UNIVERSITY OF ESWATINI

FACULTY OF HEALTH SCIENCES

DEPARTMENT OF GENERAL NURSING SCIENCE

COURSE: INTRODUCTION TO PARASITOLOGY (BNSc.)

COURSE CODE: GNS104
STUDENT NAME(S): NDWANDWE MELULEKI. S. 202301674
SIBANYONI NONHLE 202301612
MAVIMBELA WAKHILE K. 202302847
SIMELANE BRIGHT 202302772
DLAMINI LUYANDA 202302000
 I.
STOOL COLLECTION FOR MICROSCOPY
II. INTRODUCTION
Stool specimen collection is collecting a fresh feces specimen directly into a feces container. Stool specimen
collection is important, as microscopic examination is a diagnostic tool for identifying the problem with a
client’s GI tract.

III. OBJECTIVES
 How to instruct the patient to properly collect the stool sample for microscopy.
 To explain the stool collection procedure
 Parasitological diagnosis(Ova/parasites)

IV. IV.LIST OF MATERIALS

a) Biohazard bag:
The biohazard bag is used to dispose of the used gloves, paper towels, and other materials that come into
contact with the stool sample. It is important to use a biohazard bag to prevent contamination of other
materials and surfaces.
b) Shipping box:
The shipping box is used to transport the stool sample to the laboratory. It should be sturdy and leak-
proof to prevent damage or contamination of the sample during transportation.
c) Transport vital:
The transport vial is used to store and transport the stool sample to the laboratory. It contains a transport
liquid that preserves the integrity of the sample by preventing bacterial growth and maintaining its
viability during transportation.
d) Scoop or Spork:
The scoop or spork is used to collect a small amount of stool from different parts of the sample. It is
important to avoid collecting large amounts of stool or water, as this can dilute or alter the composition
of the sample (Placeholder1).
e) Plastic Wrap:
The plastic wrap is used to cover the toilet bowl before defecating. This helps prevent contamination of
the stool sample with toilet water or other materials.
f) Test Request form:
The test request form is used to provide information about the patient, such as name, age, and medical
history, as well as information about the tests that need to be performed on the stool sample.

g) Absorbent material :
Absorbent material such as paper towels or tissue paper can be used to clean up any spills or messes that
occur during stool collection. It is important to avoid using disinfectants or other cleaning agents that
can interfere with the test results.

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V. V.LITERATURE REVIEW
a) GENERAL PRINCIPLES OF STOOL COLLECTION

 Obtaining a clean container: Use a sterile, leak-proof, and wide-mouthed container to collect the stool
sample. This ensures that the sample remains uncontaminated and can be easily transferred to a
laboratory for testing.

 Hand hygiene: Wash hands thoroughly with soap and water before and after collecting the stool
specimen to prevent the spread of any potential infections.

 Collection method: Collect a small sample of stool from different areas of the stool using a spoon,
tongue depressor, or wooden applicator stick. Make sure to avoid touching the inside of the container or
any other surfaces to prevent contamination.

 Sample volume: Collect an adequate amount of stool for testing, usually around 5-10 grams or about
one teaspoonful. It is important to provide enough sample material to ensure accurate test results.

 Sample preservation: If the stool sample cannot be tested immediately, it should be preserved
appropriately. The healthcare provider or laboratory may provide specific instructions for sample
preservation (e.g., refrigeration, addition of preservatives).

 Timing: Collect the stool specimen at the appropriate time. Some tests may require a fresh sample,
while others may require samples collected over multiple days.

 Patient instructions: Provide clear instructions to the patient on how to collect the sample. This may
include information on dietary restrictions, medications to avoid, and additional hygiene practices.

 Labeling: Label the container with the patient's name, date, and other required information as per the
laboratory's protocol. This ensures proper identification and avoids any confusion during testing.

 Transport: Seal the container tightly and transport it to the laboratory as soon as possible, following
any specific instructions provided by the healthcare provider or laboratory. Stool samples should be
transported in an appropriate biohazard bag to prevent any potential contamination.

 Proper disposal: After collecting and transferring the stool sample, clean and disinfect any equipment
used and dispose of any materials according to the healthcare facility's guidelines for biohazard waste
management.

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 b) SAFETY PRECAUTIONS DURING FECAL SPECIMEN
COLLECTION

 Personal protective equipment (PPE): Wear gloves, preferably disposable ones, while collecting and
handling the stool specimen. This helps to prevent direct contact with potentially infectious material.

 Hand hygiene: Wash hands thoroughly with soap and water before and after collecting the specimen.
Hand hygiene is essential to prevent the spread of microorganisms.

 Contamination prevention: Avoid touching the inside of the container, the outside of the container lid,
or any other surfaces during specimen collection. This helps to prevent cross-contamination and ensures
the integrity of the sample.

 Proper disposal of equipment: After collecting the specimen, dispose of any used equipment, such as
gloves and collection devices, in designated biohazard waste containers. Follow the healthcare facility's
guidelines for biohazard waste disposal.

 Labeling and handling: Properly label the container with the patient's information, ensuring it is
securely closed. Handle the container appropriately to prevent accidental spills or leaks.

 Protecting the work area: Use a disposable under pad or a plastic sheet to cover the area where the
collection will take place. This makes it easier to clean up any spills or contamination that may occur
during specimen collection.

 Cleaning and disinfection: Clean and disinfect any surfaces or equipment that may have come into
contact with the specimen. Use appropriate disinfectants or cleaning agents as per the healthcare
facility's protocols.

 Hand hygiene after glove removal: After removing gloves, wash hands thoroughly with soap and
water. This helps to remove any potential contaminants and maintain proper hand hygiene.

c) STORAGE AND TRANSPORT HANDLING REQUIREMENTS

 Containment: Store the stool specimen in a leak-proof, tightly sealed container to prevent leakage,
contamination, and odors. Ensure that the container is specifically designed for specimen collection and
is compatible with the laboratory testing requirements.

 Labeling: Clearly label the specimen container with the patient's information, including their name,
identification number, and date/time of collection. This ensures accurate identification and traceability
of the specimen.

 Temperature control: Stool specimens should generally be stored and transported at cool room
temperature (around 2-8°C or 36-46°F) to help maintain the stability of the sample. Avoid freezing or
exposing the sample to extreme temperatures, as it may alter the composition and affect the test results.

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  Timing: Ideally, the stool specimen should be transported to the laboratory as soon as possible after
collection to minimize the risk of bacterial overgrowth or degradation of certain analytes. If immediate
transport is not feasible, refrigerate the specimen promptly but avoid prolonged storage before
transportation.

 Packaging: Place the tightly sealed container containing the stool specimen inside a secondary leak-
proof bag or biohazard bag for an additional layer of protection during transport. It helps to prevent any
potential contamination or odor from spreading.

 Compliance with transportation regulations: Ensure that the transport of stool specimens follows all
applicable regulations and guidelines, especially if shipping the samples to an external laboratory. These
regulations may include specific packaging instructions, documentation, and adherence to bio hazardous
material transportation guidelines.

 Informing the laboratory: Inform the laboratory of the planned transportation of stool specimens and
any necessary special handling requirements. This allows the laboratory to anticipate and provide
guidance regarding any specific transport conditions or instructions.
VI. FINDINGS
a) STOOL COLLECTION INSTRUCTIONS FOR PATIENTS
You will be collecting a sample for one or more tests, depending on your health care provider’s order.
You may use the same bowel movement for more than one test. For each test:
1. Unscrew the lid from the specimen container. Set aside.
2. Prepare the collection container (clean shallow pan, plastic bag or clear plastic wrap) in which
you will collect your sample.
3. Collect the sample. Do not collect stool that has been mixed with water or urine.
4. Using the plastic spoon attached to the lid, scoop out samples from bloody, slimy or watery areas
of the stool (if present). If the stool is hard, select areas from each end and the middle of the
stool.
5. Transfer enough of the selected stool to the orange- and green-cap specimen containers to raise
the level of liquid to the “fill to here” line. Do not overfill. If you have a screw-cap container
without liquid, transfer the liquid stool (about the size of a walnut) to this container. There is not
a “fill to here” line on this container.
6. Screw the lid back on the container. Make sure it is closed tightly. Shake to mix.
7. Write the following information on the container with a pen or marker that will not run if the ink
gets wet:
 full name
 date of birth
 Date and time of collection.
8. Place the specimen container in a zip-close bag and seal it.
9. To store (until ready to return your sample):
 Place the orange-cap specimen container (stool pathogen PCR panel, Giardia antigen,
stool culture) in the refrigerator
 Keep the green-cap specimen container (ova and parasites, Cryptosporidium) at room
temperature

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  Keep the screw-cap container without liquid (Clostridium difficile, Helicobacter pylori
antigen, white blood cell) in the refrigerator.

Image 1: Instruction manual for stool collection Image 2; Proper way to shaken
by patient sample in transportation liquid

Image 3: Stool sample home collection kit Image 4: Labeled diagram of

Transportation vial
b) PARASITOLOGICAL DIAGNOSIS:
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 OVA/PARASITES
 Parasitological diagnosis from stool sample is a laboratory test that is used to detect the
presence of parasites or their eggs in the stool.
 The most common method for identifying ova and parasites is microscopic examination
of the stool sample. The sample is examined under a microscope to identify the presence
of ova or parasites. The examination is usually done using a concentration technique to
increase the chances of detecting the parasites. . Some common parasites that can be
detected using this test include Giardia lamblia, Entamoeba histolytica, and
Cryptosporidium parvum.
 Concentration techniques separate parasites from fecal debris and increase the chances
of detecting parasitic organisms when these are small numbers. They are divided into
flotation techniques and sedimentation techniques
 Another method is molecular testing, which involves detecting the DNA of the parasite
in the stool sample. This method is more sensitive than microscopic examination and can
detect parasites that are difficult to identify using microscopy. These include
Schistosoma, Toxoplasma and Tricomonas species.

Image 5: Diagram of common parasitic cysts under a microscope

VII. QUESTIONS
1) Explain the reasons for not using anti-acids, laxatives or stool softer before collecting stool
sample collection?
Anti-acids, laxatives, and stool softeners can interfere with the test results by altering the
composition of the stool sample.

2) Name one reason for asking the age of the patient?

Age is one of the factors that can affect the test results. For example, infants and young children
may have different gut micro biota than adults, which can affect the test results.

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 3) Explain why the patient must defecate into the provided container and not collect feces
from the toilet water?
The container provided for stool sample collection is designed to preserve the integrity of the
sample by preventing contamination from toilet water or other sources.

4) What is the reason for tightening and wiping clean the outside of the transport vial?
Tightening and wiping clean the outside of the transport vial is important to prevent leakage and
contamination of the sample during transportation.

5) Explain the importance of labelling the transport vials with patients name and ID?
Labelling the transport vials with patient name and ID is important to ensure that the samples
are correctly identified and processed in the laboratory.

6) Give reasons for not refrigerating the stool sample but refrigerate the polio sample?
Stool samples should not be refrigerated because low temperatures can affect the viability of
some microorganisms in the sample. On the other hand, polio samples should be refrigerated to
preserve their viability.

7) All patients must wash their hands before and after collecting the stool sample. Why?
Washing hands before and after collecting stool samples is important to prevent contamination of
the sample with bacteria or other microorganisms from the skin.

8) Stool sample must be sent to the laboratory ASAP. Why?

Stool samples should be sent to the laboratory as soon as possible to prevent changes in the
composition of the sample due to bacterial growth or other factors

9) What is function of the Transport Liquid in the Transport Vial?

The transport liquid in the transport vial serves as a preservative for the stool sample by
preventing bacterial growth and maintaining its viability during transportation.
10) Mixing the stool sample and Urine is not allowed. Explained.
Mixing stool sample and urine is not allowed because it can dilute or alter the composition of the
stool sample, which can affect test results

VIII. CONCLUSION
We have given clear and simple instructions for stool collection by patient in line with international
guidelines. We have also explain the stool collection procedure and rationale for each step and explained
the parasitological diagnosis techniques of ova/ parasites from stool samples.

IX. REFERENCES
1. Protocols for collection and transport of specimens: European Union
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2. https://ec.europa.eu/research/participants/documents/downloadPublic?
documentIds=080166e5d4de2e82&appId=PPGMS.

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 3. Lab tests: Patient Collection, storage and Transportation for reducing ...
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18. Images:
19. IMAGE 1 https://images.app.goo.gl/hZ8UsZiyxCLgQyAw6.
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22. IMAGE 4 https://images.app.goo.gl/nyPDUKphpc9pdbcp6.
23. IMAGE 5 https://images.app.goo.gl/DrHGhtF7vLdceawP9.
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