Table 1 Questionnaires and surveys, Nicaraguan Pediatric influenza cohort study, Managua, Nicaragua, 2011–2013
From: The Nicaraguan pediatric influenza cohort study: design, methods, use of technology, and compliance
Survey/Case report form | Description |
|---|---|
Medical consult form | >80 item case report form completed by study nurses and physicians. Includes data on: height, weight, tympanic temperature, blood pressure, respiratory and heart rates, lower and upper respiratory symptoms, systemic symptoms, gastrointestinal symptoms, and nutritional status |
Influenza follow-up form | Collects daily information on 14 signs and symptoms. Filled out by physician at follow-up appointments for all possible influenza cases. |
Household annual SES and risk factor survey | Questionnaire completed per household. Includes 31 questions on crowding, water access, socioeconomic level, presence of animals, smoking and cooking inside the house. |
Participant annual risk factor survey | 44 questions focusing on medical history, socio-demographic information, individual risk factors and vaccination |
Height and weight survey | Height and weight are measured twice. If there is >5 % difference between the two measurements, a third measurement is taken. |
Breastfeeding survey | 9 questions about current and past breastfeeding |
Satisfaction survey | 12 questions about the quality of the service provided by study staff in different areas (admission, nurses, physicians, clinical laboratory) |