There are three forms, Initial Clinical and Social Survey, Contact Tracing Survey, and Sexual Contact Interview, being changed as a part of this non substantive change request. These change requests includes minor revised language, formatting and rewording to align with inclusion criteria, and one additional question added to each form.
Details of each collection instrument are as follows:
ABCs:
This non-substantive change request includes minor proposed changes to 3 approved data collection tools (form/s) detailed below:
Approved Forms:
Initial Clinical and Social Survey
Contact Tracing Survey
Sexual Contact Interview
Initial Clinical and Social Survey Form |
|||||||
Type of Change |
Itemized Changes / Justification |
Impact to Burden |
|||||
Revision |
During your initial illness – when you first got sick, what were your symptoms?
Justification: Added “when you first got sick” to clarify what was meant by initial illness. Since some individuals will be enrolled prospectively, the language was added to differentiate the illness (initial versus relapse) to correctly capture the information. |
No change to burden |
|||||
Addition |
When indoors, spent time in a place with screens or air conditioning Always Most of the time Sometimes Never Don’t know
Justification: Added to more completely capture potential risk factors for being infected with Oropouche. |
No change to burden |
|||||
Contact Tracing Survey Form |
|||||||
Revision |
Period of interest: date of illness onset travel through 6 weeks days after symptom onset, or date of interview, whichever is earliest
Justification: Updated period of interest to align with inclusion criteria; now date of illness onset rather than the date of return from travel. More clearly noted the timeframe for the interviewer by taking blank fields and reformatting into a table.
|
No change to burden |
|||||
Revision |
Did you have sexual or intimate contact with anyone between the time you became ill [give date] through [end of period of interest]?
Justification: Aligned to the period of interest by updating to “became ill” rather than “returned from travel”. |
No change to burden |
|||||
Addition/Revision |
Did this partner travel with you before your illness? Yes No [If partner traveled] Did they also get sick within two weeks of returning? Yes → move on to next partner No Unknown
Justification: Removed the skip (move on to next partner) from the question of whether the partner traveled and added a question to verify if the partner also got sick within two weeks of travel, adding the skip here, to allow inclusion of sexual contact who traveled with the participant with Oropouche virus disease to be included if they got sick after the incubation period associated with their travel. |
No change to burden |
|||||
Sexual Contact Interview Form |
|||||||
Revision |
Before interview: visit this website to see which countries are listed as having recent human disease cases (as of 11/27/24: Bolivia, Brazil, Colombia, Cuba, Dominican Republic, Guyana, Panama, and Peru)
Justification: Based on updated epidemiology, revised list of countries with recent human disease cases to include Panama and updated the corresponding date. |
No change to burden |
|||||
Revision |
Justification: More clearly noted the timeframe for the interviewer by taking blank fields and reformatting into a table. |
No change to burden |
|||||
Addition/Revision |
Did you travel to [LIST COUNTRIES WITH RECENT OROPOUCHE VIRUS DISEASE CASES] since January 1, 2023? Yes No
If yes, obtained dates of travel from (MM/DD/YY) ____/_____/_____ to _____/_____/_____ and location ________________________; if traveled to more than one location with recent Oropouche, record additional travel dates and location:______________________________________________
Justification: Removed the skip pattern (end interview) from the first question and added a question to capture the dates and locations of travel to allow sexual contact who traveled but might have been subsequently exposed through sex to Oropouche virus and develop disease more than 2 weeks after travel. |
No change to burden |
|||||
Revision |
Yes, date of first symptoms (MM/DD/YY) ___/___/___ No
Justification: Added “date of first symptoms” to allow the interviewer to verify the timing of the symptoms relative to travel. |
No change to burden |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Nti-Berko, Sonja Mali (CDC/NCEZID/DIDRI/RRRSB) |
File Modified | 0000-00-00 |
File Created | 2024-12-06 |