 in 1954, dr. kan kato & dr.

momoshige miura looked for an alternative in quantifying

schistosoma eggs because the direct fecal smear had a low sesitivity since only a small amount
of stool sample is needed in the procedure.
 Kato thick technique is also known as cellophane thick-smear technique.

Kato katz DFS

Uses large amount of stool sample Uses only a small amount of stool sample
Hydrophilic cellophane strip as a coverslip NSS or Lugol’s iodine as stool emulsifier
Higher sensitivity Lower sensitivity
 A brazilian parasitologist, Dr. Naftale Katz : modified the procedure by adding a standard
template with a fixed measurement of thickness which had a hole of a certain size in the middle
to place the stool in.
 This technique allows quantitative measurement of number of parasitic eggs seen in per gram
of feces (epg)
 WHO considered this techinique as the gold standard test especially for the diagnosis of
multiple helminth infection.

advantages
- Satisfactory in detecting medium and
large helminth eggs like ascaris (medium)
and schistosome (large) eggs
- Uses larger amount of stool sample that
can be analyzed in the slide
- Good indicator of patient’s worm burden
or intensity of infection
disadvantages
- Not recommened for small trematode
eggs like Heterophyes heterophyes
- Since the hyaline shell of Hookworms
are fragile, it may not hold up well when
exposed to certain chemicals, thus, their
eggs may collapse and disappear shortly
after clearing
- Requires many materials and is very time
consuming

MATERIALS:

- Newspaper or scrap paper

- Kato set: template with hole, screen (stainless steel, nylon, plastic or cardboard), and plastic
spatula
- Hydrophilic cellophane (40-50 um thick, strips 25 x 30 x 25 x 35 mm in size) and must be soaked
in glycerol-malachite green or glyceron-methylene blue solution for 24 hours prior to use.
- Microscope
- Microscope slide (75 x 25 mm)
- Forceps
- Tissue paper
- Markers
- Fresh stool sample
- PPE (lab gown, mask, gloves)

PROCEDURE:
 1. Place a small amount of fecal sample on newspaper and press the scmall screen on top so that
the feces are filtered through the screen and pile up on the top.
2. Scrape the flat side of the spatula across the top surface of the screen and collect the filtered
feces
3. Place template with hole on the center of the microscope slide and add the fecal sample from
the spatula. Make sure that the hole is completely filled. Remove the excess feces from the edge
of the hole using the spatula.
4. Remove the template carefully. Cover the fecal material with pre-soaked cellophane strip.
5. Invert the microscope slide and firmly press the fecal sample against the hydrophilic cellophane
strip on another microscope slide or on a smooth hard surface to spread the fecal material
evenly between the slide and the cellophane strip.
6. Make sure that the newspaper should be possible to read through the smear after clarification.
Place the slide with the cellophane upwards.
note: for all except hookworm eggs, keep slide for one or more hours at ambient temperature
to clear the fecal material prior to examination under the microscope. To speed up clearing and
examination, place the slide in a 40°C incubator or keep in direct sunlight for several minutes.
7. Place the slide under the microscope and examine the whole area in a systematic zigzag pattern
in LPO.
8. Record the number and the type of each of each species on a recording form alongside the
sample number.
9. Multiply the number of eggs counted using a factor to get the appropriate number of eggs per
gram of feces.

SPECIMEN CONSIDERATIONS

- Multiple egg counts on the same specimen be performed

- Ensure the the microscope has been calibrated
- The medical technologist should review the appearance and size of the organisms present to
ensure that they match reference material
- Adult schistosomes settle in the blood vessels surrounding certain organs of a host and
therefore it can take weeks to months for the eggs to be passed
- A negative result may indicate that adults are present but that eggs are not being passed

KATO-KATZ COMPUTATION

 Multiply by 20 if using a 50 mg template (1mm thick; 9 mm hole)

 Multiply by 50 for a 20 mg template (0.5 mm tick, 6.5 mm hole)
 Multiply by 24 for a 41.7 mg template (1.5 mm thick, 6 mm hole)

KATO-THICK REPORTING

Number of eggs counted per 10 filed will be equivalent to a particular grading

- If 1-10 ova are found per 10 fields = +1 (+)

- If 11-30 ova are found per 10 fields = +2 (++)
- If 31-60 ova are found per 10 fields = +3 (+++)
- If greater than 60 ova are found per 10 fields = +4 (++++)
LabSci Primer. (2020, March 20). Kato-Katz/Kato-Thick Technique [Video]. Youtube. Retrieved from
https://www.youtube.com/watch?v=CyzfEolndWE

World Health Organization. (1994). Kato-Katz Technique – Cellophane Faecal Thick Smear. Bench Aids
for the Diagnosis of Intestinal Parasites. Retrieved from
https://www.who.int/medical_devices/diagnostics/selection_in-vitro/selection_in-vitro-
meetings/00054_01_kato-katzBench_aids.pdf?ua=1

Acharya, T. (2016, May 24). Kato Katz Technique: Principle, Procedure, and Results. Microbe Online.
Retrieved from https://microbeonline.com/kato-katz-technique-principle-procedure-results/