THE KISUMU NATIONAL POLYTECHNICH

INDUSTRIAL ATTACHMENT REPORT

INSTITUTION: KENYA MEDICAL RESEARCH INSTITUTE (KEMRI)

DURATION : FROM JANUARY14TH - 14THAPRIL

NAME : BEATRICE ATIENO ODUOR

COLLEGE : THE KISUMU NATIONAL POLYTECHNICH

COURSE : DIPLOMA IN APPLIED BIOLOGY

DEPARTMENT: APPLIED SCIENCES

ADM NUMBER: DAPB/J19/026

LEVEL : MODULE II

SUPERVISORS:

1. COLLEGE: MR. STEPHEN OKIRI

2. KEMRI: MR. WALTER OLOO

Table of Contents
Declaration.....................................................................................................................................................3
Recommendation............................................................................................................................................4
ACKNOWLEDMENT...................................................................................................................................5
DEDICATION...............................................................................................................................................6
1.4 LIST OF ABBREVIATIONS..................................................................................................................7
CHAPTER 1.0................................................................................................................................................8
INTRODUCTION:.........................................................................................................................................8
1.1 clinic laboratory........................................................................................................................................8

 Blood smear for malaria...............................................................................................................8

 Brucellosis test.............................................................................................................................8
 Typhoid test..................................................................................................................................8
 Syphilis test..................................................................................................................................8
 Random blood sugar....................................................................................................................8
 Urinalysis.....................................................................................................................................8
 Pregnancy test..............................................................................................................................8
 HIV test........................................................................................................................................8

Blood smear for malaria.................................................................................................................................9

1.3. EntomologyLaboratory (WRP/BIOASSAY)..........................................................................................9

Identification of male and female mosquito...................................................................................................9
1.4. Microbiology laboratory/Enterics laboratory........................................................................................10
Classes of media...........................................................................................................................................10
Malacology laboratory..................................................................................................................................11
KATO KAT’S TECHNIQUE......................................................................................................................11
Tools required...............................................................................................................................................11
Procedure of KATO KAT’S TECHNIQUE.................................................................................................11
Insecticide laboratory...................................................................................................................................12
Gel electrophoresis.......................................................................................................................................12
1.6. Other laboratories..................................................................................................................................13
CHAPTER 2.0..............................................................................................................................................13
HISTORICAL BACKGROUND OF KEMRI/CDC/WALTEREED PROJECT........................................13
2.1 CORPORATE MISSION, VISION AND MOTTO..............................................................................13
VISION.........................................................................................................................................................13
MISSION......................................................................................................................................................13
MOTTO........................................................................................................................................................14
2.2.OBJECTIVES OF KEMRI.....................................................................................................................14
2.3. PROFILE OF CGHR.............................................................................................................................14

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CHAPTER 3.0..............................................................................................................................................15
MANDATES OF CENTRE FOR GLOBAL HEALTH RESEARCH (CGHR)..........................................15
3.1PROGRAMMES.....................................................................................................................................15
3.2 .INFECTIOUS DISEASE......................................................................................................................16
3.3 .SIZE OF THE WORK FORCE.............................................................................................................16
CHAPTER 5.0..............................................................................................................................................17
DESCRIPTION OF THE DEPATMENTS..................................................................................................17
5.1. IMMUNOLOGY LABORATORY.......................................................................................................17
CHAPTER 6.0..............................................................................................................................................19
ORGANIZATION’S WORK FORCE.........................................................................................................19
6.1. COMMENT ON THE INSTITUTES MODE OF:-..............................................................................19
(a) .Hiring and Training Practices................................................................................................................19
(b). Labour Organization (Trade Unions)....................................................................................................20
(c). Plant / Equipment (Description and capacity).......................................................................................20
CHAPTER 7.0..............................................................................................................................................21
PRODUCTION PROCESS AND QUALITY CONTROL..........................................................................21
7.1. Current Technology in use....................................................................................................................21
7.2. Working Condition................................................................................................................................21
7.3. Safety at the work place........................................................................................................................21
7.4. OWN SELF ANALYSIS DURING MY ATTACHMENT PERIOD..................................................22
CONCLUSIONS AND RECOMMENTATIONS.......................................................................................23
INTRODUCTION........................................................................................................................................23
CONCLUSIONS..........................................................................................................................................23
RECCOMENDATIONS..............................................................................................................................24
REFERENCES.............................................................................................................................................25

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Declaration

I BEATRICE ATIENO ODUOR declare that this is my original work and has not been submitted to by
anybody else as his/her report.

Recommendation

This report has been submitted with your recommendation as my institute led supervisor.

Institute supervisor

Mr. STEPHEN OKIRI

Signature………………………

Date………………………

Stamp

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 ACKNOWLEDMENT

My acknowledgment goes to all who were responsible in seeing me through my attachment. This was due
to their encouragement, cooperation and support.

Special thanks goes to Ag.Chief Laboratory Technologist Kemri CGHR Kisumu Mr. Walter Oloo, and the
supervisor Mr. Stephen Okiri for their tireless assistance and their intellectual guidance that enables me to
pursue my practical learning on attachment.

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 DEDICATION
I hereby dedicate this report to my parents Miss.CARREN OTIENO ,classmates and friends for their
tireless effort and support towards the success of my attachment. May God bless them all.

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1.4 LIST OF ABBREVIATIONS

KEMRI: Kenya medical research institute

CPR: cardio pulmonary resuscitation

CDC: center for disease control and prevention

BSC: biosafety cabinet

BMBL: biosafety in microbiological and biomedical laboratory

WHO: world health organization

DLSP: Diagnostic laboratory system program

PPE: personal protection equipment’s

DOLSO: deputy overall laboratory safety officer

GLP: good laboratory practice

DOHP: division of global health protection

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CHAPTER 1.0

INTRODUCTION:

KEMRI CGHR Program is a collaboration agreement between Centers and Diseases Control and
Prevention (CDC) and Kenya Medical Research Institute (KEMRI) to conduct medical research. The
Program is to develop and test improved means for predicting detecting, preventing and treating infectious
Diseases. The Program is expected to carry out research and release findings which are accurate timely
and which other Research institutions can rely upon.

In Kemri there are number of Laboratories which help to facilitate the Research Findings on various
diseases that poses serious threat to human health. Among these Laboratories that help in carrying out
research are:

1.1 clinic laboratory

Clinic is set where samples from various patients are received and various tests are carried out. Most
frequently conducted test in the laboratory
 Blood smear for malaria
 Brucellosis test
 Typhoid test
 Syphilis test
 Random blood sugar
 Urinalysis
 Pregnancy test
 HIV test
 Serology for brucellosis - It’s a science dealing with blood serum and immunological reactions and
properties.
 Urinalysis - Is a set of screening test that can detect some common deseases.This help to diagnose
such as urinary factinfections, kidney disorders and diabetes. There are two types of urinalysis test and
these are.
 Macroscopic -these is done to check the physical appearance of the urine. The normal urine was
clear and amber.
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  Microscopic –a sample of well mixed urine is centrifuged in a testube at relatively low speed at
about 200-300 for 5min

Blood smear for malaria

There are two types of blood smear and these are thick blood smear which concentrates the parasites
and the thin smear help look at the proper morphology of the parasite
Widal test-It’s a test that is used to know whether the person is infected with salmonella typhi

1.3. EntomologyLaboratory (WRP/BIOASSAY)

 It is located in CGHR Kisian Branch that deals with the mosquito rearing / breading, their control and
mode of feeding e.g. on fresh blood from animals such as rabbits and rats. Also studies on how they
transmit malaria species e.g. Plasmodium ovale.Plasmodium vivax, Plasmodium falciparum and
Plasmodium malaria to human beings and how they can be controlled.
 Here there is also mosquito dissection done and also Polymerase Chain Reaction on Mosquitoes by
extracting the Deoxyribonucleic Acid from the mosquito (also done to identify difference mosquito
sibling species of Anopheles Gambiea mosquito.
 Here they are also concerned with the malaria infecting mosquitoes such as: - Anopheles gambiea and
the Anopheles funestas.
 There is also Bio assays done in this Laboratory to determine the efficacy of various nets and
insecticides to mosquitoes. This is done by the use of Insecticide Treated Nets which do prevent the
humans from the mosquito bites and increases the mosquito’s mortality rate

Identification of male and female mosquito

 Male mosquitos have bushy antennae while the antennae of female mosquitos are not bushy

 Female mosquitos have long proboscis as compared to male proboscis

 Female mosquitos are larger than the male mosquitos

 The life span for female mosquitos is one month and those for male mosquitos is two weeks

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1.4. Microbiology laboratory/Enterics laboratory

 This laboratory deals with the study of the alimentary canal i.e. to know the causative agents of
diseases e.g. the Bacteria etc.There is also preparation and study of difference media (media is what is
needed to facilitate the bacteria’s growth i.e. it enhances the bacteria’s growth).A bacterial culture is also
done to identify the causative agent of the disease.

There are two broad categories of media;

 Broth media-it’s a liquid media

 Agar media-it’s a solid media

Classes of media

 Basal media-supports all kinds of bacteria

 Storage media-used for long term storage of isolate e.g TSB
 Enriched media-exranutritional requirement have been added to enhance to enhance growth of
certain bacteria,fasteria organisms require special treatment to grow like campalobactor
 Enrichment media-enhance multiplication of bacteria of intreste.g selenite ficalbroth,APW
 Transport media-used to maintain viability of bacteria so that they reach the lab alive e.gcaryblaire
and bafad glycerol saline
 Selective media-allows growth of specific group of bacteria to grow,e.gTCBS,Karmaly Ryan
 Differencial media-allows to distinguish between one microbe from another,
egMacConkey,XLD,HEA

Malacology laboratory

Malacology is the study of snails with medical or vetenaryimportance.Snails can be easily categorized
according to families,

The known family is planorbidae

Various snail species

1. Cornuaspersum
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2. Giant Africa snails
3. Burgundy snail
4. Achatinaachatina
5. Lymnaeastagnalis
6. Grove snails
7. Helix lucorum patella ferniginea

KATO KAT’S TECHNIQUE

This is a technique for diagnosis of schistosomiasis

Tools required

1. Stool sample
2. Template
3. Modified sieve
4. Slide labbled
5. Magazine
6. Forcept

Procedure of KATO KAT’S TECHNIQUE

i. Place small amount of feacal material on a newspaper and press a piece of nylon screen on top so
that some of the feaces are sieved through the screen and accumulate on top using a spatula
ii. Scrap up some of the sieved feaces to fill the hole in the templates avoiding air bubbles and
levelling the feaces off to any excess
iii. Carefully lift the template off and place it in a bucket of water mixed with concentrated detergent
so that it can be rinsed and re-used
iv. Place a piece of cellophane which had been soaked in methylene blue over the feaces sample
v. Invert the microscope slide and press the feacal sample firmly against the hydrophic cellophane
strip on another microscope slide or on a smooth hard surface.Thefeacal material will be spread
evenly and between the microscope slide and the cellophane strip
vi. For all hookworms eggs keep the slide for one or more hours at a room temperature to clear the
feacal material prior for investigation under the microscope to speed up cleaning
vii. Ascarislumbricoids and Trichiuristrichiura eggs will remain visible and recognizable for many
months in these preparations.Houkworm eggs clear rapidly and will nolonger be visible after 30-
60minutes

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viii. Schistosome eggs may be recognized for upto several months.

Insecticide laboratory

Here they deal with the two mosquito viruses that is;Chikungunya and Dengue virus.

Gel electrophoresis

This is a method for separation and analysis of macromolecules and their fragments based on their size
and charge.Under gel electrophoresis we found that DNA molecules can be moved through a gel mode of
agar.

RNA extraction is done where sample are lysed and homogenise in lysis buffer which contains guanidine
thiocyanate a chaotropic salt capable of protecting RNA from endogeneneousRNases.The lysate is then
mixed with ethanol and loaded on a purification column.Thechaotrophic salt and ethanol causes RNA to
bind to the silica membrane while the lysate is spun through the column two.Subsiquently impurities are
effectively removed from the membrane by washing the column with wash buffer.Pure RNA is then
eluted under low ionic strength condition with nuclease-free water

After RNA has been extracted Cdna[copy deoxyribonucleic acid] synthesis is done and then polymarase
chain reaction is done to detect the presence of Dengue and Chikungunya viruses

The objective of PCR is to detect the presence serotype of dengue virus in human serum samples. The
principle is to use standard PCR to identify the presence of dengue virus cDNA in clinical samples that
have had total RNA extracted and preferentially reverse transcribed for this virus.In positive samples
dengue virus will then be serotyped using a multiplex standard PCR.

1.6. Other laboratories

Parasitology,Ummas, Case Western and Indiana among others which are located in Nairobi which is the
Kemris’ Headquarter. These laboratories also carry out research just as those in Kemris’ CGHR Kisumu
Branch.

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 CHAPTER 2.0

HISTORICAL BACKGROUND OF KEMRI/CDC/WALTEREED PROJECT.

The Kenya Medical Research Institute (KEMRI) is a state corporation established through the science and
technology (Amendment Act) of 1979, as the national body responsible for carrying out health research in
Kenya KEMRI has grown from its humble beginning 27 years ago to become a regional leader in human
health research. The institute currently ranks as one of the leading centers of excellence in health
research both in Africa as well as globally.

2.1 CORPORATE MISSION, VISION AND MOTTO

The corporate mission is to broaden its service provision to esteemed organizations all over the country
with a vision of setting up sub branches throughout the country.

VISION.

“To be a leading centre of excellence in the promotion of quality health”.

MISSION

“To improve on the quality of health and human life through research”.

MOTTO

“In search of Better Health” towards realization of the above stated mission.

2.2. OBJECTIVES OF KEMRI

 To conduct research in human health.

 To co-operate with other organization and institution of higher learning in training programmers and
matters of relevant research.
 To liaises with other relevant bodies within and outside Kenya carrying out research and related
activities.
 To disseminate and translate research findings for evidence –based policy formulation and
implementation.

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 To co-operate with the ministry of Health, the Ministry for the time being responsible for medical
research, the national council for science and technology and the Medical science Advisory Research
Committee on matters pertaining to research policies and priorities.
 To do all things as appear to be necessary , desirable or expedites to carry out its function.

2.3. PROFILE OF CGHR

 The Centre for global Health Research is located in western Kenya.

 It is one of the Ten Research Institute .The facility was originally inherited from the former East
Africa Council (EAC) Medical Research Council.
 During the establishment of the Institute in 1984, its was named Malaria and Other Protozoa Diseases
Centre for Global Health Research (CVBCR) and the recent times Center for Global heath Research
(CGHR)

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 CHAPTER 3.0

MANDATES OF CENTRE FOR GLOBAL HEALTH RESEARCH (CGHR)

The Centre is mandated to carry out research in the following areas:

 The Biology of vectors their vectorial capacities and control strategies based on biological,
Chemical and genetic approaches.
 Vectors of bacterial and viral diseases.
 HIV/AIDS/STI
 Malaria vaccine field trials ,molecular biology of parasites and socio-cultural issues in vector
control

3.1PROGRAMMES

 INFECTIOUS DISEASES
 PARASITIC DISEASES
 EPIDEMINOLOGY,PUBLIC HEALTH AND SYSTEMS RESEARCH
 BIOTECHCHNOLOGY AND NON –COMMUNICABLE DISEASES

3.2 .INFECTIOUS DISEASE

 This programmer aims at the Reduction of the diseases burden due to infectious agents and in
particular ,HIV/AIDS and related infections
 It emphasizes on research on opportunistic infections, tuberculosis and STIs.
 The programmed focuses on epidemiology, immunology, molecular biology virology, microbiology,
prevention and control of
 Infectious diseases.

3.3 .SIZE OF THE WORK FORCE

Kemri has got very many employees in Kenya which renders it as a company of bigger workforce, it has
Branches in most major towns in Kenya such as Nairobi which is the Kemris’ headquarter along Mbagathi
Highway,Kisumu branch in Kisian along Kisumu Busia Highway,Busia at a place called Alupe and in

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Mombasa at a place called Kilifi.These Branches also have very many sub-branches with many employees
serving them at various levels’ all aspects I may say that Kemri is well equipped with employees with
various professions and each carries out his / her work effectively.

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 CHAPTER 5.0

DESCRIPTION OF THE DEPATMENTS

5.1. IMMUNOLOGY LABORATORY

(a) Nature of work or Operation

Basically this laboratory deals with research work e.g. the use livestock samples to carry out the Genomic
DNA solution isolation from a whole blood sample.
This is done by addition of protease enzyme to a whole blood to destroy the protease enzyme from the
blood sample.
Then add lysing buffer to lyse the red blood cell to release the hemoglobin in solution. And add ethanol to
dissolve the DNA.
After this vortex to mix the sample then centrifuge to clearly separate the sample (by observing the
density in that the denser ones will settle down and the light ones will be on top).
Add the spin column bead to capture the DNA, pipette the sample into the spin column. Then centrifuge
again for column to capture dna.After that throw away those that settles down after centrifuging and keep
the spin column dna on the rack for washing. Wash the spin column with awash buffer until the dna is
clear then centrifuge again until the dna column has been free from any traces of the blood and then place
the column in a clean labeled 1.5ml eppendorf tube then add 200ml buffer AE.Incubet at room
temperature for 1min then centrifuge at 8000 rpm(rounds per minute) for 1min

(b) Materials and Products

The materials used in these laboratories are modern machines which help ensure accurate results are
obtained at all times research work is done. They also use the modern product such the buffers, lysing
solution, Ethanol among others to facilitate a better result in all aspect of life. Some of the materials used
include centrifuge, fridges, deep freezers, computer and microscope among others. These laboratories are
well equipped with well maintained equipments for specific purposes.

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5.2. Work flow within Kemri

Kemri employees are well organized in such a way that each person performs his or her own task in the
workplace and hence there is no confusion and duplication of roles. All employees are answerable to the
Director Kemri even though they also have their immediate bosses to whom they are directly under in
terms of the job description and specifications. The is the delegation of duty from the top officials in the
workforce from which the tasks are performed tentatively by those concerned upto the junior employees
such as the auxiliary staffs among others. In this institution there is a good flow of the work in the
workforce field and hence this ensures that Kemri meets its objectives and mission of improving quality
health and human life through research.

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 CHAPTER 6.0

ORGANIZATION’S WORK FORCE

Kemri has got highly qualified and skilled employees in various fields in the Institute e.g. in the laboratory
there are the laboratory personnel who are well qualified in their areas of work and in carrying out
research work. Kemris employees are highly educated and with professions and better qualifications
necessary in their work.
The staffs are well trained in that most of them are graduates with the PHD; others have masters, Degrees
as well as Diploma holders. Such qualifications do help ensure that Kemri produces the best and quality
research result needed to sustain and improve the quality health of the Kenyan citizens in all aspects of
life.
In terms of experience, the staffs are very much experienced enough to carry out their duties responsibly
as expected by the employment act of Kenya. Mostly they are long term service men in that others do
have more than 20 years work experience and others do have 10 years working experience and owing to
all this even the work done is usually of high value and hence things can never go wrong.

6.1. COMMENT ON THE INSTITUTES MODE OF:-

(a) .Hiring and Training Practices

KEMRI CGHR do advertises her jobs and vacancy in the news papers and also pins most of the vacancies
on her notice boards. There are very many notice boards in Kemri and even one on KEMRI CGHR main
gate where all the community around can get access to them and apply at will. Upon, meeting the desired
qualifications one is taken on merit and be given an orientation in that particular field and then he / she
carries her expected duties. There are also training facilities offered to employees at random this is in
accordance with their areas of work e.g. an emergence of new machine with new technology that requires
some additional skills and techniques here and there.

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(b). Labor Organization (Trade Unions)

It is under the Central Organization and Trade Unions act and therefore it is governed mostly by the Labor
laws and the ministry of health.

(c). Plant / Equipment (Description and capacity)

There are very many Equipment with various work in the Institute, among them are the Incinerator for
burning up the laboratory wastes, Computer for data analysis, recording, typing and map reading among
others functions, Microscopes for cell physiology, Identification of the parasites, and slide reading after
staining the tissues. Centrifuge for spinning the samples to separate the plasma from the serum and for
proper mixing of the contents of the cell. ridges for keeping the samples and maintaining their
temperatures,Deepfreezers for keeping the samples as well as maintaining their temperatures, Sewer
treatment plant for waste management and incubators among other equipment

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 CHAPTER 7.0

PRODUCTION PROCESS AND QUALITY CONTROL

They produce high quality items such as clothes with the Kemri Logo on them, capes, bags and bics
among others. Kemri has a production unit in Nairobi that is responsible for the production of drugs that is
sold to the outside market at a small fee to assist the patients suffering from some illnesses e.g. HIV/
AIDs, TB among other diseases.

7.1. Current Technology in use

They use the modern machines such as the computer, centrifuges, deepfreezes, incubators, distiller,
modern fans which are remote controlled, modern floors and windows among other equipment like fire
alarms, electricity backups by the aide of the generators, incinerators.

7.2. Working Condition

The conditions of work in Kemri are very much conducive and accommodative such that the employees
and their bosses work under no restrictions as all are having good rapport amongst them. Every employee
does exactly what he/ she is supposed to do as per the regulations and the codes and ethics of the
Institution. Therefore here there are very good environment for all and there is no discrimination of
race,ethnicity,tribalism or oppression of any kind to employees of all types as they all serve one nation
and one institute for better of all Kenyan citizens.

7.3. Safety at the work place

All the Kemri employees are guaranteed safety at by ensuring that all employees join the Kemri Insurance
Scheme as this help give protection to all the employees irrespective of their races.

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7.4. OWN SELF ANALYSIS DURING MY ATTACHMENT PERIOD.

Throughout all my attachment work in KEMRI / CDC I gained a lot of knowledge in various field of the
study work. I gained practical skills in very most of the fields I underwent during my attachment. And
also learned great things that changed my attitudes by making me gain some experience in various field
and laboratories that I rotated at.

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CONCLUSIONS AND RECOMMENTATIONS

INTRODUCTION
On the basis of the findings of our study at literature appraisal, we have reached certain conclusions which
will be outlined in this chapter .Following on our conclusion, we made recommendation to KEMRI /CDC
for practical implemantations.we also commended on the limitations of the studies.

CONCLUSIONS.

The study clearly indicated that the KATO-KATS is the technique of choice for routine diagnosis of
intestinal helminths infections especially S.mansoni in high intensity area and after treatment. However,
some low prevalence of intestinal helminthes parasite reported at KEMRI/CDC.
Schistosomiasis laboratory was due to lack of sensitivity of the KATO-KATS to individuals with low
worm burden and those in low-prevalence areas and as much formal-ether concentration method was
found to be superior to the KATO-KATS and direct wet mounts for the diagnosis of the intestinal
helminthes in low prevalence areas.
This study has also shown that the Giemsa Microscopy still remains gold standard and most suitable
diagnostic instrument for malaria control because it’s expensive to perform, able to differentiate malaria
species and quantity parasites (junkman at 1995)
In urinalysis, the prevalence of initial iurinaryabnormality as detected by dipstick urinalysis which is
sigficantly high in clinical laboratories. The most prevalent abnormalities are blood, glucose and
leukocytes.Theres no significant association between the presence of urine abnormality and age, females
are more likely to show urine abnormality compared to males.
The study has also emphasized that both WHO and CDC bioassay give similar results with regard to
mosquito susceptibility to insecticide.Theres a complementarily between both methods , however ,some
specifies were noted for each.

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 RECCOMENDATIONS

Since this method of examination is easier than that of direct wet smear. The size and shape of parasitic
structures is maintained .Its less expensive, easy to perform and can be done at my level of health
infrastructucture.
The definitive diagnosis of malaria infections is still based on finding parasite in blood films. In
examining stained thick blood films, the RBCs are lysed so the recommended method for staining thick
film is fields which is made from field A and fields B. Malaria parasite may be missed on thin blood film
when there’s low parastaemia.Therefor ,examination of thick is recommended .Although Hob
electrophoresis bands are discernable at the end of the electrophoresis run, its recommended to
quantitative results after staining .The relative %of each Hob can be evaluated by scanning cleared dried
plates in the densitometer using a 525nm filter.
There should be monthly training and education program for attachment students at the institution about
blood borne pathogens, and medical treatment after exposure to pathogens or sample specimen such as
blood and also about phlebotomy on universal precautions /technique (including anatomy), patient safety,
specimen collection, test requests, draw restrictions, patient identifications, number of blood draws, care
of venipuncture site and appropriate use of the venipuncture device.
Stool ova and cyst test should adopt sedimentations procedure methods of concentration technique as in
this method as examination is easier than examining a direct wet smear. The size and shape of the
parasitic structures is maintained .Its expensive, easy to perform and can be done at any level of health
infrastructure.
In conclusion, I recommended that safety glasses to worn when handling samples such as blood which
may be HIV infected as the eye contains a high number of CD4 cells.

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