ANTIMALARIAL TREATMENT GUIDELINES STANDARDS

No.

Questions

Coding Categories

For official use

B1

Are malaria guideline standards followed?

1. Yes

2. No

[ ]

[ ]

Q7

Do you have antimalarial drugs in stock?

1. Yes

2. No

[ ]

[ ]

Q8

Do you have Artemether/Lumefantrine (AL)?

1. Yes

2. No

[ ]

[ ]

Q9

Artesunate/amodiaquine;

1. Yes

2. No

[ ]

[ ]

Q10

Artesunate /mefloquine;

1. Yes

2. No

[ ]

[ ]

Q11

Artesunate/sulfamethoxypyrazine/pyrimethamine.

1. Yes

2. No

[ ]

[ ]

Q12

Do you have Sulphadoxine/pyrimethamine (SP)?

1. Yes

2. No

[ ]

[ ]

Q13

Do you have Dihydroartemisinin/Piperaquine (DHA-PQ) tablet?

1. Yes

2. No

[ ]

[ ]

Q14

Do you have Mefloquine?

1. Yes

2. No

[ ]

[ ]

Q15

Do you have Injectable artesunate?

1. Yes

2. No

[ ]

[ ]

Q16

Do you have Artemether (intramuscular [IM])?

1. Yes

2. No

[ ]

[ ]

Q17

Do you have Quinine tablet?

1. Yes

2. No

[ ]

[ ]

Q18

Do you have quinine (IV/IM)?

1. Yes

2. No

[ ]

[ ]

Q19

Do you have Dapsone/pyrimethamine (Deltaprim)?

1. Yes

2. No

[ ]

[ ]

Q20

Do you have primaquine?

1. Yes

2. No

[ ]

[ ]

Q21

Do you have Quinine/clindamycin?

1. Yes

2. No

[ ]

[ ]

Q22

Do you have Doxycycline?

1. Yes

2. No

[ ]

[ ]

Q23

Do you have Atovaquone/Proguanil?

1. Yes

2. No

[ ]

[ ]

Q24

Do you have Chloroquine?

1. Yes

2. No

[ ]

[ ]

Q25

Do you have any other antimalarial? if yes specify…

1. Yes

2. No

[ ]

[ ]