ID

16220

Beschrijving

Form provided by Binyam Tilahun. Source: http://www.moh.gov.et/ (Ministry of Health, Ethiopia)

Link

http://www.moh.gov.et/

Trefwoorden

  1. 06-07-16 06-07-16 -
Geüploaded op

6 juli 2016

DOI

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Licentie

Creative Commons BY-NC 3.0

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Ministry of Health, Ethiopia- HMIS HIV exposed infant logbook card

HIV exposed infant logbook card

Logbook card
Beschrijving

Logbook card

Registration number
Beschrijving

Registration number

Datatype

text

Alias
UMLS CUI [1]
C0421512
Date of enrollment
Beschrijving

Enrollment date

Datatype

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0679646
UMLS CUI [1,3]
C1516879
Name of Infant
Beschrijving

Name

Datatype

text

Alias
UMLS CUI [1]
C0027365
Name of father
Beschrijving

Name

Datatype

text

Alias
UMLS CUI [1]
C0027365
Name of grandfather
Beschrijving

Name

Datatype

text

Alias
UMLS CUI [1]
C0027365
Name of caregiver
Beschrijving

Name

Datatype

text

Alias
UMLS CUI [1]
C0027365
Infant´s Medical record number (MRN)
Beschrijving

Medical record number

Datatype

text

Alias
UMLS CUI [1]
C1301894
Date of birth
Beschrijving

Date of birth

Datatype

date

Alias
UMLS CUI [1]
C0421451
Age at enrollment
Beschrijving

under 3 months, enter age in weeks over 3 months, enter age in months

Datatype

integer

Alias
UMLS CUI [1]
C0001779
Specify if age at enrollment is in weeks or in months
Beschrijving

Age

Datatype

text

Alias
UMLS CUI [1]
C0001779
Sex
Beschrijving

Sex

Datatype

integer

Alias
UMLS CUI [1]
C0079399
Infant referred from (Name of source)
Beschrijving

Referral

Datatype

text

Alias
UMLS CUI [1]
C0034927
Did the infant receive ARV prophylaxis at birth?
Beschrijving

ARV prophylaxis

Datatype

boolean

Alias
UMLS CUI [1,1]
C0599685
UMLS CUI [1,2]
C0199176
Does the infant come for follow up at the age of 6 weeks?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 10 weeks?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 14 weeks?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 4 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 5 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 6 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 9 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 12 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 15 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Does the infant come for follow up at the age of 18 months?
Beschrijving

Follow up

Datatype

boolean

Alias
UMLS CUI [1]
C1522577
Final outcome
Beschrijving

Final outcome

Datatype

text

Alias
UMLS CUI [1]
C0085565
Enrolled in care?
Beschrijving

Enrollment

Datatype

boolean

Alias
UMLS CUI [1]
C1516879
If enrolled in care,please specify
Beschrijving

Enrollment

Datatype

integer

Alias
UMLS CUI [1]
C1516879
Remarks
Beschrijving

Remarks

Datatype

text

Alias
UMLS CUI [1]
C0947611

Similar models

HIV exposed infant logbook card

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Logbook card
Registration number
Item
Registration number
text
C0421512 (UMLS CUI [1])
Enrollment date
Item
Date of enrollment
date
C0011008 (UMLS CUI [1,1])
C0679646 (UMLS CUI [1,2])
C1516879 (UMLS CUI [1,3])
Name
Item
Name of Infant
text
C0027365 (UMLS CUI [1])
Name
Item
Name of father
text
C0027365 (UMLS CUI [1])
Name
Item
Name of grandfather
text
C0027365 (UMLS CUI [1])
Name
Item
Name of caregiver
text
C0027365 (UMLS CUI [1])
Medical record number
Item
Infant´s Medical record number (MRN)
text
C1301894 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Age
Item
Age at enrollment
integer
C0001779 (UMLS CUI [1])
Age
Item
Specify if age at enrollment is in weeks or in months
text
C0001779 (UMLS CUI [1])
Item
Sex
integer
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
male (1)
CL Item
female (2)
Referral
Item
Infant referred from (Name of source)
text
C0034927 (UMLS CUI [1])
ARV prophylaxis
Item
Did the infant receive ARV prophylaxis at birth?
boolean
C0599685 (UMLS CUI [1,1])
C0199176 (UMLS CUI [1,2])
Follow up
Item
Does the infant come for follow up at the age of 6 weeks?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 10 weeks?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 14 weeks?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 4 months?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 5 months?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 6 months?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 9 months?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 12 months?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 15 months?
boolean
C1522577 (UMLS CUI [1])
Follow up
Item
Does the infant come for follow up at the age of 18 months?
boolean
C1522577 (UMLS CUI [1])
Item
Final outcome
text
C0085565 (UMLS CUI [1])
Code List
Final outcome
CL Item
infected (I)
CL Item
not infected (NI)
Enrollment
Item
Enrolled in care?
boolean
C1516879 (UMLS CUI [1])
Item
If enrolled in care,please specify
integer
C1516879 (UMLS CUI [1])
Code List
If enrolled in care,please specify
CL Item
Pre (1)
CL Item
ART (2)
CL Item
No (3)
CL Item
UAN (4)
Remarks
Item
Remarks
text
C0947611 (UMLS CUI [1])

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