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2.NCD Screening Tool For HFs at ART - Aug - 1 - 2024

The document outlines a Health Facility Level NCD Screening Tool specifically designed for People Living with HIV (PLHIV). It includes sections for assessing the history of non-communicable diseases (NCDs), risk factor evaluations, and clinical/lab evaluations such as blood pressure and lipid profiles. The tool aims to facilitate the identification and management of cardiovascular risks among this population.

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13 views2 pages

2.NCD Screening Tool For HFs at ART - Aug - 1 - 2024

The document outlines a Health Facility Level NCD Screening Tool specifically designed for People Living with HIV (PLHIV). It includes sections for assessing the history of non-communicable diseases (NCDs), risk factor evaluations, and clinical/lab evaluations such as blood pressure and lipid profiles. The tool aims to facilitate the identification and management of cardiovascular risks among this population.

Uploaded by

akstahost
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Health Facility Level NCD Screening Tool for PLHIV

History of NCDs Baseline Date: Date: Date: Date: Remark


__/__/____ __/__/____ __/__/____ __/__/____
Yes/No Yes/No Yes/No Yes/No
1. Have you ever been
diagnosed with Diabetes,
Hypertension, or
dyslipidemia?
2. Do you have a history
of poly symptoms
(Polydipsia, polyuria,
Polyphagia)
Risk factor assessment for Adverse cardiovascular outcomes

1.Use of tobacco & shisha

2.Harmful Alcohol use


3.Khat Use

4. Physical Inactivity

5.Unhealthy diet (high


salt sugar and fat diet
and/or low fruit and
vegetable diet)
6.Family history of DM,
HTN & CVDs
Clinical and Lab Result Remark
evaluations to be
conducted
1. Blood pressure BP 1: BP 2: BP 1: BP 2: BP 1: BP 2: BP 1: BP 2:
2. RBS/FBS ______/________ ________/_______ ______/_______ _____/_______
3.a) Lipid Profile: LDL _______ _______ _______ _______
cholesterol _______ _______ _______ _______
b) Lipid Profile: _______ _______ _______ _______
HDL/optional _______ _______ _______ _______
c) Lipid Profile:
Triglyceride/optional
Health Facility Level NCD Screening Tool for PLHIV
4. Renal function test: _______/_______ _______/_______ _______/________ _______/______
Creatinine/optional

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