+ {{ errorMessage }} +
+| Date of visit | +(New Client) | +
+ ANC + Number/NUPI + (Re Visit) + |
+
+ Number of + Visits + (1st,2nd,3rd, + 4th ….) + |
+
+ Full Name + (First, Middle, Surname) + |
+
+ Date of Birth + (DD/MM/YYYY) + |
+ Subcounty/ County | +Village/Estate/ Landmark | +
+ Marital Status + NM=Never + Married/Single + MM=Married + Monogamous + MP=Married + Polygamous + W=Widowed + D=Divorced + S=Separated + |
+ Parity | +Gravidae | +
+ Date of Last Menstrual + Period (LMP) + |
+ Expected Date of Delivery (EDD) | +
+ Gestation in + Weeks + |
+
+ MUAC + 1= Green, + 2=Yellow, + 3=Red + |
+ Height (cm) | +Weight (kg) | +Blood Pressure | +
+ Breast Exam + 1=normal + 2=abnormal + |
+ FGM (Y/N) | +Laboratory | +Maternal HAART | +Infant Prophylaxis | +Partner HIV Testing | +Other Conditions and Treatment | +Deworming | +IPT 1-3 | +TT Dose | +Supplementation | +LLITNs | +Referrrals | +Remarks | +|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANC Number | +Age | +Phone Number | +(dd/mm/yyyy) | +(dd/mm/yyyy) | +
+ FGM associated + complications: + 1=Scarring + 2=Keloids + 3=Dyspaneuria + 4=UTI 5 = NA + |
+
+ Haemoglobin + (Level/ ND/NA) + |
+
+ Blood Sugar Testing + for Diabetes: + 1=RBS< 11.1 + mmol/L, No + Diabetes, + 2=RBS>11.1 + mmol/L, Has + Diabetes, + 3=No RBS done + |
+
+ Blood group + and rhesus + (Y/N) + |
+
+ Urinalysis + (Y/N) + |
+
+ Type of Test + RPR/ VDRL/ + Duo Test/ NA + |
+
+ Hepatitis B virus + Sceening Result + (P/N/ND) + |
+
+ TB Screening: + Codes (1-5) + |
+ + |
+ N = New on ART. + OA = On ART + NA = Not + Applicable + |
+
+ AN = AZT&NVP + A = AZT + N = NVP + NA + |
+ N/P/KP/NA | +
+ 1=Hypertension; + 2=Diabetes; + 3=Epilepsy; + 4=Malaria in Pregnancy; + 5=STIs/RTI; + 6=Others (Specify) + 7=None + Record all that apply + |
+ (Y/N/NA) | +(1,2,3,N,NA) | +
+ 1=TT Dose 1st + dose 2=2nd dose + 3=3rd dose + 4=4th dose + 5=5th dose + NA=None + |
+
+ Given + Supplementation + 1=Combined IFAs + 2=Iron + 3=Folate + 4=Iron+Folate + Separately + 5=Calcium + |
+
+ Received + LLITNs + (Y/N) + |
+ From | +To | +
+ Reason for referral + (specify) + |
+ |||||||||||||||||||
| NUPI | +
+ Test Results + (P/N/NA) + |
+
+ Treatment + (Y/N/NA) + |
+
+ 1=Presumed TB + 2=No Signs + 3=On TB + Treatment + 4=On TPT + 5=Not Done + |
+
+ HIV Testing + (Initial or Retest, + Known Poitive or + Revisit) + |
+ HIV Test 1 | +HIV Test 2 | +HIV Test 3 | +HIV Results | +Treatment (Y/N/NA) | +
+ 1=From + Community Unit + 2=Another + Health Facility + 3=Not Applicable + |
+
+ 1=To Community + Unit + 2=HIV preventive + services + 3=Another Health + Facility 4=Not + Applicable + |
+ |||||||||||||||||||||||||||||||||
| (I/R/KP/ND/Rev) | +Kit Name | +Kit Name | +Kit Name | +(N/P/Ic/U/N A) | +||||||||||||||||||||||||||||||||||||||||
| Expiry / / | +Expiry / / | +Expiry / / | +||||||||||||||||||||||||||||||||||||||||||
| (N/P/I/NA) | +(N/P/I/NA) | +(N/P/I/NA) | +||||||||||||||||||||||||||||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(p) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +(z) | +(aa) | +(ab) | +(ac) | +(ad) | +(ae) | +(af) | +(ag) | +(ah) | +(ai) | +(aj) | +(ak) | +(al) | +(am) | +(an) | +(ao) | +(ap) | +(aq) | +(ar) | +(as) | +
| + {{ data.date_of_visit | date: 'dd/MM/yyyy' }} + | +{{ data.anc_number }} | +{{ data.anc_number_NUPI }} | ++ {{ data.number_of_anc_visits }} + | +{{ data.full_names }} | ++ {{ data.date_of_birth | date: 'dd/MM/yyyy' }} + | +{{ data.subcounty_county }} | +{{ data.village_estate_landmark }} | +{{ data.marital_status }} | +{{ data.parity }} | +{{ data.gravidae }} | ++ {{ data.last_lmp_date | date: 'dd/MM/yyyy' }} + | ++ {{ data.edd | date: 'dd/MM/yyyy' }} + | ++ {{ data.gestation_in_weeks }} + | +{{ data.muac }} | +{{ data.height }} | +{{ data.weight }} | +{{ data.blood_pressure }} | +{{ data.breast_exam }} | +{{ data.fgm }} | +{{ data.haemoglobin }} | +{{ data.blood_sugar_test }} | ++ {{ data.blood_group_rhesus }} + | +{{ data.urinalysis }} | +{{ data.rpr_vdrl_duo }} | +{{ data.hepatitisB }} | +{{ data.tb_screening }} | +{{ data.hiv_test_type }} | +{{ data.hiv_test_1_kit_name }} | +{{ data.hiv_test_2_kit_name }} | +{{ data.hiv_test_3_kit_name }} | +{{ data.hiv_results }} | +{{ data.maternal_haart }} | ++ {{ data.infant_prophylaxis }} + | ++ {{ data.partner_hiv_testing }} + | +{{ data.other_conditions }} | +{{ data.deworming }} | +{{ data.ipt_1_3 }} | +{{ data.tt_dose }} | +{{ data.supplementation }} | +{{ data.llitns }} | +{{ data.referrals_from }} | +{{ data.referrals_to }} | ++ {{ data.reason_for_referral }} + | +{{ data.remarks }} | +
| {{ data.NUPI }} | +{{ data.age }} | +{{ data.phone_number }} | +{{ data.fgm_complications }} | +{{ data.rpr_vdrl_duo_results }} | +{{ data.hepatitisB_treatment }} | ++ {{ data.hiv_test_1_expiry_date | date: 'dd/MM/yyyy' }} + | ++ {{ data.hiv_test_2_expiry_date | date: 'dd/MM/yyyy' }} + | ++ {{ data.hiv_test_3_expiry_date | date: 'dd/MM/yyyy' }} + | +{{ data.other_conditions_treatment }} | +|||||||||||||||||||||||||||||||||||
+ {{ errorMessage }} +
+| No | +Date | +AMRSID | +National Identification Number | +Client CCC Number | +Age | +Starting ART | +
+ TB in HIV Care (Newly Initiated on ART) + |
+ + Currently on ART (Starting and Continuing ART) + | +DSD | +Remarks | +|||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Client Unique Number (NUPI) | ++ Tick as appropriate for age + | +Screened for TB | +Started TPT | +
+ Indicate No. of months of till next appointment or + "R"for patients making unscheduled visits + |
+ Status | +Type | +|||||||||||||||||||||||||||||||||||||||||||||
| Indicate Y/N/NA | +
+ E=Established + NE=Not Established + |
+
+ C + FT + HFAG + PFAG + HCAG + PCAG + CP + CADP + IACD + |
+ |||||||||||||||||||||||||||||||||||||||||||||||||
| < 1 yrs (M) | +< 1 yrs (F) | +1-4 yrs (M) | +1-4 yrs (F) | +5-9 yrs (M) | +5-9 yrs (F) | +10-14 yrs (M) | +10-14 yrs (F) | +15-19 yrs (M) | +15-19 yrs (F) | +20-24 yrs(M) | +20-24 yrs (F) | +25+ yrs (M) | +25+ yrs (F) | +< 15 yrs | +15+ yrs | +< 15 yrs | +15+ yrs | +< 1 yrs (M) | +< 1 yrs (F) | +1-4 yrs (M) | +1-4 yrs (F) | +5-9 yrs (M) | +5-9 yrs (F) | +10-14 yrs (M) | +10-14 yrs (F) | +15-19 yrs (M) | +15-19 yrs (F) | +20-24 yrs(M) | +20-24 yrs (F) | +25+ yrs (M) | +25+ yrs (F) | +||||||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +(z) | +(aa) | +(ab) | +(ac) | +(ad) | +(ae) | +(af) | +(ag) | +(ah) | +(ai) | +(aj) | +(ak) | +(al) | +(am) | +(an) | +(ao) | +(ap) | +|||||||||||
| {{ a + 1 }} | ++ {{ data.date | date: 'dd/MM/yyyy' }} + | ++ {{ data.amrsID }} + | +{{ data.national_id_number }} | ++ {{ data.ccc_number?.replace('-', '') }} + | +{{ data.age }} | +
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+
+ |
+ {{ data.dsd_status }} | +{{ data.dsd_type }} | +{{ data.remarks }} | +|||||||||||
| {{ data.NUPI }} | +|||||||||||||||||||||||||||||||||||||||||||||||||||
| + Data element CODE + | ++ | + | HV03-O1 | +HVO3-02 | +HVO3-03 | +HVO3-04 | +HVO3-05 | +HVO3-06 | +HVO3-07 | +HVO3-08 | +HVO3-09 | +HVO3-10 | +HVO3-11 | +HVO3-12 | +HVO3-13 | +HVO3-14 | +HVO3-15 | +HVO3-16 | +HVO3-17 | +HVO3-18 | +HVO3-19 | +HVO3-20 | +HVO3-21 | +HVO3-22 | +HVO3-23 | +HVO3-24 | +HVO3-25 | +HVO3-26 | +HVO3-27 | +HVO3-28 | +HVO3-29 | +HVO3-30 | +HVO3-31 | +HVO3-32 | +HVO3-33 | +HVO3-34 | ++ | ||||||||||||||
| TOTAL this Page | +{{ careTreatmentRegisterData.length }} | ++ | + {{ getLessThanOneTotals(careTreatmentRegisterData, 'M') }} + | ++ {{ getLessThanOneTotals(careTreatmentRegisterData, 'F') }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 1, 4) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 1, 4) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 5, 9) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 5, 9) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 10, 14) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 10, 14) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 15, 19) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 15, 19) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 20, 24) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 20, 24) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 25) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 25) }} + | ++ | + | + | + | + {{ currentOnArtLessOneTotals(careTreatmentRegisterData, 'M') }} + | ++ {{ currentOnArtLessOneTotals(careTreatmentRegisterData, 'F') }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 1, 4) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 1, 4) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 5, 9) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 5, 9) }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 10, 14) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 10, 14) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 15, 19) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 15, 19) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 20, 24) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 20, 24) + }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 25) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 25) }} + | ++ | + | + | ||||||||||||||
| TOTAL this Month | +{{ careTreatmentRegisterData.length }} | ++ | + {{ getLessThanOneTotals(careTreatmentRegisterData, 'M') }} + | ++ {{ getLessThanOneTotals(careTreatmentRegisterData, 'F') }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 1, 4) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 1, 4) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 5, 9) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 5, 9) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 10, 14) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 10, 14) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 15, 19) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 15, 19) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 20, 24) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 20, 24) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'M', 25) }} + | ++ {{ getStartingARTTotals(careTreatmentRegisterData, 'F', 25) }} + | ++ | + | + | + | + {{ currentOnArtLessOneTotals(careTreatmentRegisterData, 'M') }} + | ++ {{ currentOnArtLessOneTotals(careTreatmentRegisterData, 'F') }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 1, 4) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 1, 4) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 5, 9) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 5, 9) }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 10, 14) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 10, 14) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 15, 19) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 15, 19) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 20, 24) + }} + | ++ {{ + getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 20, 24) + }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'M', 25) }} + | ++ {{ getCurrentOnARTTotals(careTreatmentRegisterData, 'F', 25) }} + | ++ | + | + | ||||||||||||||
| + | + | (e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +(z) | +(aa) | +(ab) | +(ac) | +(ad) | +(ae) | +(af) | +(ag) | +(ah) | +(ai) | +(aj) | +(ak) | +(al) | +(am) | +(an) | +(ao) | +||||||||||||||
| + Summary of clinical visits + | ++ Count of clients with 2 months appointment + | ++ | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |||||||||||||||||||||||||||||||
| Total this Month(2s) | ++ | + | + | + | + {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 2, + 'M' + ) + }} + | ++ {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 2, + 'F' + ) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'M', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'F', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'M', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'F', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'M', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'F', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'M', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'F', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'M', 20, 24) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 2, 'F', 20, 24) + }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 2, 'M', 25) }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 2, 'F', 25) }} + | +|||||||||||||||||||||||||||||||||
| + Count of clients with 3 months appointment + | ++ | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |||||||||||||||||||||||||||||||||
| Total this Month (3s) | ++ | + | + | + | + {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 3, + 'M' + ) + }} + | ++ {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 3, + 'F' + ) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'M', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'F', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'M', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'F', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'M', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'F', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'M', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'F', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'M', 20, 24) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 3, 'F', 20, 24) + }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 3, 'M', 25) }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 3, 'F', 25) }} + | +|||||||||||||||||||||||||||||||||
| + Count of clients with 4 months appointment + | ++ | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |||||||||||||||||||||||||||||||||
| Total this Month (4s) | ++ | + | + | + | + {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 4, + 'M' + ) + }} + | ++ {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 4, + 'F' + ) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'M', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'F', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'M', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'F', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'M', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'F', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'M', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'F', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'M', 20, 24) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 4, 'F', 20, 24) + }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 4, 'M', 25) }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 4, 'F', 25) }} + | +|||||||||||||||||||||||||||||||||
| + Count of clients with 5 mnths appointment + | ++ | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |||||||||||||||||||||||||||||||||
| Total this Month (5s) | ++ | + | + | + | + {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 5, + 'M' + ) + }} + | ++ {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 5, + 'F' + ) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'M', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'F', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'M', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'F', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'M', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'F', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'M', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'F', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'M', 20, 24) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 5, 'F', 20, 24) + }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 5, 'M', 25) }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 5, 'F', 25) }} + | +|||||||||||||||||||||||||||||||||
| + Count of clients with 6 months appointment + | ++ | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |||||||||||||||||||||||||||||||||
| Total this Month (6s) | ++ | + | + | + | + {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 6, + 'M' + ) + }} + | ++ {{ + getAppointmentTotalsAgeLessThanOne( + careTreatmentRegisterData, + 6, + 'F' + ) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'M', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'F', 1, 4) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'M', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'F', 5, 9) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'M', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'F', 10, 14) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'M', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'F', 15, 19) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'M', 20, 24) + }} + | ++ {{ + getAppointmentTotals(careTreatmentRegisterData, 6, 'F', 20, 24) + }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 6, 'M', 25) }} + | ++ {{ getAppointmentTotals(careTreatmentRegisterData, 6, 'F', 25) }} + | +|||||||||||||||||||||||||||||||||
+ {{ errorMessage }} +
++ {{ errorMessage }} +
+|
+ Defaulter Tracing Register + Enter all current clients that did not come for their scheduled + appointment + |
+ ||||||||
|---|---|---|---|---|---|---|---|---|
| Section A | ++ | Section B | ++ | |||||
| Client Tracking Information | ++ | Defaulter Tracing Outcomes | ++ | |||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +
| S/No. | +
+ Client Identification / + Number + |
+
+ Client Name + (First,Middle,Last) + |
+
+ Village/Estate/ + Landmark + |
+ Telephone number | +
+ Date of missed + appointment + |
+
+ Return to Care/ + Dead/ + Transferred/ + Stopped Treatment/ + On follow up + |
+
+ Date of outcome + (dd/mm/yyyy) + |
+ Remarks | +
|
+ Unique Patient + Number (NUPI) + |
+ ||||||||
| {{ a + 1 }} | +{{ data.client_id_No }} | ++ {{ data.first_name }} {{ data.middle }} {{ data.last_name }} + | +{{ data.village }} | +{{ data.telephone_number }} | ++ {{ data.date_of_missed_appointment | date: 'dd/MM/yyyy' }} + | +{{ data.defaulter_tracing_outcomes }} | ++ {{ data.date_of_outcomes | date: 'dd/MM/yyyy' }} + | +{{ data.outcomes }} | +
| {{ data.nupi }} | +||||||||
+ {{ errorMessage }} +
+| + Cohort: Month/Year (MMM-YYYY)...........................{{ + formattedStartDate + }}.............................................. + | +|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Infant and Mother/Guardian Information | ++ First HIV DNA PCR Test at Birth, 6 weeks or First Contact + | +Second HIV DNA PCR Tes | +Third HIV DNA PCR Test | +HEI Outcomes at 12 months | +Confirmatory PCR | +Antibody test (18 to 24 months) | +HEI Outcomes at 24 months | +Comments | +|||||||||||||||||||||||||||||||||||||||||||||||||
| Registration Information | +Infant's information | +Parent's information | +|||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Serial No. | +Date of enrollment (DD/MM/YYYY) | +
+ Birth Certificate + Number + |
+ HEI ID (MFL-YYYY-NNNN) | +Infant's Name | +DOB (DD/MM/YYYY) | +Sex | ++ Infant Prophylaxis 1=NVP, 2=AZT, 3=NVP &AZT, 4=None, + | +Father's/Mother's/Guardian's Name | +Age at Test (in wks) | ++ Type of Test 1=At Birth 2=at 6 weeks 3=at First Contact + | +Date Sample Collected | +Age at Test (in months) | +Date Sample Collected | +Age at Test (in months) | +Date Sample Collected | +Infant Feeding | ++ 1=Infected 2= Uninfected 3=Lost to Follow 4=Transfer Out 5=Dead + | +Age at Test (in months) | +Date Sample Collected | +Age at Test (in months) | +Date Sample Collected | +Infant Feeding | ++ 1=Infected 2= Uninfected 3=Lost to Follow 4=Transfer Out 5=Dead + | +||||||||||||||||||||||||||||||||||
| Client Unique Number (NUPI) | +(M/F) | +(M/F) | +Telephone number | +Test result (P,N) | +Test result (P,N) | +Test result (P,N) | +BF=Breastfeeding NBF=Not Breastfeeding | +Test result (P,N) | +Test result (P,N) | +BF=Breastfeeding NBF=Not Breastfeeding | +|||||||||||||||||||||||||||||||||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(p) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +|||||||||||||||||||||||||||||||||
| {{ a + 1 }} | ++ {{ transformDate(data.date_enrolled) }} + | ++ {{ data.Birth_Certificate_number }} + | ++ {{ data.HEI_ID }} + | ++ {{ data.given_name }} {{ data.middle_name }} + {{ data.family_name }} + | ++ {{ transformDate(data.dob) }} + | +Sex | +{{ data.infant_prophylaxis }} | +{{ data.parent_name }} | ++ {{ data.pcr_one ? data.pcr_one_age_weeks : '' }} + | ++ {{ date_enrolled }} + | ++ {{ transformDate(data.pcr_one ? data.pcr_one_date : '') }} + | ++ {{ data.pcr_two ? data.pcr_two_age_months : '' }} + | ++ {{ transformDate(data.pcr_two ? data.pcr_two_date : '') }} + | ++ {{ data.pcr_three ? data.pcr_three_age_months : '' }} + | ++ {{ transformDate(data.pcr_three ? data.pcr_three_date : '') }} + | +Infant Feeding | ++ {{ null }} + | ++ {{ data.confirm_pcr ? data.confirm_pcr_age_months : '' }} + | ++ {{ transformDate(data.confirm_pcr ? data.confirm_pcr_date : '') }} + | ++ {{ data.age_in_months_on_first_antibody }} + | ++ {{ transformDate(data.antibody_date) }} + | +{{ null }} | ++ {{ data.death_date ? data.death_date : data.hei_outcome }} + | +{{ data.remarks }} | +|||||||||||||||||||||||||||||||||
| {{ data.NUPI }} | +{{ data.gender }} | +{{ data.Phone_Number }} | ++ {{ data.pcr_one }} + | ++ {{ data.pcr_two }} + | ++ {{ data.pcr_three }} + | ++ {{ data.infant_feeding }} + | ++ {{ data.confirm_confirm }} + | ++ {{ data.antibody_test }} + | ++ {{ data.age_in_months === 24 ? data.infant_feeding : '' }} + | +{{ null }} | +|||||||||||||||||||||||||||||||||||||||||||||||
+ {{ errorMessage }} +
+|
+ Serial + Number + |
+
+ National + Identification + Number + |
+ AMRSID | +
+ Date of visit + (DD/MM/YYYY) + |
+
+ Client Name + (First, Middle, Last) + |
+ Age | +
+ Sex + (M/F) + |
+ Telephone Number | +
+ Marital + Status + 1=Married + 2=Widowed + 3=Single + 4=Divorced + 5=Separated + |
+
+ Population Type + 1. Gen Pop + 2. Key and + Vulnerable Pop. + Codes for KVP + - DC + - MSM/MSW + - FSW + - PWID/PWUD + - VP + |
+
+ Setting + (1=Facility + 2=Community) + |
+ HIV Test 1 | +HIV Test 2 | +HIV Test 3 | +
+ Final HIV + Result + |
+
+ Discordant + Couple + |
+
+ Referred for + Prevention + Services + 1. PrEP + 2. PEP + 3. VMMC + 4. PMTCT + 5.NA + |
+
+ HTS Provider + (Name) + |
+ Remarks | +
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
+ National Unique + Patient Identifier + (NUPI) Number + |
+ Kit Name: | +Kit Name: | +Kit Name: | +(N,P,Ic) | +(Y/N/NA) | +|||||||||||||
| Lot No. | +Lot No. | +Lot No. | +||||||||||||||||
| Expiry Date / / | +Expiry Date / / | +Expiry Date / / | +||||||||||||||||
| (N,P,I) | +(N,P,I,NA) | +(N,P,I,NA) | +||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(p) | +(q) | +(r) | +(s) | +
| {{ item.serialNumber }} | +{{ item.nupiNumber }} | +{{ item.amrsID }} | +{{ item.visitDate }} | +{{ item.clientName }} | +{{ item.age }} | +{{ item.sex }} | +{{ item.telephoneNumber }} | +{{ item.maritalStatus }} | +{{ item.populationType }} | +{{ item.setting }} | ++ {{ item.hivTest1.kitName }} / {{ item.hivTest1.lotNumber }} / + {{ item.hivTest1.expiryDate }} + | ++ {{ item.hivTest2.kitName }} / {{ item.hivTest2.lotNumber }} / + {{ item.hivTest2.expiryDate }} + | ++ {{ item.hivTest3.kitName }} / {{ item.hivTest3.lotNumber }} / + {{ item.hivTest3.expiryDate }} + | +{{ item.finalHivResult }} | +{{ item.discordantCouple }} | ++ {{ null }} + | +{{ item.htsProvider }} | +{{ item.remarks }} | +
| {{ item.nationalId }} | +{{ item.subPopulation }} | +
| Tests (n) | +2-9 | +10-14 | +15-19 | +20-24 | +25+ | +Total | +
|---|---|---|---|---|---|---|
| Male | +{{ getTotals(htsLabData, 'M', 2, 9) }} | +{{ getTotals(htsLabData, 'M', 10, 14) }} | +{{ getTotals(htsLabData, 'M', 15, 19) }} | +{{ getTotals(htsLabData, 'M', 20, 24) }} | +{{ getTotals(htsLabData, 'M', 25) }} | +{{ getTotal(htsLabData, 'M') }} | +
| Female | +{{ getTotals(htsLabData, 'F', 2, 9) }} | +{{ getTotals(htsLabData, 'F', 10, 14) }} | +{{ getTotals(htsLabData, 'F', 15, 19) }} | +{{ getTotals(htsLabData, 'F', 20, 24) }} | +{{ getTotals(htsLabData, 'F', 25) }} | +{{ getTotal(htsLabData, 'F') }} | +
| Total | +{{ getMaleAndFemaleTotal(htsLabData, 2, 9) }} | +{{ getMaleAndFemaleTotal(htsLabData, 10, 14) }} | +{{ getMaleAndFemaleTotal(htsLabData, 15, 19) }} | +{{ getMaleAndFemaleTotal(htsLabData, 20, 24) }} | +{{ getMaleAndFemaleTotal(htsLabData, 25) }} | +{{ htsLabData.length }} | +
| Positive (n) | +2-9 | +10-14 | +15-19 | +20-24 | +25+ | +Total | +
|---|---|---|---|---|---|---|
| Male | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'M', + 2, + 9 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'M', + 10, + 14 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'M', + 15, + 19 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'M', + 20, + 24 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'M', + 25 + ) + }} + | ++ {{ + getParameterTotals(htsLabData, 'finalHivResult', 'P', 'M') + }} + | +
| Female | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'F', + 2, + 9 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'F', + 10, + 14 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'F', + 15, + 19 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'F', + 20, + 24 + ) + }} + | ++ {{ + getParameterTotalsWithAge( + htsLabData, + 'finalHivResult', + 'P', + 'F', + 25 + ) + }} + | ++ {{ getParameterTotals(htsLabData, 'finalHivResult', 'P', 'F') }} + | +
| Total | ++ {{ getPositiveMaleAndFemaleTotalWithAge(htsLabData, 2, 9) }} + | ++ {{ getPositiveMaleAndFemaleTotalWithAge(htsLabData, 10, 14) }} + | ++ {{ getPositiveMaleAndFemaleTotalWithAge(htsLabData, 15, 19) }} + | ++ {{ getPositiveMaleAndFemaleTotalWithAge(htsLabData, 20, 24) }} + | ++ {{ getPositiveMaleAndFemaleTotalWithAge(htsLabData, 25) }} + | +{{ getPositiveTotal(htsLabData) }} | +
| Total Negative (n) | +
|---|
| + {{ getParameterTotals(htsLabData, 'finalHivResult', 'N') }} + | +
| Inconclusive test (n) | +
|---|
| + {{ getParameterTotals(htsLabData, 'finalHivResult', 'I') }} + | +
| Tests Facility (j) | +{{ getParameterTotals(htsLabData, 'setting', '1') }} | +
|---|---|
| Tests Community (j) | +{{ getParameterTotals(htsLabData, 'setting', '2') }} | +
| Discordant (o) | ++ {{ getParameterTotals(htsLabData, 'discordantCouple', 'Y') }} + | +
|---|
| Tests Key pops (i) | ++ {{ getParameterTotals(htsLabData, 'populationType', '2') }} + | +
|---|---|
| Positive key pops (i) & (n) | ++ {{ + getParameterTotals(htsLabData, 'populationType', '2') + + getParameterTotals(htsLabData, 'finalHivResult', 'P') + }} + | +
| HIV Test 1 (k) Number | +HIV Test 2 (I) | +Number | +HIV Test 3 (m) | +Number | +|
|---|---|---|---|---|---|
| N: Negative | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'N') }} + | +N: Negative | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'N') }} + | +N: Negative | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'N') }} + | +
| P: Positive | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'P') }} + | +P: Positive | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'P') }} + | +P: Positive | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'P') }} + | +
| I: Invalid | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'I') }} + | +I: Invalid | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'I') }} + | +I: Invalid | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'P') }} + | +
| Wastage: | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'NA') }} + | +Wastage: | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'NA') }} + | +Wastage: | ++ {{ getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'NA') }} + | +
| Total: | ++ {{ + getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'N') + + getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'P') + + getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'I') + + getHivTestTypesAndTotals(htsLabData, 'hivTest1', 'NA') + }} + | +Total: | ++ {{ + getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'N') + + getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'P') + + getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'I') + + getHivTestTypesAndTotals(htsLabData, 'hivTest2', 'NA') + }} + | +Total: | ++ {{ + getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'N') + + getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'P') + + getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'I') + + getHivTestTypesAndTotals(htsLabData, 'hivTest3', 'NA') + }} + | +
|
+ Serial + Number + |
+ AMRSID | +
+ National Identification + Number + |
+ Client Names | +Telephone Number | +
+ Identification + Strategy + (VCT/IT/HIVST + /SNS) + |
+ Patient referred to | +
+ Handed over to: + (Indicate Name (upper cell) + and Cadre (lower cell) + |
+
+ Date started on + ART + |
+ CCC Number | +Remarks | +
|---|---|---|---|---|---|---|---|---|---|---|
|
+ National Unique + Patient Identifier + (NUPI) Number + |
+ Residence | +|||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +|
| {{ item.serialNumber }} | +{{ item.amrsID }} | +{{ item.nupiNumber }} | +{{ item.clientName }} | +{{ item.telephoneNumber }} | +{{ item.identificationStrategy }} | +{{ item.patientReferredTo }} | +{{ item.handedOverTo }} | +{{ item.artStartDate }} | +{{ item.cccNumber }} | +{{ item.remarks }} | +
| {{ item.nationalId }} | +{{ item.residence }} | +{{ item.cadre }} | +||||||||
| Totals Clients Linked | +{{ pinnedBottomRowData[0].totalLinked }} | +|||||||||
+ {{ errorMessage }} +
+|
+ Date of + Admission + (dd/mm/yyyy) + |
+ Admission number (yyyy-mm-nnnn) | +
+ Full Name + (First, Middle, surname) + |
+
+ Date of Birth + (dd/mm/yyyy) + |
+
+ County/ + Subcounty + |
+
+ Village/ + Estate/ + Land mark + |
+
+ Marital Status + 1 = Married + 2 = Widowed + 3 = Single + 4 = Divorced + 5 = Separated + |
+
+ Parity + (X+Y) + |
+ Gravidae | +
+ No. of + ANC + visits + |
+
+ Date of Last + Menstrual + Period (LMP) + (dd/mm/yyyy) + |
+
+ Estimated Date + of Delivery + (EDD) + (dd/mm/yyyy) + |
+ Diagnosis | +Delivery | ++ |
+ VDRL/ + RPR + Results + (Specify + 1-VDRL + 2-RPR + 3-Duo + testing) + |
+ Baby | +
+ Maternal + HAART + |
+
+ Infant + Prophylaxis + |
+
+ Partner + Tested for + HIV + |
+
+ Counselled + on infant + feeding + (Y/N/NA) + |
+
+ Delivery + Conducted by + (Enter Name) + |
+
+ Birth + Notification + Number + |
+ Discharge | +Referral | +Comments | +||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NUPI | +Age | +Phone number | +
+ Duration of + labour + (hours) + |
+
+ Date of + Delivery + (dd/mm/yyyy) + |
+
+ Time of + Delivery + |
+
+ Gestation + at Birth + (wks) + |
+
+ Mode of + Delivery + 1) SVD + 2) CS + 3) Breech + 4) AVD + |
+
+ No.of babies + delivered + |
+
+ Placenta + Complete + 1=Yes + 2=No + 3=BBA + |
+
+ Uterotonic + given + 1=oxytocin + 2=Carbetocin + 3=Others + Specify + 4= None + |
+
+ Vaginal + Examination + 1= Normal + 2=Episiotomy + 3=Vaginal tear + 4=FGM + 5=Vaginal warts + |
+
+ Blood + loss + (mls) + |
+
+ Mother's + status after + Delivery + (Alive/ + Dead) + |
+
+ Maternal deaths + Notified + (Y/N/NA) + |
+
+ Delivery + Complications + 1=A.P.H. (Ante Partum + Haemorrhage); + 2=P.P.H. (Post Partum + Haemorrhage); + 3= Eclampsia; + 4=Ruptured Uterus; + 5=Obstructed labour; + 6=Sepsis + 7= NA + |
+
+ APGAR + Score + |
+
+ Birth + Outcome + (LB/FSB/ + MSB) + |
+
+ Birth + Weight + (grams) + |
+
+ Sex + (M/F) + |
+
+ Initiated on + BF in + < 1hr + (Y/N) + |
+
+ TEO + given at + birth? + (Y/N) + |
+
+ Chlorhexidine + applied on + cord stump + (Y/N) + |
+
+ Birth with + deformity + (Y/N) + |
+
+ Given + Vitamin + K + (Y/N) + |
+ (P/N/ND) | +HIV Test 1 | +HIV Test 2 | +HIV Test 3 | +
+ HIV Result + Maternity + (N/P/Inc/U/NA) + |
+
+ Start at + Maternity + |
+ (Y/N/NA) | +(Y/N/NA) | +
+ Date + (dd/mm/yyyy) + |
+
+ Status of + Baby + A= Alive + D= Dead + |
+ From | +To | +Reason for referral | +||||||||||||||
|
+ Date Death + notified + |
+
+ Kangaroo + Mother + Care + (Y/N) + |
+
+ 1- congenital + syphilis. + 2- spina bifida, + 3- Hydrocephalus, + 4- Talipes + |
+ Kit Name: | +Kit Name: | +Kit Name: | +
+ Initial/Retest/ + NA + |
+ (Y/N/NA) | +
+ 1= From Community + Unit, + 2= From Another + Health Facility, + 3=Not Applicable + |
+
+ 1= To Community + Unit, + 2=Referred to HIV + preventive services + 3=Another Health + Facility, + 4=Not Applicable + |
+ ||||||||||||||||||||||||||||||||||||||||||
| Lot No. | +Lot No. | +Lot No. | +|||||||||||||||||||||||||||||||||||||||||||||||||
| Expiry / / | +Expiry / / | +Expiry / / | +|||||||||||||||||||||||||||||||||||||||||||||||||
| (N/P/I/NA) | +(N/P/I/NA) | +(N/P/I/NA) | +|||||||||||||||||||||||||||||||||||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(p) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +(z) | +(aa) | +(ab) | +(ac) | +(ad) | +(ae) | +(af) | +(ag) | +(ah) | +(ai) | +(aj) | +(ak) | +(al) | +(am) | +(an) | +(ao) | +(ap) | +(aq) | +(ar) | +(as) | +(at) | +(au) | +(av) | +(aw) | +(ax) | +||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||||||||||
+ {{ errorMessage }} +
+|
+ National AIDS & STI Control Program- NASCOP + Comprehensive HIV/ AIDS reporting form +
+ (MOH 731-Ver. July 2023)
+
+ |
+
| + County______________________SubCounty___________________Facility___________________MFL_______Month______year______ + | +
| 1. HIV Testing & Pre exposure Prophylaxis | +||
|---|---|---|
| 1.1 HIV Tests | +||
| + | Male | +Female(Including PMTCT) | +
| Tests | +
+ HV01-01
+ {{ MOH731RegisterData.hiv_male }}
+ |
+
+
+ HV01-02
+
+ {{ MOH731RegisterData.hiv_female }}
+ |
+
| Tests_Facility | +
+ HV01-03
+
+ {{ MOH731RegisterData.hiv_setting_facility }}
+
+ |
+ |
| Tests_Community | +
+ HV01-04
+
+ {{ MOH731RegisterData.hiv_setting_community }}
+
+ |
+ |
| Tested KVP | +
+ HV01-05
+
+ {{ MOH731RegisterData.hiv_setting_kvp }}
+
+ |
+ |
| + 1.3 No. Initiated on PrEP(NEW) + | +||
| + | Male | +Female | +
| General popn | +
+ HV01-19
+
+ {{ MOH731RegisterData.prep_new_male_general_pop }}
+
+ |
+
+
+ HV01-20
+
+
+ {{ MOH731RegisterData.prep_new_female_general_pop }}
+
+ |
+
| MSM/MSW | +
+ HV01-21
+ {{ MOH731RegisterData.prep_new_msm }}
+ |
+ + |
| FSW | ++ |
+
+ HV01-22
+
+
+ {{ MOH731RegisterData.prep_new_fsw }}
+
+ |
+
| PWID/PWUD | +
+ HV01-23
+
+ {{ MOH731RegisterData.prep_new_pwud_male }}
+
+ |
+
+
+ HV01-24
+
+
+ {{ MOH731RegisterData.prep_new_pwud_female }}
+
+ |
+
| Discordant Couple | +
+ HV01-25
+
+ {{ MOH731RegisterData.prep_new_discordant_male }}
+
+ |
+
+
+ HV01-26
+
+
+ {{ MOH731RegisterData.prep_new_discordant_female }}
+
+ |
+
| Vulnerable Pop. | +
+ HV01-27
+
+ {{ MOH731RegisterData.prep_new_vulnerable_male }}
+
+ |
+
+
+ HV01-28
+
+
+ {{ MOH731RegisterData.prep_new_vulnerable_female }}
+
+ |
+
| AYP (10-24yrs) | +
+ HV01-29
+ {{ MOH731RegisterData.prep_new_ayp }}
+ |
+
+
+ HV01-30
+
+
+ {{ MOH731RegisterData.prep_new_ayp }}
+
+ |
+
| Pregnant and breastfeeding women | ++ |
+
+ HV01-31
+
+
+ {{ MOH731RegisterData.prep_new_preg_breastfeeding }}
+
+ |
+
| + 1.5 No. Seroconverted while on PrEP + | +||
| + | Male | +Female | +
| HIV Positive | +
+ HV01-45
+
+ {{ MOH731RegisterData.seroconverted_male }}
+
+ |
+
+
+ HV01-46
+
+
+ {{ MOH731RegisterData.seroconverted_female }}
+
+ |
+
| + 1.2 HIV Positive Results + | +||
| + | Male | +Female | +
| Positive_2-9 | +
+ HV01-06
+ {{ MOH731RegisterData.male_2_9 }}
+ |
+
+
+ HV01-07
+
+ {{ MOH731RegisterData.female_2_9 }}
+ |
+
| Positive_10-14 | +
+ HV01-08
+ {{ MOH731RegisterData.male_10_14 }}
+ |
+
+
+ HV01-09
+
+
+ {{ MOH731RegisterData.female_10_14 }}
+
+ |
+
| Positive_15-19 | +
+ HV01-10
+ {{ MOH731RegisterData.male_15_19 }}
+ |
+
+
+ HV01-11
+
+
+ {{ MOH731RegisterData.female_15_19 }}
+
+ |
+
| Positive_20-24 | +
+ HV01-12
+ {{ MOH731RegisterData.male_20_24 }}
+ |
+
+
+ HV01-13
+
+
+ {{ MOH731RegisterData.female_20_24 }}
+
+ |
+
| Positive_25+ | +
+ HV01-14
+
+ {{ MOH731RegisterData.male_25_above }}
+
+ |
+
+
+ HV01-15
+
+
+ {{ MOH731RegisterData.female_25_above }}
+
+ |
+
| Positive_KVP | ++ HV01-16 + + | +|
| Discordant | ++ HV01-17 + + | +
+
+ HV01-18
+
+
+ |
+
| Inconclusive Test Results | ++ HV01-47 + + | +
+
+ HV01-48
+
+
+ |
+
| + 1.4 No. on PrEP Diagnosed with STI + | +||
| + | Male | +Female | +
| General popn | +
+ HV01-32
+
+ {{ MOH731RegisterData.prep_sti_male_general_pop }}
+
+ |
+
+
+ HV01-33
+
+
+ {{ MOH731RegisterData.prep_sti_female_general_pop }}
+
+ |
+
| MSM/MSW | +
+ HV01-34
+ {{ MOH731RegisterData.prep_sti_msm }}
+ |
+ + |
| FSW | +
+ HV01-35
+ {{ MOH731RegisterData.prep_sti_fsw }}
+ |
+ + |
| PWID/PWUD | +
+ HV01-36
+
+ {{ MOH731RegisterData.prep_sti_pwud_male }}
+
+ |
+
+
+ HV01-37
+
+
+ {{ MOH731RegisterData.prep_sti_pwud_female }}
+
+ |
+
| Discordant Couple | +
+ HV01-38
+
+ {{ MOH731RegisterData.prep_sti_discordant_male }}
+
+ |
+
+
+ HV01-39
+
+
+ {{ MOH731RegisterData.prep_sti_discordant_female }}
+
+ |
+
| Vulnerable Pop. | +
+ HV01-40
+
+ {{ MOH731RegisterData.prep_sti_vulnerable_male }}
+
+ |
+
+
+ HV01-41
+
+
+ {{ MOH731RegisterData.prep_sti_vulnerable_female }}
+
+ |
+
| AYP(10-24 yrs) | +
+ HV01-42
+ {{ MOH731RegisterData.prep_sti_ayp }}
+ |
+
+
+ HV01-43
+
+
+ {{ MOH731RegisterData.prep_sti_ayp }}
+
+ |
+
| Pregnant and breastfeeding women | ++ |
+
+ HV01-44
+
+
+ {{ MOH731RegisterData.prep_sti_preg_breastfeeding }}
+
+ |
+
| + 2. Elimination of Mother-to-Child Transmission(EMTCT) + | +||
| + 2.1 Maternal HIV Testing + | +||
| Known Positive at 1st ANC | +
+ HV02-01
+
+ {{ MOH731RegisterData.known_positive_1st_anc }}
+
+ |
+ + |
| + | Initial | +Retest | +
| Tested at ANC | +
+ HV02-02
+
+ {{ MOH731RegisterData.initial_test_anc }}
+
+ |
+
+
+ HV02-03
+
+ {{ MOH731RegisterData.retest_anc }}
+ |
+
| Tested at L&D | +
+ HV02-04
+
+ {{ MOH731RegisterData.initial_test_LD }}
+
+ |
+
+
+ HV02-05
+
+ {{ MOH731RegisterData.retest_LD }}
+ |
+
| Tested at PNC_<=6weeks | +
+ HV02-06
+
+ {{ MOH731RegisterData.initial_test_pnc_less_6_weeks }}
+
+ |
+
+
+ HV02-07
+
+
+ {{ MOH731RegisterData.retest_pnc_less_6_weeks }}
+
+ |
+
| Tested at PNC_>6weeks | +
+ HV02-08
+
+ {{ MOH731RegisterData.initial_test_pnc_greater_6_weeks }}
+
+ |
+
+
+ HV02-09
+
+
+ {{ MOH731RegisterData.retest_pnc_greater_6_weeks }}
+
+ |
+
| + 2.2 HIV Positive Results + | +||
| Tested at ANC | +
+ HV02-10
+ {{ MOH731RegisterData.positive_anc }}
+ |
+ + |
| Tested at L&D | +
+ HV02-11
+ {{ MOH731RegisterData.positive_LD }}
+ |
+ + |
| Tested at PNC_<=6weeks | +
+ HV02-12
+
+ {{ MOH731RegisterData.positive_pnc_less_6_weeks }}
+
+ |
+ + |
| Tested at PNC_>6weeks | +
+ HV02-13
+
+ {{ MOH731RegisterData.positive_pnc_greater_6_weeks }}
+
+ |
+ + |
| + 2.3 Maternal HAART + | +||
| On HAART at 1st ANC | +
+ HV02-14
+
+ {{ MOH731RegisterData.maternal_haart_1st_anc }}
+
+ |
+ + |
| Start HAART_ANC | +
+ HV02-15
+
+ {{ MOH731RegisterData.start_maternal_haart_1st_anc }}
+
+ |
+ + |
| Start HAART_L&D | +
+ HV02-16
+
+ {{ MOH731RegisterData.start_maternal_haart_LD }}
+
+ |
+ + |
| Start HAART_PNC_< =6weeks | +
+ HV02-17
+
+ {{ MOH731RegisterData.maternal_haart_less_6_weeks }}
+
+ |
+ + |
| Start HAART_PNC_>6weeks | +
+ HV02-18
+
+ {{ MOH731RegisterData.maternal_haart_more_6_weeks }}
+
+ |
+ + |
| + 2.4 HBV Screening at ANC + | +||
| Screened_HBV_ANC | ++ HV02-19 + + | ++ |
| HBV Screened_Positive | +
+ HV02-20
+
+ {{ MOH731RegisterData.hbv_screened_positive_anc }}
+
+ |
+ + |
|
+ 2.5 Adolescents girls & Young Women (10-24 Yrs) + testing & results + |
+ ||
| + | 10-19yrs | +20-24yrs | +
| 1st ANC KP | +
+ HV02-21
+
+ {{ MOH731RegisterData.known_positive_anc_10_19 }}
+
+ |
+
+
+ HV02-22
+
+
+ {{ MOH731RegisterData.known_positive_anc_20_24 }}
+
+ |
+
| New HIV Positive | +
+ HV02-23
+
+ {{ MOH731RegisterData.positive_anc_ld_pnc_10_19 }}
+
+ |
+
+
+ HV02-24
+
+
+ {{ MOH731RegisterData.positive_anc_ld_pnc_20_24 }}
+
+ |
+
| On HAART 1st ANC KP | +
+ HV02-25
+
+ {{ MOH731RegisterData.on_art_anc_10_19 }}
+
+ |
+
+
+ HV02-26
+
+
+ {{ MOH731RegisterData.on_art_anc_20_24 }}
+
+ |
+
| Started HAART New | +
+ HV02-27
+
+ {{ MOH731RegisterData.start_art_10_19 }}
+
+ |
+
+
+ HV02-28
+
+
+ {{ MOH731RegisterData.start_art_20_24 }}
+
+ |
+
| + 2.6 Infant Prophylaxis + | +||
| Infant ARV Prophylaxis_ANC | +
+ HV02-29
+
+ {{ MOH731RegisterData.infant_arv_anc }}
+
+ |
+ + |
| Infant ARV Prophylaxis_L&D | +
+ HV02-30
+
+ {{ MOH731RegisterData.infant_arv_ld }}
+
+ |
+ + |
| Infant ARV Prophylaxis_L&PNC | +
+ HV02-31
+
+ {{ MOH731RegisterData.infant_arv_pnc }}
+
+ |
+ + |
| + 2.7 Infant Feeding + | +||
| Below 6 months | +||
| Exclusive Breastfeeding (EBF) | +
+ HV02-32
+ {{ MOH731RegisterData.exclusive_bf }}
+ |
+ + |
| 6 to 24 months | +||
| Breastfeeding (BF) | +
+ HV02-33
+ {{ MOH731RegisterData.bf }}
+ |
+ + |
| Not Breastfeeding (NBF) | +
+ HV02-34
+ {{ MOH731RegisterData.weaning }}
+ |
+ + |
| 3. HIV and TB treatment | +||
| + 3.1 Starting ART + | +||
| Start ART_<1 | +
+ (M) HV03-01
+
+ {{ MOH731RegisterData.art_new_less_1_male }}
+
+ |
+
+
+ (F) HV03-02
+
+
+ {{ MOH731RegisterData.art_new_less_1_female }}
+
+ |
+
| Start ART 1-4 | +
+ (M) HV03-03
+
+ {{ MOH731RegisterData.art_new_1_4_male }}
+
+ |
+
+
+ (F) HV03-04
+
+
+ {{ MOH731RegisterData.art_new_1_4_female }}
+
+ |
+
| Start ART 5-9 | +
+ (M) HV03-05
+
+ {{ MOH731RegisterData.art_new_5_9_male }}
+
+ |
+
+
+ (F) HV03-06
+
+
+ {{ MOH731RegisterData.art_new_5_9_female }}
+
+ |
+
| Start ART 10-14 | +
+ (M) HV03-07
+
+ {{ MOH731RegisterData.art_new_10_14_male }}
+
+ |
+
+
+ (F) HV03-08
+
+
+ {{ MOH731RegisterData.art_new_10_14_female }}
+
+ |
+
| Start ART 15-19 | +
+ (M) HV03-09
+
+ {{ MOH731RegisterData.art_new_15_19_male }}
+
+ |
+
+
+ (F) HV03-10
+
+
+ {{ MOH731RegisterData.art_new_15_19_female }}
+
+ |
+
| Start ART 20-24 | +
+ (M) HV03-11
+
+ {{ MOH731RegisterData.art_new_20_24_male }}
+
+ |
+
+
+ (F) HV03-12
+
+
+ {{ MOH731RegisterData.art_new_20_24_female }}
+
+ |
+
| Start ART 25+ | +
+ (M) HV03-013
+
+ {{ MOH731RegisterData.art_new_25_above_male }}
+
+ |
+
+
+ (F) HV03-014
+
+
+ {{ MOH731RegisterData.art_new_25_above_female }}
+
+ |
+
| + 3.2 Curently on ART ([ALL]) + | +||
| On ART_<1 | +
+ (M) HV03-015
+
+ {{ MOH731RegisterData.on_art_less_1_male }}
+
+ |
+
+
+ (F) HV03-016
+
+
+ {{ MOH731RegisterData.on_art_less_1_female }}
+
+ |
+
| On ART 1-4 | +
+ (M) HV03-017
+
+ {{ MOH731RegisterData.on_art_1_4_male }}
+
+ |
+
+
+ (F) HV03-018
+
+
+ {{ MOH731RegisterData.on_art_1_4_female }}
+
+ |
+
| On ART 5-9 | +
+ (M) HV03-019
+
+ {{ MOH731RegisterData.on_art_5_9_male }}
+
+ |
+
+
+ (F) HV03-020
+
+
+ {{ MOH731RegisterData.on_art_5_9_female }}
+
+ |
+
| On ART 10-14 | +
+ (M) HV03-021
+
+ {{ MOH731RegisterData.on_art_10_14_male }}
+
+ |
+
+
+ (F) HV03-022
+
+
+ {{ MOH731RegisterData.on_art_10_14_female }}
+
+ |
+
| On ART 15-19 | +
+ (M) HV03-023
+
+ {{ MOH731RegisterData.on_art_15_19_male }}
+
+ |
+
+
+ (F) HV03-024
+
+
+ {{ MOH731RegisterData.on_art_15_19_female }}
+
+ |
+
| On ART 20-24 | +
+ (M) HV03-025
+
+ {{ MOH731RegisterData.on_art_20_24_male }}
+
+ |
+
+
+ (F) HV03-026
+
+
+ {{ MOH731RegisterData.on_art_20_24_female }}
+
+ |
+
| On ART 25+ | +
+ (M) HV03-027
+
+ {{ MOH731RegisterData.on_art_25_above_male }}
+
+ |
+
+
+ (F) HV03-028
+
+
+ {{ MOH731RegisterData.on_art_25_above_female }}
+
+ |
+
| + 3.3 TB Screening + | +||
| Screened for TB_<15 | +
+ HV03-029
+
+ {{ MOH731RegisterData.screened_tb_less_15 }}
+
+ |
+ + |
| Screened for TB_15+ | +
+ HV03-030
+
+ {{ MOH731RegisterData.screened_tb_greater_15 }}
+
+ |
+ + |
| + 3.4 Starting TPT + | +||
| Start TPT_<15 | +
+ HV03-031
+
+ {{ MOH731RegisterData.start_tpt_less_15 }}
+
+ |
+ + |
| Start TPT_15+ | +
+ HV03-032
+
+ {{ MOH731RegisterData.start_tpt_greater_15 }}
+
+ |
+ + |
| + 3.5 Differentiated Service Delivery + | +||
| Established | +
+ HV03-033
+ {{ MOH731RegisterData.established }}
+ |
+ + |
| Not Established | +
+ HV03-034
+
+ {{ MOH731RegisterData.not_established }}
+
+ |
+ + |
| Community | +
+ HV03-035
+ {{ MOH731RegisterData.community }}
+ |
+ + |
| Facility | +
+ HV03-036
+ {{ MOH731RegisterData.facility }}
+ |
+ + |
| + 3.6 Nutrition and HIV + | +||
| Number SAM + | +||
| 0-5Months | +
+ HV03-037
+
+ {{ MOH731RegisterData.has_sam_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-038
+
+ {{ MOH731RegisterData.has_sam_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-039
+
+ {{ MOH731RegisterData.has_sam_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-040
+
+ {{ MOH731RegisterData.has_sam_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-041
+
+ {{ MOH731RegisterData.has_sam_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-042 + + | ++ |
| Number MAM + | +||
| 0-5Months | +
+ HV03-043
+
+ {{ MOH731RegisterData.has_smm_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-044
+
+ {{ MOH731RegisterData.has_smm_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-045
+
+ {{ MOH731RegisterData.has_smm_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-046
+
+ {{ MOH731RegisterData.has_smm_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-047
+
+ {{ MOH731RegisterData.has_smm_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-048 + + | ++ |
| Number SAM + receiving therapeutic foods | +||
| 0-5Months | +
+ HV03-049
+
+ {{ MOH731RegisterData.severe_acute_supp_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-050
+
+ {{ MOH731RegisterData.severe_acute_supp_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-051
+
+ {{ MOH731RegisterData.severe_acute_supp_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-052
+
+ {{ MOH731RegisterData.severe_acute_supp_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-053
+
+ {{ MOH731RegisterData.severe_acute_supp_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-054 + + | ++ |
| Number MAM + receiving Supplimental foods | +||
| 0-5Months | +
+ HV03-055
+
+ {{ MOH731RegisterData.severe_moderate_supp_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-056
+
+ {{ MOH731RegisterData.severe_moderate_supp_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-057
+
+ {{ MOH731RegisterData.severe_moderate_supp_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-058
+
+ {{ MOH731RegisterData.severe_moderate_supp_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-059
+
+ {{ MOH731RegisterData.severe_moderate_supp_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-060 + + | ++ |
| + 3.7 HIV in TB Clinic + | +||
| TB cases_New | +
+ HV03-061
+ {{ MOH731RegisterData.start_tb }}
+ |
+ + |
|
+ TB_New_Known HIV + Positive(KPs) + |
+
+ HV03-062
+
+ {{ MOH731RegisterData.start_tb_known_positive }}
+
+ |
+ + |
| TB_New HIV Positive | +
+ HV03-063
+
+ {{ MOH731RegisterData.start_tb_positive }}
+
+ |
+ + |
|
+ TB_New_Known HIV + Positive(KP) on HAART + |
+
+ HV03-064
+
+ {{ MOH731RegisterData.start_tb_on_art }}
+
+ |
+ + |
| TB New_Start_HAART | +
+ HV03-065
+
+ {{ MOH731RegisterData.start_tb_art_new }}
+
+ |
+ + |
| 4. Medical Male Circumcision | +||
| + 4.1 Number circumcised + | +||
| Circumcised_0-60 days | ++ HV04-01 + + | ++ |
| Circumcised_61 days -9 yrs days | ++ HV04-02 + + | ++ |
| Circumcised_10-14 | ++ HV04-03 + + | ++ |
| Circumcised_15 + | ++ HV04-04 + + | ++ |
| Tested_ HIV+ | ++ HV04-05 + + | ++ |
| Tested_ HIV- | ++ HV04-06 + + | ++ |
| + 4.2 Type of circumcission + | +||
| Surgical | ++ HV04-07 + + | ++ |
| Devices | ++ HV04-08 + + | ++ |
| + 4.3 Circumcission Adverse Events + | +||
| AE_During_Moderate | ++ HV04-09 + + | ++ |
| AE_During_Severe | ++ HV04-10 + + | ++ |
| AE_Post_Moderate | ++ HV04-11 + + | ++ |
| AE_Post_Severe | ++ HV04-12 + + | ++ |
| Follow up visit < 14d | ++ HV04-13 + + | ++ |
| 5. Post Exposure Prophylaxis | +||
| Exposed_Occupational | +
+ HV05-01
+
+ {{ MOH731RegisterData.exposed_occupational }}
+
+ |
+ + |
| Exposed Other | +
+ HV05-02
+
+ {{ MOH731RegisterData.exposed_non_occupational }}
+
+ |
+ + |
| PEP_Occupational | +
+ HV05-03
+
+ {{ MOH731RegisterData.pep_occupational }}
+
+ |
+ + |
| PEP_Other | +
+ HV05-04
+
+ {{ MOH731RegisterData.pep_non_occupational }}
+
+ |
+ + |
+ {{ errorMessage }} +
+| NO | +
+ Date: + (dd/mm/yyyy) + |
+
+ National + Identification + Number + |
+ CCC Number | +
+ Patient Names + (First/Middle/Last) + |
+
+ Patient visit + type: + 1=New, + 2=Revisit + |
+
+ Residence: + Village/Estate + |
+
+ Sex: + M=Male, + F=Female + |
+ AGE | +
+ Pregnant + and + Lactating + (Y/N/NA) + |
+
+ Nutrition assessment + 1. Weight for Height (Under 5’s) + 2. Weight for Age (Under 5’s) + 3. MUAC (6-59months), + Pregnant, Lactating, and any + other bedridden client. + 4. BMI for Age(5-17Years) + 5. BMI Kg/m(18+Years) + |
+
+ Nutrition + Status + (Indicate codes) + 1. SAM + 2. MAM + 3. Mild/At risk 4. + Normal + 5. Overweight + /Obese + |
+
+ Serostatus + (N/P/HEI/U) + |
+
+ Comorbidities + 1-TB + 2-Diabetes + 3-Hypertenstion + 4-Others specify + 5-None + |
+
+ Food + Secure + 1-Yes + 2-No + |
+ Remarks | +|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
+ Client Unique + Number + (NUPI) + |
+ Years | +Months | +||||||||||||||
| + | A | +B | +C | +D | +E | +F | +G | +H | +I | +J | +K | +L | +M | +N | +||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | |||||||||||||||
| Client's follow up Register | +||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Clients' Details | +On Admission | ++ | + |
+ Discharge/Transfer + Measurements + |
+ Outcome | +|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| week1 | +Week2 | +week3 | +week4 | +week5 | +week6 | +week7 | +week8 | +week9 | +week10 | +week11 | +week12 | +|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| SNO. | +
+ Date: + dd/mm/yyyy + |
+
+ National + Identification + Number + |
+ CCC Number | +Client's Name | +Village/Estate/Landmark | +Mobile number | +AGE | +
+ Sex + (M/F) + |
+
+ Type of Admission + 1. new-admission + 2. relapse + 3. returned + defaulter + |
+ Pregnant/ lactating (Y/N/NA) | +
+ Serostatus + (P/N/HEI/U) + |
+
+ Admission + Criteria + 1. WFH Z-score + 2. MUAC + 3. BMI + for age + 4. BMI + kg/m2 + |
+
+ Weight + (Kg) + |
+
+ Height + (cm) + |
+ + W/H Zscore/BMI For Age/BMIKg/m2 (1-3) + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ Height/Length(cm) + | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ Height/Length(cm) + | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ Height/Length(cm) + | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +Weight(Kg) | ++ Height/Length(cm) + | ++ W/H Zscore/BMI For Age/BMIKg/m2 + | +MUAC | ++ Nutrition Intervention + | +
+ Exit + dd/mm/yyyy + |
+ + Length of stay in days + | +
+ Exit Outcome + 1-Cured, + 2-Defaulter, + 3-Non - + Respondant, + 4-Referral , + 5-Transfer, + 6- Death + |
+ ||
|
+ Client Unique + Number + (NUPI) + |
+ Years | +Months | +||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(p) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +(z) | +(aa) | +(ab) | +(ac) | +(ad) | +(ae) | +(af) | +(ag) | +(ah) | +(ai) | +(aj) | +(ak) | +(al) | +(am) | +(an) | +(ao) | +(ap) | +(aq) | +(ar) | +(as) | +(at) | +(au) | +(av) | +(aw) | +(ax) | +(ay) | +(az) | +(ba) | +(bb) | +(bc) | +(bd) | +(be) | +(bf) | +(bg) | +(bh) | +(bi) | +(bj) | +(bk) | +(bl) | +(bm) | +(bn) | +(bo) | +(bp) | +(bq) | +(br) | +(bs) | +(bt) | +(bu) | +(bv) | +(bw) | +(bx) | +||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | |
| + | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
+ {{ errorMessage }} +
+| Date of visit | +Maternity History | +Postpartum Visit | +Vital Signs | +Postnatal Examinations | +TB screening | ++ | HAART & Infant Prophylaxis and Treatment | +
+ Cervical Cancer + Screening + (VIA/VILLI/PAP + Smear/ND) + |
+
+ Modern Post + Partum Family + Planning + (Y/N) + |
+
+ Other Maternal + Complications + |
+
+ Haematinics + (Y/N) + |
+ Refferals | +Remarks | +||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
+ Date of Visit + (dd/mm/yyyy) + |
+
+ PNC Number + (New Visit) + |
+
+ PNC Number/NUPI + (Revisit) + |
+
+ Full Name(first name, middle and + surname) + |
+
+ Date of Birth + (dd/mm/yyyy) + |
+
+ County/ + SubCounty + |
+ Village/Estate/ Landmark | +
+ Date of Delivery + (dd/mm/yyyy) + |
+
+ Place of + Delivery + 1)Facility + 2) Home + 3) BBA + |
+
+ Mode of + Delivery + 1) SVD + 2) CS + 3) Breech + 4) AVD + |
+
+ Timing + Mother + |
+ Timing Baby | +Temp | +Pulse | +
+ Blood + Pressure + |
+
+ Pallor + (Y/N) + |
+
+ Breast + 1=normal + 2= cracked + nipple + 3=engorged + 4=mastitis + |
+
+ Uterus + 1= + contracte d + 2= not + contracte d + 3= Others + Specify + |
+
+ PPH + 1=present + 2=Absent + |
+
+ C-Section Site + 1=Bleeding + 2=Normal + 3=Infected + 4=Gapping + 5=N/A + |
+
+ Lochia + 1=Normal + 2=Foul + smelling + 3=Excessi + ve + |
+
+ Episiotomy + 1=Repaired + 2=Gaping + 3=Infected + 4=Healed + 5=N/ + |
+
+ Fistula + 1=VVF + 2=RVF + 3=VVR + 4=Non + |
+
+ TB Screening + 1: Presumed TB + 2: No signs + 3: On TB treatment + 4: On TPT + 5: Not done + |
+ Tested PNC | +HIV Test 1 | +HIV Test 2 | +HIV Test 3 | +Results in PNC | +<=6wks | +>6wks | +
+ Results + 1=Normal, + 2=Suspected, + 3= Confirmed, + 4= Not done + |
+
+ Counseled + Method received + |
+ + | + | From | +To | +
+ Reasons for + referral + (specify) + |
+ ||||
| NUPI | +Age in Years | +Telephone number | +
+ 1=no change, + 2=10 days to + 14 days; + 3=4 to 6 + weeks; + 4=4 to 6 + months + |
+
+ 1=no change, + 2=10 days to + 14 days; + 3=4 to 6 + weeks; + 4=4 to 6 + months + |
+
+ 1= mild; + 2= moderate; + 3= severe + |
+ + | (I/R/ND/KP) | +Kit Name: | +Kit Name: | +Kit Name: | +<=6wks | +>6wks | +Infant | +Mother | +Infant | +Mother | ++ | + |
+ 1 = Community Unit + 2 = Another Health + Facility + 3 = Not Applicable + |
+
+ 1 = Community Unit + 2 = Another Health + Facility + 3 = Not Applicable + |
+ + | ||||||||||||||||||||
| Lot No. | +Lot No. | +Lot No. | +(N/P/Ic/NA) | +(N/P/Ic/NA) | +
+ NVP +AZT + +CTX + or + NVP +CTX + |
+ HAART | +
+ NVP +AZT + +CTX + or + NVP +CTX + |
+ HAART | ++ | + | |||||||||||||||||||||||||||||||
| Expiry No. / / | +Expiry No. / / | +Expiry No. / / | +(Y/N/NA/R) | +(Y/N/NA/R) | +(Y/N/NA/R) | +(Y/N/NA/R) | +|||||||||||||||||||||||||||||||||||
| (N,P,I,NA) | +(N,P,I,NA) | +(N,P,I,NA) | +|||||||||||||||||||||||||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +(l) | +(m) | +(n) | +(o) | +(p) | +(q) | +(r) | +(s) | +(t) | +(u) | +(v) | +(w) | +(x) | +(y) | +(z) | +(aa) | +(ab) | +(ac) | +(ad) | +(ae) | +(af) | +(ag) | +(ah) | +(ai) | +(aj) | +(ak) | +(al) | +(am) | +(an) | +(ao) | +(ap) | +
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
| + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + | + |
| + | + | + | + | + | + | ||||||||||||||||||||||||||||||||||||
+ {{ errorMessage }} +
++ {{ errorMessage }} +
+| PrEP No | +Date of Visit | ++ National Identification Number + | +Age | +
+ Sex + (M/F) + |
+
+ Population type + (Use the codes): + 1. General Population + 2. Discordant Couple + 3. MSM/MSW + 4. FSW + 5. PWID/PWUD + 6. VP + |
+
+ Client PrEP Status: + N- New + C- Continuing + D-Discontinued + R-Restart + |
+
+ PrEP Method: + 1. Daily oral PrEP + 2. Event driven oral PrEP + 3. Dapivirine Vaginal ring + 4. Cabotegravir Injectable + |
+
+ HIV Results + (N/P/Ic/NA) + |
+
+ Diagnosed with + STI + (N/Y) + |
+ Remarks | +||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| + National Unique Patient Identifier (NUPI) + | +||||||||||||||||||||||||||
| (a) | +(b) | +(c) | +(d) | +(e) | +(f) | +(g) | +(h) | +(i) | +(j) | +(k) | +||||||||||||||||
| + {{ data.PrEP_Number }} + | ++ {{ transformDate(data.Date_Of_Visit) }} + | +{{ data.National_ID }} | +{{ data.Age }} | +{{ data.Sex }} | ++ {{ data.population_type }} + | ++ {{ data.client_prep_status }} + | ++ {{ data.prep_method }} + | ++ {{ data.HIV_result }} + | ++ {{ data.with_STI }} + | ++ {{ data.remarks }} + | +||||||||||||||||
| {{ data.NUPI }} | +||||||||||||||||||||||||||
| TOTAL this Page | +{{ prepRegisterData.length }} | ++ | + | + | + | + | + | + | ||||||||||||||||||
| TOTAL this Month | +{{ prepRegisterData.length }} | ++ | + | + | + | + | + | + | ||||||||||||||||||
+ + All records loaded {{ '[ ' + patientData.length + ' ]' }} +
+ + +Error loading patient list.
++ {{ errorMessage }} +
+|
+ National AIDS & STI Control Program- NASCOP + Comprehensive HIV/ AIDS reporting form +
+ (MOH 731-Ver. July 2023)
+
+ |
+
| + County______________________SubCounty___________________Facility___________________MFL_______Month______year______ + | +
| 1. HIV Testing & Pre exposure Prophylaxis | +||
|---|---|---|
| 1.1 HIV Tests | +||
| + | Male | +Female(Including PMTCT) | +
| Tests | +
+ HV01-01
+ {{ MOH731RegisterData.hiv_male }}
+ |
+
+
+ HV01-02
+
+ {{ MOH731RegisterData.hiv_female }}
+ |
+
| Tests_Facility | +
+ HV01-03
+
+ {{ MOH731RegisterData.hiv_setting_facility }}
+
+ |
+ |
| Tests_Community | +
+ HV01-04
+
+ {{ MOH731RegisterData.hiv_setting_community }}
+
+ |
+ |
| Tested KVP | +
+ HV01-05
+
+ {{ MOH731RegisterData.hiv_setting_kvp }}
+
+ |
+ |
| + 1.3 No. Initiated on PrEP(NEW) + | +||
| + | Male | +Female | +
| General popn | +
+ HV01-19
+
+ {{ MOH731RegisterData.prep_new_male_general_pop }}
+
+ |
+
+
+ HV01-20
+
+
+ {{ MOH731RegisterData.prep_new_female_general_pop }}
+
+ |
+
| MSM/MSW | +
+ HV01-21
+ {{ MOH731RegisterData.prep_new_msm }}
+ |
+ + |
| FSW | ++ |
+
+ HV01-22
+
+
+ {{ MOH731RegisterData.prep_new_fsw }}
+
+ |
+
| PWID/PWUD | +
+ HV01-23
+
+ {{ MOH731RegisterData.prep_new_pwud_male }}
+
+ |
+
+
+ HV01-24
+
+
+ {{ MOH731RegisterData.prep_new_pwud_female }}
+
+ |
+
| Discordant Couple | +
+ HV01-25
+
+ {{ MOH731RegisterData.prep_new_discordant_male }}
+
+ |
+
+
+ HV01-26
+
+
+ {{ MOH731RegisterData.prep_new_discordant_female }}
+
+ |
+
| Vulnerable Pop. | +
+ HV01-27
+
+ {{ MOH731RegisterData.prep_new_vulnerable_male }}
+
+ |
+
+
+ HV01-28
+
+
+ {{ MOH731RegisterData.prep_new_vulnerable_female }}
+
+ |
+
| AYP (10-24yrs) | +
+ HV01-29
+ {{ MOH731RegisterData.prep_new_ayp }}
+ |
+
+
+ HV01-30
+
+
+ {{ MOH731RegisterData.prep_new_ayp }}
+
+ |
+
| Pregnant and breastfeeding women | ++ |
+
+ HV01-31
+
+
+ {{ MOH731RegisterData.prep_new_preg_breastfeeding }}
+
+ |
+
| + 1.5 No. Seroconverted while on PrEP + | +||
| + | Male | +Female | +
| HIV Positive | +
+ HV01-45
+
+ {{ MOH731RegisterData.seroconverted_male }}
+
+ |
+
+
+ HV01-46
+
+
+ {{ MOH731RegisterData.seroconverted_female }}
+
+ |
+
| + 1.2 HIV Positive Results + | +||
| + | Male | +Female | +
| Positive_2-9 | +
+ HV01-06
+ {{ MOH731RegisterData.male_2_9 }}
+ |
+
+
+ HV01-07
+
+ {{ MOH731RegisterData.female_2_9 }}
+ |
+
| Positive_10-14 | +
+ HV01-08
+ {{ MOH731RegisterData.male_10_14 }}
+ |
+
+
+ HV01-09
+
+
+ {{ MOH731RegisterData.female_10_14 }}
+
+ |
+
| Positive_15-19 | +
+ HV01-10
+ {{ MOH731RegisterData.male_15_19 }}
+ |
+
+
+ HV01-11
+
+
+ {{ MOH731RegisterData.female_15_19 }}
+
+ |
+
| Positive_20-24 | +
+ HV01-12
+ {{ MOH731RegisterData.male_20_24 }}
+ |
+
+
+ HV01-13
+
+
+ {{ MOH731RegisterData.female_20_24 }}
+
+ |
+
| Positive_25+ | +
+ HV01-14
+
+ {{ MOH731RegisterData.male_25_above }}
+
+ |
+
+
+ HV01-15
+
+
+ {{ MOH731RegisterData.female_25_above }}
+
+ |
+
| Positive_KVP | ++ HV01-16 + + | +|
| Discordant | ++ HV01-17 + + | +
+
+ HV01-18
+
+
+ |
+
| Inconclusive Test Results | ++ HV01-47 + + | +
+
+ HV01-48
+
+
+ |
+
| + 1.4 No. on PrEP Diagnosed with STI + | +||
| + | Male | +Female | +
| General popn | +
+ HV01-32
+
+ {{ MOH731RegisterData.prep_sti_male_general_pop }}
+
+ |
+
+
+ HV01-33
+
+
+ {{ MOH731RegisterData.prep_sti_female_general_pop }}
+
+ |
+
| MSM/MSW | +
+ HV01-34
+ {{ MOH731RegisterData.prep_sti_msm }}
+ |
+ + |
| FSW | +
+ HV01-35
+ {{ MOH731RegisterData.prep_sti_fsw }}
+ |
+ + |
| PWID/PWUD | +
+ HV01-36
+
+ {{ MOH731RegisterData.prep_sti_pwud_male }}
+
+ |
+
+
+ HV01-37
+
+
+ {{ MOH731RegisterData.prep_sti_pwud_female }}
+
+ |
+
| Discordant Couple | +
+ HV01-38
+
+ {{ MOH731RegisterData.prep_sti_discordant_male }}
+
+ |
+
+
+ HV01-39
+
+
+ {{ MOH731RegisterData.prep_sti_discordant_female }}
+
+ |
+
| Vulnerable Pop. | +
+ HV01-40
+
+ {{ MOH731RegisterData.prep_sti_vulnerable_male }}
+
+ |
+
+
+ HV01-41
+
+
+ {{ MOH731RegisterData.prep_sti_vulnerable_female }}
+
+ |
+
| AYP(10-24 yrs) | +
+ HV01-42
+ {{ MOH731RegisterData.prep_sti_ayp }}
+ |
+
+
+ HV01-43
+
+
+ {{ MOH731RegisterData.prep_sti_ayp }}
+
+ |
+
| Pregnant and breastfeeding women | ++ |
+
+ HV01-44
+
+
+ {{ MOH731RegisterData.prep_sti_preg_breastfeeding }}
+
+ |
+
| + 2. Elimination of Mother-to-Child Transmission(EMTCT) + | +||
| + 2.1 Maternal HIV Testing + | +||
| Known Positive at 1st ANC | +
+ HV02-01
+
+ {{ MOH731RegisterData.known_positive_1st_anc }}
+
+ |
+ + |
| + | Initial | +Retest | +
| Tested at ANC | +
+ HV02-02
+
+ {{ MOH731RegisterData.initial_test_anc }}
+
+ |
+
+
+ HV02-03
+
+ {{ MOH731RegisterData.retest_anc }}
+ |
+
| Tested at L&D | +
+ HV02-04
+
+ {{ MOH731RegisterData.initial_test_LD }}
+
+ |
+
+
+ HV02-05
+
+ {{ MOH731RegisterData.retest_LD }}
+ |
+
| Tested at PNC_<=6weeks | +
+ HV02-06
+
+ {{ MOH731RegisterData.initial_test_pnc_less_6_weeks }}
+
+ |
+
+
+ HV02-07
+
+
+ {{ MOH731RegisterData.retest_pnc_less_6_weeks }}
+
+ |
+
| Tested at PNC_>6weeks | +
+ HV02-08
+
+ {{ MOH731RegisterData.initial_test_pnc_greater_6_weeks }}
+
+ |
+
+
+ HV02-09
+
+
+ {{ MOH731RegisterData.retest_pnc_greater_6_weeks }}
+
+ |
+
| + 2.2 HIV Positive Results + | +||
| Tested at ANC | +
+ HV02-10
+ {{ MOH731RegisterData.positive_anc }}
+ |
+ + |
| Tested at L&D | +
+ HV02-11
+ {{ MOH731RegisterData.positive_LD }}
+ |
+ + |
| Tested at PNC_<=6weeks | +
+ HV02-12
+
+ {{ MOH731RegisterData.positive_pnc_less_6_weeks }}
+
+ |
+ + |
| Tested at PNC_>6weeks | +
+ HV02-13
+
+ {{ MOH731RegisterData.positive_pnc_greater_6_weeks }}
+
+ |
+ + |
| + 2.3 Maternal HAART + | +||
| On HAART at 1st ANC | +
+ HV02-14
+
+ {{ MOH731RegisterData.maternal_haart_1st_anc }}
+
+ |
+ + |
| Start HAART_ANC | +
+ HV02-15
+
+ {{ MOH731RegisterData.start_maternal_haart_1st_anc }}
+
+ |
+ + |
| Start HAART_L&D | +
+ HV02-16
+
+ {{ MOH731RegisterData.start_maternal_haart_LD }}
+
+ |
+ + |
| Start HAART_PNC_< =6weeks | +
+ HV02-17
+
+ {{ MOH731RegisterData.maternal_haart_less_6_weeks }}
+
+ |
+ + |
| Start HAART_PNC_>6weeks | +
+ HV02-18
+
+ {{ MOH731RegisterData.maternal_haart_more_6_weeks }}
+
+ |
+ + |
| + 2.4 HBV Screening at ANC + | +||
| Screened_HBV_ANC | ++ HV02-19 + + | ++ |
| HBV Screened_Positive | +
+ HV02-20
+
+ {{ MOH731RegisterData.hbv_screened_positive_anc }}
+
+ |
+ + |
|
+ 2.5 Adolescents girls & Young Women (10-24 Yrs) + testing & results + |
+ ||
| + | 10-19yrs | +20-24yrs | +
| 1st ANC KP | +
+ HV02-21
+
+ {{ MOH731RegisterData.known_positive_anc_10_19 }}
+
+ |
+
+
+ HV02-22
+
+
+ {{ MOH731RegisterData.known_positive_anc_20_24 }}
+
+ |
+
| New HIV Positive | +
+ HV02-23
+
+ {{ MOH731RegisterData.positive_anc_ld_pnc_10_19 }}
+
+ |
+
+
+ HV02-24
+
+
+ {{ MOH731RegisterData.positive_anc_ld_pnc_20_24 }}
+
+ |
+
| On HAART 1st ANC KP | +
+ HV02-25
+
+ {{ MOH731RegisterData.on_art_anc_10_19 }}
+
+ |
+
+
+ HV02-26
+
+
+ {{ MOH731RegisterData.on_art_anc_20_24 }}
+
+ |
+
| Started HAART New | +
+ HV02-27
+
+ {{ MOH731RegisterData.start_art_10_19 }}
+
+ |
+
+
+ HV02-28
+
+
+ {{ MOH731RegisterData.start_art_20_24 }}
+
+ |
+
| + 2.6 Infant Prophylaxis + | +||
| Infant ARV Prophylaxis_ANC | +
+ HV02-29
+
+ {{ MOH731RegisterData.infant_arv_anc }}
+
+ |
+ + |
| Infant ARV Prophylaxis_L&D | +
+ HV02-30
+
+ {{ MOH731RegisterData.infant_arv_ld }}
+
+ |
+ + |
| Infant ARV Prophylaxis_L&PNC | +
+ HV02-31
+
+ {{ MOH731RegisterData.infant_arv_pnc }}
+
+ |
+ + |
| + 2.7 Infant Feeding + | +||
| Below 6 months | +||
| Exclusive Breastfeeding (EBF) | +
+ HV02-32
+ {{ MOH731RegisterData.exclusive_bf }}
+ |
+ + |
| 6 to 24 months | +||
| Breastfeeding (BF) | +
+ HV02-33
+ {{ MOH731RegisterData.bf }}
+ |
+ + |
| Not Breastfeeding (NBF) | +
+ HV02-34
+ {{ MOH731RegisterData.weaning }}
+ |
+ + |
| 3. HIV and TB treatment | +||
| + 3.1 Starting ART + | +||
| Start ART_<1 | +
+ (M) HV03-01
+
+ {{ MOH731RegisterData.art_new_less_1_male }}
+
+ |
+
+
+ (F) HV03-02
+
+
+ {{ MOH731RegisterData.art_new_less_1_female }}
+
+ |
+
| Start ART 1-4 | +
+ (M) HV03-03
+
+ {{ MOH731RegisterData.art_new_1_4_male }}
+
+ |
+
+
+ (F) HV03-04
+
+
+ {{ MOH731RegisterData.art_new_1_4_female }}
+
+ |
+
| Start ART 5-9 | +
+ (M) HV03-05
+
+ {{ MOH731RegisterData.art_new_5_9_male }}
+
+ |
+
+
+ (F) HV03-06
+
+
+ {{ MOH731RegisterData.art_new_5_9_female }}
+
+ |
+
| Start ART 10-14 | +
+ (M) HV03-07
+
+ {{ MOH731RegisterData.art_new_10_14_male }}
+
+ |
+
+
+ (F) HV03-08
+
+
+ {{ MOH731RegisterData.art_new_10_14_female }}
+
+ |
+
| Start ART 15-19 | +
+ (M) HV03-09
+
+ {{ MOH731RegisterData.art_new_15_19_male }}
+
+ |
+
+
+ (F) HV03-10
+
+
+ {{ MOH731RegisterData.art_new_15_19_female }}
+
+ |
+
| Start ART 20-24 | +
+ (M) HV03-11
+
+ {{ MOH731RegisterData.art_new_20_24_male }}
+
+ |
+
+
+ (F) HV03-12
+
+
+ {{ MOH731RegisterData.art_new_20_24_female }}
+
+ |
+
| Start ART 25+ | +
+ (M) HV03-013
+
+ {{ MOH731RegisterData.art_new_25_above_male }}
+
+ |
+
+
+ (F) HV03-014
+
+
+ {{ MOH731RegisterData.art_new_25_above_female }}
+
+ |
+
| + 3.2 Curently on ART ([ALL]) + | +||
| On ART_<1 | +
+ (M) HV03-015
+
+ {{ MOH731RegisterData.on_art_less_1_male }}
+
+ |
+
+
+ (F) HV03-016
+
+
+ {{ MOH731RegisterData.on_art_less_1_female }}
+
+ |
+
| On ART 1-4 | +
+ (M) HV03-017
+
+ {{ MOH731RegisterData.on_art_1_4_male }}
+
+ |
+
+
+ (F) HV03-018
+
+
+ {{ MOH731RegisterData.on_art_1_4_female }}
+
+ |
+
| On ART 5-9 | +
+ (M) HV03-019
+
+ {{ MOH731RegisterData.on_art_5_9_male }}
+
+ |
+
+
+ (F) HV03-020
+
+
+ {{ MOH731RegisterData.on_art_5_9_female }}
+
+ |
+
| On ART 10-14 | +
+ (M) HV03-021
+
+ {{ MOH731RegisterData.on_art_10_14_male }}
+
+ |
+
+
+ (F) HV03-022
+
+
+ {{ MOH731RegisterData.on_art_10_14_female }}
+
+ |
+
| On ART 15-19 | +
+ (M) HV03-023
+
+ {{ MOH731RegisterData.on_art_15_19_male }}
+
+ |
+
+
+ (F) HV03-024
+
+
+ {{ MOH731RegisterData.on_art_15_19_female }}
+
+ |
+
| On ART 20-24 | +
+ (M) HV03-025
+
+ {{ MOH731RegisterData.on_art_20_24_male }}
+
+ |
+
+
+ (F) HV03-026
+
+
+ {{ MOH731RegisterData.on_art_20_24_female }}
+
+ |
+
| On ART 25+ | +
+ (M) HV03-027
+
+ {{ MOH731RegisterData.on_art_25_above_male }}
+
+ |
+
+
+ (F) HV03-028
+
+
+ {{ MOH731RegisterData.on_art_25_above_female }}
+
+ |
+
| + 3.3 TB Screening + | +||
| Screened for TB_<15 | +
+ HV03-029
+
+ {{ MOH731RegisterData.screened_tb_less_15 }}
+
+ |
+ + |
| Screened for TB_15+ | +
+ HV03-030
+
+ {{ MOH731RegisterData.screened_tb_greater_15 }}
+
+ |
+ + |
| + 3.4 Starting TPT + | +||
| Start TPT_<15 | +
+ HV03-031
+
+ {{ MOH731RegisterData.start_tpt_less_15 }}
+
+ |
+ + |
| Start TPT_15+ | +
+ HV03-032
+
+ {{ MOH731RegisterData.start_tpt_greater_15 }}
+
+ |
+ + |
| + 3.5 Differentiated Service Delivery + | +||
| Established | +
+ HV03-033
+ {{ MOH731RegisterData.established }}
+ |
+ + |
| Not Established | +
+ HV03-034
+
+ {{ MOH731RegisterData.not_established }}
+
+ |
+ + |
| Community | +
+ HV03-035
+ {{ MOH731RegisterData.community }}
+ |
+ + |
| Facility | +
+ HV03-036
+ {{ MOH731RegisterData.facility }}
+ |
+ + |
| + 3.6 Nutrition and HIV + | +||
| Number SAM + | +||
| 0-5Months | +
+ HV03-037
+
+ {{ MOH731RegisterData.has_sam_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-038
+
+ {{ MOH731RegisterData.has_sam_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-039
+
+ {{ MOH731RegisterData.has_sam_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-040
+
+ {{ MOH731RegisterData.has_sam_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-041
+
+ {{ MOH731RegisterData.has_sam_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-042 + + | ++ |
| Number MAM + | +||
| 0-5Months | +
+ HV03-043
+
+ {{ MOH731RegisterData.has_smm_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-044
+
+ {{ MOH731RegisterData.has_smm_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-045
+
+ {{ MOH731RegisterData.has_smm_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-046
+
+ {{ MOH731RegisterData.has_smm_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-047
+
+ {{ MOH731RegisterData.has_smm_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-048 + + | ++ |
| Number SAM + receiving therapeutic foods | +||
| 0-5Months | +
+ HV03-049
+
+ {{ MOH731RegisterData.severe_acute_supp_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-050
+
+ {{ MOH731RegisterData.severe_acute_supp_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-051
+
+ {{ MOH731RegisterData.severe_acute_supp_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-052
+
+ {{ MOH731RegisterData.severe_acute_supp_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-053
+
+ {{ MOH731RegisterData.severe_acute_supp_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-054 + + | ++ |
| Number MAM + receiving Supplimental foods | +||
| 0-5Months | +
+ HV03-055
+
+ {{ MOH731RegisterData.severe_moderate_supp_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-056
+
+ {{ MOH731RegisterData.severe_moderate_supp_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-057
+
+ {{ MOH731RegisterData.severe_moderate_supp_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-058
+
+ {{ MOH731RegisterData.severe_moderate_supp_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-059
+
+ {{ MOH731RegisterData.severe_moderate_supp_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-060 + + | ++ |
| + 3.7 HIV in TB Clinic + | +||
| TB cases_New | +
+ HV03-061
+ {{ MOH731RegisterData.start_tb }}
+ |
+ + |
|
+ TB_New_Known HIV + Positive(KPs) + |
+
+ HV03-062
+
+ {{ MOH731RegisterData.start_tb_known_positive }}
+
+ |
+ + |
| TB_New HIV Positive | +
+ HV03-063
+
+ {{ MOH731RegisterData.start_tb_positive }}
+
+ |
+ + |
|
+ TB_New_Known HIV + Positive(KP) on HAART + |
+
+ HV03-064
+
+ {{ MOH731RegisterData.start_tb_on_art }}
+
+ |
+ + |
| TB New_Start_HAART | +
+ HV03-065
+
+ {{ MOH731RegisterData.start_tb_art_new }}
+
+ |
+ + |
| 4. Medical Male Circumcision | +||
| + 4.1 Number circumcised + | +||
| Circumcised_0-60 days | ++ HV04-01 + + | ++ |
| Circumcised_61 days -9 yrs days | ++ HV04-02 + + | ++ |
| Circumcised_10-14 | ++ HV04-03 + + | ++ |
| Circumcised_15 + | ++ HV04-04 + + | ++ |
| Tested_ HIV+ | ++ HV04-05 + + | ++ |
| Tested_ HIV- | ++ HV04-06 + + | ++ |
| + 4.2 Type of circumcission + | +||
| Surgical | ++ HV04-07 + + | ++ |
| Devices | ++ HV04-08 + + | ++ |
| + 4.3 Circumcission Adverse Events + | +||
| AE_During_Moderate | ++ HV04-09 + + | ++ |
| AE_During_Severe | ++ HV04-10 + + | ++ |
| AE_Post_Moderate | ++ HV04-11 + + | ++ |
| AE_Post_Severe | ++ HV04-12 + + | ++ |
| Follow up visit < 14d | ++ HV04-13 + + | ++ |
| 5. Post Exposure Prophylaxis | +||
| Exposed_Occupational | +
+ HV05-01
+
+ {{ MOH731RegisterData.exposed_occupational }}
+
+ |
+ + |
| Exposed Other | +
+ HV05-02
+
+ {{ MOH731RegisterData.exposed_non_occupational }}
+
+ |
+ + |
| PEP_Occupational | +
+ HV05-03
+
+ {{ MOH731RegisterData.pep_occupational }}
+
+ |
+ + |
| PEP_Other | +
+ HV05-04
+
+ {{ MOH731RegisterData.pep_non_occupational }}
+
+ |
+ + |
+ {{ errorMessage }} +
+|
+ National AIDS & STI Control Program- NASCOP + Comprehensive HIV/ AIDS reporting form +
+ (MOH 731-Ver. July 2023)
+
+ |
+
| + County______________________SubCounty___________________Facility___________________MFL_______Month______year______ + | +
| 1. HIV Testing & Pre exposure Prophylaxis | +||
|---|---|---|
| 1.1 HIV Tests | +||
| + | Male | +
+ Female(Including + PMTCT) + |
+
| Tests | +
+ HV01-01
+ {{ MOH731RegisterData.hiv_male }}
+ |
+
+
+ HV01-02
+
+ {{ MOH731RegisterData.hiv_female }}
+ |
+
| Tests_Facility | +
+ HV01-03
+
+ {{ MOH731RegisterData.hiv_setting_facility }}
+
+ |
+ |
| Tests_Community | +
+ HV01-04
+
+ {{ MOH731RegisterData.hiv_setting_community }}
+
+ |
+ |
| Tested KVP | +
+ HV01-05
+
+ {{ MOH731RegisterData.hiv_setting_kvp }}
+
+ |
+ |
| + 1.3 No. Initiated on PrEP(NEW) + | +||
| + | Male | +Female | +
| General popn | +
+ HV01-19
+
+ {{ MOH731RegisterData.prep_new_male_general_pop }}
+
+ |
+
+
+ HV01-20
+
+
+ {{ MOH731RegisterData.prep_new_female_general_pop }}
+
+ |
+
| MSM/MSW | +
+ HV01-21
+ {{ MOH731RegisterData.prep_new_msm }}
+ |
+ + |
| FSW | ++ |
+
+ HV01-22
+
+
+ {{ MOH731RegisterData.prep_new_fsw }}
+
+ |
+
| PWID/PWUD | +
+ HV01-23
+
+ {{ MOH731RegisterData.prep_new_pwud_male }}
+
+ |
+
+
+ HV01-24
+
+
+ {{ MOH731RegisterData.prep_new_pwud_female }}
+
+ |
+
| Discordant Couple | +
+ HV01-25
+
+ {{ MOH731RegisterData.prep_new_discordant_male }}
+
+ |
+
+
+ HV01-26
+
+
+ {{ MOH731RegisterData.prep_new_discordant_female }}
+
+ |
+
| Vulnerable Pop. | +
+ HV01-27
+
+ {{ MOH731RegisterData.prep_new_vulnerable_male }}
+
+ |
+
+
+ HV01-28
+
+
+ {{ MOH731RegisterData.prep_new_vulnerable_female }}
+
+ |
+
| AYP (10-24yrs) | +
+ HV01-29
+ {{ MOH731RegisterData.prep_new_ayp }}
+ |
+
+
+ HV01-30
+
+
+ {{ MOH731RegisterData.prep_new_ayp }}
+
+ |
+
| Pregnant and breastfeeding women | ++ |
+
+ HV01-31
+
+
+ {{ MOH731RegisterData.prep_new_preg_breastfeeding }}
+
+ |
+
| + 1.5 No. Seroconverted while on PrEP + | +||
| + | Male | +Female | +
| HIV Positive | +
+ HV01-45
+
+ {{ MOH731RegisterData.seroconverted_male }}
+
+ |
+
+
+ HV01-46
+
+
+ {{ MOH731RegisterData.seroconverted_female }}
+
+ |
+
| + 1.2 HIV Positive Results + | +||
| + | Male | +Female | +
| Positive_2-9 | +
+ HV01-06
+ {{ MOH731RegisterData.male_2_9 }}
+ |
+
+
+ HV01-07
+
+ {{ MOH731RegisterData.female_2_9 }}
+ |
+
| Positive_10-14 | +
+ HV01-08
+ {{ MOH731RegisterData.male_10_14 }}
+ |
+
+
+ HV01-09
+
+
+ {{ MOH731RegisterData.female_10_14 }}
+
+ |
+
| Positive_15-19 | +
+ HV01-10
+ {{ MOH731RegisterData.male_15_19 }}
+ |
+
+
+ HV01-11
+
+
+ {{ MOH731RegisterData.female_15_19 }}
+
+ |
+
| Positive_20-24 | +
+ HV01-12
+ {{ MOH731RegisterData.male_20_24 }}
+ |
+
+
+ HV01-13
+
+
+ {{ MOH731RegisterData.female_20_24 }}
+
+ |
+
| Positive_25+ | +
+ HV01-14
+
+ {{ MOH731RegisterData.male_25_above }}
+
+ |
+
+
+ HV01-15
+
+
+ {{ MOH731RegisterData.female_25_above }}
+
+ |
+
| Positive_KVP | ++ HV01-16 + + | +|
| Discordant | ++ HV01-17 + + | +
+
+ HV01-18
+
+
+ |
+
| Inconclusive Test Results | ++ HV01-47 + + | +
+
+ HV01-48
+
+
+ |
+
| + 1.4 No. on PrEP Diagnosed with STI + | +||
| + | Male | +Female | +
| General popn | +
+ HV01-32
+
+ {{ MOH731RegisterData.prep_sti_male_general_pop }}
+
+ |
+
+
+ HV01-33
+
+
+ {{ MOH731RegisterData.prep_sti_female_general_pop }}
+
+ |
+
| MSM/MSW | +
+ HV01-34
+ {{ MOH731RegisterData.prep_sti_msm }}
+ |
+ + |
| FSW | +
+ HV01-35
+ {{ MOH731RegisterData.prep_sti_fsw }}
+ |
+ + |
| PWID/PWUD | +
+ HV01-36
+
+ {{ MOH731RegisterData.prep_sti_pwud_male }}
+
+ |
+
+
+ HV01-37
+
+
+ {{ MOH731RegisterData.prep_sti_pwud_female }}
+
+ |
+
| Discordant Couple | +
+ HV01-38
+
+ {{ MOH731RegisterData.prep_sti_discordant_male }}
+
+ |
+
+
+ HV01-39
+
+
+ {{ MOH731RegisterData.prep_sti_discordant_female }}
+
+ |
+
| Vulnerable Pop. | +
+ HV01-40
+
+ {{ MOH731RegisterData.prep_sti_vulnerable_male }}
+
+ |
+
+
+ HV01-41
+
+
+ {{ MOH731RegisterData.prep_sti_vulnerable_female }}
+
+ |
+
| AYP(10-24 yrs) | +
+ HV01-42
+ {{ MOH731RegisterData.prep_sti_ayp }}
+ |
+
+
+ HV01-43
+
+
+ {{ MOH731RegisterData.prep_sti_ayp }}
+
+ |
+
| Pregnant and breastfeeding women | ++ |
+
+ HV01-44
+
+
+ {{ MOH731RegisterData.prep_sti_preg_breastfeeding }}
+
+ |
+
| + 2. Elimination of Mother-to-Child Transmission(EMTCT) + | +||
| + 2.1 Maternal HIV Testing + | +||
| Known Positive at 1st ANC | +
+ HV02-01
+
+ {{ MOH731RegisterData.known_positive_1st_anc }}
+
+ |
+ + |
| + | Initial | +Retest | +
| Tested at ANC | +
+ HV02-02
+
+ {{ MOH731RegisterData.initial_test_anc }}
+
+ |
+
+
+ HV02-03
+
+ {{ MOH731RegisterData.retest_anc }}
+ |
+
| Tested at L&D | +
+ HV02-04
+
+ {{ MOH731RegisterData.initial_test_LD }}
+
+ |
+
+
+ HV02-05
+
+ {{ MOH731RegisterData.retest_LD }}
+ |
+
| Tested at PNC_<=6weeks | +
+ HV02-06
+
+ {{ MOH731RegisterData.initial_test_pnc_less_6_weeks }}
+
+ |
+
+
+ HV02-07
+
+
+ {{ MOH731RegisterData.retest_pnc_less_6_weeks }}
+
+ |
+
| Tested at PNC_>6weeks | +
+ HV02-08
+
+ {{ MOH731RegisterData.initial_test_pnc_greater_6_weeks }}
+
+ |
+
+
+ HV02-09
+
+
+ {{ MOH731RegisterData.retest_pnc_greater_6_weeks }}
+
+ |
+
| + 2.2 HIV Positive Results + | +||
| Tested at ANC | +
+ HV02-10
+ {{ MOH731RegisterData.positive_anc }}
+ |
+ + |
| Tested at L&D | +
+ HV02-11
+ {{ MOH731RegisterData.positive_LD }}
+ |
+ + |
| Tested at PNC_<=6weeks | +
+ HV02-12
+
+ {{ MOH731RegisterData.positive_pnc_less_6_weeks }}
+
+ |
+ + |
| Tested at PNC_>6weeks | +
+ HV02-13
+
+ {{ MOH731RegisterData.positive_pnc_greater_6_weeks }}
+
+ |
+ + |
| + 2.3 Maternal HAART + | +||
| On HAART at 1st ANC | +
+ HV02-14
+
+ {{ MOH731RegisterData.maternal_haart_1st_anc }}
+
+ |
+ + |
| Start HAART_ANC | +
+ HV02-15
+
+ {{ MOH731RegisterData.start_maternal_haart_1st_anc }}
+
+ |
+ + |
| Start HAART_L&D | +
+ HV02-16
+
+ {{ MOH731RegisterData.start_maternal_haart_LD }}
+
+ |
+ + |
| Start HAART_PNC_< =6weeks | +
+ HV02-17
+
+ {{ MOH731RegisterData.maternal_haart_less_6_weeks }}
+
+ |
+ + |
| Start HAART_PNC_>6weeks | +
+ HV02-18
+
+ {{ MOH731RegisterData.maternal_haart_more_6_weeks }}
+
+ |
+ + |
| + 2.4 HBV Screening at ANC + | +||
| Screened_HBV_ANC | ++ HV02-19 + + | ++ |
| HBV Screened_Positive | +
+ HV02-20
+
+ {{ MOH731RegisterData.hbv_screened_positive_anc }}
+
+ |
+ + |
|
+ 2.5 Adolescents girls & Young Women (10-24 Yrs) + testing & results + |
+ ||
| + | 10-19yrs | +20-24yrs | +
| 1st ANC KP | +
+ HV02-21
+
+ {{ MOH731RegisterData.known_positive_ayp_10_19 }}
+
+ |
+
+
+ HV02-22
+
+
+ {{ MOH731RegisterData.known_positive_ayp_20_24 }}
+
+ |
+
| New HIV Positive | +
+ HV02-23
+
+ {{ MOH731RegisterData.new_positive_ayp_10_19 }}
+
+ |
+
+
+ HV02-24
+
+
+ {{ MOH731RegisterData.new_positive_ayp_20_24 }}
+
+ |
+
| On HAART 1st ANC KP | +
+ HV02-25
+
+ {{ MOH731RegisterData.on_art_ayp_10_19 }}
+
+ |
+
+
+ HV02-26
+
+
+ {{ MOH731RegisterData.on_art_ayp_20_24 }}
+
+ |
+
| Started HAART New | +
+ HV02-27
+
+ {{ MOH731RegisterData.start_art_ayp_10_19 }}
+
+ |
+
+
+ HV02-28
+
+
+ {{ MOH731RegisterData.start_art_ayp_20_24 }}
+
+ |
+
| + 2.6 Infant Prophylaxis + | +||
| Infant ARV Prophylaxis_ANC | +
+ HV02-29
+
+ {{ MOH731RegisterData.infant_arv_anc }}
+
+ |
+ + |
| Infant ARV Prophylaxis_L&D | +
+ HV02-30
+
+ {{ MOH731RegisterData.infant_arv_ld }}
+
+ |
+ + |
| Infant ARV Prophylaxis_L&PNC | +
+ HV02-31
+
+ {{ MOH731RegisterData.infant_arv_pnc }}
+
+ |
+ + |
| + 2.7 Infant Feeding + | +||
| Below 6 months | +||
| Exclusive Breastfeeding (EBF) | +
+ HV02-32
+ {{ MOH731RegisterData.exclusive_bf }}
+ |
+ + |
| 6 to 24 months | +||
| Breastfeeding (BF) | +
+ HV02-33
+ {{ MOH731RegisterData.bf }}
+ |
+ + |
| Not Breastfeeding (NBF) | +
+ HV02-34
+ {{ MOH731RegisterData.weaning }}
+ |
+ + |
| 3. HIV and TB treatment | +||
| + 3.1 Starting ART + | +||
| Start ART_<1 | +
+ (M) HV03-01
+
+ {{ MOH731RegisterData.art_new_less_1_male }}
+
+ |
+
+
+ (F) HV03-02
+
+
+ {{ MOH731RegisterData.art_new_less_1_female }}
+
+ |
+
| Start ART 1-4 | +
+ (M) HV03-03
+
+ {{ MOH731RegisterData.art_new_1_4_male }}
+
+ |
+
+
+ (F) HV03-04
+
+
+ {{ MOH731RegisterData.art_new_1_4_female }}
+
+ |
+
| Start ART 5-9 | +
+ (M) HV03-05
+
+ {{ MOH731RegisterData.art_new_5_9_male }}
+
+ |
+
+
+ (F) HV03-06
+
+
+ {{ MOH731RegisterData.art_new_5_9_female }}
+
+ |
+
| Start ART 10-14 | +
+ (M) HV03-07
+
+ {{ MOH731RegisterData.art_new_10_14_male }}
+
+ |
+
+
+ (F) HV03-08
+
+
+ {{ MOH731RegisterData.art_new_10_14_female }}
+
+ |
+
| Start ART 15-19 | +
+ (M) HV03-09
+
+ {{ MOH731RegisterData.art_new_15_19_male }}
+
+ |
+
+
+ (F) HV03-10
+
+
+ {{ MOH731RegisterData.art_new_15_19_female }}
+
+ |
+
| Start ART 20-24 | +
+ (M) HV03-11
+
+ {{ MOH731RegisterData.art_new_20_24_male }}
+
+ |
+
+
+ (F) HV03-12
+
+
+ {{ MOH731RegisterData.art_new_20_24_female }}
+
+ |
+
| Start ART 25+ | +
+ (M) HV03-013
+
+ {{ MOH731RegisterData.art_new_25_above_male }}
+
+ |
+
+
+ (F) HV03-014
+
+
+ {{ MOH731RegisterData.art_new_25_above_female }}
+
+ |
+
| + 3.2 Curently on ART ([ALL]) + | +||
| On ART_<1 | +
+ (M) HV03-015
+
+ {{ MOH731RegisterData.on_art_less_1_male }}
+
+ |
+
+
+ (F) HV03-016
+
+
+ {{ MOH731RegisterData.on_art_less_1_female }}
+
+ |
+
| On ART 1-4 | +
+ (M) HV03-017
+
+ {{ MOH731RegisterData.on_art_1_4_male }}
+
+ |
+
+
+ (F) HV03-018
+
+
+ {{ MOH731RegisterData.on_art_1_4_female }}
+
+ |
+
| On ART 5-9 | +
+ (M) HV03-019
+
+ {{ MOH731RegisterData.on_art_5_9_male }}
+
+ |
+
+
+ (F) HV03-020
+
+
+ {{ MOH731RegisterData.on_art_5_9_female }}
+
+ |
+
| On ART 10-14 | +
+ (M) HV03-021
+
+ {{ MOH731RegisterData.on_art_10_14_male }}
+
+ |
+
+
+ (F) HV03-022
+
+
+ {{ MOH731RegisterData.on_art_10_14_female }}
+
+ |
+
| On ART 15-19 | +
+ (M) HV03-023
+
+ {{ MOH731RegisterData.on_art_15_19_male }}
+
+ |
+
+
+ (F) HV03-024
+
+
+ {{ MOH731RegisterData.on_art_15_19_female }}
+
+ |
+
| On ART 20-24 | +
+ (M) HV03-025
+
+ {{ MOH731RegisterData.on_art_20_24_male }}
+
+ |
+
+
+ (F) HV03-026
+
+
+ {{ MOH731RegisterData.on_art_20_24_female }}
+
+ |
+
| On ART 25+ | +
+ (M) HV03-027
+
+ {{ MOH731RegisterData.on_art_25_above_male }}
+
+ |
+
+
+ (F) HV03-028
+
+
+ {{ MOH731RegisterData.on_art_25_above_female }}
+
+ |
+
| + 3.3 TB Screening + | +||
| Screened for TB_<15 | +
+ HV03-029
+
+ {{ MOH731RegisterData.screened_tb_less_15 }}
+
+ |
+ + |
| Screened for TB_15+ | +
+ HV03-030
+
+ {{ MOH731RegisterData.screened_tb_greater_15 }}
+
+ |
+ + |
| + 3.4 Starting TPT + | +||
| Start TPT_<15 | +
+ HV03-031
+
+ {{ MOH731RegisterData.start_tpt_less_15 }}
+
+ |
+ + |
| Start TPT_15+ | +
+ HV03-032
+
+ {{ MOH731RegisterData.start_tpt_greater_15 }}
+
+ |
+ + |
| + 3.5 Differentiated Service Delivery + | +||
| Established | +
+ HV03-033
+ {{ MOH731RegisterData.established }}
+ |
+ + |
| Not Established | +
+ HV03-034
+
+ {{ MOH731RegisterData.not_established }}
+
+ |
+ + |
| Community | +
+ HV03-035
+ {{ MOH731RegisterData.community }}
+ |
+ + |
| Facility | +
+ HV03-036
+ {{ MOH731RegisterData.facility }}
+ |
+ + |
| + 3.6 Nutrition and HIV + | +||
| Number SAM + | +||
| 0-5Months | +
+ HV03-037
+
+ {{ MOH731RegisterData.has_sam_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-038
+
+ {{ MOH731RegisterData.has_sam_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-039
+
+ {{ MOH731RegisterData.has_sam_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-040
+
+ {{ MOH731RegisterData.has_sam_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-041
+
+ {{ MOH731RegisterData.has_sam_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-042 + + | ++ |
| Number MAM + | +||
| 0-5Months | +
+ HV03-043
+
+ {{ MOH731RegisterData.has_smm_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-044
+
+ {{ MOH731RegisterData.has_smm_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-045
+
+ {{ MOH731RegisterData.has_smm_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-046
+
+ {{ MOH731RegisterData.has_smm_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-047
+
+ {{ MOH731RegisterData.has_smm_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-048 + + | ++ |
| Number SAM + receiving therapeutic foods | +||
| 0-5Months | +
+ HV03-049
+
+ {{ MOH731RegisterData.severe_acute_supp_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-050
+
+ {{ MOH731RegisterData.severe_acute_supp_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-051
+
+ {{ MOH731RegisterData.severe_acute_supp_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-052
+
+ {{ MOH731RegisterData.severe_acute_supp_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-053
+
+ {{ MOH731RegisterData.severe_acute_supp_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-054 + + | ++ |
| Number MAM + receiving Supplimental foods | +||
| 0-5Months | +
+ HV03-055
+
+ {{ MOH731RegisterData.severe_moderate_supp_0_5_months }}
+
+ |
+ + |
| 6-59Months | +
+ HV03-056
+
+ {{ MOH731RegisterData.severe_moderate_supp_6_59_months }}
+
+ |
+ + |
| 5-9Years | +
+ HV03-057
+
+ {{ MOH731RegisterData.severe_moderate_supp_5_9_years }}
+
+ |
+ + |
| 10-17Years | +
+ HV03-058
+
+ {{ MOH731RegisterData.severe_moderate_supp_10_17_years }}
+
+ |
+ + |
| 18+Years | +
+ HV03-059
+
+ {{ MOH731RegisterData.severe_moderate_supp_18_and_above_years }}
+
+ |
+ + |
| Pregnant & Lactating | ++ HV03-060 + + | ++ |
| + 3.7 HIV in TB Clinic + | +||
| TB cases_New | +
+ HV03-061
+ {{ MOH731RegisterData.start_tb }}
+ |
+ + |
|
+ TB_New_Known HIV + Positive(KPs) + |
+
+ HV03-062
+
+ {{ MOH731RegisterData.start_tb_known_positive }}
+
+ |
+ + |
| TB_New HIV Positive | +
+ HV03-063
+
+ {{ MOH731RegisterData.start_tb_positive }}
+
+ |
+ + |
|
+ TB_New_Known HIV + Positive(KP) on HAART + |
+
+ HV03-064
+
+ {{ MOH731RegisterData.start_tb_on_art }}
+
+ |
+ + |
| TB New_Start_HAART | +
+ HV03-065
+
+ {{ MOH731RegisterData.start_tb_art_new }}
+
+ |
+ + |
| 4. Medical Male Circumcision | +||
| + 4.1 Number circumcised + | +||
| Circumcised_0-60 days | ++ HV04-01 + + | ++ |
| Circumcised_61 days -9 yrs days | ++ HV04-02 + + | ++ |
| Circumcised_10-14 | ++ HV04-03 + + | ++ |
| Circumcised_15 + | ++ HV04-04 + + | ++ |
| Tested_ HIV+ | ++ HV04-05 + + | ++ |
| Tested_ HIV- | ++ HV04-06 + + | ++ |
| + 4.2 Type of circumcission + | +||
| Surgical | ++ HV04-07 + + | ++ |
| Devices | ++ HV04-08 + + | ++ |
| + 4.3 Circumcission Adverse Events + | +||
| AE_During_Moderate | ++ HV04-09 + + | ++ |
| AE_During_Severe | ++ HV04-10 + + | ++ |
| AE_Post_Moderate | ++ HV04-11 + + | ++ |
| AE_Post_Severe | ++ HV04-12 + + | ++ |
| Follow up visit < 14d | ++ HV04-13 + + | ++ |
| 5. Post Exposure Prophylaxis | +||
| Exposed_Occupational | +
+ HV05-01
+
+ {{ MOH731RegisterData.exposed_occupational }}
+
+ |
+ + |
| Exposed Other | +
+ HV05-02
+
+ {{ MOH731RegisterData.exposed_non_occupational }}
+
+ |
+ + |
| PEP_Occupational | +
+ HV05-03
+
+ {{ MOH731RegisterData.pep_occupational }}
+
+ |
+ + |
| PEP_Other | +
+ HV05-04
+
+ {{ MOH731RegisterData.pep_non_occupational }}
+
+ |
+ + |