Monarch.RTHB.Child.3 Sweetness H Dube 2017-06-06 NADA Monarch RTHB Child 3 MO-01.Monarch.RTHB.Child.3 NADA Monarch Data South Africa Face-to-face [f2f] MO-01 Monarch RTHB Child 3 2 80 Barcoded sticker ID number (M10.........) 2 M10 2027 M10 3080 RedCap Event Name 2 child3_arm_1 RedCap Data Access Group Is the bar coded study ID available? 1 1 No 1 Yes Sysmiss Number of bar coded ID: 1 M10 2027 Bar code label(s) for photo (if different) Infant gender 1 1 1 Male 2 Unknown Sysmiss Date of data collection if photo was taken at Delivery: 1 2016-03-08 2016-03-08 2016-03-08 Facility where data was collected if photo was taken at Delivery: 1 1 1 Esiyembeni 2 Gunjaneni 3 Machibini 4 Somkhele 5 Mpukonyoni 6 Mtubatuba 7 KwaMsane 8 Hlabisa Sysmiss Name of data collector if photo was taken at Delivery: 1 1 1 Thandazile 2 Phindile 3 Jabulile 4 Mandla 5 Nomatahu 6 Thabi 7 Winnie 8 Sphiwe 9 Gugu 10 Muntuh 11 Buke 12 Anele Sysmiss Consent given (and signed) to take photo at Delivery? 1 1 1 Yes 2 No 3 Unknown Sysmiss Date of data collection if photo was taken at 3-6 day postnatal visit: Facility where data was collected if photo was taken at 3-6 days postnatal visit: 2 1 Esiyembeni 2 Gunjaneni 3 Machibini 4 Somkhele 5 Mpukonyoni 6 Mtubatuba 7 KwaMsane 8 Hlabisa Sysmiss Name of data collector if photo was taken at 3-6 days post natal visit: 2 1 Thandazile 2 Phindile 3 Jabulile 4 Mandla 5 Nomatahu 6 Thabi 7 Winnie 8 Sphiwe 9 Gugu 10 Muntuh 11 Buke 12 Anele Sysmiss If first photo was taken at delivery, is the RtHB blank (or only cover page compl 2 No 1 Yes Sysmiss Consent given (and signed) to take photo at 3-6 days postnatal visit? 2 1 Yes 2 No 3 Unknown Sysmiss Date of data collection if photo was taken at 6-weeks postnatal visit: 1 2016-04-04 2016-04-04 2016-04-04 Facility where data was collected if photo was taken at 6-weeks postnatal visit: 1 1 1 Esiyembeni 2 Gunjaneni 3 Machibini 4 Somkhele 5 Mpukonyoni 6 Mtubatuba 7 KwaMsane 8 Hlabisa Sysmiss If first photo was taken at 3-6 days postnatal visit, is the RtHB blank (or only 2 No 1 Yes Sysmiss Name of data collector if photo was taken at 6-weeks post natal visit: 1 1 1 Thandazile 2 Phindile 3 Jabulile 4 Mandla 5 Nomatahu 6 Thabi 7 Winnie 8 Sphiwe 9 Gugu 10 Muntuh 11 Buke 12 Anele Sysmiss Consent given (and signed) to take photo at 6-weeks post natal visit? 1 1 1 Yes 2 No 3 Unknown 11 .. Sysmiss If first, 2nd or last photo was taken at 6-weeks postnatal visit, is the RtHB bla 2 No 1 Yes Sysmiss Mother Date of Birth 1 1981-09-29 1981-09-29 1981-09-29 Mothers ID Number 1 8109290571083 Mother's age 1 1 39 Sysmiss Mother's contact number 2 1000000001 .. Date Of Birth 1 2016-02-19 2016-02-19 2016-02-19 Date of 3-6 day visit Growth (IMCI) at 3-6 days PMTCT/HIV status (IMCI) 3-day visit Feeding (EBF/EFF/mixed feeding) on 3-day visit Date of 6 weeks visit 1 2016-04-04 2016-04-04 2016-04-04 Growth (IMCI) at 6 weeks 1 Nil PMTCT/HIV status (IMCI) 6 weeks visit 1 Exposed Feeding (EBF/EFF/mixed feeding) at 6 weeks visit 1 FF Facility Delivered 1 1 1 Hlabisa 2 KwaMsane 3 Home 4 Other 5 Unknown Sysmiss If other, please specify How many children has the mother had (including this child and stillbirths)? 1 1 6 Sysmiss How many children are alive now (including this child)? 1 1 6 Sysmiss If any of her children died, what was the reason for death 1 ? What was the reason for death 2 ? What was the reason for death 3 ? Is the infant a twin? 1 1 1 Yes 2 No 3 Unknown Sysmiss Is there any disability (including birth defects)? 1 1 1 Yes 2 No 3 Unknown Sysmiss If Yes, please specify Birth weight 1 1 2100 Sysmiss Birth length 1 1 43 Sysmiss Head circumference at birth 1 1 32 Sysmiss Mothers gestational age 1 Nil What was the mode of delivery? 1 C/s for triplet Is there any information in the "Antenatal (Maternal History) " section? 1 1 1 Yes 2 No 3 Nothing noted in RthB Sysmiss What is the antenatal history? 1 G4 P3 Was there any neonatal problems noted down? 1 1 No 1 Yes Sysmiss If Yes, please specify. Neonatal feeding decided on at birth 1 1 1 Exclusive Breast 2 Exclusive Formule 3 Breast and Formule 4 Other 5 Unknown Sysmiss Date of completion of PMTCT/HIV Information Mother's latest HIV result 1 1 1 Positive 2 Negative 3 To be done 4 Unknown Sysmiss Before pregnancy 2 No 1 Yes During pregnancy 2 No 1 Yes At delivery 2 No 1 Yes Unknown 2 No 1 Yes Is the mother on life-long ART? 1 1 1 Yes 2 No 3 Unknown Sysmiss If Yes, duration of life-long ART at time of delivery? 1 1 1 <4weeks 2 >4weeks 3 Before pregnancy 4 Unknown Sysmiss Document the ARV's the mother received 1 Nil Did the mother receive infant feeding counselling? 1 1 1 Yes 2 No 3 Unknown Sysmiss Decision about infant feeding 1 1 1 Exclusive breast 2 Exclusive formula 3 Unknown Sysmiss Document Nevirapine given: 1 Yes NV Is there a labsticker for PCR done? 1 1 No 1 Yes Sysmiss If Yes, what is the lab sticker code? Has mother disclosed to anyone in household? 1 1 1 Yes 2 No 3 Unknown Sysmiss Has the mother's partner been tested? 1 1 1 Yes 2 No 3 Unknown Sysmiss What feeds has the infant received? Was the HIV PCR test done? If Yes, when? If the result is available, is the PCR negative or positive? Cotrimoxazole started? Infant feeding discussed? Has the child received Nevirapine? If Yes, should it be stopped or continued? Rthb Data Extraction Complete 2 1 Incomplete 2 Complete