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MINISTRY OF HEALTH
LABORATORY TESTS DATA SUMMARY REPORT FORM
|
Facility Name: Bungoma District Hospital Reporting Period Begining: Bungoma District Hospital
Ending: Bungoma District Hospital Affilliation: GOU
N/B: INDICATE N/S Where there is no service
URINE ANALYSIS
| Urine Chemistry |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Glucose |
0 |
0 |
0 |
0 |
0 |
0 |
| Ketones |
|
|
|
|
|
|
| Proteins |
|
|
|
|
|
|
| Blood |
|
|
|
|
|
|
| Bilirubin |
|
|
|
|
|
|
| Urobilinogen Pyruvic acid |
|
|
|
|
|
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| HGC |
|
|
|
|
|
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| Others |
|
|
|
|
|
|
| Urine Microscopy |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Pus cells (>5/hpf) |
|
|
|
|
|
|
| S. haematobium |
|
|
|
|
|
|
| T. vaginalis |
|
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| Yeast cells |
|
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| Red blood cells |
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| Bacteria |
|
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| Spermatozoa |
|
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| Others |
|
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| Blood Chemistry |
|
No. Exam |
Number positive |
| M |
F |
Total |
Low |
Normal |
High |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Fasting blood sugar |
|
|
|
|
|
|
| Random blood sugar |
|
|
|
|
|
|
| OGTT |
|
|
|
|
|
|
| Renal function tests |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
|
|
|
|
|
|
| Creatinine |
|
|
|
|
|
|
| Urea |
|
|
|
|
|
|
| Sodium |
|
|
|
|
|
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| Potassium |
|
|
|
|
|
|
| Chloride |
|
|
|
|
|
|
| Liver Function Tests |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Direct bilirubin |
|
|
|
|
|
|
| Total bilirubin |
|
|
|
|
|
|
| ASAT (SGOT) |
|
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|
|
|
| ASAT (SGPT) |
|
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|
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| Serum Protein |
|
|
|
|
|
|
| Albumin |
|
|
|
|
|
|
| Alkaline Phosphate |
|
|
|
|
|
|
| Gamma GT |
|
|
|
|
|
|
| Lipid Profile |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Amylase |
|
|
|
|
|
|
| Total cholestrol |
|
|
|
|
|
|
| Trigycerides |
|
|
|
|
|
|
| HDL |
|
|
|
|
|
|
| LDE |
|
|
|
|
|
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| PSA |
|
|
|
|
|
|
| CSF Chemistry |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Protein |
|
|
|
|
|
|
| Glucose |
|
|
|
|
|
|
| Body Fluids |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| Proteins |
|
|
|
|
|
|
| Glucose |
|
|
|
|
|
|
| Acid phosphatase |
|
|
|
|
|
|
| Bence jones protein |
|
|
|
|
|
|
| Thyroid Function Tests |
|
No. Exam |
Number positive |
| M |
F |
Total |
<5yrs |
5-14yrs |
>14yrs |
| Totals |
0 |
0 |
0 |
0 |
0 |
0 |
| T3 |
|
|
|
|
|
|
| T4 |
|
|
|
|
|
|
| TSH |
|
|
|
|
|
|
| Others |
|
|
|
|
|
|
PARASITOLOGY
| Blood Smears |
| Malaria |
Positive |
| Total Done |
<5yrs |
5-14yrs |
>14yrs |
|
|
|
|
|
| Falciparum |
|
|
|
|
| Ovale |
|
|
|
|
| Malariae |
|
|
|
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| Vivax |
|
|
|
|
| Borrelia |
|
|
|
|
| Microfilariae |
|
|
|
|
| Trypanosomes |
|
|
|
|
| Genital Smears |
| Total |
|
|
|
|
| T. vaginalis |
|
|
|
|
| S. haematobium |
|
|
|
|
| Yeast cells |
|
|
|
|
| Others |
|
|
|
|
| Spleen/bone marrow |
| Total |
|
|
|
|
| L. donovani |
|
|
|
|
| Stool |
| Total |
| Taenia spp. |
|
|
|
|
| H. nana |
|
|
|
|
| H. Diminuta |
|
|
|
|
| Hookworm |
|
|
|
|
| Roundworms |
|
|
|
|
| S. mansoni |
|
|
|
|
| Trichuris trichiura |
|
|
|
|
| Strongyloides stercoralis |
|
|
|
|
| Isospora belli |
|
|
|
|
| E hystolytica |
|
|
|
|
| Giardia lamblia |
| cysts |
|
|
|
| trophozoites |
|
|
|
| Cryptosporidium |
|
|
|
|
| Cyclospora |
|
|
|
|
| Others |
|
|
|
|
| Skin snips |
| Total |
|
|
|
|
| Onchocerca volvulus |
|
|
|
|
| Leishmania |
|
|
|
|
| Others |
|
|
|
|
| Lavages |
| Total |
|
|
|
|
BACTERIOLOGY
| Total examinations done |
0 |
| Urine |
0 |
Pus swabs |
|
High Vaginal swab |
|
Throat swab |
|
Stool |
|
Rectal swab |
|
Blood |
|
CSF |
|
Water |
|
Food |
|
Other (specify).... |
|
| Drugs |
|
|
|
|
|
| Sensitivity (Total done) |
|
|
|
|
|
| Resistance per drug |
|
|
|
|
|
| KOH Preparations |
Fungi |
|
|
|
|
Others (specify) |
| Others |
|
|
|
|
... |
|
| Total |
|
|
|
|
... |
|
SPUTUM
|
Total |
Positive |
| TB new suspects |
|
|
| Followup |
|
|
| TB smears |
|
|
| MDR |
|
|
|
Urine |
Pus |
HVS |
Throat |
Stool |
Blood |
CSF |
Water |
Food |
Other fluids |
| Naisseria |
|
|
|
|
|
|
|
|
|
|
| Klebsiella |
|
|
|
|
|
|
|
|
|
|
| Staphyloccoci |
|
|
|
|
|
|
|
|
|
|
| Streptoccoci |
|
|
|
|
|
|
|
|
|
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| Proteus |
|
|
|
|
|
|
|
|
|
|
| Shigella |
|
|
|
|
|
|
|
|
|
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| Salmonella |
|
|
|
|
|
|
|
|
|
|
| V. cholera |
|
|
|
|
|
|
|
|
|
|
| E. coli |
|
|
|
|
|
|
|
|
|
|
| C. neoformans |
|
|
|
|
|
|
|
|
|
|
| Cardinella vaginalis |
|
|
|
|
|
|
|
|
|
|
| Haemophilus |
|
|
|
|
|
|
|
|
|
|
| Bordotella pertusis |
|
|
|
|
|
|
|
|
|
|
| Pseudomonas |
|
|
|
|
|
|
|
|
|
|
| Coliforms |
|
|
|
|
|
|
|
|
|
|
| Faecal coliforms |
|
|
|
|
|
|
|
|
|
|
| Enterococcus faecalis |
|
|
|
|
|
|
|
|
|
|
| Total viable counts-22C |
|
|
|
|
|
|
|
|
|
|
| Total viable counts-37C |
|
|
|
|
|
|
|
|
|
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| Clostridium |
|
|
|
|
|
|
|
|
|
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| Others |
|
|
|
|
|
|
|
|
|
|
| Specify species of each isolate |
HEMATOLOGY REPORT
| Type of examination |
No. of Tests |
Controls |
| Full blood count |
|
|
| Manual WBC counts |
|
|
| Peripheral blood films |
|
|
| Erythrocyte Sedimentation rate |
|
|
| Sickling test |
|
|
| HB electrophoresis |
|
|
| G6PD screening |
|
|
| Bleeding time |
|
|
| Clotting time |
|
|
| Prothrombin test |
|
|
| Partial prothrombin time |
|
|
| Bone Marrow Aspirates |
|
|
| Reticulocyte counts |
|
|
| Others |
|
|
| Haemoglobin |
No. Tests |
<5 |
5<Hb<10 |
|
|
|
| CD4/CD8 |
No. Tests |
<200 |
200-350 |
|
|
|
| CD4% |
No. Tests |
<25% |
>25% |
|
|
|
| Peripheral Blood Films |
Parasites |
No. smears with inclusions |
|
|
|
BLOOD GROUPING AND CROSSMATCH REPORT
| Total groupings done |
|
| Blood units grouped |
|
| Total transfusion reactions |
|
| Blood cross matches |
|
Blood safety
| Measure |
Number |
| A. Blood units collected from regional blood transfusion centres |
|
| Blood units collected from other centres and screened at health facility |
|
| Blood units screened at health facility that are HIV positive |
|
| Blood units screened at health facility that are Hepatitis positive |
|
| Blood units positive for other infections |
|
| Blood units transfered |
|
| General remarks ............................. |
|
HISTOLOGY AND CYTOLOGY REPORT
|
Total |
Normal |
Infective |
Non-infective |
Positive findings |
| Benign |
Malignant |
<5 yrs |
5-14 yrs |
>14 yrs |
| SMEARS |
| Pap Smear |
|
|
|
|
|
|
|
|
| Tissue Impressions |
|
|
|
|
|
|
|
|
| TISSUE ASPIRATES (FNA) |
|
|
|
|
|
|
|
|
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|
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|
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|
|
|
| FLUID CYTOLOGY |
| Ascitic fluid |
|
|
|
|
|
|
|
|
| CSF |
|
|
|
|
|
|
|
|
| Pleural fluid |
|
|
|
|
|
|
|
|
| Others |
|
|
|
|
|
|
|
|
| TISSUE HISTOLOGY |
| Cervix |
|
|
|
|
|
|
|
|
| Prostrate |
|
|
|
|
|
|
|
|
| Breast |
|
|
|
|
|
|
|
|
| Ovarian cyst |
|
|
|
|
|
|
|
|
| Fibroids |
|
|
|
|
|
|
|
|
| Lymph nodes |
|
|
|
|
|
|
|
|
| Others |
|
|
|
|
|
|
|
|
SEROLOGY REPORT
| Serological test |
Total |
<5 yrs |
5-14 yrs |
>14 yrs |
| Tested |
No. +ve |
Tested |
No. +ve |
Tested |
No. +ve |
Tested |
No. +ve |
| Rapid Plasma Region |
|
|
|
|
|
|
|
|
| TPHA |
|
|
|
|
|
|
|
|
| ASO Test |
|
|
|
|
|
|
|
|
| HIV Test |
|
|
|
|
|
|
|
|
| Widal Test |
|
|
|
|
|
|
|
|
| Brucella Test |
|
|
|
|
|
|
|
|
| Rheumatoid Factor Tests |
|
|
|
|
|
|
|
|
| Cryptococcal Antigen |
|
|
|
|
|
|
|
|
| Helicobacter pylori test |
|
|
|
|
|
|
|
|
| Hepatitis A test |
|
|
|
|
|
|
|
|
| Hepatitis B test |
|
|
|
|
|
|
|
|
| Hepatitis C test |
|
|
|
|
|
|
|
|
| Viral Load |
|
|
|
|
|
|
|
|
| Formal Gel Test |
|
|
|
|
|
|
|
|
| Other Tests |
|
|
|
|
|
|
|
|
| Dried Blood Spots |
Tested |
# +ve |
Discrepant |
| Early Infant Diagnosis of HIV |
|
|
|
| Quality Assurance |
|
|
|
| Discordant couples |
|
|
|
| Others |
|
|
|
Specimen referral to higher levels
| Specimen |
No |
Sent to |
No. of Reports/results received |
|
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