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["APPENDIX A"]
["Proposed Amendments to form CDC 54.1 (Malaria Case Surveillance Report)"]
[]
["***Changes are in Bold font"]
[]
["Current Form (Field Names)","Current Value Set","Proposed Form (Field Names)","Proposed Value Set","Justification"]
["DASH No.",null,"CSID No.",null,"DASH changed to CSID (CDC Specimen Identifier ) to conform to the new changes in laboratory specimen identification system in place"]
["County",null,"County",null,"Field placement has been moved underneath \"State/territory reporting this case\""]
["Age/ (yrs)(mos)",null,"Age/ yrs. mos. wks. days (circle units)",null,"Change to account for various reporting age units"]
["Lab results","Smear positive, smear negative, No smear taken","Positive lab test result (check all that apply)","Smear, PCR, RDT, No test done/unknown","Change to capture PCR and RDT positive test results"]
["Species (check all that apply)","Vivax, Falciparum, Malariae, Ovale, Not determined","Species (check all that apply)","Vivax, Falciparum, Malariae, Ovale, Not determined, Other (specify)","Change to capture other plasmodium species"]
["NEW FIELD",null,"Parasitemia (%)",null,"Added to capture parasetemia data if available"]
["Patient admitted to hospital","Yes, No","Patient admitted to hospital","Yes, No, Unknown","Added unknown as a possible value to collect more accurate data"]
["Specimen being sent to CDC","Yes, No","Specimen being sent to CDC","Yes, No, Unknown","Added unknown as a possible value to collect more accurate data"]
["Has patient traveled or lived outside the US during the past 4 year?","Yes, No","Has patient traveled or lived outside the US during the past 2 year?","Yes, No","Change to 2 years sufficiently captures travel history"]
["Duration of stay in foreign country (days)",null,"Duration in country/ yrs. mos. wks. days (circle units)",null,"Reworded Change to account for various reporting duration/time units"]
["Did patient reside in US prior to most recent travel?","Yes, for ≥12 months, Yes, for <12 months, No (specify country), Unknown","Did patient reside in US prior to most recent travel?","Yes, No (specify country), Unknown","Simplified value set to capture the same data; Added unknown as a possible value to collect accurate data"]
["Principal reason for travel from/to US for most recent trip","Tourism, Military, Business, Peace Corps, Visiting friends/relatives, Airline/ship crew, Missionary or dependent, Refugee/immigrant, Student/teacher, Other","Principal reason for travel from/to US for most recent trip","Tourism, Military, Business, Peace Corps, Visiting friends/relatives, Airline/ship crew, Missionary or dependent, Refugee/immigrant, Student/teacher, Other, Unknown","Added unknown as a possible value to collect more accurate data"]
["Was malaria chemoprophylaxis taken","Yes, No","Was malaria chemoprophylaxis taken","Yes, No, Unknown","Added unknown as a possible value to collect more accurate data"]
["If yes, which drugs were taken","Chloroquine, Mefloquine, Doxycycline, Primaquine, Malarone, Other","If yes, which drugs were taken","Chloroquine, Mefloquine, Doxycycline, Primaquine, Atovaquone/proguanil, Other, Unknown","Used chemical name of Malarone; Added unknown as a possible value to collect more accurate data"]
["Were all pills taken as prescribed","Yes missed no doses, No missed one to a few doses, No missed more than a few but <half of the doses, No missed doses but not sure how many, Don't know","Were all pills taken as prescribed","Yes missed no doses, No missed doses, Unknown","Simplified value set to capture the same data"]
["If doses were missed, what was the reason","Forgot, Didn’t think needed, Had a side affect (specify), Was advised by others to stop, Prematurely stopped taking once home, Other (specify)","If doses were missed, what was the reason","Forgot, Didn’t think needed, Had a side affect (specify), Was advised by others to stop, Prematurely stopped taking once home, Other (specify), Unknown","Added unknown as a possible value to collect more accurate data"]
["History of malaria in last 12 months (prior to this report)","Yes, No","History of malaria in last 12 months (prior to this report)","Yes, No, Unknown","Added unknown as a possible value to collect more accurate data"]
["If yes, species (check all that apply)","Vivax, Falciparum, Malariae, Ovale, Not determined","If yes, species (check all that apply)","Vivax, Falciparum, Malariae, Ovale, Not determined, Other (specify)","Change to capture other plasmodium species"]
["Blood transfusion/organ transplant within last 12 months","Yes, No","Blood transfusion/organ transplant within last 12 months","Yes, No, Unknown","Added unknown as a possible value to collect more accurate data"]
["Clinical Complications","Cerebral malaria, Renal Failure, ARDS, Anemia (Hb<11, Hct<33), None, Other","Clinical Complications","Cerebral malaria, Renal Failure, ARDS, Severe anemia (Hb<7), None, Other","Changed Anemia value to better identify associated clinical complications"]
["Was illness fatal","Yes, No","Was illness fatal","Yes, No, Unknown","Added unknown as a possible value to collect more accurate data"]
["Therapy for this attack (check all that apply)","Chloroquine, Tetracycline/Doxycycline, Mefloquine, Exchange transfusion, Unknown, Primaquine, Quinine/quinidine, Pyrimethamine-sulfadoxine, Malarone, Other (specify)","Therapy for this attack (check all that apply)","Chloroquine, Tetracycline, Doxycycline, Mefloquine, Exchange transfusion, Unknown, Primaquine, Quinine, Quinidine, Clindamyacin, Atovaquone/proguanil, Artesunate, Other (specify)","Used chemical name of Malarone; Updated value set to capture drugs available for treatment"]
["Date",null,"Date Submitted",null,"Change to clarify date description"]

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