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Swaziland 2007 - (NERCHA), the Info Centre - National Emergency ...

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LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LASTBIRTHNO. QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________539 CHECK 538: TWO OR ONLY TWO OR ONLY TWO OR ONLYMORE ONE MORE ONE MORE ONECODES CODE CODES CODE CODES CODECIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED(SKIP TO 541) (SKIP TO 541) (SKIP TO 541)540 Where did you first seek adviceor treatment?USE LETTER CODE FROM 538.FIRST PLACE . . . FIRST PLACE . . . FIRST PLACE . . .541 How many days after the illnessbegan did you first seek adviceor treatment for (NAME)? DAYS . . . . . DAYS . . . . . DAYS . . . . .IF THE SAME DAY, RECORD '00'.542 Is (NAME) still sick with a (fever/ YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1cough)? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8543 At any time during the illness, did YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1(NAME) take any drugs for the NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2illness? (SKIP TO 546) (SKIP TO 546) (SKIP TO 546)DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8544 What drugs did (NAME) take? ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS ANTIMALARIAL DRUGSSP/FANSIDAR . . . . . A SP/FANSIDAR . . . . . A SP/FANSIDAR . . . . . ACHLOROQUINE . . . B CHLOROQUINE . . . B CHLOROQUINE . . . BAny other drugs? QUININE . . . . . . . . C QUININE . . . . . . . . C QUININE . . . . . . . . CRECORD ALL MENTIONED. OTHER ANTI- OTHER ANTI- OTHER ANTI-MALARIAL . . . . . D MALARIAL . . . . . D MALARIAL . . . . . DANTIBIOTIC ANTIBIOTIC ANTIBIOTICCOTRIMOXAZOLE . . E COTRIMOXAZOLE . . E COTRIMOXAZOLE . . EAMOXYCILLIN . . . . . F AMOXYCILLIN . . . . . F AMOXYCILLIN . . . . . FPEN VK . . . . . . . . . . G PEN VK . . . . . . . . . . G PEN VK . . . . . . . . . . GERITHROMYCIN . . . H ERITHROMYCIN . . . H ERITHROMYCIN . . . HOTHER DRUGS OTHER DRUGS OTHER DRUGSPANADOL . . . . . . I PANADOL . . . . . . I PANADOL . . . . . . IPHENERGAN . . . . . J PHENERGAN . . . . . J PHENERGAN . . . . . JOTHER X OTHER X OTHER X(SPECIFY) (SPECIFY) (SPECIFY)DON'T KNOW3. . . . . . . . Z DON'T KNOW . . . . . . . . Z DON'T KNOW . . . . . . . . Z544A CHECK 544: YES NO YES NO YES NOANY CODE A-H CIRCLED?(SKIP TO 546) (SKIP TO 546) (SKIP TO 546)545 Did you already have (NAME OF ANTIMALARIAL DRUGS ANTIMALARIAL DRUGS ANTIMALARIAL DRUGSDRUG FROM 544) at home when SP/FANSIDAR . . . A SP/FANSIDAR . . . A SP/FANSIDAR . . . Athe child became ill? CHLOROQUINE . B CHLOROQUINE . B CHLOROQUINE . BQUININE . . . . . . . . C QUININE . . . . . . . . C QUININE . . . . . . . . CIF YES, CIRCLE CODE FOR OTHER ANTI- OTHER ANTI- OTHER ANTI-THAT DRUG. MALARIAL . . . D MALARIAL . . . D MALARIAL . . . DANTIBIOTIC ANTIBIOTIC ANTIBIOTICASK SEPARATELY FOR EACH COTRIMOXAZOLE E COTRIMOXAZOLE E COTRIMOXAZOLE EANTIMALARIAL OR ANTIBIOTIC AMOXCYCILIN . . F AMOXCYCILIN . . F AMOXCYCILIN . . FDRUG GIVEN IN 544. PEN VK . . . . . . . . G PEN VK . . . . . . . . G PEN VK . . . . . . . . GERITHROMYCIN . . H ERITHROMYCIN . . H ERITHROMYCIN . . HNO DRUG AT HOME Y NO DRUG AT HOME Y NO DRUG AT HOME Y546 GO BACK TO 503 IN GO BACK TO 503 IN GO TO 503 INNEXT COLUMN; OR, IF NEXT COLUMN; OR, IF NEXT-TO-LASTNO MORE BIRTHS, GO NO MORE BIRTHS, GO COLUMN OF NEWTO 547. TO 547. QUESTIONNAIRE; OR,IF NO MORE BIRTHS,GO TO 547.400 | Appendix F

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