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TB Screening
* If "Yes" is selected for any one of the questions below with "" auto select "yes" for "Referral Required." Show these beneficiaries to 'Suspected TB cases' section Show these beneficiaries to 'Referral list module in the Home' section as per the test selected ("AI Cough Assessment",* "Digital Chest X-ray", "Sputum Collection", "NAAT")
If "Yes" is selected for any one of the questions below with "" auto select "yes" for "Referral Required." Show these beneficiaries to 'Suspected TB cases' section Show these beneficiaries to 'Referral list module in the Home' section as per the test selected ("AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT") Screen all the family members and contacts of the beneficiary
Date	Calendar Date Picker	Is Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
Symptomatic Screening
Coughing More than 2 weeks *	radio button	Yes No	Mandatory
Blood in Sputum *	radio button	Yes No	Mandatory
Fever > 2 weeks *	radio button	Yes No	Mandatory
Rise of fever in evening*	radio button	Yes No	Mandatory
Loss of Appetite*	radio button	Yes No	Mandatory
Loss of Weight *	radio button	Yes No	Mandatory
Night Sweats *	radio button	Yes No	Mandatory
History of TB *	radio button	Yes No	Mandatory
Are you currently taking Anti TB drugs **	radio button	Yes No	Mandatory
Anyone in Family Currently Suffering from TB **	radio button	Yes No	Mandatory
Asymptomatic Screening
Age more than 60	radio button	Yes No	Mandatory Should automatically get selected based on age from the beneficiary registration.
Diabetic	radio button	Yes No	Mandatory
Tobacco user	radio button	Yes No	Mandatory
Contact with TB patient on treatment	radio button	Yes No	Mandatory
Referral Required	radio button	Yes No	"Yes" Should be auto selected if any of the "" or "" field is "yes" If "Yes" is selected, show these beneficiaries in Suspected TB* module
Referral forReferral to		AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT	Multiple option selection possible. Mandatory if "Referral required"= "Yes"
Capture Geolocation			Capture current location details (latitude, longitude, address)
Submit	Button

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2.2.2.b Suspected TB cases
This section should contain only Suspected TB cases. should contain all beneficiaries If "referral required "= "Yes"

Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Date	Calendar Date Picker	Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
Name	Textbox		Auto fill from Beneficiary details Show: First Name + Last Name Read only
Age	Textbox		Auto fill from Beneficiary details Read only
Gender	Textbox		Auto fill from Beneficiary details Read only
Is Sputum sample collected?	radio button	Yes No	Symptomatic TB		To be enabled if " Yes" is selected in any "Symptomatic Screening fields"
Is Sputum sample collected?	radio button	Yes No	Mandatory
Referral for" = "Sputum Collection" Mandatory if enabled If “Yes” is selected enable ‘Nikshay Id’
Sputum sample submitted at Sputum sample submitted at	radio button	MC DH CHC PHC HWC	Enable if "Yes" is selected for 'Is Sputum sample collected? HWC= Health and Wellness Centre, PHC= Primary Health Centre, CHC= Community Health Centre, DH= District hospital, MC= Medical College
Sputum Test result	radio button	Positive Negative	Enable if "Yes" is selected for 'Is Sputum sample collected?' If positive, move this case to Confirmed TB cases module.
Asymptomatic TBIs Digital Chest X-ray conducted		Yes No	To be enabled if " Yes" is selected in any "Asymptomatic Screening fields"	TB Chest X-Ray Test done	Yes No	Enable only for Asymptomatic TB case Referral for" = "Digital Chest X-ray" If “Yes” is selected enable ‘Nikshay Id’
Chest X-Ray Test Result Digital Chest X-Ray Test Result		Clinically Diagnosed TB TB Not suspected Enable only “Yes” is selected for X-Ray test	Enable only for Asymptomatic TB case if "Digital Chest X-ray conducted"=“Yes” If "Clinically diagnosed TB" is selected, move this case to Confirmed TB cases module.
AI Cough Assessment conducted		Yes No	To be enabled if "Referral for" = "AI Cough Assessment"
AI Cough Assessment result		Positive Negative	Enable if "Yes" is selected for 'AI Cough Assessment conducted?' If positive, move this case to Confirmed TB cases module.
NAAT conducted		Yes No	To be enabled if "Referral for" = "NAAT"
NAAT result		Positive Negative	Enable if "Yes" is selected for "NAAT conducted?" If positive If "Clinically diagnosed TB" is selected , move this case to Confirmed TB cases module.
Nikshay ID	Textbox		Enable if "Yes" is selected for 'Is Sputum sample collected. Enable if "Yes" is selected for "TB Digital Chest X-ray test doneconducted" Enable if "Yes" is selected for "AI Cough Assessment conducted" Enable if "Yes" is selected for "NAAT conducted"
Type of suspected TB case	Radio button	New case of TB Previously treated TB case DR-TB case	Mandatory
Reason for suspected TB case	Dropdown	Treatment failure TB Relapse/ Recurring symptoms Contact with DR-TB case Treatment after LFU (Lost to Follow-up) Other	Enable this field only if “Type of TB case” is “Previously treated TB case” or “DR-TB case”
Other	textbox		Mandatory if enabled To be enabled if “Reason for suspected TB case” = “Other”
Has the diagnosis of DR-TB been confirmed?	Radio button	Yes No	Enable this field only if “type of suspected TB case”= “Previously treated TB case” or “DR-TB case” Default value is “No” If “Yes” is selected then move this case to Confirmed TB cases module.
Capture Geolocation			Capture current location details (latitude, longitude, address)
Submit	Button

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