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MICROSCOPIC EXAMINATION OF FECAL SPECIMEN:

Kato Thick Smear Technique


INTRODUCTION
A technique introduced by Kato and Miura (1954) involving a simple, thick smear method
and using a cellophane cover for the examination of helminth eggs in stools. The Kato
technique in the past has been used for the detection of helminth eggs but nowadays it is most
commonly used for detecting schistosomal eggs. However, it cannot be used to identify
hookworm eggs because they collapse within 30 to 60 minutes of preparation using this
method. This technique differs from the ordinary direct smear in that a larger quantity of stool
will be used and coverslips are substituted for cellulose acetate film soaked in glycerine.
Schistosoma mansoni, a significant parasite of humans, is a trematode that is one of the
major agents of the disease schistosomiasis of intestinal origin.

PROCEDURE AND METHODS


Place 40-60 mg of
stool on a clean glass
slide

Cover with cellophane


soaked with glycerin-

malachite green
solution

Observe under LPO


*suspicious objects: HPO

Press with rubber


stopper

At room
temp.,
allow to
stand 2030 minutes

RESULTS AND INTERPRETATIONS


Result:
FECALYSIS
Name of patient: Luigi Gomez
Age: 7 y/o
Sex: Male
PHYSICAL:
Character: Mushy
Color: Dark Brown
Mucus: None
Blood: None

Date: November 6, 2014

MICROSCOPIC:
RBC: None
WBC: None
Parasite: No ova or parasite seen

Interpretation:
The patients Physical and Microscopic results based from the experiment obtained
shows an abnormal stool specimen for the physical examination but no ova or parasites were
seen.

ANSWERS TO GUIDE QUESTIONS AND THE QUESTIONS FOR RESEARCH


Guide Questions:
1. What is the purpose of the malachite green and glycerin?
Malachite green is for staining the background to make a contrasting environment so
that we can easily visualize the number of eggs that is present in the stool sample. Glycerin on
the other hand is used as a clearing solution and it dissolves fecal debris.
Questions for Research:
Draw and Label
A. Important phases of the Kato thick smear technique.

B. A schematic diagram of any abnormal microscopic structures found in your preparation.

1. Give the advantages and disadvantages of the Kato thick smear technique.
ADVANTAGES

Simple
Time saving
Economical
High chances to find eggs
Useful in mass examination of common
soil transmitted helminth infections

DISADVANTAGES
It cannot be used in liquid, soft, or
diarrheic stool.
It cannot be used for detection of
protozoan infection.
Limited within 1hour because after
1hour it would be disintegrated.

2. What are some precautions that should be observed in the performance of the Kato Thick
smear technique?
a) Remember that liquid, soft and diarrheic stools are not suitable for Kato Thick.
b) Specimen should be spread evenly, not too thick nor too thin.
c) Do not let preparation to dry up while letting it stand
d) The clearing process will not begin until the cellophane covered smear is turned up so
that it can absorb the solution.

e) Perform the Kato Thick immediately because it disintegrates after an hour.

UPDATES
Comparison of the Bell technique, a modified Kato thick smear technique, and a digestion method for
the field diagnosis of schistosomiasis mansoni
A modification of the Kato thick smear technique, the Bell filtration technique, and a digestion
method were investigated to determine the relative merits of each for the detection of schistosome
eggs in human faecal samples. The modified Kato technique was the method of choice because it was
sensitive, simple to perform, and suitable for field use. The Bell filtration technique was equally sensitive
in detecting light infections, but was more tedious and more complicated to perform than the thick
smear technique.
http://journals.cambridge.org/action/displayAbstract?aid=5196260

REFERENCE/S:
Elizabeth A. Zeibig, Clinical Parasitology: A Practical Approach, Second Edition, 2013
John and Petri, Markell and Voges Medical Parasitology 9th edition, 2010
http://www.popline.org/node/468732
http://www.atitesting.com/ati_next_gen/skillsmodules/content/specimen-collectionnew/images/ap_stool_spec_cnt_sld_lbl.jpg
http://www.parasitol.or.kr/kjp/Synapse/Data/PDFData/0066KJP/kjp-7-48.pdf
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=5196260