ANTIMALARIAL TREATMENT GUIDELINES STANDARDS | ||||
No. | Questions | Coding Categories |
| For official use |
B1 | Are malaria guideline standards followed? | 1. Yes 2. No | [ ] [ ] |
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Q7 | Do you have antimalarial drugs in stock? | 1. Yes 2. No | [ ] [ ] |
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Q8 | Do you have Artemether/Lumefantrine (AL)? | 1. Yes 2. No | [ ] [ ] |
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Q9 | Artesunate/amodiaquine; | 1. Yes 2. No | [ ] [ ] |
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Q10 | Artesunate /mefloquine; | 1. Yes 2. No | [ ] [ ] |
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Q11 | Artesunate/sulfamethoxypyrazine/pyrimethamine. | 1. Yes 2. No | [ ] [ ] |
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Q12 | Do you have Sulphadoxine/pyrimethamine (SP)? | 1. Yes 2. No | [ ] [ ] |
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Q13 | Do you have Dihydroartemisinin/Piperaquine (DHA-PQ) tablet? | 1. Yes 2. No | [ ] [ ] |
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Q14 | Do you have Mefloquine? | 1. Yes 2. No | [ ] [ ] |
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Q15 | Do you have Injectable artesunate? | 1. Yes 2. No | [ ] [ ] |
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Q16 | Do you have Artemether (intramuscular [IM])? | 1. Yes 2. No | [ ] [ ] |
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Q17 | Do you have Quinine tablet? | 1. Yes 2. No | [ ] [ ] |
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Q18 | Do you have quinine (IV/IM)? | 1. Yes 2. No | [ ] [ ] |
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Q19 | Do you have Dapsone/pyrimethamine (Deltaprim)? | 1. Yes 2. No | [ ] [ ] |
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Q20 | Do you have primaquine? | 1. Yes 2. No | [ ] [ ] |
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Q21 | Do you have Quinine/clindamycin? | 1. Yes 2. No | [ ] [ ] |
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Q22 | Do you have Doxycycline? | 1. Yes 2. No | [ ] [ ] |
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Q23 | Do you have Atovaquone/Proguanil? | 1. Yes 2. No | [ ] [ ] |
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Q24 | Do you have Chloroquine? | 1. Yes 2. No | [ ] [ ] |
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Q25 | Do you have any other antimalarial? if yes specify… | 1. Yes 2. No | [ ] [ ] |
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