JIMMA UNIVERSITY

COLLEGE OF PUBLIC HEALTH AND MEDICAL SCIENCES

COMMUNITY BASED TRAINING PROGRAM FOR GRADUATE STUDENTS (DTTP)

November 26-December 5, 2012

Dear Sir/madam;

My name is_________________________ and my colleague name is______________________

We are Master’s Degree students from Jimma University. As part of our academic requirements,
we are expected to conduct assessment on environmental sanitation and common communicable
disease in Hermata Mentina Kebele, Jimma Town. We are going to conduct a study in Hermata
Mentina Kebele and design possible intervention strategies to tackle them. Thus this interview is
prepared for this purpose to get appropriate information on the environmental sanitation and
communicable disease prevention and control.

This information will be used only for research purpose and your confidentiality will be assured.
Therefore; we politely request your cooperation to participate in this interview. You do have
the right not to respond at all or to withdraw in the meantime, but your input has great
value for the success of our objective

Agree ________ (If agree continue)

Do not agree _________ (If do not agree stop)

Thank you for your cooperation!!!

 Part I: Background information
1. Zone (gote) ___________________
2. House No/Household Code _______
Part II: Socio-demographic data
Sex Age Religion Ethnicity Educational status Marital status Occupational status Family size

Sex: Religion: Ethnicity: Educational status: Marital status: Occupational status:

1. Muslim 1. Oromo 1. Illiterate 1. Governmental
1. Male 2. Orthodox 2. Amhara 2. Read & write only 1. Single worker
2. Female 3. Protestant 3. Dawuro 3. 1st cycle (1-4) 2. Separated 2. Farmer
4. Catholic 4. Gurage 4. 2nd cycle (8-10) 3. Married 3. Merchant
5. Other 5. Kefa 5. Secondary (9-10) 4. Divorced 4. House wife
specify 6. other 6. Preparatory (11- 5. Widowed 5. Daily labor
specify__ 12) 6. Student
_ 7. 12+ 7. NGO worker
8. Unemployed
9. other specify__
Part III: Housing Condition
No Questions Possible choices/Answers Remark
301 Main material of the roof 1. Thatched
2. Corrugated iron sheet
3. Other, specify____________
302 Main material of the floor 1. Earthen
2. Cemented
3. Wooden
4. Other, specify____________
303 Cleanliness of the house 1. Good 2. Fair 3. Poor

304 Ventilation of the house 1. Good 2. Fair 3. Poor

305 illumination of the house 1. Good
2. Fair
3. Poor
306 Kitchen Site 1. Inside home
2. Separate
3. Other, specify_____
307 Are there animals living in the house? 1. Yes
2. No
308 If yes, for Q 307 which animal? 1. Dog
2. Cat
3. Ruminant animal
4. Non Ruminant animal
5. Other specify____________

Part IV: Condition of water Supply

No Questions Possible choices/Answers Remark

401 What is the source? 1. Pipe
2. Protected well/ spring
3. Unprotected well/spring
4. River/pond
5. Other, specify
402 Distance of water source from the house (in 1. Less than 10 min
minutes) 2. Greater than 10 min
403 If your water source is other than pipe do 1. Yes
you treat it? 2. No
404 If you treat it what method(s) do you use? 1. Chlorination
2. Boiling
3. Filtering
4. Other, specify __
405 How do you store your water? 1. Jerkan
2. pot
3. Pail (Bucket)
4. tanker
5. Other specify_________
406 How do you draw water from the container? 1. By immersing inside
2. By pouring
3. Directly from pipe
4. Other specify __________
407 How many liters of water do you 1. _________
consume/day
Part V: Latrine facility
No Questions Possible choices/Answers Remark
501 Is there latrine facility in the compound? 1. Yes 2. No
502 Is the latrine functional? 1. Yes 2. No
503 If No to 502, what is the reason? 1. Filled
2. Construction not finished
3. Damaged
4. No water facility
5. Other, specify _____________
504 If Yes to 501, what type? 1. Flush toilet 2. Pit latrine
3. VIP 4. Other, specify__________
505 If No to 501, where do you use? 1. Open field
2. Communal
3. Public
506 If No to 501, what is the reason? 1. In availability of space
2. High Water table
3. Soil type
4. Shortage of resource
5. Other specify ___________
507 If yes to 501, does the latrine have a 1. Yes 2. No
cover?
508 If yes to 507, do you use it? 1. Yes 2. No
509 If yes to 501, is the latrine provided with 1. Yes
hand washing facility? 2. No
510 If yes to 509, do you use it? 1. Yes 2. No

Part VI. Waste disposal system

No Questions Possible choices/Answers Remark

601 Where do you dispose your liquid 1. Open field
wastes? 2. Pit
3. Septic tank
4. Toilet
5. Other, specify___________
602 Do you segregate the waste before 1. Yes
disposal? 2. No
603 Do you have your own solid waste 1. Yes
storage container? 2. No
604 Is there garbage container placed by 1. Yes
municipality in your locality? 2. No
605 Does garbage container placed at 1. Yes
appropriate site? 2. No
606 If No to 604, how do you dispose it? 1. On field
2. Solid waste Pit
3. Burn
4. Other, specify___________

Part: VII Communicable disease

No Questions Possible choices/Answers Remark

701 Is there anyone in the house who 1. yes
develops illness currently? 2. No
702 If yes what was the illness (ailment)? 1. Diarrheal disease
2. AFI
3. Respiratory disease
4. Other specify
703 Is there any stagnant water in your 1. Yes
compound or surrounding? 2. No
704 Does your house sprayed with chemical 1. Yes
to control mosquitoes in the last 3 2. No
months?
705 Do you have ITN? 1. Yes
2. No
706 If yes, How many ITN do you have? 1. _________
707 Does the family use ITN? 1. Yes
2. No
708 If yes, who use it? 1. all family members
2. only husband
3. only wife
4. only children
5. only husband and wife
6. mother and children
709 If yes to 707, how frequently do you use 1. Always
it? 2. Sometimes
710 Do you think ITN prevent Malaria? 1. Yes
2. No
711 Is there anyone with fever in the house? 1. Yes
2. No
712 If yes, take blood sample for
haemoparasites?

713 Annual income of the family?

Jimma University
College of Public Health and Medical Sciences

 Request Form for Parasitological Survey

Name ______________________________
 Age ______________sex_______________
Code number P______________________
Result______________

 Request Form for Malaria Survey

Name ______________________________
Age ______________sex_______________
Code number M______________________
Result______________

JIMMA UNIVERSITY

COLLEGE OF PUBLIC HEALTH AND MEDICAL SCIENCES

COMMUNITY BASED TRAINING PROGRAM FOR GRADUATE STUDENTS (DTTP)

November 26-December 5, 2012

Observation checklist

I. Liquid waste disposal

1. Presence of appropriate waste water disposal system (Sewerage system)

______________________________________________________________________________
______________________________________________________________________________

2. Name of communal latrine ____________________

 Zone _____________________
 Condition and facility
i. Roof________________________________________
ii. floor ________________________________________
iii. functionality___________________________________
 iv. Wall __________________________________________
v. door __________________________________________
vi. fence__________________________________________
vii. Slab __________________________________________
viii. Cover ________________________________________
ix. Hand washing facility ____________________________
x. VIP __________________________________________
3. Name of Public latrine _______________________________
 Zone _____________________
 Condition and facility
i. Roof________________________________________
ii. floor ________________________________________
iii. functionality___________________________________
iv. Wall __________________________________________
v. door __________________________________________
vi. fence__________________________________________
vii. Slab __________________________________________
viii. Cover ________________________________________
ix. Hand washing facility ____________________________
x. VIP __________________________________________

II. Solid waste disposal

1. Presence of temporary garbage storage (Secondary storage)
__________________________________________________________________________
__________________________________________________________________________
2. Condition of storage garbage (Secondary storage):
a. Over filled ___________________________
b. Presence of scavengers ________________
c. Waste inside garbage _________________
d. Waste around garbage _________________

III. Water related issues

12. Distance between latrine facility (communal or public) and water source including pipe line
for water supply

______________________________________________________________________________
______________________________________________________________________________

13. Condition of water sources in relation to possibility of other sources of contamination

______________________________________________________________________________
______________________________________________________________________________

14. Presence of stagnant water within the Zone

______________________________________________________________________________
______________________________________________________________________________

JIMMA UNIVERSITY

COLLEGE OF PUBLIC HEALTH AND MEDICAL SCIENCES

COMMUNITY BASED TRAINING PROGRAM FOR GRADUATE STUDENTS OF 2012

Focus Group consent letter

Ladies and gentlemen
………………………………………………………………………………………………………
……………………………

Thank you for your willingness to participate in our focus group. As we explained to you, we
would like to hear your ideas and opinions about health and health related problems in Hermata
Mentina Kebele. You will be in a group consisting of 7 to 10 members. Your responses to the
questions will be kept anonymous. The date, time, and place are listed below. Please look for
signs once you arrive directing you to the room where the focus group will be held.

DATE _____________________________

TIME _____________________________

PLACE _____________________________
Sincerely,

Members Hermata Mentina DTTP group

FGD Guide

FGD no.

Site.

Modulator (facilitator) _____

Note taker_____________

Start time ____________

End time____________

KEY
I - INTERVIEWER
R1- Respondent number 1
R2- Respondent number 2
R3- Respondent number 3
R4- Respondent number 4
R5- Respondent number 5
R6- Respondent number 6
R7- Respondent number 7
R8- Respondent number 8

Introduction:

1. Welcome
2. Explanation of the process
3. Ground Rules
4. Turn on Tape Recorder
Guiding questions for FGD on environmental sanitation and common communicable
disease in Hirmata Mentina kebele

1. How do you see the relation between environmental sanitation and communicable disease in
H/M kebele?

2 How do you explain solid waste handling at house hold level in relation to communicable
disease?

3 How do you explain liquid waste handling at house hold level in relation to communicable
disease?

4 How do you explain the sources of water supply for drinking, bathing & storage &
consumptions ion in relation to CD?

5 How do you see latrine utilization in relation to CD?

6 What measures had been taken to solve those problems previously?

 JIMMA UNIVERSITY

COLLEGE OF PUBLIC HEALTH AND MEDICAL SCIENCES

COMMUNITY BASED TRAINING PROGRAM FOR GRADUATE STUDENTS OF 2012

Preparation of a thick and a thin blood film on the same slide

For routine malaria microscopy, a thin and a thick film are made on the same slide. The thick
film is used for the detection of parasites, while the thin film is used in identifying the species of
parasite.
Materials and reagents
 Microscope
 Clean glass microscope slides
 sterile blood lancets
 Cotton wool
 Grease pencil
 Methanol
 70% Ethanol.
 Giemsastain
 Buffered water, pH 7.2 or distilled water
Method and Procedures for blood collection
Blood to be examined for malaria parasites is usually collected at a health centre. The most
suitable time for collection is at the height of an episode of fever, when the parasites are most
numerous in the blood. Blood specimens should always be collected before antimalarial drugs
are given.
1. With the patient’s left hand palm upwards, select the third or fourth finger. (The big toe can be
used with infants. The thumb should never be used for adults or children.) Use cotton wool
lightly soaked in ethanol to clean the finger — using firm strokes to remove dirt and grease from
the ball of the finger. Dry the finger with a clean piece of cotton wool (or lint).
2. With a sterile lancet, puncture the ball of the finger, using a quick rolling action. By applying
gentle pressure to the finger, express the first drop of blood and wipe it away with dry cotton
wool. Make sure that no strands of cotton wool remain on the finger.
3. Working quickly and handling clean slides only by the edges, collect the blood as follows:
• Apply gentle pressure to the finger and collect a single small drop of blood, about this size, on
to the middle of the slide. This is for the thin film.
• Apply further pressure to express more blood and collect two or three larger drops, about this
size, on to the slide about 1 cm from the drop intended for the thin film. Wipe the remaining
blood away with cotton wool.
4. Thin film. Using another clean slide as a “spreader”, and with the slide with the blood drops
resting on a flat, firm surface, touch the small drop with the spreader and allow the blood to run
along its edge. Firmly push the spreader along the slide, away from the largest drops, keeping the
spreader at an angle of 45°. Make sure that the spreader is in even contact with the surface of the
slide all the time the blood is being spread.
5. Thick film. Always handle slides by the edges, or by a corner, to make the thick film as
follows:
Using the corner of the spreader, quickly join the larger drops of blood and spread them to make
an even, thick film.
6. Allow the thick film to dry in a flat, level position protected from flies, dust and extreme heat.
Label the dry film with a grease pencil by writing across the thicker portion of the thin film the
patient’s name or number and date.
Staining blood films with Giemsa stain
Principle
During staining of the blood film, the haemoglobin in the erythrocytes dissolves
(dehaemoglobinization) and is removed by the water in the staining solution. All that remain are
the parasites and the leukocytes, which can be seen under the microscope.
Routine method for staining thick and thin blood films
Ideally, for optimum staining, thick and thin films should be made on separate slides. This is
often not possible and thick and thin films are generally made on the same slide. When this is
done, good-quality staining of the thick film is of primary importance. Best results are obtained
if the blood films have dried overnight.
This method is suitable for staining 20 or more slides.
1. Fix the thin film by adding three drops of methanol, or by dipping it into a container of
methanol for a few seconds.
 2. Prepare a 3% Giemsa solution in buffered or distilled water, pH 7.2, in sufficient quantity
to fill the number of staining troughs being used. Mix the stain well.
3. Pour the stain gently into the staining trough, until all the slides are totally covered. Stain
for 30–45 minutes out of sunlight.
4. Pour clean water gently into the trough to remove the deposit on the surface of the
staining solution.
5. Gently pour off the remaining stain, and rinse again in clean water for a few seconds.
Pour the water off.
6. Then dry the slide and observe under microscope
Microscopic examination
Examine the slide under the microscope using the 100x objective. Malaria parasites found in the
blood are at different stages of development .Some malaria parasites have granules of pigments
in their cytoplasm.
1. Thin blood films
In thin blood films, the infected erythrocytes may remain unchanged or have a different colour or
shape, or may contain pink (“Schüffner’s”) or red (“James”) dots. Thin films can be used to
identify the species of malaria parasite.
2. Thick blood films
In thick blood films, the background should be clean and free from debris, as the infected
erythrocytes are lysed. The malaria parasites should have deep red chromatin and blue or pale
purplish-blue cytoplasm. In thick films stained with Giemsa, the nuclei of leukocytes should be
stained dark purple. Schüffner’s dots may be seen around the malaria parasites.

JIMMA UNIVERSITY

COLLEGE OF PUBLIC HEALTH AND MEDICAL SCIENCES

COMMUNITY BASED TRAINING PROGRAM FOR GRADUATE STUDENTS OF 2012

1. Bacteriological Examination of Water: MPN Test

Materials
 Luaryl sulfate – tryptose –lactose broth
 Distilled water
 Tap/well/ water sample
 Test tubes
 Beakers
 Micropipettes
 MPN table
 Autoclave
 Incubator
 Alcohol lamp
 Aluminum foil
 Tube rack
 Alcohol lamp
Procedure
Presumptive test
 Prepare 9ml of distilled water
 Mix up the sample
 Transfer 1ml of Water sample to 9 ml of distilled water and label 100
 Serially dilute up to 10-3
 Inoculated 0.1 ml to three replicates of luaryl sulfate – tryptose –lactose broth (17.75g
luaryl sulfate – tryptose –lactose in 500ml of distilled water) using micro pipette.
 Incubated at 35 0c for two days
 Calculate Total Coliform concentrations in the water samples using
MPN table.

Confirmatory test
 Take +ve presumptive tube
 Gently shake
 Using sterile metal loop transfer the growth to EC broth
  Incubate it at 44.50c 24 hours with loosely capped
 Examine the tube exhibiting growth (acid gas production)

2. Chloride
Determination of chloride using the argentometric Method.

Reagent.

a). Potassium chromate indicator solution:

Dissolve 50g K2 CrO4 in a little distilled water. Add AgNO 3 solution until a definite a red
precipitate is formed. Let stand 12h filter and dilute to 1L with distilled water.

b). Standard silver nitrate titrant, 0.0141N:

Dissolve 2.395g AgNO3 in distilled water and dilute to 1000mL. Standardize against
0.0141N NaCl solution. 1.00mL = 500 µgCl-, store in a brown bottle.

c) Standard sodium chloride. 0.0141N: Dissolve 824g NaCl (dried at 140Oc) in distilled water
and dilute to 1000 mL, 1.00mL=600µg cl-.

d) Special reagents for removal of interference:

i. Aluminum hydroxide suspension: dissolve 125g Aluminum potassium sulfate or

aluminum ammonium sulfate, in 1L distilled water. Warm to 60Oc and add 55mL conc. NH4OH
slowly with stirring. Let stand about 1hr transfer to a large bottle, and wash precipitate by
successive additions, with thorough mixing and decanting with distilled water, until free from
chloride.

i. Phenolphthalein in indicator solution .

ii. Sodium hydroxide 1N.
iii. Sulfuric acid, 1N.
iv. Hydrogen peroxide, 30
Procedure

Argentometric method

1. Measure the appropriate sample volume for the indicated chloride range using the following
table and transfer to a 250 ml Erlenmeyer flask or porcelain casserole.
 Sample Volume mL Alkalinity Range mg/Las CaCO3

100 1-50

50 51-100

25 101-200

10 201-500

2. Brink the total volume to 100 mL with distilled water If the sample size is less than 100 mL
3. Prepare a color comparison blank by placing distilled water in a similar flask and the volume
must be equal to that of the sample.
4. Add 1 mL potassium dichromate indicator solution to the blank and the sample; and mix.
5. To the color comparison blank carefully add from a burette drop by drop silver nitrate titrant
until the yellow color changes to a brownish tine.
6. Record the mL silver nitrate titrant consumed
7. If the sample turns yellow, gradually add silver nitrate titrate from a burette. Shake the flask
continuously and continue adding the titrant until the sample turns the same.
8. Record mL silver nitrate titrant consumed
9. Calculation
mg Cl/l= (A-B) XNX35,450

Ml of sample

Where

A= Ml nitration for sample

B= mL titration for blank and

N= normality of silver nitrate

 Mg NaCl/L = (mg Cl/L) x 1.65

3. Nitrate
Determination of nitrate

Reagent and apparatus

a). standards silver sulfate solution: Dissolve 4.40g silver sulfate free from nitrate in distilled
water and dilute to 1000 mL ,1.00 mL = 1.00 mg /L

b). Phenoldisulfonic acid reagent: Dissolve 25g pure white phenol in 150 mL conc. H 2SO4.Add
75 mL fuming H2SO4 (15% free SO3) stir well and heat for 2 hour on a hot water bath.

c). Ammonium hydroxide Conc: if this cannot be used, prepare 12N KOH solution by dissolving
673 g KOH in distilled water and diluting to 1 liter

d). EDTA reagent: Rub 50 gm disodium ethylendeiamine tetracetae dehydrate with 20mL
distilled water to form a thoroughly weight paste add 60 ml concentrated ammonium hydroxide
(NH4OH) and mix well to dissolve the paste.

e). Stock nitrate solution: dissolve 9.7218g anhydrous potassium nitrate and dilute to 1000 mL
with distilled water 1 mL = 100 µg N.

f) Standard Nitrate solution: Evaporate 50.0 mL stock nitrate solution to dryness on a steam or
water bath dissolve the residue by rubbing with 2.0 mL Phenoldisulfonic acid reagent, and dilute
to 500 mL with distilled water,1.00 mL= 10.0 µg N= 44.3 µg No3-

g). Reagent for treatment of unusual interference:

a. Aluminum hydroxide suspension-prepares as in for chloride determination but wash KHO free
of ammonia, chloride nitrite, and nitrate

b. Sulfuric acid 1N dilutes cautiously 28 mL conc. H2 SO4 to 11 with distilled water.

c. Potassium permanganate 0.1N: dissolve 0.316g KMNO 4 in distilled water and dilute to 100
mL

d. Dilute hydrogen peroxide solution: dilute 10 mL of 30% hydrogen peroxide to 100 mL with
distilled water.

e. Sodium hydroxide 1N: dissolve 40g NaOH and dilute to 1 Liter with distilled water.
Procedure

Phenoldisulfonic acid method

1. Determine the chloride content of the water sample and treat 100 ml with an equivalent
amount of silver sulfate solution (1mL for 1 mg Cl) to precipitate the chlorides
2. Remove the precipitated chloride either by centrifugation or by filtration coagulating the
AgC1 by heat if necessary.
3. If the sample has color of more than 10 unit (on platinum cobalt scale), decolorize by adding
3 mL aluminum hydroxide suspension to 150 mL sample; stir very thoroughly; allow to stand for
a few minutes; then filter, discarding the first portion of the filtrate
4. Pipette a suitable quantity of the sample or the clarified filtrate in to an evaporating dish and
neutralize to approximately PH7
5. Evaporate to dryness over a hot water bath.
6. Add 2 mL Phenoldisulfonic acid reagent and rub the residue thoroughly to insure dissolution
of all solids. If needed heat on the water bath a short time to dissolve the entire reside
7. Dilute with 20 mL of distilled water and add with stirring about 6 to 7 mL of NH4OH or
about 5 to 6 mL KOH solution (12N) until maximum yellow color is developed
8. Remove any resulting flocculent hydroxides by filtration or add the EDTA reagent drop wise
with stirring until the turbidity re dissolves
9. Transfer the filtrate of clear solution to a 50-mL volumetric flask or graduated cylinder. Rinse
the dish, glass rod and filter paper with distilled water, adding the rinsing to the flask or cylinder
until all the colored solution has been transferred.
10. Dilute to the 50-mL mark with distilled water, and mix thoroughly
11. Measure the absorbance at a wave length of 410 nm against a blank prepared from the same
volumes of reagents as used for the samples.
12. Construct a calibration curve in the range 0-2mg/L NO3-N by adding 0,0.2, 0.5,1.0,3.0,5.0,
and 10 mL of standard nitrate solution to separate evaporating dishes and treating them in the
same way as the sample.
13. Determine the µg of NO3-N in the sample by reference to the calibration curve
14. Calculation:
a) mg/L NO3-N = ug NO3-N
mL sample

b) mg/L NO3 = ug NO3-Nx4.427

mL sample