Generated Narrative: Questionnaire Moh505 Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints MOH 505 Health Facility Weekly Reporting Form for disease surveillance Questionnaire http://example.org/Questionnaire/Moh505#0.1.0 #xD; 151479012557 Reporting Site 0..1 group #xD; 546255966914 Hospital/Facility Location 0..1 display #xD; user_role User Role 0..1 string #xD; user_facility User Facility 0..1 string #xD; user_ward User Ward 0..1 string #xD; user_sub_county User Sub County 0..1 string #xD; user_county User County 0..1 string #xD; facility_level null 0..1 group Enable When: user_role = VACCINATOR #xD; 294367770999 County 1..1 reference #xD; 819946803642 Sub County 1..1 reference #xD; 819943434 Ward 1..1 reference #xD; 819946803677 Health Facility 1..1 reference #xD; 438862163919 Type of health facility 1..1 choice Options: 3 options #xD; sub_county_level null 0..1 group Enable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER #xD; 294367770999_sub_county County 1..1 reference #xD; 819946803642_sub_county Sub County 1..1 reference #xD; 819943434_sub_county Ward 1..1 reference #xD; 819946803677_sub_county Health Facility 1..1 reference #xD; 438862163919_sub_county Type of health facility 1..1 choice Options: 3 options #xD; county_level null 0..1 group Enable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER #xD; 294367770999_county County 1..1 reference #xD; 819946803642_county Sub County 1..1 reference #xD; 819943434_county Ward 1..1 reference #xD; 819946803677_county Health Facility 1..1 reference #xD; 438862163919_county Type of health facility 1..1 choice Options: 3 options #xD; national_level null 0..1 group Enable When: user_role = ADMINISTRATOR #xD; 294367770999_national County 1..1 reference #xD; 819946803642_national Sub County 1..1 reference #xD; 819943434_national Ward 1..1 reference #xD; 819946803677_national Health Facility 1..1 reference #xD; 438862163919_national Type of health facility 1..1 choice Options: 3 options #xD; 728034137219 Week Ending Date 1..1 date Definition: http://example.org/sdh/dtr/aslp/StructureDefinition/aslp-bmi#Observation.value[x] #xD; 306799299 Diseases, Conditions or Events Information 0..1 group #xD; aefi-summary Were any AEFI cases reported? 1..1 choice Options: 2 options #xD; aefi-cases-under-5 Under 5 Cases 1..1 integer Enable When: aefi-summary = Yes (yes) #xD; aefi-cases-over-5 Over 5 Cases 1..1 integer Enable When: aefi-summary = Yes (yes) #xD; aefi-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: aefi-summary = Yes (yes) #xD; aefi-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: aefi-summary = Yes (yes) #xD; aefi-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: aefi-summary = No (no) Initial Value: integer = 0 #xD; aefi-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: aefi-summary = No (no) Initial Value: integer = 0 #xD; aefi-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: aefi-summary = No (no) Initial Value: integer = 0 #xD; aefi-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: aefi-summary = No (no) Initial Value: integer = 0 #xD; bacterial-meningitis-summary Were any Bacterial Meningitis cases reported? 1..1 choice Options: 2 options #xD; bacterial-meningitis-cases-under-5 Under 5 Cases 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-cases-over-5 Over 5 Cases 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 #xD; bacterial-meningitis-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 #xD; bacterial-meningitis-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 #xD; bacterial-meningitis-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 #xD; acute-jaundice-summary Were any Acute Jaundice cases reported? 1..1 choice Options: 2 options #xD; acute-jaundice-cases-under-5 Under Cases 1..1 integer Enable When: acute-jaundice-summary = Yes (yes) #xD; acute-jaundice-cases-over-5 Over Cases 1..1 integer Enable When: acute-jaundice-summary = Yes (yes) #xD; acute-jaundice-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: acute-jaundice-summary = Yes (yes) #xD; acute-jaundice-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: acute-jaundice-summary = Yes (yes) #xD; acute-jaundice-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 #xD; acute-jaundice-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 #xD; acute-jaundice-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 #xD; acute-jaundice-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 #xD; neonatal-deaths-summary Were any Neonatal Deaths cases reported? 1..1 choice Options: 2 options #xD; neonatal-deaths-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: neonatal-deaths-summary = Yes (yes) #xD; neonatal-deaths-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: neonatal-deaths-summary = No (no) #xD; acute-malnutrition-summary Were any Acute Malnutrition cases reported? 1..1 choice Options: 2 options #xD; acute-malnutrition-cases-under-5 Under 5 Cases 1..1 integer Enable When: acute-malnutrition-summary = Yes (yes) #xD; acute-malnutrition-cases-over-5 Over 5 Cases 1..1 integer Enable When: acute-malnutrition-summary = Yes (yes) #xD; acute-malnutrition-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: acute-malnutrition-summary = Yes (yes) #xD; acute-malnutrition-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: acute-malnutrition-summary = Yes (yes) #xD; acute-malnutrition-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 #xD; acute-malnutrition-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 #xD; acute-malnutrition-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 #xD; acute-malnutrition-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 #xD; neonatal-tetanus-summary Were any Neonatal Tetanus cases reported? 1..1 choice Options: 2 options #xD; neonatal-tetanus-cases-under-5 Under 5 Cases 1..1 integer Enable When: neonatal-tetanus-summary = Yes (yes) #xD; neonatal-tetanus-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: neonatal-tetanus-summary = Yes (yes) #xD; neonatal-tetanus-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: neonatal-tetanus-summary = No (no) #xD; neonatal-tetanus-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: neonatal-tetanus-summary = No (no) #xD; afp-poliomyelitis-summary Were any Afp Poliomyelitis cases reported? 1..1 choice Options: 2 options #xD; afp-poliomyelitis-cases-under-5 Under 5 Cases 1..1 integer Enable When: afp-poliomyelitis-summary = Yes (yes) #xD; afp-poliomyelitis-cases-over-5 Over 5 Cases 1..1 integer Enable When: afp-poliomyelitis-summary = Yes (yes) #xD; afp-poliomyelitis-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: afp-poliomyelitis-summary = Yes (yes) #xD; afp-poliomyelitis-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: afp-poliomyelitis-summary = Yes (yes) #xD; afp-poliomyelitis-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 #xD; afp-poliomyelitis-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 #xD; afp-poliomyelitis-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 #xD; afp-poliomyelitis-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 #xD; onchocerciasis-summary Were any Onchocerciasis cases reported? 1..1 choice Options: 2 options #xD; onchocerciasis-cases-under-5 Under 5 Cases 1..1 integer Enable When: onchocerciasis-summary = Yes (yes) #xD; onchocerciasis-cases-over-5 Over 5 Cases 1..1 integer Enable When: onchocerciasis-summary = Yes (yes) #xD; onchocerciasis-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: onchocerciasis-summary = Yes (yes) #xD; onchocerciasis-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: onchocerciasis-summary = Yes (yes) #xD; onchocerciasis-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 #xD; onchocerciasis-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 #xD; onchocerciasis-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 #xD; onchocerciasis-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 #xD; plague-summary Were any Plague cases reported? 1..1 choice Options: 2 options #xD; plague-cases-under-5 Under 5 Cases 1..1 integer Enable When: plague-summary = Yes (yes) #xD; plague-cases-over-5 Over 5 Cases 1..1 integer Enable When: plague-summary = Yes (yes) #xD; plague-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: plague-summary = Yes (yes) #xD; plague-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: plague-summary = Yes (yes) #xD; plague-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: plague-summary = No (no) Initial Value: integer = 0 #xD; plague-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: plague-summary = No (no) Initial Value: integer = 0 #xD; plague-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: plague-summary = No (no) Initial Value: integer = 0 #xD; plague-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: plague-summary = No (no) Initial Value: integer = 0 #xD; anthrax-summary Were any Anthrax cases reported? 1..1 choice Options: 2 options #xD; anthrax-cases-under-5 Under 5 Cases 1..1 integer Enable When: anthrax-summary = Yes (yes) #xD; anthrax-cases-over-5 Over 5 Cases 1..1 integer Enable When: anthrax-summary = Yes (yes) #xD; anthrax-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: anthrax-summary = Yes (yes) #xD; anthrax-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: anthrax-summary = Yes (yes) #xD; anthrax-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: anthrax-summary = No (no) Initial Value: integer = 0 #xD; anthrax-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: anthrax-summary = No (no) Initial Value: integer = 0 #xD; anthrax-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: anthrax-summary = No (no) Initial Value: integer = 0 #xD; anthrax-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: anthrax-summary = No (no) Initial Value: integer = 0 #xD; rabies-summary Were any Rabies cases reported? 1..1 choice Options: 2 options #xD; rabies-cases-under-5 Under 5 Cases 1..1 integer Enable When: rabies-summary = Yes (yes) #xD; rabies-cases-over-5 Over 5 Cases 1..1 integer Enable When: rabies-summary = Yes (yes) #xD; rabies-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: rabies-summary = Yes (yes) #xD; rabies-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: rabies-summary = Yes (yes) #xD; rabies-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: rabies-summary = No (no) Initial Value: integer = 0 #xD; rabies-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: rabies-summary = No (no) Initial Value: integer = 0 #xD; rabies-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: rabies-summary = No (no) Initial Value: integer = 0 #xD; rabies-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: rabies-summary = No (no) Initial Value: integer = 0 #xD; cholera-summary Were any Cholera cases reported? 1..1 choice Options: 2 options #xD; cholera-cases-under-5 Under 5 Cases 1..1 integer Enable When: cholera-summary = Yes (yes) #xD; cholera-cases-over-5 Over 5 Cases 1..1 integer Enable When: cholera-summary = Yes (yes) #xD; cholera-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: cholera-summary = Yes (yes) #xD; cholera-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: cholera-summary = Yes (yes) #xD; cholera-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: cholera-summary = No (no) Initial Value: integer = 0 #xD; cholera-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: cholera-summary = No (no) Initial Value: integer = 0 #xD; cholera-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: cholera-summary = No (no) Initial Value: integer = 0 #xD; cholera-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: cholera-summary = No (no) Initial Value: integer = 0 #xD; rift-valley-fever-summary Were any Rift Valley Fever cases reported? 1..1 choice Options: 2 options #xD; rift-valley-fever-cases-under-5 Under 5 Cases 1..1 integer Enable When: rift-valley-fever-summary = Yes (yes) #xD; rift-valley-fever-cases-over-5 Over 5 Cases 1..1 integer Enable When: rift-valley-fever-summary = Yes (yes) #xD; rift-valley-fever-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: rift-valley-fever-summary = Yes (yes) #xD; rift-valley-fever-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: rift-valley-fever-summary = Yes (yes) #xD; rift-valley-fever-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 #xD; rift-valley-fever-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 #xD; rift-valley-fever-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 #xD; rift-valley-fever-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 #xD; chikungunya-summary Were any Chikungunya cases reported? 1..1 choice Options: 2 options #xD; chikungunya-cases-under-5 Under 5 Cases 1..1 integer Enable When: chikungunya-summary = Yes (yes) #xD; chikungunya-cases-over-5 Over 5 Cases 1..1 integer Enable When: chikungunya-summary = Yes (yes) #xD; chikungunya-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: chikungunya-summary = Yes (yes) #xD; chikungunya-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: chikungunya-summary = Yes (yes) #xD; chikungunya-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 #xD; chikungunya-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 #xD; chikungunya-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 #xD; chikungunya-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 #xD; covid--19-summary Were any Covid 19 cases reported? 1..1 choice Options: 2 options #xD; covid--19-cases-under-5 Under 5 Cases 1..1 integer Enable When: covid--19-summary = Yes (yes) #xD; covid--19-cases-over-5 Over 5 Cases 1..1 integer Enable When: covid--19-summary = Yes (yes) #xD; covid--19-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: covid--19-summary = Yes (yes) #xD; covid--19-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: covid--19-summary = Yes (yes) #xD; covid--19-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: covid--19-summary = No (no) Initial Value: integer = 0 #xD; covid--19-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: covid--19-summary = No (no) Initial Value: integer = 0 #xD; covid--19-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: covid--19-summary = No (no) Initial Value: integer = 0 #xD; covid--19-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: covid--19-summary = No (no) Initial Value: integer = 0 #xD; sari-cluster-ge3-cases-summary Were any Sari Cluster Ge3 Cases cases reported? 1..1 choice Options: 2 options #xD; sari-cluster-ge3-cases-cases-under-5 Under 5 Cases 1..1 integer Enable When: sari-cluster-ge3-cases-summary = Yes (yes) #xD; sari-cluster-ge3-cases-cases-over-5 Over 5 Cases 1..1 integer Enable When: sari-cluster-ge3-cases-summary = Yes (yes) #xD; sari-cluster-ge3-cases-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: sari-cluster-ge3-cases-summary = Yes (yes) #xD; sari-cluster-ge3-cases-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: sari-cluster-ge3-cases-summary = Yes (yes) #xD; sari-cluster-ge3-cases-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 #xD; sari-cluster-ge3-cases-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 #xD; sari-cluster-ge3-cases-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 #xD; sari-cluster-ge3-cases-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 #xD; dengue-summary Were any Dengue cases reported? 1..1 choice Options: 2 options #xD; dengue-cases-under-5 Under 5 Cases 1..1 integer Enable When: dengue-summary = Yes (yes) #xD; dengue-cases-over-5 Over 5 Cases 1..1 integer Enable When: dengue-summary = Yes (yes) #xD; dengue-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: dengue-summary = Yes (yes) #xD; dengue-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: dengue-summary = Yes (yes) #xD; dengue-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: dengue-summary = No (no) Initial Value: integer = 0 #xD; dengue-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: dengue-summary = No (no) Initial Value: integer = 0 #xD; dengue-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: dengue-summary = No (no) Initial Value: integer = 0 #xD; dengue-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: dengue-summary = No (no) Initial Value: integer = 0 #xD; dysentery-bacillary-summary Were any Dysentery Bacillary cases reported? 1..1 choice Options: 2 options #xD; dysentery-bacillary-cases-under-5 Under 5 Cases 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; dysentery-bacillary-cases-over-5 Over 5 Cases 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; dysentery-bacillary-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; dysentery-bacillary-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; dysentery-bacillary-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 #xD; dysentery-bacillary-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 #xD; dysentery-bacillary-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 #xD; dysentery-bacillary-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 #xD; suspected-mdr-xdr-tb-summary Were any Suspected Mdr Xdr Tb cases reported? 1..1 choice Options: 2 options #xD; suspected-mdr-xdr-tb-cases-under-5 Under 5 Cases 1..1 integer Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) #xD; suspected-mdr-xdr-tb-cases-over-5 Over 5 Cases 1..1 integer Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) #xD; suspected-mdr-xdr-tb-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) #xD; suspected-mdr-xdr-tb-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) #xD; suspected-mdr-xdr-tb-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 #xD; suspected-mdr-xdr-tb-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 #xD; suspected-mdr-xdr-tb-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 #xD; suspected-mdr-xdr-tb-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 #xD; guinea-worm-disease-summary Were any Guinea Worm Disease cases reported? 1..1 choice Options: 2 options #xD; guinea-worm-disease-cases-under-5 Under 5 Cases 1..1 integer Enable When: guinea-worm-disease-summary = Yes (yes) #xD; guinea-worm-disease-cases-over-5 Over 5 Cases 1..1 integer Enable When: guinea-worm-disease-summary = Yes (yes) #xD; guinea-worm-disease-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: guinea-worm-disease-summary = Yes (yes) #xD; guinea-worm-disease-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: guinea-worm-disease-summary = Yes (yes) #xD; guinea-worm-disease-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 #xD; guinea-worm-disease-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 #xD; guinea-worm-disease-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 #xD; guinea-worm-disease-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 #xD; typhoid-summary Were any Typhoid cases reported? 1..1 choice Options: 2 options #xD; typhoid-cases-under-5 Under 5 Cases 1..1 integer Enable When: typhoid-summary = Yes (yes) #xD; typhoid-cases-over-5 Over 5 Cases 1..1 integer Enable When: typhoid-summary = Yes (yes) #xD; typhoid-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: typhoid-summary = Yes (yes) #xD; typhoid-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: typhoid-summary = Yes (yes) #xD; typhoid-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: typhoid-summary = No (no) Initial Value: integer = 0 #xD; typhoid-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: typhoid-summary = No (no) Initial Value: integer = 0 #xD; typhoid-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: typhoid-summary = No (no) Initial Value: integer = 0 #xD; typhoid-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: typhoid-summary = No (no) Initial Value: integer = 0 #xD; measles-summary Were any Measles cases reported? 1..1 choice Options: 2 options #xD; measles-cases-under-5 Under 5 Cases 1..1 integer Enable When: measles-summary = Yes (yes) #xD; measles-cases-over-5 Over 5 Cases 1..1 integer Enable When: measles-summary = Yes (yes) #xD; measles-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: measles-summary = Yes (yes) #xD; measles-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: measles-summary = Yes (yes) #xD; measles-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: measles-summary = No (no) Initial Value: integer = 0 #xD; measles-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: measles-summary = No (no) Initial Value: integer = 0 #xD; measles-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: measles-summary = No (no) Initial Value: integer = 0 #xD; measles-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: measles-summary = No (no) Initial Value: integer = 0 #xD; vhf-summary Were any Vhf cases reported? 1..1 choice Options: 2 options #xD; vhf-cases-under-5 Under 5 Cases 1..1 integer Enable When: vhf-summary = Yes (yes) #xD; vhf-cases-over-5 Over 5 Cases 1..1 integer Enable When: vhf-summary = Yes (yes) #xD; vhf-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: vhf-summary = Yes (yes) #xD; vhf-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: vhf-summary = Yes (yes) #xD; vhf-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: vhf-summary = No (no) Initial Value: integer = 0 #xD; vhf-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: vhf-summary = No (no) Initial Value: integer = 0 #xD; vhf-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: vhf-summary = No (no) Initial Value: integer = 0 #xD; vhf-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: vhf-summary = No (no) Initial Value: integer = 0 #xD; suspected-malaria-summary Were any Suspected Malaria cases reported? 1..1 choice Options: 2 options #xD; suspected-malaria-cases-under-5 Under 5 Cases 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; suspected-malaria-cases-over-5 Over 5 Cases 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; suspected-malaria-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; suspected-malaria-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; suspected-malaria-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 #xD; suspected-malaria-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 #xD; suspected-malaria-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 #xD; suspected-malaria-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 #xD; yellow-fever-summary Were any Yellow Fever cases reported? 1..1 choice Options: 2 options #xD; yellow-fever-cases-under-5 Under 5 Cases 1..1 integer Enable When: yellow-fever-summary = Yes (yes) #xD; yellow-fever-cases-over-5 Over 5 Cases 1..1 integer Enable When: yellow-fever-summary = Yes (yes) #xD; yellow-fever-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: yellow-fever-summary = Yes (yes) #xD; yellow-fever-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: yellow-fever-summary = Yes (yes) #xD; yellow-fever-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 #xD; yellow-fever-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 #xD; yellow-fever-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 #xD; yellow-fever-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 #xD; deaths-due-to-malaria-summary Were any Deaths Due To Malaria cases reported? 1..1 choice Options: 2 options #xD; deaths-due-to-malaria-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: deaths-due-to-malaria-summary = Yes (yes) #xD; deaths-due-to-malaria-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: deaths-due-to-malaria-summary = Yes (yes) #xD; deaths-due-to-malaria-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: deaths-due-to-malaria-summary = No (no) #xD; deaths-due-to-malaria-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: deaths-due-to-malaria-summary = No (no) Initial Value: integer = 0 #xD; zika-virus-summary Were any Zika Virus cases reported? 1..1 choice Options: 2 options #xD; zika-virus-cases-under-5 Under 5 Cases 1..1 integer Enable When: zika-virus-summary = Yes (yes) #xD; zika-virus-cases-over-5 Over 5 Cases 1..1 integer Enable When: zika-virus-summary = Yes (yes) #xD; zika-virus-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: zika-virus-summary = Yes (yes) #xD; zika-virus-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: zika-virus-summary = Yes (yes) #xD; zika-virus-summary-cases-under-5-if-no Under 5 Cases 0..1 integer Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 #xD; zika-virus-summary-cases-over-5-if-no Over 5 Cases 0..1 integer Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 #xD; zika-virus-summary-deaths-under-5-if-no Under 5 Deaths 0..1 integer Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 #xD; zika-virus-summary-deaths-over-5-if-no Over 5 Deaths 0..1 integer Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 #xD; others-specify-summary Were any Others Specify cases reported? 1..1 choice Options: 2 options #xD; others-specify-cases-name Others (Specify) 1..1 string Enable When: others-specify-summary = Yes (yes) #xD; others-specify-cases-under-5 Under 5 Cases 1..1 integer Enable When: others-specify-summary = Yes (yes) #xD; others-specify-cases-over-5 Over 5 Cases 1..1 integer Enable When: others-specify-summary = Yes (yes) #xD; others-specify-deaths-under-5 Under 5 Deaths 1..1 integer Enable When: others-specify-summary = Yes (yes) #xD; others-specify-deaths-over-5 Over 5 Deaths 1..1 integer Enable When: others-specify-summary = Yes (yes) #xD; 3067992989898 Laboratory Surveillance 0..1 group #xD; malaria-tested-under-5 Malaria Microscopy Tested < 5 years 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; malaria-tested-over-5 Malaria Microscopy Tested ≥ 5 years 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; malaria-positive-under-5 Malaria Microscopy Positive < 5 years 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; malaria-positive-over-5 Malaria Microscopy Positive ≥ 5 years 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; malaria-total-tested Malaria Microscopy Total Tested < 5 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; malaria-mrdt-under-5 Malaria mRDT < 5 years 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; malaria-mrdt-over-5 Malaria mRDT ≥ 5 years 1..1 integer Enable When: suspected-malaria-summary = Yes (yes) #xD; dysentery-tested-under-5 Dysentery Tested < 5 years 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; dysentery-tested-over-5 Dysentery Tested ≥ 5 years 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; dysentery-positive-shigella Dysentery Positive (S. dysenteriae) 1..1 integer Enable When: dysentery-bacillary-summary = Yes (yes) #xD; bacterial-meningitis-csf-no Bacterial Meningitis No CSF 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-csf-contaminated Bacterial Meningitis No contaminated 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-tested-positive Bacterial Meningitis Tested +ve 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nm Bacterial Meningitis +ve Nm 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-spneum Bacterial Meningitis +ve S. Pneum 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-hib Bacterial Meningitis +ve Hib 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-sagalactiae Bacterial Meningitis +ve S. agalactiae 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-csf-subtyped Bacterial Meningitis No of CSF Sub-Typed 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nma Bacterial Meningitis +ve Nm A 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nmb Bacterial Meningitis +ve Nm B 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nmc Bacterial Meningitis +ve Nm C 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nmw Bacterial Meningitis +ve Nm W 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nmx Bacterial Meningitis +ve Nm X 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; bacterial-meningitis-positive-nmy Bacterial Meningitis +ve Nm Y 1..1 integer Enable When: bacterial-meningitis-summary = Yes (yes) #xD; tuberculosis-mdr-xdr-tested-under-5 Tuberculosis (MDR/XDR) Tested < 5 years 1..1 integer #xD; tuberculosis-mdr-xdr-tested-over-5 Tuberculosis (MDR/XDR) Tested ≥ 5 years 1..1 integer #xD; tuberculosis-mdr-xdr-positive Tuberculosis (MDR/XDR) Positive < 5 years 1..1 integer #xD; typhoid-tested-under-5 Typhoid Tested < 5 years 1..1 integer Enable When: typhoid-summary = Yes (yes) #xD; typhoid-tested-over-5 Typhoid Tested ≥ 5 years 1..1 integer Enable When: typhoid-summary = Yes (yes) #xD; Documentation for this format Options Sets Answer options for 438862163919 null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for 438862163919_sub_county null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for 438862163919_county null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for 438862163919_national null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for aefi-summary null#yes ("Yes") null#no ("No") Answer options for bacterial-meningitis-summary null#yes ("Yes") null#no ("No") Answer options for acute-jaundice-summary null#yes ("Yes") null#no ("No") Answer options for neonatal-deaths-summary null#yes ("Yes") null#no ("No") Answer options for acute-malnutrition-summary null#yes ("Yes") null#no ("No") Answer options for neonatal-tetanus-summary null#yes ("Yes") null#no ("No") Answer options for afp-poliomyelitis-summary null#yes ("Yes") null#no ("No") Answer options for onchocerciasis-summary null#yes ("Yes") null#no ("No") Answer options for plague-summary null#yes ("Yes") null#no ("No") Answer options for anthrax-summary null#yes ("Yes") null#no ("No") Answer options for rabies-summary null#yes ("Yes") null#no ("No") Answer options for cholera-summary null#yes ("Yes") null#no ("No") Answer options for rift-valley-fever-summary null#yes ("Yes") null#no ("No") Answer options for chikungunya-summary null#yes ("Yes") null#no ("No") Answer options for covid--19-summary null#yes ("Yes") null#no ("No") Answer options for sari-cluster-ge3-cases-summary null#yes ("Yes") null#no ("No") Answer options for dengue-summary null#yes ("Yes") null#no ("No") Answer options for dysentery-bacillary-summary null#yes ("Yes") null#no ("No") Answer options for suspected-mdr-xdr-tb-summary null#yes ("Yes") null#no ("No") Answer options for guinea-worm-disease-summary null#yes ("Yes") null#no ("No") Answer options for typhoid-summary null#yes ("Yes") null#no ("No") Answer options for measles-summary null#yes ("Yes") null#no ("No") Answer options for vhf-summary null#yes ("Yes") null#no ("No") Answer options for suspected-malaria-summary null#yes ("Yes") null#no ("No") Answer options for yellow-fever-summary null#yes ("Yes") null#no ("No") Answer options for deaths-due-to-malaria-summary null#yes ("Yes") null#no ("No") Answer options for zika-virus-summary null#yes ("Yes") null#no ("No") Answer options for others-specify-summary null#yes ("Yes") null#no ("No")
MOH 505 - Health Facility Weekly Reporting Form
MOH 505 Health Facility Weekly Reporting Form for disease surveillance
Diseases, Conditions or Events Information
Were any Bacterial Meningitis cases reported?
Were any Neonatal Deaths cases reported?
Were any Acute Malnutrition cases reported?
Were any Neonatal Tetanus cases reported?
Were any Afp Poliomyelitis cases reported?
Were any Rift Valley Fever cases reported?
Were any Sari Cluster Ge3 Cases cases reported?
Were any Dysentery Bacillary cases reported?
Were any Suspected Mdr Xdr Tb cases reported?
Were any Guinea Worm Disease cases reported?
Were any Suspected Malaria cases reported?
Were any Deaths Due To Malaria cases reported?
Bacterial Meningitis No of CSF Sub-Typed
Tuberculosis (MDR/XDR) Positive < 5 years