| Factors Associated with Typhoid Fever Amon Attending Kangema Sub County Hospital, County, Kenya |
Ng Adults Murang’A |
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Serial No: |
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Date: |
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Please tick where applicable |
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| PART 1: DEMOGRAPHIC CHARACTERISTICS |
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| 1 |
What is your sex? |
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Male |
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Female |
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| 2 |
What is your age (In years) |
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| 3 |
What is your religion? |
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| 4 |
What is your ethnicity? |
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| 5 |
What is your marital status? |
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Married |
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Single |
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Divorced |
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Widowed |
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| 6 |
Which is your highest level of education attained? |
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University |
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O-level |
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College |
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Primary |
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None |
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| 7 |
What is your occupation? |
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employed |
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Unemployed |
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self-employed |
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| 8 |
What is the reason for you seeking medical care in this facility? |
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Sick |
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go to question 9 |
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Vaccination |
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Medical certificate |
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Go to part 2 |
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Other reasons (Indicate) |
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| 9 |
How long have you been unwell? |
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0 - 2 days |
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9 - 11 days |
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3 - 5 days |
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12 - 14 days |
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6 - 8 days |
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>14 days |
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| 10 |
Were there any medical care sought? |
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Yes |
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No |
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If no go to part 2 |
| 11 |
Where did you seek health care? |
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Public |
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Friends |
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Private |
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Others |
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Pharmacy |
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Traditional healers |
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