Study Conclusion
SAEs recorded up to visit 7, month 21 of Malaria-026 to be recorded in Malaria-026; SAEs recorded 1 day after Visit 7, month 21 to be recorded in Malaria-039 SAE forms.
boolean
Total number of SAEs for the Malaria 039 period only
integer
Subject Withdrawal
A subject is withdrawn from the interim analysis if he/she did not come for the interim analysis timepoint visit
boolean
tick one box only
text
In case of death, please specify SAE number
integer
In case of serious adverse event, specify SAE number
integer
In case of protocol violation, specify
text
In other cases, specify
text
Who made the decision
text
Date of last contact
date
Was the subject in good condition at date of last contact?
text
Investigator's Signature
I confirm that I have reviewed the data in this Case Report Form for this subject. All information entered by myself or my colleagues is, to the best of my knowledge, complete and accurate, as of the date below.
date
Investigator's signature
text
Investigator's name (in print)
text