Skip to main content
. 2018 Oct 11;2:48. Originally published 2018 Sep 21. [Version 2] doi: 10.12688/gatesopenres.12866.2

Table 1. Overview of the study morbidity questionnaire.

Category Questions
Diarrhoea Any diarrhoea?
If yes, duration (days)
If yes, number of stools per day
If yes, is there blood/mucus in stool?
Is the child urinating less?
Is the child lethargic or unconscious?
Is the child restless and irritable?
Does the child have sunken eyes?
Is the child drinking poorly?
Is the child thirsty, drinking eagerly?
Does the skin pinch go back slowly?
Fever Axillary temperature
History of fever?
If yes, number of days
Cough Cough?
If yes, duration of cough (days)
Vomiting Has the child been vomiting since last visit?
If yes, number of days
Appetite How is your child’s appetite?
If decreased, number of days
If decreased, describe
Medication Has the child been or is on any medication since last visit?
If yes, please state the medication
Other Difficulty breathing?
Convulsion?
Has the child had any other illness since last visit?
If yes, describe