Questionnaire for evaluation of Tuberculosis surveillance in AJ&K

Date: Name of the respondent: Designation of the respondent: Name of the program: :

1. How you diagnose the Tuberculosis patient? a. Only Clinical / Case definition b. By Laboratory Confirmation. 2. If diagnosed only clinically then any case definition you used? a. Syndromic. b. Specific case Definition. 3. If laboratory confirmation is mandatory then which test you request? a. Sputum b. Eliza c. PCR 4. Where do you sent these samples for investigation a. Facility Laboratory b. Reference laboratory 5. How many days it takes to confirm the diagnose? a. With in 10 days b. With in a month c. More than a month 6. On which diagnose you start treatment? a. Clinical diagnosis b. After laboratory confirmation 7. How you maintain the record of registered patients? a. Hard copies/registers/file b. Computerized Data Base 8. Which type of information are included in registration tools? a. Only diagnosis and treatment information. b. Other personal, bavioural, exposure etc information. 9. To whom you are reporting these cases then? a. EDO Health Office b. Program Office 10. How you are reporting these cases? a. Aggregated b. Case history files 11. How these report are sent to higher ups? a. Hard copies. b. Soft copies through mail/USB/Floppy. 12. What is the frequency of reporting? a. Regular Monthly b. Not Regular 13. Is there any feed back given?

a. Yes b. No 14. Are you sharing this data with other programs working on tuberculosis? a. Yes b. No 15. Did you get any special training on registration and reporting tools? a. Yes b. No 16. How do you feel filling the registration / reporting tools? a. Comfortable b. Not easy 17. If not comfortable with tools did you need any further training? a. Yes b. No 18. Since the start of the program did any changes made in diagnostic, reporting protocols? a. Yes b. No 19. If any change made in program in past how you find that change? a. Easy to Continue. b. Hard to manage. 20. If you are unable to understand some column of registration and reporting tools what you do then? a. Left blank b. Ask from higher ups 21. How is the approach of the patients towards the program? a. Happy b. Not satisfied 22. Had any breakdown occurred since start of the program? a. Yes b. No 23. If yes what type of break down? a. Financial b. Human resources c. Logistics like diagnostic, treatment, Stationary etc. 24. How it affects the functions of the program? a. Badly b. No affect at functions

Interviewed by: Dr.Muhammad Naseem Hasrat Date