# CLINIC REPORTS ### 1. Clinic Defaulters Report A patient-level list of patients who have missed their expected return date by more than 28 days (PEPFAR IIT threshold) as of the report end date, and who have not yet been recorded as transferred out, died, or having stopped treatment. #### Patient Identification Logic:
- Patient status is "On antiretrovirals" at some point before the report end date
- Calculated supply expiry date (quantity ÷ daily dose) + 28 days < report end date
- No active terminal program state (not transferred out, not died, not stopped)
Fields: ARV Number · First name · Last name · Gender · Date of birth · Appointment date · Date defaulted · Phone number · Village · District · TA · Landmark #### Data Source orders, drug\_order (for supply dates), patient\_identifier (for ARV number), person (for demographics), person\_attribute (for phone number), person\_address (for location). Reporting period: User-defined (typically weekly or monthly). #### DQ Note: Accuracy of this report is directly dependent on the quality of dispensing data (quantity and daily dose recorded at each visit). If quantity is not recorded, patients cannot have a supply expiry date calculated and will not appear in this report. ### 2. Clinic TX RTT Report (Return to Treatment) PEPFAR MER Equivalent: TX\_RTT The number of ART patients who experienced an Interruption in Treatment (had no clinical contact or ART pick-up for > 28 days after their last expected supply date) but restarted ARVs within the current reporting quarter. #### Patient Identification Logic: A patient is counted as TX\_RTT if ALL of the following are true:
1. Previously on ART: Has a program state = 7 (On ART) with a start\_date before the quarter start.
2. Not active at start of quarter: Their outcome at quarter start - 1 day was either:
1. Defaulted (supply expired + 28 days before quarter start), OR
2. Treatment stopped (state = 6 in patient\_state)
3. Received ART in the quarter: At least one ARV drug order with quantity > 0 was dispensed between quarter start and end.
4. On ART at end of quarter: Outcome at the end date = 'On antiretrovirals' OR the patient had an ARV order with auto\_expire\_date ≥ (end\_date − 60 days).
5. Not on ART in the 60 days before the quarter: No ARV order had its start\_date or auto\_expire\_date in the window from (quarter start − 60 days) to quarter start.
#### Months-away Classification: The system computes the duration of IIT as: Months away = TIMESTAMPDIFF(months, initial\_outcome\_date, first\_ARV\_dispense\_in\_quarter) #### Categories:
**Category ** **Months away (PEPFAR IIT duration) **
IIT < 3 months Returned after < 3 months of interruption
IIT 3–5 months Returned after 3–5 months
IIT ≥ 6 months Returned after ≥ 6 months
Disaggregations: Age group × sex. #### DQ Note: The 60-day exclusion window (before the quarter) is used as a practical filter to separate patients who simply had their last dispense close to the quarter boundary, from true IIT returnees. This is a local implementation approximation; the strict PEPFAR MER definition uses 28 days. M&E teams should note this when comparing system TX\_RTT figures with manually verified counts. ### 3. Clinic Retention Report Among patients initiated on ART during a historical period, how many are still alive and on treatment at 1 month, 3 months, and 6 months after initiation? Cohort Window: The report selects patients initiated exactly 1, 3, or 6 months before the end of the current reporting period. Denominator (Initiated): COUNT of patients with date\_enrolled in the applicable historical window. Numerator (Retained): Among those patients, COUNT who currently have moh\_cum\_outcome = 'On antiretrovirals' at the report end date. Disaggregations: Age group × sex. #### DQ Note: Patients who transferred out but were retained in care at another facility will appear as "not retained" in this report, causing apparent retention losses that are not true program failures. Transfers-out should be monitored separately. ### 4. Clinic Regimen Report A patient-level listing of patients currently on ART with their current regimen, dispensed ARV drugs, weight, and most recent viral load result. Population: TX\_CURR patients (alive and on ART at report end date, MoH definition). #### Data Source
- Regimen: patient\_current\_regimen() database function at the end date
- ARV dispense: Most recent drug order records
- Weight: Most recent "Weight (Kg)" observation
- Viral load: Most recent viral load observation result (result modifier + numeric value)
- ART start date: temp\_earliest\_start\_date.earliest\_start\_date
Reporting period: As of report end date. ### 5. Clinic Viral Load Report (Patient-level) A patient-level listing of viral load test results returned during the reporting period, with ability to filter by result type. #### Result Classification:
Category Threshold
Suppressed VL result < 1,000 copies/mL (including LDL — lower than detectable limit)
Low-level viraemia VL result > 0 and < 1,000 copies/mL (some configurations may separate LDL from this)
High viraemia (Viraemia ≥ 1000) VL result ≥ 1,000 copies/mL
#### Data Source Lab results observation (LIMS integration or manual entry) from the obs table where concept = "Viral load" and obs\_datetime falls within the reporting period. Linked to the patient's ART program enrolment and most recent regimen. Fields: ARV Number · Gender · DOB · Specimen type · Order date · VL result (modifier + value) · Result release date · Current regimen. ### 6. Clinic VL Suppression Report PEPFAR MER Equivalent: TX\_PVLS (Denominator and Numerator, by regimen) Among patients currently alive and on ART who were due for a viral load within the reporting period, how many had a sample collected (drawn), and of those, how many were virologically suppressed (VL < 1,000 copies/mL)? #### Three-level indicator: Due for VL → Sample Drawn → Result: High VL (≥1000) or Low VL (<1000) ##### "Due for VL" logic (VL milestone schedule): The system applies the national VL monitoring schedule via the VlReminder service:
**Milestone ** **Trigger **
6-month VL 6 months after ART start date — for patients newly initiated
12-month VL 12 months after ART start, where 6-month result exists
Annual VL Every 12 months after the last VL result, for established patients
Targeted (High VL follow-up) 3 months after a high VL result (≥ 1,000 copies/mL)
Suppression threshold: VL < 1,000 copies/mL OR result coded as "LDL" (lower than detectable limit) = suppressed. Disaggregation: By ART regimen (same regimen classification as TX\_CURR disaggregated). Patients with no matched regimen are classified as "N/A". #### Data Source:
- "Due for VL" list: PatientsAliveAndOnTreatment × VlReminder.vl\_reminder\_info
- "Sample Drawn" list: Lab order records with specimen collection date within the period
- VL result: Most recent LIMS-linked or manually entered VL observation
#### DQ Note: The "Due" population is calculated at the patient level using the VL schedule. Patients without a previous VL result or with no ART start date recorded cannot have their VL milestone calculated and will be excluded from the Due count. Ensure ART start dates are accurately recorded for all patients. ### 7. Clients Due for Viral Load Report A patient-level list of patients who: (1) have an appointment scheduled within the selected week/period, AND (2) are flagged as due for a viral load test by the VL milestone schedule. #### Patient Identification:
- Alive and on ART (moh\_cum\_outcome = 'On antiretrovirals')
- Has an appointment observation (Appointment date concept) with date within the selected period
- VlReminder.vl\_reminder\_info.eligible == true- evaluated at the report end date
Fields: Filing/ARV number, Name, Gender, Age, Appointment date, ART start date, Months on ART, VL milestone type, Last VL ordered, Last VL result. Reporting period: User-defined period (typically weekly). ### 8. Clinic Lab Results Report Lab test results returned for HIV program patients during the selected period, viewable in two modes:
**Mode ** **Description **
Disaggregated Summary counts by age group and sex for each test type
Patient-level Individual rows per patient per test
#### Data Source obs table records where the observation concept corresponds to a tracked lab test (CD4 count, viral load, creatinine, ALT, haemoglobin, etc.) and obs\_datetime falls within the period. Linked to the HIV program via encounter.program\_id = 1. Available test types are dynamically determined from the concept set configured for laboratory results in the system; they are not hardcoded, allowing new tests to be included automatically when configured. ### 9. HTN Enrollment Report (Hypertension Co-morbidity) Definition: Among HIV-positive patients in the program, the number with a recorded hypertension (HTN) diagnosis, and their status in hypertension care. #### Section 1- Enrolment Status:
**Indicator ** **Derivation **
Registered with HTN Patients with a "Hypertension" diagnosis observation recorded at any date
Active in HTN care HTN patients with an ART visit in the past 3 months
Defaulted HTN care HTN patients with no visit in > 3 months
Died HTN patients with "Patient died" program state
Transferred out HTN patients with "Transferred out" state
Stopped HTN care HTN patients with a "Stopped HTN" state recorded
Had clinic visit (last 3 months) HTN patients with any encounter in the past 90 days
BP measurement recorded Subset of above with a blood pressure observation in the visit
BP below target (< 140/90) Subset with recorded systolic < 140 AND diastolic < 90
#### Section 2 -Treatment by drug class: HTN drug dispense orders are classified by drug concept into:
- Diuretics
- Beta Blockers
- Calcium Channel Blockers (CCBs)
- ACE Inhibitors
- Angiotensin Receptor Blockers (ARBs)
- Vasodilators
- Other/Unclassified.
#### Data Source obs (BP readings, HTN diagnosis), orders/drug\_order (HTN drug dispenses), patient\_state (program outcomes), encounter (visit dates). ### 10. Hypertension Cascade Report A disaggregated flow report showing patients moving through the hypertension care cascade: screened → diagnosed → on treatment → with controlled BP. #### Cascade Steps and Derivation
**Step ** **Indicator ** **Derivation **
1 Due for BP screening ART patients with no BP recorded in the current quarter
2 Screened ART patients with a BP observation recorded in the quarter
3 Normal BP < 140/90 Screened patients with systolic < 140 AND diastolic < 90
4 Mild hypertension Systolic 140–159 OR diastolic 90–99
5 Moderate hypertension Systolic 160–179 OR diastolic 100–109
6 Severe hypertension Systolic ≥ 180 OR diastolic ≥ 110
Tx Dispensed each drug class Patients with a drug order for listed anti-hypertensive drugs in the quarter
Disaggregations: Age group × sex. ### 11. Clinic TPT Outcomes Report PEPFAR MER Equivalent: TB\_PREV (Completion numerator detail) A more granular view of TPT outcomes than the MoH TPT Cohort, including side effect data. Shows TPT initiation and completion disaggregated by TPT type (3HP or 6H) and whether patients were new or previously on ART. #### Key additional indicators (beyond MoH TPT Cohort)
**Outcome ** **Definition **
Side effects- Skin rash TPT patient with a "Rash" adverse event observation recorded
Peripheral neuropathy TPT patient with "Peripheral neuropathy" adverse event
Nausea TPT patient with "Nausea" adverse event
Dizziness TPT patient with "Dizziness" adverse event
Yellow eyes (jaundice) TPT patient with "Jaundice" or "Yellow eyes" adverse event
Side effect classifications use the same source observations as ART side effect monitoring (encounter type: ART Visit, concept: "Drug-induced symptom"). ### 12. Clinic Other Outcomes Report A patient-level listing of patients with a specific terminal outcome recorded during the selected period. #### Available Outcomes:
**Outcome ** **Patient State Code ** **What triggers it **
Transferred Out Program state = 2 (Transferred out) User records a "Transfer Out" outcome in the system
Died Program state = 3 (Patient died) User records "Patient died" outcome
Treatment Stopped Program state = 6 (Treatment stopped) User records "Treatment stopped" outcome
#### Data Source patient\_state records where start\_date falls within the selected reporting period.