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close this bookCommunicable Disease Control in Emergencies - A Field Manual (WHO - OMS, 2003, 223 p.)
View the document(introduction...)
View the documentACKNOWLEDGEMENTS
View the documentINTRODUCTION
Open this folder and view contentsCHAPTER 1: RAPID ASSESSMENT
Open this folder and view contentsCHAPTER 2: PREVENTION
Open this folder and view contentsCHAPTER 3: SURVEILLANCE
Open this folder and view contentsCHAPTER 4: OUTBREAK CONTROL
Open this folder and view contentsCHAPTER 5: DISEASE PREVENTION AND CONTROL
View the documentANNEX 1: WHO REFERENCE VALUES FOR EMERGENCIES
View the documentANNEX 2: SAMPLE HEALTH SURVEY FORMS
View the documentANNEX 3: NCHS/WHO NORMALIZED REFERENCE VALUES FOR WEIGHT FOR HEIGHT BY SEX
View the documentANNEX 4: SAMPLE WEEKLY SURVEILLANCE FORMS
View the documentANNEX 5: RECOMMENDED CASE DEFINITIONS
View the documentANNEX 6: OUTBREAK INVESTIGATION FORMS
View the documentANNEX 7: ORGANIZATION OF AN ISOLATION CENTRE
View the documentANNEX 8: BASIC LABORATORY SERVICES
View the documentANNEX 9: LABORATORY INVESTIGATION KIT
View the documentANNEX 10: TREATMENT GUIDELINES
View the documentANNEX 11: MANAGEMENT OF THE CHILD WITH COUGH OR DIFFICULTY IN BREATHING6
View the documentANNEX 12: ASSESSMENT AND TREATMENT OF DIARRHOEA
View the documentANNEX 13: FLOW CHARTS FOR SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS
View the documentANNEX 14: SAMPLE HEALTH CARD
View the documentANNEX 15: LIST OF WHO GUIDELINES ON COMMUNICABLE DISEASES
View the documentANNEX 16: LIST OF PUBLISHERS
View the documentANNEX 17: GENERAL REFERENCES

ANNEX 14: SAMPLE HEALTH CARD

HEALTH CARD
CARTE DE SANTE

Card No.
Carte No.


Date of registration
Date d'enregistrement


Site Lieu


Section/House No.
Section /Habitation No.


Date of arrival at site
Date d'arrivée sur le lieu


Family name
Nom de famille


Given names
Prénoms


Date of birth or age
Date de naissance ou âge


Or
Ou

Years Ans


Sex
Sexe

M/F

Name commonly known by
Nom d'usage habituel


CHILDREN
ENFANTS

Mother's name
Nom de la mère


Father's name Nom du père



Height
Taille

CM

Weight
Poids

KG

Percentage weight/height
Pourcentage poids/taille



Feeding programme
Programme d'alimentation



Immunization

Measles
Rougeole

Date

1

2

BCG Date


Others Autres



Immunization

Polio

Date


DPT Polio Date
DTC Polio

1

2

3

WOMEN
FEMMES

Pregnant
Enceinte

Yes/No
Oui/Non

No. of pregnancies
No. de grossesses

No. of children
No. d'enfants


Lactating Allaitante

Yes/no
Oui/Non


Tetanus
Tétanos

Date

1

2

3

4

5


Feeding programme
Programme d'alimentation


COMMENTS
OBSERVATIONS

General (Family circumstances, living conditions, etc.)
Générales (Circonstances familiales, condition de vie, etc.)


Health (Brief history, present condition)
Médicales (Résumé de l'état actuel)

DATE

CONDITION
(Signs/symptoms/diagnosis)

ETAT
(Signes/symptômes/diagnostic)

TREATMENT
(Medication/dose time)

TRAITEMENT
(Médication/durée de la dose)

COURSES
(Medication due/given)

APPLICATION
(Médication requise/effectuée)

OBSERVATIONS
(Change in condition)
NAME OF HEALTH WORKER

OBSERVATIONS
(Changement d'état)
NOM DE L'AGENT DE SANTE








Source: The New Emergency Health Kit 98. Geneva, World Health Organization, 1998 (document WHO/DAP/98.10).