HIVQUAL-U Manual Data Collection Form (version 4) Adult/Adolescent
Start Date: XX/ XX/ XXXX
End Date: XX/XX/XXXX
Patient Profile Patient Data Entry Screen 1: “Monitoring HIV Status and Continuity of Care” 1.1 Did the patient have any CD4 counts during the review period? Yes No Not stated
• If no, go to 1.1.2 1.1.1 (If yes in 1.1) Record CD4 counts from tests during the review period only: 1.1.2 (If No in 1.1) Are Total lymphocyte counts available for this patient during review period? Yes No Not stated
• If yes, go to 1.1.2.1, • if no or “not stated”, go to 1.2 1.1.2.1 (If yes in 1.1) Record TLC results from tests during the review period only: 1.2 Did the patient visit for medical care in the past 6 months? Yes No Not stated 1.2.1 Record visit dates and WHO Clinical staging at each visit in the past 12 months: Patient Data Entry Screen 2: Prevention Education and Prophylaxis 2.1 Was HIV prevention discussed in the last 3 months? Yes No Not stated Prevention education includes talks on Abstinence, Faithfulness, Condom use VCT – Child’s blood tests and Testing partners 2.2. Was cotrimoxazole prescribed to the patient in the last 6 months? Yes No Not stated Patient Data Entry Screen 3: “Anti-retroviral Therapy and Adherence”
3.1 Was the patient on ARV therapy (other than PMTCT) during the review period? Yes No Not stated
• If yes, go to 3.1.1
• If no or “not stated,”, stop 3.1.1 Is the patient still on ARV therapy at the end of the review period? Yes No Not
3.1.2 Report all ARV regimens received during the review period, with starting date and ending
date (if applicable). Each line should include a complete regimen (not just a new single drug). Do not include ARV taken solely to prevent mother-to-child transmission of HIV. Select drug regimens or individual drugs from the pop-up menu
• Trimune (d4T+3TC+NVP)
• Combivir (AZT+3TC), also known as Zarlivir
• Trivada (TDF+3TC+EMC)
• Trizivir (AZT+3TC+NVP)
• SQV Saquinavir, Invirase, Fortovase
• RTV Ritonavir, Norvir
• NFV Nelfinavir, Viracept
• 3TC Lamivudine, Lamivir, Epivir
• Kaletra
• TDF Tenofovir, Viread (used in clinical boosted Lopinavir trials only)
• NVP Nevirapine, Viramune Specified other drug “Specify______________________________”
3.2. Was patient adherence to ARV therapy assessed in the last 2 quarters during the review period?
• If no or “not stated,” go to 4.1
3.3. What was the score at the last adherence assessment in the review period? Good Fair Poor
SCORE GUIDE SCORE PERCENTAGE Good Patient Data Entry Screen 4: “TB”
4.1 Was the patient assessed for clinical symptoms or risk factor for TB during the review period? Yes No Not stated
• If yes go to 4.1.1 Clinical Symptoms Risk factors Contact with individuals with active TB
4.1.1 (If yes) was the patient screened for TB? Yes No Not stated
4.1.1.1 Was the patient screened by chest x-ray? Yes
4. 1.1.2 Was the patient screened by sputum AFB? Yes
4. 1.1.3 Did the patient diagnosed TB disease? Yes
4.2 Was the patient treated for active TB? Yes No Not stated
Novartis stellt Schweinegrippe-Impfstoff unter BeweisNach einer Pilot-Studie hat Novartis die Wirksamkeit seines Schweinegrippe-Impfstoffes unter Beweis gestellt. Der Test an 100 gesunden Probanden ergab, dass das Mittel Celtura bereits nach der ersten Dosis bei 80 Prozent der Geimpften eine starke Immunantwort auslöst. Ein vom Schweizer Novartis-Konzern entwickelter Impfstoff gegen die sogenan
What is.? series The NHS and HTA Implementing NICE guidance ● The National Institute for Health and Clinical Excellence Norman Evans BPharm (NICE) was established to provide national guidance on the promotion of good health and the prevention of ill health. NICEguidance is integral to a standards-based healthcare system. ● NICE issues four types of guidance: