This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
á¼¹ÀÙÁÔ¡ÒèÓṡ¼ÙŒ»†ÇÂÇѳâäµÒÁºÑÞªÕ Óṡ·Ò§Ê¶ÔµÔÃÐËÇ‹Ò§»ÃÐà·È¢Í§âäáÅлÞËÒÊØ¢ÀÒ¾·Õèà¡ÕèÂÇ¢ŒÍ§ (International Statistical Classification of Diseases and Related Health Problems : ICD 10)
วณโรค(Tuberculosis: TB)
วณโรคในปอด(Pulmonary TB)
เสมหะพบเชอ A1501. S+ & C+2. S+ & C-3. S+ & C not done
เสมหะพบไมพบเชอ A151(S- & C+)
ยนยนดวยกาตรวจชนเนอ A151(Confirmed histologically)
ไมระบวธยนยน A153(Confirmed by unspecified means)
ไมไดกลาวถงวธยนยนใด A162(Without mention of confirmation)
Çѹ·Õèà¡çºàÊÁËÐÊ‹§à¾ÒÐàª×éÍáÅз´Êͺ¤ÇÒÁäǵ‹ÍÂÒ (Date of sputum taken for culture and DST) Çѹ·Õè................../................../..................ÃкػÃÐàÀ·¼ÙŒ»†Ç (Type of TB) q 1. ¼ÙŒ»†ÇÂãËÁ‹ (New) m 1.1 ÁÕ¤ÇÒÁàÊÕè§ ઋ¹ TB/HIV, ÁÕ»ÃÐÇѵÔÊÑÁ¼ÑÊ ¼ÙŒ»†Ç MDR-TB, ¼ÙŒµŒÍ§¢Ñ§ (Risk factors such as contact of MDR-TB, TB/HIV, prisoners, other) m 1.2 äÁ‹ÁÕ¤ÇÒÁàÊÕè§ (No risk factors)q 2. ¼ÙŒ»†Ç·ÕèÁÕ»ÃÐÇѵÔà¤ÂÃÑ¡ÉÒÇѳâäÁÒ¡‹Í¹ (Relapse, TAF, After Loss to Follow-up) q 3. ¼ÙŒ»†ÇÂÃÐËÇ‹Ò§¡ÒÃÃÑ¡ÉÒ (Still on treatment)
ä´Œ¼Å¡ÒÃà¾ÒÐàª×éÍ (Date of results received.) Çѹ·Õè................/................./................. ¼Å q Growth (Culture number......................................................................) q No Growth q Contaminated
¼Å¡Ò÷´Êͺ¤ÇÒÁäǵ‹ÍÂÒÃÑ¡ÉÒÇѳâä (DST results)R = Resistant, S = Susceptible, C = Contaminated
q ä´‡ÃѺ¡‹Í¹¡ÒÃÃÑ¡ÉÒÇѳâä (Yes, before TB treatment) ÊÙµÃÂÒ...........................................................q ä´ŒÃѺËÅѧ¡ÒÃàÃÔèÁÃÑ¡ÉÒÇѳâä (Yes, after TB treatment) ÊÙµÃÂÒ........................................................... Çѹ·Õè .................................../.................................../...................................q NAPHA No. .....................................................................................
q äÁ‹ä´ŒÃѺ (No)q ä´ŒÃѺ (Yes)
q äÁ‹ÂÔ¹ÂÍÁ (No)q ÂÔ¹ÂÍÁ (Yes)
q ź (Neg)q ºÇ¡ (Pos)
¡ÒÃãËŒ¡ÒûÃÖ¡ÉÒ (HIV counseling)
¡ÒõÃǨàÅ×Í´(HIV testing)
¼ÅàÅ×Í´(Result)
¼ÙŒ»†Ç·ÕèÁÕ¼ÅàÅ×Í´ºÇ¡à´ÔÁ(Existing HIV positive person)l ª×èÍʶҹ¾ÂÒºÒÅ (Name of the hospital) ..........................................................................................
l Çѹ·Õè (Date of HIV positive) ............................/............................/............................