VISIT 1 MEDICAL HISTORY MALARIA SYMPTOMS LOG = MALARIA SYMPTOMS – List all protocol specified symptoms that occurred within the last (xx) days MHYN The variable EVLINT is used to represent the last days” Yes No “within “xx” Ongoing Symptom date Start time End date End time Greatest severity (highest intensity) MHONGO MHTERM MHSTDAT MHSTDTC MHSTTIM MHENDAT MHENDTC MHSTTIM MHSEV |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| |__|__|:|__|__| Yes Mild Moderate Severe |__|__|-|__|__|__|-|__|__|__|__| |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| |__|__|:|__|__| Yes Mild Moderate Severe |__|__|-|__|__|__|-|__|__|__|__| |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| |__|__|:|__|__| Yes Mild Moderate Severe |__|__|-|__|__|__|-|__|__|__|__|
VISIT 1 MEDICAL HISTORY – MALARIA SYMPTOMS LOG = MALARIA SYMPTOMS List all protocol specified symptoms that occurred within the last (xx) days MHYN The variable EVLINT is used to represent “within the last “xx” days” Yes No Symptom MHTERM date MHSTDAT MHSTDTC Start time MHSTTIM End date MHENDAT MHENDTC End time MHSTTIM Ongoing MHONGO Greatest severity (highest intensity) MHSEV |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| Yes Mild Moderate Severe |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| Yes Mild Moderate Severe |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| |__|__|-|__|__|__|-|__|__|__|__| |__|__|:|__|__| Yes Mild Moderate Severe