FHIR IG analytics| Package | fhir.surveillanceIG |
| Resource Type | Questionnaire |
| Id | Questionnaire-Moh505.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/IntelliSOFT-Consulting/Surveillance-FHIR-IG/Questionnaire-Moh505.html |
| URL | http://example.org/Questionnaire/Moh505 |
| Version | 0.1.0 |
| Status | draft |
| Date | 2026-04-02T20:27:34+00:00 |
| Title | MOH 505 - Health Facility Weekly Reporting Form |
| Realm | us |
| Authority | hl7 |
| Description | MOH 505 Health Facility Weekly Reporting Form for disease surveillance |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire Moh505
Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  | MOH 505 Health Facility Weekly Reporting Form for disease surveillance | Questionnaire | http://example.org/Questionnaire/Moh505#0.1.0 | ||
  151479012557 | Reporting Site | 0..1 | group | ||
  546255966914 | Hospital/Facility Location | 0..1 | display | ||
 user_role | User Role | 0..1 | string |  | |
| user_facility | User Facility | 0..1 | string | | |
| user_ward | User Ward | 0..1 | string | | |
| user_sub_county | User Sub County | 0..1 | string | | |
| user_county | User County | 0..1 | string | | |
| facility_level | null | 0..1 | group | Enable When: user_role = VACCINATOR | |
 294367770999 | County | 1..1 | reference | ||
| 819946803642 | Sub County | 1..1 | reference | ||
| 819943434 | Ward | 1..1 | reference | ||
| 819946803677 | Health Facility | 1..1 | reference | ||
  438862163919 | Type of health facility | 1..1 | choice | Options: 3 options | |
| sub_county_level | null | 0..1 | group | Enable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER | |
| 294367770999_sub_county | County | 1..1 | reference | ||
| 819946803642_sub_county | Sub County | 1..1 | reference | ||
| 819943434_sub_county | Ward | 1..1 | reference | ||
| 819946803677_sub_county | Health Facility | 1..1 | reference | ||
| 438862163919_sub_county | Type of health facility | 1..1 | choice | Options: 3 options | |
| county_level | null | 0..1 | group | Enable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER | |
| 294367770999_county | County | 1..1 | reference | ||
| 819946803642_county | Sub County | 1..1 | reference | ||
| 819943434_county | Ward | 1..1 | reference | ||
| 819946803677_county | Health Facility | 1..1 | reference | ||
| 438862163919_county | Type of health facility | 1..1 | choice | Options: 3 options | |
| national_level | null | 0..1 | group | Enable When: user_role = ADMINISTRATOR | |
| 294367770999_national | County | 1..1 | reference | ||
| 819946803642_national | Sub County | 1..1 | reference | ||
| 819943434_national | Ward | 1..1 | reference | ||
| 819946803677_national | Health Facility | 1..1 | reference | ||
| 438862163919_national | Type of health facility | 1..1 | choice | Options: 3 options | |
 728034137219 | Week Ending Date | 1..1 | date | Definition: http://example.org/sdh/dtr/aslp/StructureDefinition/aslp-bmi#Observation.value[x] | |
| 306799299 | Diseases, Conditions or Events Information | 0..1 | group | ||
| aefi-summary | Were any AEFI cases reported? | 1..1 | choice |  | Options: 2 options |
 aefi-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: aefi-summary = Yes (yes) | |
| aefi-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: aefi-summary = Yes (yes) | |
| aefi-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: aefi-summary = Yes (yes) | |
| aefi-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: aefi-summary = Yes (yes) | |
| aefi-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: aefi-summary = No (no) Initial Value: integer = 0 |
| aefi-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: aefi-summary = No (no) Initial Value: integer = 0 |
| aefi-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: aefi-summary = No (no) Initial Value: integer = 0 |
| aefi-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: aefi-summary = No (no) Initial Value: integer = 0 |
| bacterial-meningitis-summary | Were any Bacterial Meningitis cases reported? | 1..1 | choice | | Options: 2 options |
| bacterial-meningitis-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 |
| bacterial-meningitis-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 |
| bacterial-meningitis-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 |
| bacterial-meningitis-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: bacterial-meningitis-summary = No (no) Initial Value: integer = 0 |
| acute-jaundice-summary | Were any Acute Jaundice cases reported? | 1..1 | choice | | Options: 2 options |
| acute-jaundice-cases-under-5 | Under Cases | 1..1 | integer | Enable When: acute-jaundice-summary = Yes (yes) | |
| acute-jaundice-cases-over-5 | Over Cases | 1..1 | integer | Enable When: acute-jaundice-summary = Yes (yes) | |
| acute-jaundice-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: acute-jaundice-summary = Yes (yes) | |
| acute-jaundice-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: acute-jaundice-summary = Yes (yes) | |
| acute-jaundice-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 |
| acute-jaundice-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 |
| acute-jaundice-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 |
| acute-jaundice-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: acute-jaundice-summary = No (no) Initial Value: integer = 0 |
| neonatal-deaths-summary | Were any Neonatal Deaths cases reported? | 1..1 | choice | | Options: 2 options |
| neonatal-deaths-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: neonatal-deaths-summary = Yes (yes) | |
| neonatal-deaths-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: neonatal-deaths-summary = No (no) |
| acute-malnutrition-summary | Were any Acute Malnutrition cases reported? | 1..1 | choice | | Options: 2 options |
| acute-malnutrition-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: acute-malnutrition-summary = Yes (yes) | |
| acute-malnutrition-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: acute-malnutrition-summary = Yes (yes) | |
| acute-malnutrition-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: acute-malnutrition-summary = Yes (yes) | |
| acute-malnutrition-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: acute-malnutrition-summary = Yes (yes) | |
| acute-malnutrition-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 |
| acute-malnutrition-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 |
| acute-malnutrition-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 |
| acute-malnutrition-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: acute-malnutrition-summary = No (no) Initial Value: integer = 0 |
| neonatal-tetanus-summary | Were any Neonatal Tetanus cases reported? | 1..1 | choice | | Options: 2 options |
| neonatal-tetanus-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: neonatal-tetanus-summary = Yes (yes) | |
| neonatal-tetanus-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: neonatal-tetanus-summary = Yes (yes) | |
| neonatal-tetanus-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: neonatal-tetanus-summary = No (no) |
| neonatal-tetanus-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: neonatal-tetanus-summary = No (no) |
| afp-poliomyelitis-summary | Were any Afp Poliomyelitis cases reported? | 1..1 | choice | | Options: 2 options |
| afp-poliomyelitis-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: afp-poliomyelitis-summary = Yes (yes) | |
| afp-poliomyelitis-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: afp-poliomyelitis-summary = Yes (yes) | |
| afp-poliomyelitis-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: afp-poliomyelitis-summary = Yes (yes) | |
| afp-poliomyelitis-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: afp-poliomyelitis-summary = Yes (yes) | |
| afp-poliomyelitis-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 |
| afp-poliomyelitis-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 |
| afp-poliomyelitis-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 |
| afp-poliomyelitis-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: afp-poliomyelitis-summary = No (no) Initial Value: integer = 0 |
| onchocerciasis-summary | Were any Onchocerciasis cases reported? | 1..1 | choice | | Options: 2 options |
| onchocerciasis-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: onchocerciasis-summary = Yes (yes) | |
| onchocerciasis-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: onchocerciasis-summary = Yes (yes) | |
| onchocerciasis-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: onchocerciasis-summary = Yes (yes) | |
| onchocerciasis-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: onchocerciasis-summary = Yes (yes) | |
| onchocerciasis-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 |
| onchocerciasis-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 |
| onchocerciasis-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 |
| onchocerciasis-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: onchocerciasis-summary = No (no) Initial Value: integer = 0 |
| plague-summary | Were any Plague cases reported? | 1..1 | choice | | Options: 2 options |
| plague-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: plague-summary = Yes (yes) | |
| plague-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: plague-summary = Yes (yes) | |
| plague-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: plague-summary = Yes (yes) | |
| plague-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: plague-summary = Yes (yes) | |
| plague-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: plague-summary = No (no) Initial Value: integer = 0 |
| plague-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: plague-summary = No (no) Initial Value: integer = 0 |
| plague-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: plague-summary = No (no) Initial Value: integer = 0 |
| plague-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: plague-summary = No (no) Initial Value: integer = 0 |
| anthrax-summary | Were any Anthrax cases reported? | 1..1 | choice | | Options: 2 options |
| anthrax-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: anthrax-summary = Yes (yes) | |
| anthrax-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: anthrax-summary = Yes (yes) | |
| anthrax-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: anthrax-summary = Yes (yes) | |
| anthrax-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: anthrax-summary = Yes (yes) | |
| anthrax-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: anthrax-summary = No (no) Initial Value: integer = 0 |
| anthrax-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: anthrax-summary = No (no) Initial Value: integer = 0 |
| anthrax-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: anthrax-summary = No (no) Initial Value: integer = 0 |
| anthrax-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: anthrax-summary = No (no) Initial Value: integer = 0 |
| rabies-summary | Were any Rabies cases reported? | 1..1 | choice | | Options: 2 options |
| rabies-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: rabies-summary = Yes (yes) | |
| rabies-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: rabies-summary = Yes (yes) | |
| rabies-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: rabies-summary = Yes (yes) | |
| rabies-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: rabies-summary = Yes (yes) | |
| rabies-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: rabies-summary = No (no) Initial Value: integer = 0 |
| rabies-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: rabies-summary = No (no) Initial Value: integer = 0 |
| rabies-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: rabies-summary = No (no) Initial Value: integer = 0 |
| rabies-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: rabies-summary = No (no) Initial Value: integer = 0 |
| cholera-summary | Were any Cholera cases reported? | 1..1 | choice | | Options: 2 options |
| cholera-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: cholera-summary = Yes (yes) | |
| cholera-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: cholera-summary = Yes (yes) | |
| cholera-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: cholera-summary = Yes (yes) | |
| cholera-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: cholera-summary = Yes (yes) | |
| cholera-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: cholera-summary = No (no) Initial Value: integer = 0 |
| cholera-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: cholera-summary = No (no) Initial Value: integer = 0 |
| cholera-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: cholera-summary = No (no) Initial Value: integer = 0 |
| cholera-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: cholera-summary = No (no) Initial Value: integer = 0 |
| rift-valley-fever-summary | Were any Rift Valley Fever cases reported? | 1..1 | choice | | Options: 2 options |
| rift-valley-fever-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: rift-valley-fever-summary = Yes (yes) | |
| rift-valley-fever-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: rift-valley-fever-summary = Yes (yes) | |
| rift-valley-fever-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: rift-valley-fever-summary = Yes (yes) | |
| rift-valley-fever-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: rift-valley-fever-summary = Yes (yes) | |
| rift-valley-fever-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 |
| rift-valley-fever-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 |
| rift-valley-fever-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 |
| rift-valley-fever-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: rift-valley-fever-summary = No (no) Initial Value: integer = 0 |
| chikungunya-summary | Were any Chikungunya cases reported? | 1..1 | choice | | Options: 2 options |
| chikungunya-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: chikungunya-summary = Yes (yes) | |
| chikungunya-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: chikungunya-summary = Yes (yes) | |
| chikungunya-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: chikungunya-summary = Yes (yes) | |
| chikungunya-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: chikungunya-summary = Yes (yes) | |
| chikungunya-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 |
| chikungunya-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 |
| chikungunya-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 |
| chikungunya-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: chikungunya-summary = No (no) Initial Value: integer = 0 |
| covid--19-summary | Were any Covid 19 cases reported? | 1..1 | choice | | Options: 2 options |
| covid--19-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: covid--19-summary = Yes (yes) | |
| covid--19-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: covid--19-summary = Yes (yes) | |
| covid--19-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: covid--19-summary = Yes (yes) | |
| covid--19-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: covid--19-summary = Yes (yes) | |
| covid--19-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: covid--19-summary = No (no) Initial Value: integer = 0 |
| covid--19-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: covid--19-summary = No (no) Initial Value: integer = 0 |
| covid--19-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: covid--19-summary = No (no) Initial Value: integer = 0 |
| covid--19-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: covid--19-summary = No (no) Initial Value: integer = 0 |
| sari-cluster-ge3-cases-summary | Were any Sari Cluster Ge3 Cases cases reported? | 1..1 | choice | | Options: 2 options |
| sari-cluster-ge3-cases-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: sari-cluster-ge3-cases-summary = Yes (yes) | |
| sari-cluster-ge3-cases-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: sari-cluster-ge3-cases-summary = Yes (yes) | |
| sari-cluster-ge3-cases-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: sari-cluster-ge3-cases-summary = Yes (yes) | |
| sari-cluster-ge3-cases-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: sari-cluster-ge3-cases-summary = Yes (yes) | |
| sari-cluster-ge3-cases-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 |
| sari-cluster-ge3-cases-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 |
| sari-cluster-ge3-cases-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 |
| sari-cluster-ge3-cases-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: sari-cluster-ge3-cases-summary = No (no) Initial Value: integer = 0 |
| dengue-summary | Were any Dengue cases reported? | 1..1 | choice | | Options: 2 options |
| dengue-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: dengue-summary = Yes (yes) | |
| dengue-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: dengue-summary = Yes (yes) | |
| dengue-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: dengue-summary = Yes (yes) | |
| dengue-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: dengue-summary = Yes (yes) | |
| dengue-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: dengue-summary = No (no) Initial Value: integer = 0 |
| dengue-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: dengue-summary = No (no) Initial Value: integer = 0 |
| dengue-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: dengue-summary = No (no) Initial Value: integer = 0 |
| dengue-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: dengue-summary = No (no) Initial Value: integer = 0 |
| dysentery-bacillary-summary | Were any Dysentery Bacillary cases reported? | 1..1 | choice | | Options: 2 options |
| dysentery-bacillary-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| dysentery-bacillary-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| dysentery-bacillary-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| dysentery-bacillary-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| dysentery-bacillary-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 |
| dysentery-bacillary-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 |
| dysentery-bacillary-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 |
| dysentery-bacillary-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: dysentery-bacillary-summary = No (no) Initial Value: integer = 0 |
| suspected-mdr-xdr-tb-summary | Were any Suspected Mdr Xdr Tb cases reported? | 1..1 | choice | | Options: 2 options |
| suspected-mdr-xdr-tb-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) | |
| suspected-mdr-xdr-tb-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) | |
| suspected-mdr-xdr-tb-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) | |
| suspected-mdr-xdr-tb-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: suspected-mdr-xdr-tb-summary = Yes (yes) | |
| suspected-mdr-xdr-tb-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 |
| suspected-mdr-xdr-tb-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 |
| suspected-mdr-xdr-tb-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 |
| suspected-mdr-xdr-tb-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: suspected-mdr-xdr-tb-summary = No (no) Initial Value: integer = 0 |
| guinea-worm-disease-summary | Were any Guinea Worm Disease cases reported? | 1..1 | choice | | Options: 2 options |
| guinea-worm-disease-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: guinea-worm-disease-summary = Yes (yes) | |
| guinea-worm-disease-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: guinea-worm-disease-summary = Yes (yes) | |
| guinea-worm-disease-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: guinea-worm-disease-summary = Yes (yes) | |
| guinea-worm-disease-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: guinea-worm-disease-summary = Yes (yes) | |
| guinea-worm-disease-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 |
| guinea-worm-disease-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 |
| guinea-worm-disease-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 |
| guinea-worm-disease-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: guinea-worm-disease-summary = No (no) Initial Value: integer = 0 |
| typhoid-summary | Were any Typhoid cases reported? | 1..1 | choice | | Options: 2 options |
| typhoid-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: typhoid-summary = Yes (yes) | |
| typhoid-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: typhoid-summary = Yes (yes) | |
| typhoid-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: typhoid-summary = Yes (yes) | |
| typhoid-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: typhoid-summary = Yes (yes) | |
| typhoid-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: typhoid-summary = No (no) Initial Value: integer = 0 |
| typhoid-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: typhoid-summary = No (no) Initial Value: integer = 0 |
| typhoid-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: typhoid-summary = No (no) Initial Value: integer = 0 |
| typhoid-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: typhoid-summary = No (no) Initial Value: integer = 0 |
| measles-summary | Were any Measles cases reported? | 1..1 | choice | | Options: 2 options |
| measles-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: measles-summary = Yes (yes) | |
| measles-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: measles-summary = Yes (yes) | |
| measles-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: measles-summary = Yes (yes) | |
| measles-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: measles-summary = Yes (yes) | |
| measles-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: measles-summary = No (no) Initial Value: integer = 0 |
| measles-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: measles-summary = No (no) Initial Value: integer = 0 |
| measles-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: measles-summary = No (no) Initial Value: integer = 0 |
| measles-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: measles-summary = No (no) Initial Value: integer = 0 |
| vhf-summary | Were any Vhf cases reported? | 1..1 | choice | | Options: 2 options |
| vhf-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: vhf-summary = Yes (yes) | |
| vhf-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: vhf-summary = Yes (yes) | |
| vhf-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: vhf-summary = Yes (yes) | |
| vhf-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: vhf-summary = Yes (yes) | |
| vhf-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: vhf-summary = No (no) Initial Value: integer = 0 |
| vhf-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: vhf-summary = No (no) Initial Value: integer = 0 |
| vhf-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: vhf-summary = No (no) Initial Value: integer = 0 |
| vhf-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: vhf-summary = No (no) Initial Value: integer = 0 |
| suspected-malaria-summary | Were any Suspected Malaria cases reported? | 1..1 | choice | | Options: 2 options |
| suspected-malaria-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| suspected-malaria-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| suspected-malaria-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| suspected-malaria-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| suspected-malaria-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 |
| suspected-malaria-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 |
| suspected-malaria-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 |
| suspected-malaria-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: suspected-malaria-summary = No (no) Initial Value: integer = 0 |
| yellow-fever-summary | Were any Yellow Fever cases reported? | 1..1 | choice | | Options: 2 options |
| yellow-fever-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: yellow-fever-summary = Yes (yes) | |
| yellow-fever-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: yellow-fever-summary = Yes (yes) | |
| yellow-fever-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: yellow-fever-summary = Yes (yes) | |
| yellow-fever-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: yellow-fever-summary = Yes (yes) | |
| yellow-fever-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 |
| yellow-fever-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 |
| yellow-fever-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 |
| yellow-fever-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: yellow-fever-summary = No (no) Initial Value: integer = 0 |
| deaths-due-to-malaria-summary | Were any Deaths Due To Malaria cases reported? | 1..1 | choice | | Options: 2 options |
| deaths-due-to-malaria-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: deaths-due-to-malaria-summary = Yes (yes) | |
| deaths-due-to-malaria-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: deaths-due-to-malaria-summary = Yes (yes) | |
| deaths-due-to-malaria-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: deaths-due-to-malaria-summary = No (no) |
| deaths-due-to-malaria-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: deaths-due-to-malaria-summary = No (no) Initial Value: integer = 0 |
| zika-virus-summary | Were any Zika Virus cases reported? | 1..1 | choice | | Options: 2 options |
| zika-virus-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: zika-virus-summary = Yes (yes) | |
| zika-virus-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: zika-virus-summary = Yes (yes) | |
| zika-virus-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: zika-virus-summary = Yes (yes) | |
| zika-virus-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: zika-virus-summary = Yes (yes) | |
| zika-virus-summary-cases-under-5-if-no | Under 5 Cases | 0..1 | integer | | Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 |
| zika-virus-summary-cases-over-5-if-no | Over 5 Cases | 0..1 | integer | | Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 |
| zika-virus-summary-deaths-under-5-if-no | Under 5 Deaths | 0..1 | integer | | Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 |
| zika-virus-summary-deaths-over-5-if-no | Over 5 Deaths | 0..1 | integer | | Enable When: zika-virus-summary = No (no) Initial Value: integer = 0 |
| others-specify-summary | Were any Others Specify cases reported? | 1..1 | choice | | Options: 2 options |
| others-specify-cases-name | Others (Specify) | 1..1 | string | Enable When: others-specify-summary = Yes (yes) | |
| others-specify-cases-under-5 | Under 5 Cases | 1..1 | integer | Enable When: others-specify-summary = Yes (yes) | |
| others-specify-cases-over-5 | Over 5 Cases | 1..1 | integer | Enable When: others-specify-summary = Yes (yes) | |
| others-specify-deaths-under-5 | Under 5 Deaths | 1..1 | integer | Enable When: others-specify-summary = Yes (yes) | |
| others-specify-deaths-over-5 | Over 5 Deaths | 1..1 | integer | Enable When: others-specify-summary = Yes (yes) | |
| 3067992989898 | Laboratory Surveillance | 0..1 | group | ||
 malaria-tested-under-5 | Malaria Microscopy Tested < 5 years | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| malaria-tested-over-5 | Malaria Microscopy Tested ≥ 5 years | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| malaria-positive-under-5 | Malaria Microscopy Positive < 5 years | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| malaria-positive-over-5 | Malaria Microscopy Positive ≥ 5 years | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| malaria-total-tested | Malaria Microscopy Total Tested < 5 | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| malaria-mrdt-under-5 | Malaria mRDT < 5 years | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| malaria-mrdt-over-5 | Malaria mRDT ≥ 5 years | 1..1 | integer | Enable When: suspected-malaria-summary = Yes (yes) | |
| dysentery-tested-under-5 | Dysentery Tested < 5 years | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| dysentery-tested-over-5 | Dysentery Tested ≥ 5 years | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| dysentery-positive-shigella | Dysentery Positive (S. dysenteriae) | 1..1 | integer | Enable When: dysentery-bacillary-summary = Yes (yes) | |
| bacterial-meningitis-csf-no | Bacterial Meningitis No CSF | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-csf-contaminated | Bacterial Meningitis No contaminated | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-tested-positive | Bacterial Meningitis Tested +ve | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nm | Bacterial Meningitis +ve Nm | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-spneum | Bacterial Meningitis +ve S. Pneum | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-hib | Bacterial Meningitis +ve Hib | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-sagalactiae | Bacterial Meningitis +ve S. agalactiae | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-csf-subtyped | Bacterial Meningitis No of CSF Sub-Typed | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nma | Bacterial Meningitis +ve Nm A | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nmb | Bacterial Meningitis +ve Nm B | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nmc | Bacterial Meningitis +ve Nm C | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nmw | Bacterial Meningitis +ve Nm W | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nmx | Bacterial Meningitis +ve Nm X | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| bacterial-meningitis-positive-nmy | Bacterial Meningitis +ve Nm Y | 1..1 | integer | Enable When: bacterial-meningitis-summary = Yes (yes) | |
| tuberculosis-mdr-xdr-tested-under-5 | Tuberculosis (MDR/XDR) Tested < 5 years | 1..1 | integer | ||
| tuberculosis-mdr-xdr-tested-over-5 | Tuberculosis (MDR/XDR) Tested ≥ 5 years | 1..1 | integer | ||
| tuberculosis-mdr-xdr-positive | Tuberculosis (MDR/XDR) Positive < 5 years | 1..1 | integer | ||
| typhoid-tested-under-5 | Typhoid Tested < 5 years | 1..1 | integer | Enable When: typhoid-summary = Yes (yes) | |
| typhoid-tested-over-5 | Typhoid Tested ≥ 5 years | 1..1 | integer | Enable When: typhoid-summary = Yes (yes) | |
| Documentation for this format | |||||
Options Sets
Answer options for 438862163919
Answer options for 438862163919_sub_county
Answer options for 438862163919_county
Answer options for 438862163919_national
Answer options for aefi-summary
Answer options for bacterial-meningitis-summary
Answer options for acute-jaundice-summary
Answer options for neonatal-deaths-summary
Answer options for acute-malnutrition-summary
Answer options for neonatal-tetanus-summary
Answer options for afp-poliomyelitis-summary
Answer options for onchocerciasis-summary
Answer options for plague-summary
Answer options for anthrax-summary
Answer options for rabies-summary
Answer options for cholera-summary
Answer options for rift-valley-fever-summary
Answer options for chikungunya-summary
Answer options for covid--19-summary
Answer options for sari-cluster-ge3-cases-summary
Answer options for dengue-summary
Answer options for dysentery-bacillary-summary
Answer options for suspected-mdr-xdr-tb-summary
Answer options for guinea-worm-disease-summary
Answer options for typhoid-summary
Answer options for measles-summary
Answer options for vhf-summary
Answer options for suspected-malaria-summary
Answer options for yellow-fever-summary
Answer options for deaths-due-to-malaria-summary
Answer options for zika-virus-summary
Answer options for others-specify-summary
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "Moh505",
"meta": {
"profile": [
"http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "patient"
}
},
{
"url": "type",
"valueCode": "Patient"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "countyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "patientCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='a4-county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "patientSubCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='a3-sub-county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedFacilityName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_county').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedRole",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_role').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_sub_county').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedWard",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_ward').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedFacility",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_facility').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedCountyNameCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyNameCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardNameCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedCountyNameNational",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999_national').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyNameNational",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642_national').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardNameNational",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434_national').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedCountyNameSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999_sub_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyNameSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642_sub_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardNameSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434_sub_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode",
"valueCode": "prior-edit"
}
],
"url": "http://example.org/Questionnaire/Moh505",
"version": "0.1.0",
"title": "MOH 505 - Health Facility Weekly Reporting Form",
"status": "draft",
"subjectType": [
"Encounter"
],
"date": "2026-04-02T20:27:34+00:00",
"publisher": "intellisoftConsulting",
"contact": [
{
"name": "intellisoftConsulting",
"telecom": [
{
"system": "url",
"value": "http://example.org/example-publisher"
}
]
},
{
"name": "IntelliSOFT Consulting Ltd.",
"telecom": [
{
"system": "email",
"value": "info@intellisoftkenya.com",
"use": "work"
}
]
}
],
"description": "MOH 505 Health Facility Weekly Reporting Form for disease surveillance",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "KE",
"display": "Kenya"
}
]
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "page",
"display": "Page"
}
]
}
}
],
"linkId": "151479012557",
"text": "Reporting Site",
"type": "group",
"item": [
{
"linkId": "546255966914",
"text": "Hospital/Facility Location",
"type": "display"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_role",
"text": "User Role",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_facility",
"text": "User Facility",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_ward",
"text": "User Ward",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_sub_county",
"text": "User Sub County",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_county",
"text": "User County",
"type": "string"
},
{
"linkId": "facility_level",
"type": "group",
"enableWhen": [
{
"question": "user_role",
"operator": "=",
"answerString": "VACCINATOR"
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "294367770999",
"text": "County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803642",
"text": "Sub County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedWard}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819943434",
"text": "Ward",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedFacility}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803677",
"text": "Health Facility",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "438862163919",
"text": "Type of health facility",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "Private",
"display": "Private"
}
},
{
"valueCoding": {
"code": "Public",
"display": "Public"
}
},
{
"valueCoding": {
"code": "Faith Based",
"display": "Faith Based"
}
}
]
}
]
},
{
"linkId": "sub_county_level",
"type": "group",
"enableWhen": [
{
"question": "user_role",
"operator": "=",
"answerString": "SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER"
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "294367770999_sub_county",
"text": "County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803642_sub_county",
"text": "Sub County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedSubCountyNameSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819943434_sub_county",
"text": "Ward",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedWardNameSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803677_sub_county",
"text": "Health Facility",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "438862163919_sub_county",
"text": "Type of health facility",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "Private",
"display": "Private"
}
},
{
"valueCoding": {
"code": "Public",
"display": "Public"
}
},
{
"valueCoding": {
"code": "Faith Based",
"display": "Faith Based"
}
}
]
}
]
},
{
"linkId": "county_level",
"type": "group",
"enableWhen": [
{
"question": "user_role",
"operator": "=",
"answerString": "COUNTY_DISEASE_SURVEILLANCE_OFFICER"
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "294367770999_county",
"text": "County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedCountyNameCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803642_county",
"text": "Sub County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedSubCountyNameCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819943434_county",
"text": "Ward",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedWardNameCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803677_county",
"text": "Health Facility",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "438862163919_county",
"text": "Type of health facility",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "Private",
"display": "Private"
}
},
{
"valueCoding": {
"code": "Public",
"display": "Public"
}
},
{
"valueCoding": {
"code": "Faith Based",
"display": "Faith Based"
}
}
]
}
]
},
{
"linkId": "national_level",
"type": "group",
"enableWhen": [
{
"question": "user_role",
"operator": "=",
"answerString": "ADMINISTRATOR"
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof=Location/0&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "294367770999_national",
"text": "County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedCountyNameNational}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803642_national",
"text": "Sub County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedSubCountyNameNational}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819943434_national",
"text": "Ward",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedWardNameNational}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803677_national",
"text": "Health Facility",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "438862163919_national",
"text": "Type of health facility",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "Private",
"display": "Private"
}
},
{
"valueCoding": {
"code": "Public",
"display": "Public"
}
},
{
"valueCoding": {
"code": "Faith Based",
"display": "Faith Based"
}
}
]
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/entryFormat",
"valueString": "d/M/y"
},
{
"url": "http://ehelse.no/fhir/StructureDefinition/validationtext",
"valueString": "Cannot be a date in the future"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/entryFormat",
"valueString": "yyyy-mm-dd"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"_valueDate": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
"valueExpression": {
"language": "text/fhirpath",
"expression": "today()"
}
}
]
}
}
],
"linkId": "728034137219",
"definition": "http://example.org/sdh/dtr/aslp/StructureDefinition/aslp-bmi#Observation.value[x]",
"text": "Week Ending Date",
"type": "date",
"required": true
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "page",
"display": "Page"
}
]
}
}
],
"linkId": "306799299",
"text": "Diseases, Conditions or Events Information",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "radio-button",
"display": "Radio Button"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode": "horizontal"
}
],
"linkId": "aefi-summary",
"text": "Were any AEFI cases reported?",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"code": "no",
"display": "No"
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "aefi-cases-under-5",
"text": "Under 5 Cases",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "aefi-cases-over-5",
"text": "Over 5 Cases",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "aefi-deaths-under-5",
"text": "Under 5 Deaths",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "aefi-deaths-over-5",
"text": "Over 5 Deaths",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "aefi-summary-cases-under-5-if-no",
"text": "Under 5 Cases",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "no",
"display": "No"
}
}
],
"initial": [
{
"valueInteger": 0
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "aefi-summary-cases-over-5-if-no",
"text": "Over 5 Cases",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "no",
"display": "No"
}
}
],
"initial": [
{
"valueInteger": 0
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "aefi-summary-deaths-under-5-if-no",
"text": "Under 5 Deaths",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "no",
"display": "No"
}
}
],
"initial": [
{
"valueInteger": 0
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "aefi-summary-deaths-over-5-if-no",
"text": "Over 5 Deaths",
"type": "integer",
"enableWhen": [
{
"question": "aefi-summary",
"operator": "=",
"answerCoding": {
"code": "no",
"display": "No"
}
}
],
"initial": [
{
"valueInteger": 0
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "radio-button",
"display": "Radio Button"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode": "horizontal"
}
],
"linkId": "bacterial-meningitis-summary",
"text": "Were any Bacterial Meningitis cases reported?",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"code": "no",
"display": "No"
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-cases-under-5",
"text": "Under 5 Cases",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-cases-over-5",
"text": "Over 5 Cases",
"type": "integer",
"enableWhen": [
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"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-tested-under-5",
"text": "Malaria Microscopy Tested < 5 years",
"type": "integer",
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{
"question": "suspected-malaria-summary",
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"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-tested-over-5",
"text": "Malaria Microscopy Tested ≥ 5 years",
"type": "integer",
"enableWhen": [
{
"question": "suspected-malaria-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-positive-under-5",
"text": "Malaria Microscopy Positive < 5 years",
"type": "integer",
"enableWhen": [
{
"question": "suspected-malaria-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-positive-over-5",
"text": "Malaria Microscopy Positive ≥ 5 years",
"type": "integer",
"enableWhen": [
{
"question": "suspected-malaria-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-total-tested",
"text": "Malaria Microscopy Total Tested < 5",
"type": "integer",
"enableWhen": [
{
"question": "suspected-malaria-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-mrdt-under-5",
"text": "Malaria mRDT < 5 years",
"type": "integer",
"enableWhen": [
{
"question": "suspected-malaria-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "malaria-mrdt-over-5",
"text": "Malaria mRDT ≥ 5 years",
"type": "integer",
"enableWhen": [
{
"question": "suspected-malaria-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "dysentery-tested-under-5",
"text": "Dysentery Tested < 5 years",
"type": "integer",
"enableWhen": [
{
"question": "dysentery-bacillary-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "dysentery-tested-over-5",
"text": "Dysentery Tested ≥ 5 years",
"type": "integer",
"enableWhen": [
{
"question": "dysentery-bacillary-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "dysentery-positive-shigella",
"text": "Dysentery Positive (S. dysenteriae)",
"type": "integer",
"enableWhen": [
{
"question": "dysentery-bacillary-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-csf-no",
"text": "Bacterial Meningitis No CSF",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-csf-contaminated",
"text": "Bacterial Meningitis No contaminated",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-tested-positive",
"text": "Bacterial Meningitis Tested +ve",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nm",
"text": "Bacterial Meningitis +ve Nm",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-spneum",
"text": "Bacterial Meningitis +ve S. Pneum",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-hib",
"text": "Bacterial Meningitis +ve Hib",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-sagalactiae",
"text": "Bacterial Meningitis +ve S. agalactiae",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-csf-subtyped",
"text": "Bacterial Meningitis No of CSF Sub-Typed",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nma",
"text": "Bacterial Meningitis +ve Nm A",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
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}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nmb",
"text": "Bacterial Meningitis +ve Nm B",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nmc",
"text": "Bacterial Meningitis +ve Nm C",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nmw",
"text": "Bacterial Meningitis +ve Nm W",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nmx",
"text": "Bacterial Meningitis +ve Nm X",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "bacterial-meningitis-positive-nmy",
"text": "Bacterial Meningitis +ve Nm Y",
"type": "integer",
"enableWhen": [
{
"question": "bacterial-meningitis-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "tuberculosis-mdr-xdr-tested-under-5",
"text": "Tuberculosis (MDR/XDR) Tested < 5 years",
"type": "integer",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "tuberculosis-mdr-xdr-tested-over-5",
"text": "Tuberculosis (MDR/XDR) Tested ≥ 5 years",
"type": "integer",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "tuberculosis-mdr-xdr-positive",
"text": "Tuberculosis (MDR/XDR) Positive < 5 years",
"type": "integer",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "typhoid-tested-under-5",
"text": "Typhoid Tested < 5 years",
"type": "integer",
"enableWhen": [
{
"question": "typhoid-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger": 999
}
],
"linkId": "typhoid-tested-over-5",
"text": "Typhoid Tested ≥ 5 years",
"type": "integer",
"enableWhen": [
{
"question": "typhoid-summary",
"operator": "=",
"answerCoding": {
"code": "yes",
"display": "Yes"
}
}
],
"required": true
}
]
}
]
}