Kenya Disease Surveillance FHIR Implementation Guide.
0.1.0 - ci-build Kenya flag

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

Questionnaire: Mpox Tally Sheet

Official URL: http://example.org/Questionnaire/MpoxTallySheet Version: 0.1.0
Active as of 2026-04-04 Computable Name:

Mpox Tally Sheet questionnaire for disease surveillance

Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. Mpox Tally Sheet questionnaire for disease surveillanceQuestionnairehttp://example.org/Questionnaire/MpoxTallySheet#0.1.0
... 151479012557Reporting Site0..1groupValue Set:
.... 546255966914Hospital/Facility Location0..1displayValue Set:
.... user_roleUser Role0..1stringiconiconValue Set:
.... user_facilityUser Facility0..1stringiconiconValue Set:
.... user_wardUser Ward0..1stringiconiconValue Set:
.... user_sub_countyUser Sub County0..1stringiconiconValue Set:
.... user_countyUser County0..1stringiconiconValue Set:
.... facility_levelnull0..1groupEnable When: user_role = VACCINATOR
Value Set:
..... 294367770999County1..1referenceValue Set:
..... 819946803642Sub County1..1referenceValue Set:
..... 819943434Ward1..1referenceValue Set:
..... 819946803677Health Facility1..1referenceValue Set:
..... 438862163919Type of health facility1..1choiceValue Set:
Options: 3 options
.... sub_county_levelnull0..1groupEnable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER
Value Set:
..... 294367770999_sub_countyCounty1..1referenceValue Set:
..... 819946803642_sub_countySub County1..1referenceValue Set:
..... 819943434_sub_countyWard1..1referenceValue Set:
..... 819946803677_sub_countyHealth Facility1..1referenceValue Set:
..... 438862163919_sub_countyType of health facility1..1choiceValue Set:
Options: 3 options
.... county_levelnull0..1groupEnable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER
Value Set:
..... 294367770999_countyCounty1..1referenceValue Set:
..... 819946803642_countySub County1..1referenceValue Set:
..... 819943434_countyWard1..1referenceValue Set:
..... 819946803677_countyHealth Facility1..1referenceValue Set:
..... 438862163919_countyType of health facility1..1choiceValue Set:
Options: 3 options
.... national_levelnull0..1groupEnable When: user_role = ADMINISTRATOR
Value Set:
..... 294367770999_nationalCounty1..1referenceValue Set:
..... 819946803642_nationalSub County1..1referenceValue Set:
..... 819943434_nationalWard1..1referenceValue Set:
..... 819946803677_nationalHealth Facility1..1referenceValue Set:
..... 438862163919_nationalType of health facility1..1choiceValue Set:
Options: 3 options
.... villageVillage1..1stringValue Set:
.... team_noTeam No1..1stringValue Set:
.... team_typeTeam type1..1choiceValue Set:
Options: 3 options
.... campaign_dayCampaign Day1..1choiceValue Set:
Options: 10 options
.... 728034137219Date1..1dateValue Set:
.... supervisor_nameSupervisor Name1..1stringValue Set:
.... supervisor_levelSupervisor Level1..1choiceValue Set:
Options: 4 options
... target_populationNumber Reached0..1groupValue Set:
.... hcw_18_39_reportedWere any healthcare workers aged 18–39 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... hcw_18_39_maleNumber of male healthcare workers aged 18–39 years reported0..1integerEnable When: hcw_18_39_reported = yes (yes)
Value Set:
.... hcw_18_39_femaleNumber of female healthcare workers aged 18–39 years reported0..1integerEnable When: hcw_18_39_reported = yes (yes)
Value Set:
.... hcw_18_39_male_noNumber of male healthcare workers aged 18–39 years reported0..1integericoniconEnable When: hcw_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... hcw_18_39_female_noNumber of female healthcare workers aged 18–39 years reported0..1integericoniconEnable When: hcw_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... hcw_40_59_reportedWere any healthcare workers aged 40–59 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... hcw_40_59_maleNumber of male healthcare workers aged 40–59 years reported0..1integerEnable When: hcw_40_59_reported = yes (yes)
Value Set:
.... hcw_40_59_femaleNumber of female healthcare workers aged 40–59 years reported0..1integerEnable When: hcw_40_59_reported = yes (yes)
Value Set:
.... hcw_40_59_male_noNumber of male healthcare workers aged 40–59 years reported0..1integericoniconEnable When: hcw_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... hcw_40_59_female_noNumber of female healthcare workers aged 40–59 years reported0..1integericoniconEnable When: hcw_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... hcw_60_plus_reportedWere any healthcare workers aged 60+ years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... hcw_60_plus_maleNumber of male healthcare workers aged 60+ years reported0..1integerEnable When: hcw_60_plus_reported = yes (yes)
Value Set:
.... hcw_60_plus_femaleNumber of female healthcare workers aged 60+ years reported0..1integerEnable When: hcw_60_plus_reported = yes (yes)
Value Set:
.... hcw_60_plus_male_noNumber of male healthcare workers aged 60+ years reported0..1integericoniconEnable When: hcw_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... hcw_60_plus_female_noNumber of female healthcare workers aged 60+ years reported0..1integericoniconEnable When: hcw_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_under_18_reportedWere any sex workers aged under 18 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... sw_under_18_maleNumber of male sex workers under 18 years reported0..1integerEnable When: sw_under_18_reported = yes (yes)
Value Set:
.... sw_under_18_femaleNumber of female sex workers aged under 18 years reported0..1integerEnable When: sw_under_18_reported = yes (yes)
Value Set:
.... sw_under_18_male_noNumber of male sex workers aged under 18 years reported0..1integericoniconEnable When: sw_under_18_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_under_18_female_noNumber of female sex workers aged under 18 years reported0..1integericoniconEnable When: sw_under_18_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_18_39_reportedWere any sex workers aged 18–39 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... sw_18_39_maleNumber of male sex workers aged 18–39 years reported0..1integerEnable When: sw_18_39_reported = yes (yes)
Value Set:
.... sw_18_39_femaleNumber of female sex workers aged 18–39 years reported0..1integerEnable When: sw_18_39_reported = yes (yes)
Value Set:
.... sw_18_39_male_noNumber of male sex workers aged 18–39 years reported0..1integericoniconEnable When: sw_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_18_39_female_noNumber of female sex workers aged 18–39 years reported0..1integericoniconEnable When: sw_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_40_59_reportedWere any sex workers aged 40–59 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... sw_40_59_maleNumber of male sex workers aged 40–59 years reported0..1integerEnable When: sw_40_59_reported = yes (yes)
Value Set:
.... sw_40_59_femaleNumber of female sex workers aged 40–59 years reported0..1integerEnable When: sw_40_59_reported = yes (yes)
Value Set:
.... sw_40_59_male_noNumber of male sex workers aged 40–59 years reported0..1integericoniconEnable When: sw_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_40_59_female_noNumber of female sex workers aged 40–59 years reported0..1integericoniconEnable When: sw_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_60_plus_reportedWere any sex workers aged 60+ years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... sw_60_plus_maleNumber of male sex workers aged 60+ years reported0..1integerEnable When: sw_60_plus_reported = yes (yes)
Value Set:
.... sw_60_plus_femaleNumber of female sex workers aged 60+ years reported0..1integerEnable When: sw_60_plus_reported = yes (yes)
Value Set:
.... sw_60_plus_male_noNumber of male sex workers aged 60+ years reported0..1integericoniconEnable When: sw_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... sw_60_plus_female_noNumber of female sex workers aged 60+ years reported0..1integericoniconEnable When: sw_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... td_18_39_reportedWere any truck drivers aged 18–39 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... td_18_39_maleNumber of male truck drivers aged 18–39 years reported0..1integerEnable When: td_18_39_reported = yes (yes)
Value Set:
.... td_18_39_femaleNumber of female truck drivers aged 18–39 years reported0..1integerEnable When: td_18_39_reported = yes (yes)
Value Set:
.... td_18_39_male_noNumber of male truck drivers aged 18–39 years reported0..1integericoniconEnable When: td_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... td_18_39_female_noNumber of female truck drivers aged 18–39 years reported0..1integericoniconEnable When: td_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... td_40_59_reportedWere any truck drivers aged 40–59 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... td_40_59_maleNumber of male truck drivers aged 40–59 years reported0..1integerEnable When: td_40_59_reported = yes (yes)
Value Set:
.... td_40_59_femaleNumber of female truck drivers aged 40–59 years reported0..1integerEnable When: td_40_59_reported = yes (yes)
Value Set:
.... td_40_59_male_noNumber of male truck drivers aged 40–59 years reported0..1integericoniconEnable When: td_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... td_40_59_female_noNumber of female truck drivers aged 40–59 years reported0..1integericoniconEnable When: td_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... td_60_plus_reportedWere any truck drivers aged 60+ years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... td_60_plus_maleNumber of male truck drivers aged 60+ years reported0..1integerEnable When: td_60_plus_reported = yes (yes)
Value Set:
.... td_60_plus_femaleNumber of female truck drivers aged 60+ years reported0..1integerEnable When: td_60_plus_reported = yes (yes)
Value Set:
.... td_60_plus_male_noNumber of male truck drivers aged 60+ years reported0..1integericoniconEnable When: td_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... td_60_plus_female_noNumber of female truck drivers aged 60+ years reported0..1integericoniconEnable When: td_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... others_18_39_reportedWere any others aged 18–39 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... others_18_39_maleNumber of male others aged 18–39 years reported0..1integerEnable When: others_18_39_reported = yes (yes)
Value Set:
.... others_18_39_femaleNumber of female others aged 18–39 years reported0..1integerEnable When: others_18_39_reported = yes (yes)
Value Set:
.... others_18_39_male_noNumber of male others aged 18–39 years reported0..1integericoniconEnable When: others_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... others_18_39_female_noNumber of female others aged 18–39 years reported0..1integericoniconEnable When: others_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... others_40_59_reportedWere any others aged 40–59 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... others_40_59_maleNumber of male others aged 40–59 years reported0..1integerEnable When: others_40_59_reported = yes (yes)
Value Set:
.... others_40_59_femaleNumber of female others aged 40–59 years reported0..1integerEnable When: others_40_59_reported = yes (yes)
Value Set:
.... others_40_59_male_noNumber of male others aged 40–59 years reported0..1integericoniconEnable When: others_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... others_40_59_female_noNumber of female others aged 40–59 years reported0..1integericoniconEnable When: others_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... others_60_plus_reportedWere any others aged 60+ years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... others_60_plus_maleNumber of male others aged 60+ years reported0..1integerEnable When: others_60_plus_reported = yes (yes)
Value Set:
.... others_60_plus_femaleNumber of female others aged 60+ years reported0..1integerEnable When: others_60_plus_reported = yes (yes)
Value Set:
.... others_60_plus_male_noNumber of male others aged 60+ years reported0..1integericoniconEnable When: others_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... others_60_plus_female_noNumber of female others aged 60+ years reported0..1integericoniconEnable When: others_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_under_18_reportedWere any contacts aged under 18 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... contact_under_18_maleNumber of male contacts aged under 18 years reported0..1integerEnable When: contact_under_18_reported = yes (yes)
Value Set:
.... contact_under_18_femaleNumber of female contacts aged under 18 years reported0..1integerEnable When: contact_under_18_reported = yes (yes)
Value Set:
.... contact_under_18_male_noNumber of male contacts aged under 18 years reported0..1integericoniconEnable When: contact_under_18_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_under_18_female_noNumber of female contacts aged under 18 years reported0..1integericoniconEnable When: contact_under_18_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_18_39_reportedWere any contacts aged 18–39 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... contact_18_39_maleNumber of male contacts aged 18–39 years reported0..1integerEnable When: contact_18_39_reported = yes (yes)
Value Set:
.... contact_18_39_femaleNumber of female contacts aged 18–39 years reported0..1integerEnable When: contact_18_39_reported = yes (yes)
Value Set:
.... contact_18_39_male_noNumber of male contacts aged 18–39 years reported0..1integericoniconEnable When: contact_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_18_39_female_noNumber of female contacts aged 18–39 years reported0..1integericoniconEnable When: contact_18_39_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_40_59_reportedWere any contacts aged 40–59 years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... contact_40_59_maleNumber of male contacts aged 40–59 years reported0..1integerEnable When: contact_40_59_reported = yes (yes)
Value Set:
.... contact_40_59_femaleNumber of female contacts aged 40–59 years reported0..1integerEnable When: contact_40_59_reported = yes (yes)
Value Set:
.... contact_40_59_male_noNumber of male contacts aged 40–59 years reported0..1integericoniconEnable When: contact_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_40_59_female_noNumber of female contacts aged 40–59 years reported0..1integericoniconEnable When: contact_40_59_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_60_plus_reportedWere any contacts aged 60+ years reported?1..1choiceiconiconValue Set:
Options: 2 options
.... contact_60_plus_maleNumber of male contacts aged 60+ years reported0..1integerEnable When: contact_60_plus_reported = yes (yes)
Value Set:
.... contact_60_plus_femaleNumber of female contacts aged 60+ years reported0..1integerEnable When: contact_60_plus_reported = yes (yes)
Value Set:
.... contact_60_plus_male_noNumber of male contacts aged 60+ years reported0..1integericoniconEnable When: contact_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
.... contact_60_plus_female_noNumber of female contacts aged 60+ years reported0..1integericoniconEnable When: contact_60_plus_reported = no (no)
Value Set:
Initial Value: integer = 0
... utilization_aefi_mpox_surveilanceVaccine Utilization, AEFI and Mpox Surveillance0..1groupValue Set:
.... vaccine_receivedNumber of doses of vaccine received1..1integerValue Set:
.... vaccine_usedNumber of vaccine doses used1..1integerValue Set:
.... vaccine_remainingNumber of vaccine doses remaining1..1integerValue Set:
.... aefiAEFI0..1displayValue Set:
.... aefi_yes_noReported AEFI?1..1choiceiconiconValue Set:
Options: 2 options
.... aefi_countNumber of vaccinee with reported AEFI1..1integerEnable When: aefi_yes_no = yes (yes)
Value Set:
.... surveilanceSurveilance0..1displayValue Set:
.... mpox_suspected_case_countNo. of Mpox Suspected Case detected1..1integerValue Set:
.... rumour_trackingRumour Tracking0..1displayValue Set:
.... rumour_reportedWere any rumours reported1..1choiceiconiconValue Set:
Options: 2 options
.... rumour_detailsWhat was the rumour about1..1stringEnable When: rumour_reported = Yes (yes)
Value Set:
.... rumour_escalatedWere they escalated1..1choiceiconiconEnable When: rumour_reported = Yes (yes)
Value Set:
Options: 2 options

doco 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 team_type

  • null#static ("Static")
  • null#temporary_fixed ("Temporary Fixed")
  • null#mobile_sites ("Mobile sites")

Answer options for campaign_day

  • null#1 ("Day 1")
  • null#2 ("Day 2")
  • null#3 ("Day 3")
  • null#4 ("Day 4")
  • null#5 ("Day 5")
  • null#6 ("Day 6")
  • null#7 ("Day 7")
  • null#8 ("Day 8")
  • null#9 ("Day 9")
  • null#10 ("Day 10")

Answer options for supervisor_level

  • null#National ("National")
  • null#County ("County")
  • null#Sub County ("Sub County")
  • null#Partner ("Partner")

Answer options for hcw_18_39_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for hcw_40_59_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for hcw_60_plus_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sw_under_18_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sw_18_39_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sw_40_59_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sw_60_plus_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for td_18_39_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for td_40_59_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for td_60_plus_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for others_18_39_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for others_40_59_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for others_60_plus_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for contact_under_18_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for contact_18_39_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for contact_40_59_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for contact_60_plus_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for aefi_yes_no

  • null#yes ("Yes")
  • null#no ("No")

Answer options for rumour_reported

  • null#yes ("Yes")
  • null#no ("No")

Answer options for rumour_escalated

  • null#yes ("Yes")
  • null#no ("No")