National Malaria Elimination

Case Investigation with Reactive

FTAT

Coding, Registers
and Case Scenarios
Gudissa A.
MoH/ NMEP
March, 2021
Adama, Ethiopia
Coding of RDTs and individuals
• Standardized 15 digit unique codes will be used for each participant’s RDT and
documentation lines and below is an instance for the coding:

The HEW will enter a code on each of the following items:

• On the RDT of index case and subsequent case investigation participants, unique for
each RDT;
• On the FTAT HH QUESTIONNAIRE and HH TRACKING FORM within the identification
section, the same code is entered for HHs investigated under same index case.
• On the FTAT HH QUESTIONNAIRE, unique for each member of the HH listing
Focal Test and Treat (FTAT) Forms
Paper documentation
• Health post registration book
• Health Center registration book
• FTAT Passive Case Documentation (Screening Form)
• FTAT Case Investigation Household Tracking Form
• FTAT Household Questionnaire
• FTAT Weekly Reporting Form
• FTAT Monthly Supervisor/Surveillance Focal Checklist form
 Updated register data elements

1. Serial number
• The numbers should start with “1” on the first date of each month. A new serial
number is given to a patient who comes with a new diagnosis and those who come
as re-attendances.
2. Examination Date
• Date the patient presented for consultation to HP described as dd/mm/yy
3. Name of patient
• Write the patient’s first and middle name including surname
Updated register data elements…

4. Sex
• Write the Sex (Gender) of the patient. Indicate M for male and F for female.
5.Pregnancy status
• If the woman is non-pregnant please indicate “NPW” for those where pregnancy
is not to be asked indicate “NA” If a woman is pregnant indicate "PW”
Updated register data elements…
6. Age
• Write the patient’s age in complete years if the patient is over five years of age.
• Write the patient’s age in months if the patient is between under five year of age and
greater than 29 days
• Write the patient’s age in months “00” if the patient is less than one month of age
7. Phone number
• Write mobile number of permanent resident of the household member. Priority will
be given for patient’s phone if s/he is adult otherwise phone of husband or wife
Updated register data elements…

8. Permanent address: Woreda

• Permanent woreda address where the patient stays
9. Permanent address: Kebele
• Permanent Kebele address of patient where the patient stays
10. Permanent address: Village/ Gott/ Focus
• Permanent “Gott” or Focus address of patient where the patient stays
11. Permanent address: House number
• A number allocated to the House Hold, where the patient stays and to patient’s
family folder
12. Permanent address: Name of Head of Household
• Name of house hold head indicated in family folder
Updated register data elements…
13. How did the client get the service
• Mechanism the patient initiated to seek treatment
14. Sign and symptoms
• Chief complaints presented by the patient
15. Fever
• Normal body temperature: 36.5° – 37.5° C
• Fever is defined as body temperature above normal OR
• Presence or absence of fever as reported by the patient or parent/guardian of the
patient.
16. Body temperature
• Body temperatures taken under the arm using a glass or digital thermometer in ˚C
Updated register data elements…

17. On set of fever (≤ 24hrs. or >24 hrs.)

• Patient’s/ the guardians of patients complaint documented as ≤ 24 hrs for patients
presenting within less than 24 hrs. of the onset fever or else >24 hrs.
18. Any travel history in the past 30 days
• Traveling out of your permanent village and staying at least one night.
19. If travel history is yes where?
• Refers to the 9 regions and 2 administrative cities of Ethiopia
• Refers to the district name belonging to the region
• Refers to a kebele name belonging to the district
Updated register data elements…
20. New or repeated (within 2 weeks)
New
• Is defined by a person who attends the health unit with a new episode
of illness. If there are many diagnoses for one new attendance.
Repeated
• This refers to a person who attends the health unit for the second, third
or higher number of visits for the same episode of illness as was
previously diagnosed. No diagnosis is recorded in the diagnosis column
for a repeated. However, you should still write all diagnoses in the
patient cards.
Updated register data elements…
21. RDT Result
• Diagnosis interpretations made according to the standard diagnostic procedure
and case definitions as “pf”, “pv”, “mixed” , “neg” and “NA”
22. Diagnosis result other than malaria
• Diagnosis other than malaria where the HEWs ruled out
23. Drug provided
• Indicate type of drug prescribed
24. Referred
• Indicate if the patient is sent to next level health facility for better management
25. Reason for referral
• When a patient is NOT manageable at HP level referral is document with the
probable cause of referral (e.g. due to: sever malaria, sever diarrhea etc…)
 Thank you
and
any questions?
 CASE STUDIES IN
ELIMINATION SETTING
EXERCISE

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Exercise 1
Practical sessions (20 minutes)
• Complete revised HP OPD registers as per case
studies below:

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Case-Study 1

A 32 years non pregnant Toyba Ahmed farmer and

Head of HH visited B Health post (Hakim Woreda)
from gott A house number 11/123 today. She has
fever, headache and her body temperature is 36.4oC .
The onset of the disease started a week ago. She had
visited Dire Dawa 3 weeks ago and stayed 2 nights.
Amira Abdu in charge of B HP conducted RDT test and
found a positive RDT result for P.falciparum.
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Case-Study 2

A 21 years Ayantu Bayisa housewife visited D Health post

(Hakim Woreda) from gott C house number 04/105 today.
Seid Ali is her husband accompanied her to the HP. She is
5 months pregnant and has persistent vomiting, high
fever, and her body temperature is 39.2oC . The onset of
the disease started 17 hours ago. She had travelled 6
weeks ago for 4 days to Adama. Samia Seid in charge of D
HP conducted RDT test and found a positive RDT result for
P.falciparum.
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Case-Study 3

A 9 month child Tsige Haile visited F Health post

with her father Haile Abebe (Sofi Woreda) from
gott C house number 11/442 today. She has
Diarrhea, vomiting and her body temperature is
36.0oC . The onset of the disease started two
days ago. Rewda Amir in charge of F HP referred
the child to Harrar Health Center for better
management.
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Case-Study 4

A 29 years Woubit Eshetu with her husband Dawit

Takele visited M Health post (Sofi Woreda) from gott D
house number 04/196 today. She is 2 months pregnant
and has vomiting, fever, and her body temperature is
36.7oC . The onset of the disease started 2 days ago.
She had travelled to Jigjiga a week ago and back the
same day. She was diagnosed and treated with P. f
week ago. Selam in charge of M HP conducted RDT test
and found a positive RDT result for P.f infection.
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Case-Study 5

A 24 years old Adem Humed visited M Health

post (Errer Woreda) with unknown address. He
has vomiting, fever, and her body temperature is
36.7oC . The onset of the disease started today.
He traveled with his wife to Semera town a week
ago. Asiya in charge of M HP conducted RDT test
and found a positive RDT result for mixed
infection.
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Case-Study 6

A 9 years Liya Hailu visited W Health post (Errer Woreda)

from gott D house number 34/111 today. She is has
vomiting, fever, and her body temperature is 37.7oC . The
onset of fever started 2 days ago. She had travelled to
Harar with her widowed mother Almaz Abebe a week
ago and stayed one week. Fasika in charge of W HP
conducted RDT test and found a positive RDT result for
P.vivax infection.

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Exercise 1 : Answer
Completed Health Post OPD register result
Health Post Registration Book_v1_Exercise 1.docx

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Exercise 2

Practical sessions (40 minutes)

• Conduct FTAT initiated from index cases diagnosed at
each health post(case study 1) and complete
necessary FTAT forms
– Passive Case documentation (Screening Form)
– Case Investigation HH Tracking Form
– Household Questionnaire
• Complete weekly report and send to the nearest HC
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Case-Study 1

A 32 years Toyba Ahmed farmer visited B Health post (Hakim Woreda) from
gott A house number 11/123 today. She has fever, headache and her body
temperature is 36.4oC . The onset of the disease started a week ago. She had
visited Dire Dawa 3 weeks ago and stayed 2 nights. Amira Abdu in charge of
B HP conducted RDT test and found a positive RDT result for P.falciparum.
Aminat conducted FTAT around Toyba’s house. She is head of the household
has 5 household members including her. Their names are XX 4 months (M),
YX 4 years(M), ZX 10 years(F) and WX 13 years(M). These HH members did
not move from home except XX during that time. All have 37.2 oC body
temperature and had not fever at all. There are 6 houses named 1-6 within
70m of Toyba’s house. FTAT was conducted in all households except one
student missed in the second nearest HH.
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Case-Study 1…

The first neighboring house has 3 household

members namely AB 14 years (M), CB 4 years (F)
and AC 32 years(F) Farmer. These HH members
did not move from home in the last six months.
All have 37oC body temperature and had not fever
at all. They have tested for malaria and become
negative.

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Exercise 2 Answer
• Results
– Passive Case documentation (Screening Form)
– FTAT Passive Case Documentation (Screening Form)_Exercise 2.xlsx
– Case Investigation HH Tracking Form for Index case 1
– FTAT CASE INVESTIGATION TRACKING FORM_Index 1.docx
– Household Questionnaire for Index case 1 HH
– FTAT HOUSEHOLD QUESTIONNAIRE_Index 1 Household.docx
– Household Questionnaire for a neighbor1 HH of Index case 1 HH
– FTAT HOUSEHOLD QUESTIONNAIRE_Index 1 Neighbor 1.docx
– Weekly FTAT report
– FTAT Weekly reporting format_1.docx
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