VlCaseHospitalization
type: Questionnaire
node role: treeRoot
id:
  v: VlCaseHospitalization
meta:
  profile:
    v: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire
    l: Questionnaire
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: Questionnaire VlCaseHospitalization Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Hospitalization and treatment information for Visceral Leishmaniasis cases Questionnaire http://example.org/Questionnaire/VlCaseHospitalization#0.1.0 #xD; 782742635664 Treatment/Hospitilazation 0..1 group #xD; 428237064956 IP No 1..1 string #xD; 272556667885 Hospital Ward 1..1 string #xD; 885705999856 Date of Admission 1..1 date #xD; 150613899880 Date Leishmaniasis Treatment Started 1..1 date #xD; 733604782646 Treatment Regimen 1..1 choice Options: 5 options #xD; 498949031326 Other Treatment Regimen ( Specify) 1..1 string Enable When: 733604782646 = Other (Specify). (reg-005) #xD; regimen-dosage Treatment Regimen Dosage 1..1 decimal #xD; 175945763878 Number of Treatment Days 1..1 choice Options: 4 options #xD; 686824046139 Number of treatment days (Specify) 1..1 integer Enable When: 175945763878 = Other (Specify) (trtemnt-004) #xD; 723427815459 Was Treatment Completed? 0..1 choice Options: 2 options #xD; 342763225855 Reason for Incomplete Treatment 1..1 string Enable When: 723427815459 = No (no) #xD; 708058904265 Initial Treatment Outcome 1..1 choice Options: 5 options #xD; 131738268669 Cause of Death 1..1 choice Enable When: 708058904265 = Death (outcome-005) Options: 6 options #xD; 884379481934 Was there any reported severe adverse event of drug(s) used? 1..1 choice Options: 2 options #xD; 560909523868 Input Name(s) of Drug Causing Adverse Event 1..1 string Enable When: 884379481934 = Yes (yes) #xD; 396444399071 Indicate Description of Severe Adverse Event 1..1 string Enable When: 884379481934 = Yes (yes) #xD; 904748389038 Any other condition(s) treated during Initial VL treatment? 1..1 choice Options: 2 options #xD; 922498480736 Name of Other Condition 1..1 string Enable When: 904748389038 = Yes (yes) #xD; …
url:
  v: http://example.org/Questionnaire/VlCaseHospitalization
  l: VlCaseHospitalization
version:
  v: 0.1.0
title:
  v: VL Case Lab Information
status:
  v: draft
date:
  v: 2026-05-04T06:19:40+00:00
publisher:
  v: Kenya National Public Health Institute
contact:
  name:
    v: Kenya National Public Health Institute
  telecom:
    system:
      v: url
    value:
      v: https://www.nphi.go.ke/
contact:
  name:
    v: Kenya National Public Health Institute
  telecom:
    system:
      v: url
    value:
      v: https://www.nphi.go.ke/
    use:
      v: work
description:
  v: Hospitalization and treatment information for Visceral Leishmaniasis cases
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
      l: 3166
    code:
      v: KE
    display:
      v: Kenya
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      l: questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: 782742635664
  text:
    v: Treatment/Hospitilazation
  type:
    v: group
  item:
    link id:
      v: 428237064956
    text:
      v: IP No
    type:
      v: string
    required:
      v: true
  item:
    link id:
      v: 272556667885
    text:
      v: Hospital Ward
    type:
      v: string
    required:
      v: true
  item:
    extension:
      url:
        v: http://ehelse.no/fhir/StructureDefinition/validationtext
        l: validationtext
      value: String
        v: Cannot be a date in the future
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/maxValue
        l: maxValue
      value: Date
    link id:
      v: 885705999856
    text:
      v: Date of Admission
    type:
      v: date
    required:
      v: true
  item:
    extension:
      url:
        v: http://ehelse.no/fhir/StructureDefinition/validationtext
        l: validationtext
      value: String
        v: Cannot be a date in the future
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/maxValue
        l: maxValue
      value: Date
    link id:
      v: 150613899880
    text:
      v: Date Leishmaniasis Treatment Started
    type:
      v: date
    required:
      v: true
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
        l: questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: 733604782646
    text:
      v: Treatment Regimen
    type:
      v: choice
    required:
      v: true
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    link id:
      v: 498949031326
    text:
      v: Other Treatment Regimen ( Specify)
    type:
      v: string
    enable when:
      question:
        v: 733604782646
      operator:
        v: =
      answer: Coding
    required:
      v: true
  item:
    link id:
      v: regimen-dosage
    text:
      v: Treatment Regimen Dosage
    type:
      v: decimal
    required:
      v: true
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
        l: questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: 175945763878
    text:
      v: Number of Treatment Days
    type:
      v: choice
    required:
      v: true
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    link id:
      v: 686824046139
    text:
      v: Number of treatment days (Specify)
    type:
      v: integer

v: page

v: Page

url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue
  l: cqf-calculatedValue
value: Expression
  language:
    v: text/fhirpath
  expression:
    v: today()

url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue
  l: cqf-calculatedValue
value: Expression
  language:
    v: text/fhirpath
  expression:
    v: today()

system:
  v: http://hl7.org/fhir/questionnaire-item-control
  l: questionnaire-item-control
code:
  v: drop-down
display:
  v: Drop down

v: reg-001

v: Combination (SSG + Paramomycin)(17 days)

v: reg-002

v: Pentostam (SSG) (30 days)

v: reg-003

v: Glucantime

v: reg-004

v: Liposomal Amphotericin B (6-10 days)

v: reg-005

v: Other (Specify).

v: reg-005

v: Other (Specify).

system:
  v: http://hl7.org/fhir/questionnaire-item-control
  l: questionnaire-item-control
code:
  v: drop-down
display:
  v: Drop down

v: trtemnt-001

v: 6-10 Days

v: trtemnt-002

v: 17 Days

v: trtemnt-003

v: 30 Days

v: trtemnt-004

v: Other (Specify)

question:
  v: 175945763878
operator:
  v: =
answer: Coding
  code:
    v: trtemnt-004
  display:
    v: Other (Specify)

v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: radio-button
      display:
        v: Radio Button
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
    l: questionnaire-choiceOrientation
  value: Code
    v: horizontal
link id:
  v: 723427815459
text:
  v: Was Treatment Completed?
type:
  v: choice
answer option:
  value: Coding
    code:
      v: yes
    display:
      v: Yes
answer option:
  value: Coding
    code:
      v: no
    display:
      v: No

link id:
  v: 342763225855
text:
  v: Reason for Incomplete Treatment
type:
  v: string
enable when:
  question:
    v: 723427815459
  operator:
    v: =
  answer: Coding
    code:
      v: no
    display:
      v: No
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: 708058904265
text:
  v: Initial Treatment Outcome
type:
  v: choice
required:
  v: true
answer option:
  value: Coding
    code:
      v: outcome-001
    display:
      v: Initial cure
answer option:
  value: Coding
    code:
      v: outcome-002
    display:
      v: Probable non-response
answer option:
  value: Coding
    code:
      v: outcome-003
    display:
      v: Confirmed non-response
answer option:
  value: Coding
    code:
      v: outcome-004
    display:
      v: Default
answer option:
  value: Coding
    code:
      v: outcome-005
    display:
      v: Death

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: 131738268669
text:
  v: Cause of Death
type:
  v: choice
enable when:
  question:
    v: 708058904265
  operator:
    v: =
  answer: Coding
    code:
      v: outcome-005
    display:
      v: Death
required:
  v: true
answer option:
  value: Coding
    code:
      v: death-cause-001
    display:
      v: Unknown
answer option:
  value: Coding
    code:
      v: death-cause-002
    display:
      v: VL
answer option:
  value: Coding
    code:
      v: death-cause-003
    display:
      v: HIV
answer option:
  value: Coding
    code:
      v: death-cause-004
    display:
      v: Other disease
answer option:
  value: Coding
    code:
      v: death-cause-005
    display:
      v: SAE
answer option:
  value: Coding
    code:
      v: death-cause-006
    display:
      v: Non-medical condition

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: radio-button
      display:
        v: Radio Button
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
    l: questionnaire-choiceOrientation
  value: Code
    v: horizontal
link id:
  v: 884379481934
text:
  v: Was there any reported severe adverse event of drug(s) used?
type:
  v: choice
required:
  v: true
answer option:
  value: Coding
    code:
      v: yes
    display:
      v: Yes
answer option:
  value: Coding
    code:
      v: no
    display:
      v: No

link id:
  v: 560909523868
text:
  v: Input Name(s) of Drug Causing Adverse Event
type:
  v: string
enable when:
  question:
    v: 884379481934
  operator:
    v: =
  answer: Coding
    code:
      v: yes
    display:
      v: Yes
required:
  v: true

link id:
  v: 396444399071
text:
  v: Indicate Description of Severe Adverse Event
type:
  v: string
enable when:
  question:
    v: 884379481934
  operator:
    v: =
  answer: Coding
    code:
      v: yes
    display:
      v: Yes
required:
  v: true

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: radio-button
      display:
        v: Radio Button
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
    l: questionnaire-choiceOrientation
  value: Code
    v: horizontal
link id:
  v: 904748389038
text:
  v: Any other condition(s) treated during Initial VL treatment?
type:
  v: choice
required:
  v: true
answer option:
  value: Coding
    code:
      v: yes
    display:
      v: Yes
answer option:
  value: Coding
    code:
      v: no
    display:
      v: No

link id:
  v: 922498480736
text:
  v: Name of Other Condition
type:
  v: string
enable when:
  question:
    v: 904748389038
  operator:
    v: =
  answer: Coding
    code:
      v: yes
    display:
      v: Yes
required:
  v: true