Kenya Disease Surveillance FHIR Implementation Guide., published by Kenya National Public Health Institute. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/Surveillance-FHIR-IG/ and changes regularly. See the Directory of published versions
| Official URL: http://example.org/Questionnaire/AfpCaseReport | Version: 0.1.0 | |||
| Draft as of 2026-04-04 | Computable Name: | |||
AFP Surveillance questionnaire for disease surveillance
Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints![]() |
|---|---|---|---|---|---|
![]() | AFP Surveillance questionnaire for disease surveillance | Questionnaire | http://example.org/Questionnaire/AfpCaseReport#0.1.0 | ||
![]() ![]() | Reporting Site | 0..1 | group | Value Set: | |
![]() ![]() ![]() | User Role | 0..1 | string | Value Set: | |
![]() ![]() ![]() | User Facility | 0..1 | string | Value Set: | |
![]() ![]() ![]() | User Ward | 0..1 | string | Value Set: | |
![]() ![]() ![]() | User Sub County | 0..1 | string | Value Set: | |
![]() ![]() ![]() | User County | 0..1 | string | Value Set: | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: user_role = VACCINATOR Value Set: | |
![]() ![]() ![]() ![]() | County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Sub County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Ward | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Health Facility | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Type of health facility | 1..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER Value Set: | |
![]() ![]() ![]() ![]() | County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Sub County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Ward | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Health Facility | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Type of health facility | 1..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER Value Set: | |
![]() ![]() ![]() ![]() | County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Sub County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Ward | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Health Facility | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Type of health facility | 1..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: user_role = ADMINISTRATOR Value Set: | |
![]() ![]() ![]() ![]() | County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Sub County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Ward | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Health Facility | 1..1 | reference | Value Set: | |
![]() ![]() ![]() ![]() | Type of health facility | 1..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() | EPID No | 0..1 | string | Value Set: | |
![]() ![]() | Case Demographics | 0..1 | group | Value Set: | |
![]() ![]() ![]() | First name | 1..1 | string | Value Set: | |
![]() ![]() ![]() | Middle name | 0..1 | string | Value Set: | |
![]() ![]() ![]() | Surname/Family name | 1..1 | string | Value Set: | |
![]() ![]() ![]() | Sex | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() | What is the sex of the patient? | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date of Birth known or unknown? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() | Date of birth of the patient (DD/MM/YYYY) | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date of Birth. | 1..1 | date | Enable When: 442636360588 = Known (known) Value Set: | |
![]() ![]() ![]() | Age at Onset | 0..1 | string | Value Set: Initial Value: string = 0 | |
![]() ![]() ![]() | Age in Years | 1..1 | integer | Enable When: 442636360588 = Unknown (unknown) Value Set: | |
![]() ![]() ![]() | Age in Months | 0..1 | integer | Enable When: 442636360588 = Unknown (unknown) Value Set: | |
![]() ![]() ![]() | Age in Days | 0..1 | integer | Enable When: 442636360588 = Unknown (unknown) Value Set: | |
![]() ![]() ![]() | Name of Parent/Guardian. | 1..1 | string | Value Set: | |
![]() ![]() ![]() | Telephone no. of parent/guardian. | 1..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | 07xxxxxxxx | 0..1 | display | Value Set: | |
![]() ![]() ![]() | County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() | Sub County | 1..1 | reference | Value Set: | |
![]() ![]() ![]() | Ward | 1..1 | reference | Value Set: | |
![]() ![]() ![]() | Residence (Village/Estate/Hse No). | 1..1 | string | Value Set: | |
![]() ![]() ![]() | Neighborhood major landmark. | 1..1 | string | Value Set: | |
![]() ![]() ![]() | Name Nearest Health Facility. | 1..1 | string | Value Set: | |
![]() ![]() ![]() | Town/City/Location. | 1..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | The specific town, city, or geographical location of residence. | 0..1 | display | Value Set: | |
![]() ![]() | Case Information | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Date of Investigation. | 1..1 | date | Value Set: | |
![]() ![]() ![]() ![]() | The date when the affected individual first sought medical care. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date of Notification. | 1..1 | date | Value Set: | |
![]() ![]() ![]() ![]() | The date when the health facility reported the case to the sub-county and national health authorities. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Notified by? | 1..1 | choice | Value Set: Options: 4 options | |
![]() ![]() ![]() | Was the patient admitted? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() | Was the patient hospitalized? | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date of admission. | 1..1 | date | Enable When: 336643888536 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | The date when the patient was admitted to a healthcare facility. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | IP/OP No. | 1..1 | string | Value Set: | |
![]() ![]() ![]() ![]() | Inpatient (IP) or Outpatient (OP) number assigned by the health facility. | 0..1 | display | Value Set: | |
![]() ![]() | Clinical Information | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Date of onset of paralysis. | 1..1 | date | Value Set: | |
![]() ![]() ![]() | Fever at onset of paralysis? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Is paralysis of sudden onset? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Progressive Paralysis < 3 days? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() ![]() | Was the progression of paralysis less than 3 days? | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Is paralysiss flaccid(floppy)? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Is the paralysis asymmetric? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Site of paralysis (check all that apply) | 1..* | choice | Value Set: Options: 5 options | |
![]() ![]() ![]() | Specify other site of Paralysis | 1..1 | string | Enable When: 828001350323 = Other (Specify) (othersite) Value Set: | |
![]() ![]() ![]() | Paralyzed limb sensitive to pain? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Was there any injection just before onset of paralysis? | 1..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Site of injection ( check all that applies). | 0..* | choice | Enable When: 638592165160 = Yes (yes) Value Set: Options: 10 options | |
![]() ![]() ![]() | After Investigation, was this a true AFP? | 0..1 | choice | Value Set: Options: 2 options | |
![]() ![]() ![]() | Outcome | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() | Vaccination History for disease under investigation | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Was the patient vaccinated against illness (including campaign)? | 1..1 | choice | Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() | Was the patient vaccinated against illness (including campaign)? | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Number of doses administered(Excluding birth OPV Dose) | 1..1 | integer | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | The total number of polio vaccines administered (excluding birth OPV) | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date of OPV dose at birth. | 1..1 | date | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() | Date of 1st dose. | 1..1 | date | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() | Date of 2nd dose. | 0..1 | date | Enable When: 886125589225 > 1 Value Set: | |
![]() ![]() ![]() | Date of 3rd Dose. | 0..1 | date | Enable When: 886125589225 > 2 Value Set: | |
![]() ![]() ![]() | Date of 4th Dose. | 0..1 | date | Enable When: 886125589225 > 3 Value Set: | |
![]() ![]() ![]() | If more than 4 doses, date of last dose. | 0..1 | date | Enable When: 886125589225 > 4 Value Set: | |
![]() ![]() ![]() ![]() | If more than 4 doses, date of last dose. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Were there any vaccines given in last 30 days? | 0..1 | choice | Enable When: 970455623029 = Yes (yes) Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() | Were there any vaccines given in the last 30 days? | 0..1 | display | Value Set: | |
![]() ![]() ![]() | if yes, confirm number of days/interval | 1..1 | integer | Enable When: 610048088023 = Yes (yes) Value Set: | |
![]() ![]() ![]() | Date of last OPV dose received through SIA. | 1..1 | date | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | Date of last OPV dose administered during Supplementary Immunization Activity (SIA) e.g. vaccination campaigns. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Total OPV (bOPV/mOPV2) doses received through SIA. | 1..1 | integer | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | Total number of OPV doses administered during Supplementary Immunization Activity (SIA) e.g. vaccination campaigns. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Total OPV (bOPV/mOPV2/) doses received through RI. | 1..1 | integer | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | Total number of OPV doses administered during Routine Immunization (RI). | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Total IPV doses received through SIA | 1..1 | integer | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | Total number of IPV doses administered during Supplementary Immunization Activity (SIA) e.g. vaccination campaigns. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Total IPV doses received through RI. | 1..1 | integer | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | Total number of IPV doses administered during Routine Immunization (RI). | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date of last IPV dose received through RI or SIA. | 1..1 | date | Enable When: 970455623029 = Yes (yes) Value Set: | |
![]() ![]() ![]() ![]() | Date of last IPV dose administered during Routine Immunization (RI) OR Supplementary Immunization Activity (SIA) e.g. vaccination campaigns. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Source of RI vaccination Information. | 1..1 | choice | Enable When: 970455623029 = Yes (yes) Value Set: Options: 3 options | |
![]() ![]() ![]() ![]() | What is the source of Routine Vaccination Information. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Immunocompromised status suspected? | 0..1 | choice | Value Set: Options: 3 options | |
![]() ![]() | Stool Specimen Collection Information | 0..1 | group | Value Set: | |
![]() ![]() ![]() | Date 1st specimen collected. | 1..1 | date | Value Set: | |
![]() ![]() ![]() ![]() | Collect the first date when the case is investigated. | 0..1 | display | Value Set: | |
![]() ![]() ![]() | Date 2nd specimen collected. | 1..1 | date | Value Set: | |
![]() ![]() ![]() | Date Specimen sent to the national level | 1..1 | date | Value Set: | |
Documentation for this format | |||||
Options Sets
Answer options for 438862163919
Answer options for 438862163919_sub_county
Answer options for 438862163919_county
Answer options for 438862163919_national
Answer options for 929966324957
Answer options for 442636360588
Answer options for 171292274939
Answer options for 336643888536
Answer options for 932108244312
Answer options for 396371836778
Answer options for 917680711879
Answer options for 776980947995
Answer options for 679475123276
Answer options for 828001350323
Answer options for 249388449455
Answer options for 638592165160
Answer options for 701518392602
Answer options for 564450145870
Answer options for 212304573462
Answer options for 970455623029
Answer options for 610048088023
Answer options for 650080600932
Answer options for 511517897367