HTS LAB REGISTER

COVID-19 Antigen Results Upload Template Facility Name:

Note: Fileds in red must be filled

Age Unit
Type of case Date of sample
Client Name (Days /
Sample No. (Initial / collection Age Sex Telephone Number ID / Passport Number Occupation Nationality County of Residence
(First, Middle, Last) Months /
Repeat) (DD/MM/YYYY)
Years)

(M/F)

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) L

152121169 Initial 24/6/22 ISABELLA THOGORI MACHARIA 14 Years F 0726714558 STUDENT Kenya Nakuru

152121170 Initial 24/6/22 EVERLYNE KAMAU 26 Years F 0703540005 32858333 farmer Kenya Nakuru

152121171 Initial 24/6/22 BILHA KERUBO 73 Years F 0707573985 HOUSEWIFE Kenya Nakuru

152121172 Initial 24/6/22 FRESHIA WANGUI 26 Years F 0748159559 32511121 HOUSEWIFE Kenya Nakuru

152121173 Initial 24/6/22 ESTHER KEMUNTO 18 Years F 0706525590 STUDENT Kenya Nakuru

152121174 Initial 24/6/22 KEWA MUGO 15 Years M 0705352642 STUDENT Kenya Nakuru

152121175 Initial 24/6/22 ABIGAEL NJERI MATARI 14 Years F 0720058006 farmer Kenya Nakuru

152121176 Initial 24/6/22 BEATRICE WAMBUI 38 Years F 0704327210 31029117 STUDENT Kenya Nakuru

152121177 Initial 25/6/22 JOSEPH KAVAGAHU NJOROGE 55 Years M 07229066453 8443138 BUSINESS Kenya Nakuru

152121178 Initial 27/6/22 DELELA MUTULLA 27 Years F 0714433059 30045286 BUSINESS Kenya Nakuru

EVANSON MWANGI 55 Years M 0722852877 8892718 HCW Kenya Nakuru

VALENTINE JELIMO 22 Years F 0790341226 37275757 BUSINESS Kenya Nakuru

LUCY NJERI CHEGE 48 Years F 0729203061 22158230 farmer Kenya Nakuru

SUSAN WAIRIMU 55 Years F 0710658571 909941 farmer Kenya Nakuru

LEVY AKUYO ANYOSO 65 Years M 0723778563 1105918 farmer Kenya Nakuru

JOSEPH NDUNGU 14 Years M 0721744127 STUDENT Kenya Nakuru

SIMON MWANGI 52 Years M 0720917864 11035950 farmer Kenya Nakuru

MERCY WANJIRU NJUGUNA 24 Years F 0793773945 335999272 TEACHER Kenya Nakuru

JOHN NJUE 56 Years M 0717095573 25137439 farmer Kenya Nakuru

MERCY CHELANGAT KIBET 28 Years F 0745528617 29756370 CASUAL Kenya Nakuru

GIDION NUNGARI 28 Years F 0796705069 25794272 HOUSEWIFE Kenya Nakuru

EVERLYNE MORAA 26 Years F 0725587373 33370645 CASUAL Kenya Nakuru

 HTS LAB REGISTER

RUTH NJERI 17 Years F 0714188817 STUDENT Kenya Nakuru

DANAN NJABI 44 Years F 0710079477 32303426 BUSINESS Kenya Nakuru

DOMINIC KARANJA 55 Years M 0700348109 26546847 STUDENT Kenya Nakuru

ALFRED ONYIRI 49 Years M 0725086126 9643087 farmer Kenya Nakuru

NAOMI NYAMBURA 38 Years F 0720376840 11154530 CASUAL Kenya Nakuru

MARY NJERI 23 Years F 0720428521 23074737 PASTOR Kenya Nakuru

GEOFFREY KORI 37 Years M 0796918249 34985920 CASUAL Kenya Nakuru

FERY MBABENI MWANGI 45 Years M 0706295525 23625108 TEACHER Kenya Nakuru

ROGERI KISAKA 31 Years FM 0722215528 20481434 HCW Kenya Nakuru

JACKLINE GESARE NYAMBURA 26 Years F 0714669053 30513839 BUSINESS Kenya Nakuru

ESTHER NJERI 26 Years F 0743131304 330206 BUSINESS Kenya Nakuru

JANE WANGAI 17 Years M 0716582365 STUDENT Kenya Nakuru

PHILIP MWANGI 7 Years M 0706295525 PUPIL Kenya Nakuru

CATHERINE ERUSA 62 Years F 0725254216 23625708 farmer Kenya Nakuru

BEATRICE WAMBUI 80 Years F 07985030375 6352979 farmer Kenya Nakuru

MARIA WAMBUI 42 YEARS F 0726992944 21787336 CASUAL Kenya Nakuru

 HTS LAB REGISTER

Sample Type
Village / Estate of Reason for Have Date of Onset of Symptoms
Sub-county of Residence Symptoms shown Assay Kit Name Lot No. Antigen Result Action Taken Date of PCR Sample collection
Residence Testing Symptoms (DD/MM/YYYY)

Sample Type
Expiry
/ /
(NP swab, OP
Swab, NP/OP (Refer to
(Y / N) (Refer to Codes) (N, P, I) (Refer to Codes) (DD/MM/YYYY) or NA)
Swabs, Sputum, Codes)
Serum)
(m) (n) o (p) (q) (s) (t) (u) (v) (w) (x) (y)

molo 20 ACRES NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 P 1

molo DUKA MBILI NP swab 1 N 21/6/22 SD BIOSENSOR 2023/01/14 P 1

molo RONGAI NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo TAYARI NP swab 1 Y 20/6/22 SD BIOSENSOR 2023/01/14 N 1

molo GREENLAND NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MOTTO NP swab 1 Y 22/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MUTIRITHIA NP swab 1 Y 23/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MOTTO NP swab 1 Y 23/6/22 SD BIOSENSOR 2023/01/14 P 1

molo EVERBEST NP swab 1 Y 27/3/22 SD BIOSENSOR 2023/01/14 N 1

molo MUTIRITHIA NP swab 1 Y 24/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MUTIRITHIA NP swab 1 Y 25/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MUTIRITHIA NP swab 1 Y 26/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MUCHORWE NP swab 1 Y 26/6/22 SD BIOSENSOR 2023/01/14 P 1

molo MUCHORWE NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo PROMISE NP swab 1 Y 20/6/22 SD BIOSENSOR 2023/01/14 P 1

molo TAYARI NP swab 1 Y 25/6/22 SD BIOSENSOR 2023/01/14 N 1

molo TAYARI NP swab 1 Y 22/6/22 SD BIOSENSOR 2023/01/14 N 1

molo KEEPLEFT NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo PEACE NP swab 1 Y 22/6/22 SD BIOSENSOR 2023/01/14 N 1

molo KENYATTA NP swab 1 Y 27/6/22 SD BIOSENSOR 2023/01/14 P 1

molo TURI NP swab 1 Y 26/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MUNYU NP swab 1 Y 25/6/22 SD BIOSENSOR 2023/01/14 P 1

 HTS LAB REGISTER

molo MOTTO NP swab 1 Y 26/6/22 SD BIOSENSOR 2023/01/14 N 1

molo BARAKA NP swab 1 Y 27/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MOTTO NP swab 1 Y 22/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MOLO NP swab 1 Y 22/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MOLO NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo EVERBEST NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 P 1

molo MOLO NP swab 1 Y 22/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MOLO NP swab 1 Y 23/6/22 SD BIOSENSOR 2023/01/14 P 1

molo TREASURE NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo KEEPLEFT NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo TAYARI NP swab 1 Y 23/6/22 SD BIOSENSOR 2023/01/14 P 1

molo TAYARI NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo BOROR NP swab 1 Y 23/6/22 SD BIOSENSOR 2023/01/14 N 1

molo TAYARI NP swab 1 Y 21/6/22 SD BIOSENSOR 2023/01/14 N 1

molo MAU SAMMIT NP swab 1 Y 23/6/22 SD BIOSENSOR 2023/01/14 N 1

molo KEEPLEFT NP swab 1 Y 24/6/22 SD BIOSENSOR 2023/01/14 N 1

 HTS LAB REGISTER

PCR Result Tester Initials Remarks

(N / P)

(z) (aa) (ab)

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 HTS LAB REGISTER

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Column Label Column ID Description

Sample Number (a) Enter sample number. These are serially generated.

Type of Case (Initial/Repeat) (b) Indicate whether the case is an Initial or Repeat

Date of sample collection (c) Write date of sample collection: DD/MM/YYYY

Client Name (d) Client Name in the order (First, Middle, Last)

Age (e) Enter age in years at last birthday.

Age Unit (f) Indicatew whether the age provided is in Years, Months, Days

Sex (g) Enter M for male or F for female.

Enter the client’s phone number preferrably mobile number where they can easily be
Telephone Number (h)
contacted
ID / Passport Number (i) Client ID number or Passport Number

Occupation (j) What work the patient does

Nationality (k) Country of origin of the patient

County of Residence (l) County where the client resides

Sub-county of Residence (m) Sub County where the client esides

Village / Estate of Residence (n) Village or estate where the client routinely stays
Sample collected for antigen testing . Enter an applicable sample type: NP swab, OP
Sample Type (o)
Swab, NP/OP Swabs, Sputum, Serum

Reason for Testing
Indicate the reason for testing. Enter applicable code. Chose from : - Symptomatic
(1); Contact with suspected case - {household or workplace contacts} 2); Health Care
(p) Worker (3); Outbreak Investigation –{ schools, prions, gathering} (4); Prison/remand
(5); High risk client in health facility- {in-patient, before surgical procedure, patients
seeking dental services} (6)

Contact with a case (q) If the patient has been in contact with a confirmed case indicate 'Y' else indicate 'N'
Have Symptoms (r) If the patient has shown any symptoms indicate 'Y', else indicate 'N'
 if the patient has symptoms, indicate when these symptoms started showing in
Date of Onset of Symptoms (s)
(DD/MM/YYYY)

indicate the symptoms shown, list them separated by a semi colon (;) eg 1; 5;
1. Fever
2. Cough
3. Shortness of breath or difficulty breathing
4. Fatigue
5. Muscle or body aches
Symptoms shown (t)
6. Headache
7. New loss of taste or smell
8. Sore throat
9. Congestion or runny nose
10. Nausea or vomiting
11. Other"

Lot No: Write lot number of the test kit. If the lot number changes in the middle of the
Assay Kit Name (u) Write the name
page, skip of the
one row andantigen testnew
write the kit which you have
lot number used.t
on the next (Eg
rowBio sensor, etc)
Lot No. / Expiry
(v)
/ / Test Result: Write either ofdate
thethe
following initials;
Antigen Result (w) Expiry
IndicateDate:
actionWrite
takenexpiry
folloeing of the
testtest kit. EnterN:
result. Negativecode.
applicable ; P: Positive ); I: :- (1)
Chose from
Invalid
Refer to action
clinician for folloeing
all antigenthepositive results; (2)applicable
Preventative counselling for :- (1)
Action Taken (x) Indicate taken test result. Enter code. Chose from
negative ayptomatic clients ; (3) Refer for PCR sample collection and testing
Refer to clinician for all antigen positive results; (2) Preventative counselling for within
Date of PCR Sample collection (y) 48hrs forayptomatic
clients whoclients
are symptomatic but PCR
antigen test negative;
negative ; (3) Refer for sample collection and testing within
PCR Result (z) Indicate whether PCR result was P (positive)
48hrs for clients who are symptomatic but antigen test or N ( Negative)
negative;
Tester Initials (aa) Indicate the initials of healthcare provider who performed the antigen test
Write any additional information that can clarify the data collected about the client
Remarks (ab)
further. Including referrals for all the clients who require a PCR test.
Note

Serialize annually.
(need more clarification on this especially for antigen repeat
testing)
If invalid, indicate "I": skip a line and repeat the test again. If 2
consecutive invalid results are obtained, report to the supervisor.
Test with a kit aving a different Lot number.