Nepal

847C* Does this facility do any test for Diagnosis of Kalaazar / YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Leishmaniasis? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 848
847D* Does this facility use rapid diagnostic test Kit (RK-39) for YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
diagnosis of Kalaazar / Leishmaniasis?? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 848
847E May I see a sample of RK-39? OBSERVED, AT LEAST 1 VALID. . . . . . . . . . . . . . . . . 1
OBSERVED, NONE VALID. . . . . . . . . . . . . . . . . . . . . 2
CHECK TO SEE IF AT LEAST ONE IS VALID REPORTED AVAILABLE, NOT SEEN. . . . . . . . . . . . 3
NONE AVAILABLE TODAY . . . . . . . . . . . . . . . . . . . . . 4
848 Does this facility do any GRAM STAINING? YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 850
849 Please tell me if the following are (a) (b)
used and are available today.
EQUIPMENT/ALL ITEMS FOR TEST
USED
AVAILABLE?
NORMALLY
IF USED ASK TO SEE IT
Yes No
REPORTED, AVAILABLE
OBSERVED NOT SEEN NOT TODAY
01 Crystal violet or Gentian violet 1 b 2 1 2 3
02
02 Lugol's iodine / Lugol's solution 1 b 2 1 2 3
03
03 Acetone or Acetone alcohol 1 b 2 1 2 3
04
04 Neutral red, carbol fuchsin, or other 1 b 2 1 2 3
counter stain 850
850 Do you ever send any specimen outside for YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Gram staining , India Ink staining, malaria NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 852
testing or for culture?
851 INDICATE IF THERE IS AN OBSERVED RECORD
OF RESULTS FOR TESTS CONDUCTED OUTSIDE
(A) SEND SPECIMEN
OUTSIDE FOR TEST
(B) RECORD OF TEST
RESULTS OBSERVED
YES NO YES
01 Gram stain 1 b 2 1
02
02 India ink stain 1 b 2 1
03
03 Malaria 1 b 2 1
04
04 Specimen for culture 1 b 2 1
852
NO
2
2
2
2
852 Does this facility do STOOL MICROSCOPY? YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 854
853 Please tell me if the following are (a) (b)
used and are available today.
USED
EQUIPMENT/ALL ITEMS FOR TEST
AVAILABLE?
NORMALLY
Yes No
REPORTED, AVAILABLE
OBSERVED NOT SEEN NOT TODAY
01 Formal saline (for concentration method) 1 b 2 1 2 3
02
02 Normal saline (for direct microscopy) 1 b 2 1 2 3
03
03 Lugol's iodine / Lugol's solution 1 b 2 1 2 3
854
Appendix C • 253