Typhoid fever is endemic in regions with poor sanitation and limited access to
clean drinking water. These regions include: South and Southeast Asia, Sub-
Saharan Africa, Central and South America.

Prevention
Sanitation and Hygiene: Proper disposal of human waste, clean water supply, and
personal hygiene practices.

Vaccination: Two types of vaccines are available: Ty21a (oral, live attenuated
vaccine) and Vi polysaccharide vaccine (injectable)

Treatment
Antibiotics: First-line antibiotics(Ciprofloxacin, Azithromycin, or
Ceftriaxone).Drug resistance is a growing concern, requiring sensitivity testing.
Supportive Care: Rehydration therapy and nutritional support.

3.9.4 Widal Test Procedure

36
Materials Required: Patient's serum sample, Antigens (commercially prepared S.
typhi O and H antigens and S. paratyphi A and B antigens), Test tubes or slide (for
slide agglutination method) or white tiles, Pipette and Saline solution.

Test Procedure:
a. Sample Collection:Collect 2–5 ml of venous blood.Allow the blood to clot,
then centrifuge to separate the serum.
b. Preparation:Dilute the patient’s serum in saline solution for the tube
method.Place a drop of serum on a glass slide for the slide or white tiles
method.
c. Agglutination:Add specific antigens (S. typhi O, S. typhi H, S. paratyphi A,
and B) to the diluted serum (tube) or directly on the slide or white tiles .Mix
and observe for agglutination (clumping).
d. Interpret Results: Agglutination indicates the presence of antibodies against
the respective antigen.

Interpretation of Widal Test Results

Reactive vs. Unreactive method:
Reactive: Agglutination is visible. This suggests the presence of antibodies
Indicating a current or recent typhoid infection.
Unreactive: No agglutination is observed. This suggests the absence of a typhoid
infection.

3.9.5 Pregnancy test

A pregnancy test detects the presence of the hormone human chorionic
gonadotropin (HCG) in a person's urine or blood to confirm pregnancy. HCG is
produced by the placenta shortly after a fertilized egg attaches to the uterine lining.
HCG (Human Chorionic Gonadotropin): A hormone secreted by cells of the
developing placenta. It supports the maintenance of the corpus luteum, ensuring
the production of progesterone, essential for sustaining pregnancy. HCG levels
increase rapidly in early pregnancy.

37
 Pregnancy Test Determine Strip

Procedure for a Pregnancy Test

Materials Needed:Pregnancy test kit (urine-based or blood-based test)
, Clean collection container (for urine sample), Timer or clock.

Procedure for a Urine Pregnancy Test(can be done at home):

a. Preparation: Read the instructions specific to the test kit. Use the first
morning urine, as it has the highest concentration of HCG.
b. Collect the Sample: Either urinate directly on the test strip or collect urine in
a clean container and dip the test strip into it (as per the instructions).
c. Wait for the Results: Place the test strip on a flat surface and wait for the
specified time (usually 3–5 minutes).
d. Interpret the Results: Check for lines or symbols as per the instructions in
the test kit.

Procedure for a Blood Pregnancy Test (Done in medical lab):

a. Blood sample is collected and centrifuge for 10minute.
b. The HCG PT test strip is dip into the centrifuge blood sample
c. Result is read after 30 minutes

Interpretation of Pregnancy Test Results

 PositiveTwo lines, a plus sign, or the word "pregnant" (depending on the kit)
indicate pregnancy.
 Negative: One line, a minus sign, or the word "not pregnant" indicates no
detectable HCG in the urine.
 Invalid: If no control line appears, the test is invalid and should be repeated.

38
3.10 IMMUNOLOGY LABORATORY
An immunology laboratory specializes in studying and analyzing the immune
system to diagnose, monitor, and manage immune-related disorders, infections,
and diseases. It employs various immunological techniques, such as serological
tests and molecular assays, to detect antibodies, antigens, and immune cell
activity.Diagnostic tests in an immunology lab includes:
 HIV/AIDs.
 CD4 counts test.
 Hepatitis B and C
 TB lam
 DBS blood collection.
 EID test.

3.10.1 HIV/AIDS
HIV (Human Immunodeficiency Virus) belongs to the family Retrovidae and sub-
family lentrividae, HIV is classified into two classes namely HIV-1(more potent
and prevalent) & HIV-2, it was firstly found in the world in 1981, and Nigeria in
1983.
HIV virus attacks the immune system, particularly CD4+ T cells(located inside
leukocytes of the white blood cells), weakening the body's ability to fight
infections.
AIDS (Acquired Immunodeficiency Syndrome) is the advanced stage of HIV
infection, marked by a critically weakened immune system and increased
susceptibility to opportunistic infections and certain cancers. Early detection,
regular monitoring, and antiretroviral therapy (ART) are crucial for managing HIV
and preventing its progression to AIDS.

Route of HIV/AIDs transmission: Sexual contact, Contaminated blood

transfusion, using of unsterilized instrument, vertical transmission from an
infectious mother to child during pregnancy or breastfeeding.
HIV Route test Algorithm
Algorithm is the set of test performed on a patient with sign or symptoms of HIV,
There are two HIV algorithms, These involves Serial and Parallel, Serial algorithm
is recommended by WHO in Nigeria.so, my report will be base on serial algorithm
only.
Serial Algorithm is use mostly for Rapid diagnosis, The test kit recommended for
serial are:
1) Determine (Unigol) having 99% sensitivity
2) Confirmatory (Unigol)

39
 3) Tie breaker ( Stat-pak).
Any test kit having 99% sensitivity must be approved by the honourable minister
of health and Government agency.

3.10.2 HIV/AIDs test

Material needed: Determine kit, Unigol kit, Stat-pak kit, buffer solutions,
centrifuging machine, Blood samples, PPE, Applicator and Timer.
Procedure
Firstly, The blood sample is spin using centrifugung machine to separate the red
blood cells and the plasma if there's no buffer solution, When there's buffer,the
whole blood can be used.

HIV Test-type Test kit Duration Sample

measurements
Screening Determine 15 minutes 50μl
Confirmatory Unigol 10 minutes 60μl
Tie-breaker Stat-pack 10 minutes 5μl

WHO guidelines: To confirm for HIV test positivity, Two test kit must be positive.

3.10.3 CD4 Test

The CD4 test measures the number of CD4+ T cells in the blood to assess immune
function in HIV patients.
Materials Needed: Blood collection tubes (EDTA preferred), CD4 cassette and
Buffer solution
Procedure
a. Collect a blood sample from the patient.
b. Label and prepare the sample for cd4 count test.
c. Put a drop of blood onto well A and wait for 3 munites
d. Add a drop buffer solution on the blood spot and wait for another 17
e. Add 3 drops of buffer on well B and wait for the last five munites
Read the results

Interpretation of Results:
 If the 200 line is thicker than T line, It means CD4 count < 200
 If 200 line is lighter than T line, It means that CD4 couns > 200
 If CD4 count line is equal to 200 line, It means that CD4 counts is equal or
below 200.
HIV patients with CD4 counts <200 cells/µL are at high risk for opportunistic
infections and meet the criteria for AIDS.
40
 CD4 counts test interpretation

3.10.4 Early Infant Diagnosis (EID)Test

EID detects HIV infection in infants under 18 months, primarily through nucleic
acid-based methods like PCR.

Materials Needed: Dried blood spot (DBS) collection cards, PCR equipment and
reagents, Blood sample collection materials
Procedure
Collect a blood sample via heel prick or venipuncture.
Prepare dried blood spots on specialized collection cards.
Perform DNA PCR to detect HIV proviral DNA in the sample.

Interpretation of Results
 Positive: Indicates the presence of HIV DNA, confirming infection.
 Negative: No HIV DNA detected; retesting may be needed after
breastfeeding or exposure risk.

3.10.5 Hepatitis B and C Tests

41
These tests identify infection with Hepatitis B virus (HBV) or Hepatitis C virus
(HCV) through serological or molecular methods.

Materials Needed:Blood collection tubes, ELISA kits for HBsAg (HBV)

containing the determine strip and buffer.
Procedure
a. Collect a blood sample.
b. Add a drop of blood on the HBsAg determine strip.
c. Add a drop of buffer solution and time it for 20 minutes
Interpretation of Results:
HBV: HBsAg positive or detectable
Positive if there's presence of both control and test line, Negative if there's
presence of only control line.

3.10.6 TB LAM (Lipoarabinomannan) Test

TB LAM is a diagnostic test to detect lipoarabinomannan, a component of
Mycobacterium tuberculosis, in urine.

Materials Needed: Urine sample collection containers, TB LAM test strips or kits

Procedure
a. Collect a fresh urine sample.
b. Apply the sample to the test strip as per kit instructions.
c. Incubate and read results within 15 minutes

Interpretation of Results:
 Positive: Indicates TB infection, particularly in HIV-positive individuals
with low CD4 counts.
 Negative: No detectable TB LAM; other diagnostic methods may be needed.

3.10.7 Dried Blood Spot (DBS) Collection Procedure

Materials needed: Filter paper/DBS Cards, Sterile Lancets, Alcohol Swabs,
Gauze or Cotton Balls, Gloves, Drying Rack, Biohazard Disposal Bags, Plastic
Bags or Envelope, Temperature-Contrlled Storage(If required), and Pen or Maker
Procedure
a. Ensure the infant is calm and lying down, typically done at 6 weeks or older.
b. Blood Collection: Use a sterile lancet to puncture the infant's heel (for
infants ≤12 months).Collect blood drops onto specialized filter paper (DBS
card).
c. Drying: Allow the blood spots to air dry completely (3–4 hours).
42
 d. Packaging: Place the DBS card in a protective pouch with desiccants to
prevent moisture.
e. Storage and Transport: Store at room temperature and transport to the lab
within the recommended time.

Significance of DBS in Infants

 Facilitates early diagnosis of HIV, especially for EID testing in resource-
limited settings.
 Requires minimal blood, making it suitable for infants.
 Easy to store and transport, even without refrigeration.
 Critical for timely initiation of ART in HIV-positive infants.

SUPERVISORY WORKS

CHAPTER FOUR
WORK EXPERIENCE, PROBLEM ENCOUNTERED AND PROBLEM
SOLVED

INTRODUCTION
During my SIWES program at Medical laboratory department general hospital
dutse, I had the opportunity to acquired practical knowledge and skills related to
laboratory science. The laboratory specializes in hematology, microbiology,
biochemistry, and pathology and Immunology. My duties included assisting in
sample collection, preparing reagents, performing routine tests, maintaining
laboratory equipment, and ensuring proper documentation of results. This
experience allowed me to bridge the gap between theoretical knowledge and
practical application in a real-world medical setting.My siwes experience lasted for
nineteen weeks, during which I gained hands-on experience in various laboratory
procedures and setting.

Work Experience
During my SIWES program, I was involved in various laboratory activities,
Including:
1. Sample collection and processing
2. Haematology testing (e.g., glucose, urea, creatinine, genotype, blood
grouping, and others).
3. Microbiology testing (e.g., bacterial culture, antibiotic sensitivity)
4. Immunology testing (e.g., HIV, hepatitis)
I worked under the supervision of experienced laboratory scientists and technician,
who guided me through the various laboratory procedures and techniques.

43
Problem Encountered
During my SIWES program, I encountered several challenges, including:

1) Inadequate laboratory equipment: The laboratory lacked some essential

equipment, such as automated analyzers which made it difficult to perform
some tests efficiently.
2) Limited reagent availability_: The laboratory sometimes ran out of essential
reagents, which delayed testing and reporting of results.
3) Power outages: The laboratory experienced frequent power outages, which
affected the operation of equipment and delayed testing.
4) Difficulties to interpret the results of tests in some lab unit e.g Combi-9
results interpretation of urinalysis in Side lab.

Problem Solved
To address these challenges, I suggested the following solutions:
1) I seeked help from the lab guidance or supervisor about the test results I
can't interpret, and sometimes I made self research if it's not much.
2) The lab implement more Solar power batteries and panel to have sufficient
power supply during government power outage moments.
3) The laboratory management petition the Laboratory materials supplier to
increase the amount of materials purchasing due to increase in patients
sample diagnosis

CHAPTER FIVE
SUMMARY, RECOMMENDATION AND CONCLUSION

5.0 SUMMARY
The report comprehensively details the Student Industrial Work Experience
Scheme (SIWES) undertaken at the Ecwa Comprehensive Health Initiative
(KANO). The program aimed to bridge theoretical knowledge with practical skills
in medical laboratory science. The report elaborates on the organization’s
structure, activities, and challenges, highlighting the student's involvement in
diverse laboratory practices such as sample collection, blood analysis,
microbiological tests, and immunological diagnostics. Emphasis is placed on
problem-solving approaches to address issues like inadequate equipment, reagent
shortages, and frequent power outages. The practical training equipped the student
with technical expertise, professional ethics, and problem-solving skills vital for
real-world applications.

44
5.1 Recommendations
Based on my SIWES experience, I recommend the following:

1) Regular training and workshops: Laboratory staff should participate in

regular training and workshops to update their knowledge and skills.
2) Equipment upgrade and Maintenance Schedule: The laboratory should
consider upgrading its equipment to automated analyzers to improve
efficiency and accuracy, also the laboratory management should implement
a strict maintenance schedule for all equipment to prevent unexpected
breakdowns.
3) Quality control and assurance: The laboratory should establish a robust
quality control and assurance program to ensure accurate and reliable test
results.
4) Inventory Management: An automated inventory system should be adopted
to monitor reagent levels and trigger restocking alerts.
5) Power Backup Systems: The laboratory should invest in reliable backup
power systems such as inverters or generators to address power issues.
6) This report highlights the hands-on experience gained, the challenges faced,
and practical solutions implemented during my SIWES program at Medical
laboratory department General Hospital Dutse. The recommendations
provided aim to enhance the efficiency and reliability of the laboratory’s
operations.

5.3 CONCLUSION

The SIWES program was instrumental in providing hands-on experience and

aligning academic learning with professional practice. The exposure to various
medical laboratory units enabled the development of technical skills and critical
thinking abilities. Addressing challenges during the program not only enriched my
learning experience but also emphasized the importance of resourcefulness and
adaptability. Recommendations to improve laboratory operations, including
equipment upgrades, better inventory management, and staff training, promise to
enhance the efficiency and reliability of medical services. This experience
underscores the indispensable role of SIWES in preparing future professionals in
medical and life sciences.

45
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