Generated Narrative: Library HIVIND78Logic

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/**
 * Library: HIV.IND.78 Logic
 * Ref No: STI.8A
 * Short Name: Repeat diagnosis of STI syndrome, HIV prevention services
 *
 * Definition: % of people attending HIV prevention services diagnosed with a particular STI syndrome who were diagnosed with the same STI syndrome two or more times during the reporting period
 *
 * Numerator: Number of people attending HIV prevention services diagnosed with a particular STI syndrome two or more times during the reporting period
 * Numerator Calculation: COUNT of clients with "Any STI syndrome diagnosed"=True on multiple values of "Date accessed HIV prevention intervention" in reporting period
 * Numerator Exclusions: 
 *
 * Denominator: Number of people attending HIV prevention services diagnosed with a particular STI syndrome during the reporting period
 * Denominator Calculation: COUNT of clients with "Date accessed HIV prevention intervention" in the reporting period
 * Denominator Exclusions: 
 *
 * Disaggregations:
 * • Gender (female, male, other*) 
 *  • Age (15–19, 20–24, 25–29, 30–49, 50+ years) 
 *  • Key populations (men who have sex with men, people living in prisons and other closed settings, people who inject drugs, sex workers, trans and gender diverse people)** 
 *  • HIV status (HIV-positive, HIV-negative, unknown status) 
 *  • HIV prevention intervention (for example, PrEP) 
 *  • STI syndrome (urethral discharge syndrome, vaginal discharge syndrome, lower abdominal pain, genital ulcer disease syndrome, or anorectal discharge) 
 *  • Cities and other administrative regions of epidemiologic importance
 *
 * Disaggregation Elements: Gender | Age | Key population member type | HIV status | HIV prevention intervention | Syndrome/STI diagnosed
 *
 * Numerator and Denominator Elements:
 * Any STI syndrome diagnosed 
 *  Date accessed HIV prevention intervention
 *
 * Reference: Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization; 2022
 * 
 * Data Concepts:
 * HIV.A.DE17: Age | Calculated age (number of years) of the client based on date of birth
 * HIV.A.DE18: Gender* | Gender of the client*
 * HIV.A.DE19: Female | Client identifies as female
 * HIV.A.DE20: Male | Client identifies as male
 * HIV.A.DE21: Transgender male | Client identifies as transgender male
 * HIV.A.DE22: Transgender female | Client identifies as transgender female
 * HIV.A.DE23: Other | Additional category
 * HIV.B.DE50: Key population member type* | The type of key population that the client is included in
 * HIV.B.DE51: Sex worker | Client is a sex worker
 * HIV.B.DE52: Men who have sex with men | Client is a man who has sex with men
 * HIV.B.DE53: Trans and gender-diverse people | Client identifies as trans and gender-diverse
 * HIV.B.DE54: People who inject drugs | Client is a person who injects drugs
 * HIV.B.DE55: People living in prisons and other closed settings | Client lives in a prison or another closed setting
 * HIV.B.DE115: HIV status | HIV status reported after applying the national HIV testing algorithm. No single HIV test can provide an HIV-positive diagnosis.
 * HIV.B.DE116: HIV-positive | Client is HIV-positive
 * HIV.B.DE117: HIV-negative | Client is HIV-negative
 * HIV.B.DE118: Unknown | Client has unknown HIV status
 * HIV.B.DE226: Syndrome/STI diagnosed | Syndrome or STI for which client is diagnosed
 * HIV.B.DE227: Urethral discharge syndrome | Client diagnosed with urethral discharge syndrome
 * HIV.B.DE228: Vaginal discharge syndrome | Client diagnosed with vaginal discharge syndrome
 * HIV.B.DE229: Lower Abdominal pain  | Client diagnosed with lower abdominal pain
 * HIV.B.DE230: Genital ulcer disease syndrome | Client diagnosed with genital ulcer disease syndrome
 * HIV.B.DE231: Anorectal discharge | Client diagnosed with anorectal discharge
 * HIV.B.DE232: Sent for testing | Specimen sent for testing
 * HIV.B.DE233: Other | Other syndrome/STI diagnosed
 * HIV.B.DE235: Any STI syndrome diagnosed | Was the client diagnosed with any of the five STI syndromes during this visit?
 * HIV.D.DE778: Syndrome/STI diagnosed | Syndrome or STI for which client is diagnosed
 * HIV.D.DE779: Urethral discharge syndrome | Client diagnosed with urethral discharge syndrome
 * HIV.D.DE780: Vaginal discharge syndrome | Client diagnosed with vaginal discharge syndrome
 * HIV.D.DE781: Lower Abdominal pain  | Client diagnosed with lower abdominal pain
 * HIV.D.DE782: Genital ulcer disease syndrome | Client diagnosed with genital ulcer disease syndrome
 * HIV.D.DE783: Anorectal discharge | Client diagnosed with anorectal discharge
 * HIV.D.DE784: Sent for testing | Specimen sent for testing
 * HIV.D.DE785: Other | Other syndrome/STI diagnosed
 * HIV.D.DE787: Any STI syndrome diagnosed | Was the client diagnosed with any of the five STI syndromes during this visit?
 * HIV.E.DE114: Key population member type* | The type of key population that the infant's mother is included in
 * HIV.E.DE115: Sex worker | Infant's mother is a sex worker
 * HIV.E.DE116: People who inject drugs | Infant's mother is a person who injects drugs
 * HIV.E.DE117: Trans and gender-diverse people | Infant's mother identifies as trans and gender-diverse
 * HIV.E.DE118: People living in prisons and other closed setting | Infant's mother is in a prison or closed setting
 * HIV.PRV.DE2: HIV prevention intervention | HIV prevention intervention that client accessed
 * HIV.PRV.DE3: PrEP service | Client accessed PrEP services
 * HIV.PRV.DE4: OAMT | Client accessed opioid agonist maintenance treatment (OAMT) services
 * HIV.PRV.DE5: NSP | Client accessed needle-syringe programme (NSP) services
 * HIV.PRV.DE6: STI services | Client accessed sexually transmitted infection (STI) services
 * HIV.PRV.DE7: VMMC | Client accessed voluntary medical male circumcision (VMMC) services
 * HIV.PRV.DE8: Other | Client accessed other HIV prevention services
 * HIV.PRV.DE10: Date accessed HIV prevention intervention | Date the client accessed HIV prevention intervention
 *
 * Additional Context
 * - what it measures: A: % of people attending HIV prevention services who were diagnosed with the same STI | syndrome two or more times during the reporting period | B: % of people living with HIV who were diagnosed with the same STI syndrome two or more times during the reporting period
 * - rationale: Presenting with the same STI syndrome two or more times in a short period suggests that an individual was not treated appropriately, has an untreated partner or is practicing unsafe sex.
 * - method: Individual-level data obtained from programme records
 * 
 * Suggested Scoring Method: proportion | http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm
 */

library HIVIND78Logic

// Included Libraries
using FHIR version '4.0.1'

include HIVCommon version '0.0.1' called HIC
include FHIRHelpers version '4.0.1'

include WHOCommon called WCom
include HIVElements called HE
include HIVIndicatorElements called HIE
include HIVConfig called Config

// Indicator Definition
parameter "Measurement Period" Interval<Date> default Interval[@2023-01-01, @2023-01-30]

context Patient
/* Populations */

/*
 *Initial Population
 */

define "Initial Population":
  true

/**
 * Numerator
 * 
 * Definition: Number of people attending HIV prevention services diagnosed with a particular STI syndrome two or more times during the reporting period
 * Calculation: COUNT of clients with "Any STI syndrome diagnosed"=True on multiple values of "Date accessed HIV prevention intervention" in reporting period
 */

define "Numerator":
  Count((HE."Syndrome/STI diagnosed B.DE226 Observation" O
    where O.effective.toInterval() during "Measurement Period" 
  and exists (HE."Date accessed HIV prevention intervention" t where t = start of O.effective.toInterval())))>1


/**
 * Denominator
 *
 * Definition: Number of people attending HIV prevention services diagnosed with a particular STI syndrome during the reporting period
 * Calculation: COUNT of clients with "Date accessed HIV prevention intervention" in the reporting period
 */

define "Denominator":
  exists(HE."Syndrome/STI diagnosed B.DE226 Observation" O
    where O.effective.toInterval() during "Measurement Period" 
  and exists (HE."Date accessed HIV prevention intervention" t where t = start of O.effective.toInterval()))
    

/* end Populations */


/*
 * Disaggregators
 */

define "Administrative Gender Stratifier":
	HIE."By Administrative Gender Stratifier"

define "Age Stratifier":
	HIE."By Age Stratifier 2"

define "Geographic Region Stratifier":
	HIE."By Geographic Region Stratifier"

define "patientGroups Stratifier":
	HIE."patientGroups"

define "HIV prevention intervention":
	HIE."HIV prevention intervention"

  define "STI syndrome":
	HIE."STI syndrome"

define "HIV Status":
  HIE."HIV Status Stratifier"


define "Stratification":
 HIE."By Administrative Gender Stratifier".code 
  + ':' + HIE."By Age Stratifier 2"
+ ':' + HIE."By Geographic Region Stratifier"
+ Combine(HIE.patientGroups, ':')
+ Combine(HIE."HIV prevention intervention", ':')
+ ':' + HIE."HIV Status Stratifier".code 
+ Combine(HIE."STI syndrome", ':')

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