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Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...

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342 | Appendix E<br />

LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTH<br />

NO. QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME _________________<br />

547 What drugs did (NAME) take? ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS<br />

SP/FANSIDAR . . . A SP/FANSIDAR . . . A SP/FANSIDAR . . . A<br />

CHLOROQUINE . B CHLOROQUINE . B CHLOROQUINE . B<br />

Any other drugs? QUININE . . . . . . . . D QUININE . . . . . . . . D QUININE . . . . . . . . D<br />

COMBINATION COMBINATION COMBINATION<br />

WITH WITH WITH<br />

RECORD ALL MENTIONED. ARTEMISININ . E ARTEMISININ . E ARTEMISININ . E<br />

OTHER ANTI- OTHER ANTI- OTHER ANTI-<br />

MALARIAL MALARIAL MALARIAL<br />

. . . G . . . G . . . G<br />

(SPECIFY) (SPECIFY) (SPECIFY)<br />

ANTIBIOTIC DRUGS ANTIBIOTIC DRUGS ANTIBIOTIC DRUGS<br />

PILL/SYRUP . . . H PILL/SYRUP . . . H PILL/SYRUP . . . H<br />

INJECTION . . . I INJECTION . . . I INJECTION . . . I<br />

OTHER DRUGS OTHER DRUGS OTHER DRUGS<br />

PARACETAMOL .. J PARACETAMOL .. J PARACETAMOL .. J<br />

ACETA- ACETA- ACETA-<br />

MINOPHEN . . . K MINOPHEN . . . K MINOPHEN . . . K<br />

IBUPROFEN . . . L IBUPROFEN . . . L IBUPROFEN . . . L<br />

OTHER X OTHER X OTHER X<br />

(SPECIFY) (SPECIFY) (SPECIFY)<br />

DON'T KNOW . . . . . Z DON'T KNOW . . . . . Z DON'T KNOW . . . . . Z<br />

548 CHECK 547: YES NO YES NO YES NO<br />

ANY CODE A-H CIRCLED?<br />

(GO BACK TO (GO BACK TO (GO TO 503<br />

503 IN NEXT 503 IN NEXT IN NEXT-TO-LAST<br />

COLUMN; OR, COLUMN; OR, COLUMN OF NEW<br />

IF NO MORE IF NO MORE QUESTIONNAIRE; OR,<br />

BIRTHS, GO BIRTHS, GO IF NO MORE BIRTHS,<br />

TO 573) TO 573) GO TO 573)<br />

549 Did you already have (NAME OF ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS<br />

DRUG FROM 547) at home when SP/FANSIDAR . . . A SP/FANSIDAR . . A SP/FANSIDAR . . . A<br />

the child became ill? CHLOROQUINE . B CHLOROQUINE . B CHLOROQUINE . B<br />

QUININE . . . . . . . . D QUININE . . . . . . . . D QUININE . . . . . . . . D<br />

ASK SEPARATELY FOR EACH COMBINATION COMBINATION COMBINATION<br />

OF THE DRUGS 'A' THROUGH WITH WITH WITH<br />

'H' THAT THE CHILD IS ARTEMISININ . E ARTEMISININ . E ARTEMISININ . E<br />

RECORDED AS HAVING<br />

TAKEN IN 547. OTHER ANTI- OTHER ANTI- OTHER ANTI-<br />

MALARIAL . . . G MALARIAL . . . G MALARIAL . . . G<br />

IF YES FOR ANY DRUG,<br />

CIRCLE CODE FOR THAT<br />

DRUG.<br />

ANTIBIOTIC PILL/ ANTIBIOTIC PILL/ ANTIBIOTIC PILL/<br />

IF NO FOR ALL DRUGS, SYRUP . . . . . . . . H SYRUP . . . . . . . . H SYRUP . . . . . . . . H<br />

CIRCLE 'Y'.<br />

NO DRUG AT HOME . Y NO DRUG AT HOME . Y NO DRUG AT HOME . Y<br />

550 CHECK 547: YES NO YES NO YES NO<br />

ANY CODE A-G CIRCLED?<br />

(GO BACK TO (GO BACK TO (GO TO 503 IN<br />

503 IN NEXT 503 IN NEXT NEXT-TO-LAST<br />

COLUMN; OR, COLUMN; OR, COLUMN OF NEW<br />

IF NO MORE IF NO MORE QUESTIONNAIRE;<br />

BIRTHS, GO BIRTHS, GO OR, IF NO MORE<br />

TO 573) TO 573) BIRTHS, GO TO 573)

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