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Module / Malaria /[insert country]/ MSF,[20xx]Version 1.1: April 2017MODULE: MalariaList of questionsAim of this list of questions on malaria is to gain some insight into knowledge, attitude andpractice (KAP) amongst the MSF projects’ population regarding malaria. This information willhelp to better tailor malaria-related programs to the community.Selected questions with relevant coding could be inserted into the household/mortalityquestionnaire format of the retrospective mortality survey. For more details see also chapter2.2 and chapter 8 of the template protocol for a retrospective mortality survey.MODULE 1: MALARIA IN PREGNANCIES.................................................................2MODULE 2: PREVENTION OF MALARIA IN INFANTS (AGED 0 – 12 MONTHS)...2QUESTIONS FOR EACH CHILD AGED 0 – 12 MONTHS INDIVIDUALLY................2MODULE 3: HEALTH SEEKING BEHAVIOUR IN CHILDREN AGED 6 – 59MONTHS BEING SICK WITH MALARIA (REPORTED BY THE CARETAKER).......3QUESTIONS FOR EACH CHILD AGED 6 – 59 MONTHS INDIVIDUALLY (REPEATQ1-8 FOR EACH CHILD).............................................................................................3MODULE 4: COVERAGE AND UTILIZATION OF LONG-LASTING INSECTICIDE-TREATED BEDNETS (LLITNS) IN THE HOUSEHOLDS............................................4MODULE 5: BASELINE MALARIA MORBIDITY THROUGH MALARIOMETRICINDICES IN CHILDREN AGED 6 – 59 MONTHS........................................................5Information sheet................................................................................................................6informed Consent form........................................................................................................61
Module / Malaria /[insert country]/ MSF,[20xx]Version 1.1: April 2017___________________________________________________________________________MODULE 1: Malaria in pregnanciesOBJECTIVETo determine the proportion of pregnant women (in the second and third trimester) aged15–49 in the study population who received intermittent preventive treatment (IPTp) formalariaQUESTIONS for women being between 15 and 49 years of ageQuestionsCoded answersNotes(1)If female and 15-49years: Pregnant?0 = no1 = yes9 = don’t knowif 0 = ‘no’ or 9 = ‘don’t know’do not continue to thefollowing question, end ofquestionnaire.(2)If yes: Took malariaprevention/treatment?0 = no1 = yes, at least 3 doses2 = yes, 1-2 doses9 = don’t know(insert the name of theregimen for the country)(3)If yes: Did you receive abednet in ANC?___________________________________________________________________________MODULE 2: Prevention of malaria in infants (aged 0 – 12 months)OBJECTIVETo determine the proportion of infants aged 0 – 12 months in the study population whoreceived intermittent preventive treatment (IPTi) for malariaQUESTIONS for each child aged 0 – 12 months individuallyQuestionsCoded answersNotes(1)If aged 0-12 months0 = no1 = yes9 = don’t knowif 0 = ‘no’ or 9 = ‘don’t know’do not continue to thefollowing question, end ofquestionnaire.

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Term
Fall
Professor
JohnCarey
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