Apppendices to Standard Operating Procedures Manual

GUATEMALA STOVE INTERVENTION TRIALStudy Instruments, Questionnaires, and FormsAppendix I: Blinding of Doctors (10_01_02)................................................................................................ 3Appendix III: Verbal Consent Form .............................................................................................................. 6Appendix IV. Baseline Questionnaire-1 (BLQ1) SPANISH VERSION...................................................... 8Appendix V. Baseline Questionnaire-1 (BLQ1) ENGLISH VERSION .................................................... 21Appendix VI. Baseline Questionnaire-2 (BLQ2) SPANISH VERSION.................................................... 33Appendix VII. Baseline Questionnaire-2 (BLQ2) ENGLISH VERSION.................................................. 41Appendix VIII: Baseline Questionnaire-3 (BLQ3) SPANISH VERSION.................................................. 48Appendix IX: Baseline Questionnaire-3 (BLQ3) ENGLISH VERSION.................................................... 62Appendix X: 6 Month Assessment Follow-up Questionnaire "AAA" Spanish........................................... 76Appendix XI: 6 Month Assessment Follow-up Questionnaire "AAA" English.......................................... 90Appendix XII. Overview of IAQ Monitoring............................................................................................. 103Appendix XIII. Extensive Air Pollution Monitoring: Quarterly Visit (ENGLISH) (forthcoming)......... 111Appendix XIV. Extensive Air Pollution Monitoring: Quarterly Visit (SPANISH)................................. 112Appendix XV. Randomization Protocol .................................................................................................... 115Appendix XVI: Weekly Plancha Log (English Version) .......................................................................... 118Appendix XVII: Weekly Plancha Log (Spanish Version) ......................................................................... 121Appendix XVII: Form: Supervision of Stove Construction (ENGLISH VERSION)............................... 123Appendix XVIII: Intensive IAQ Plancha Log............................................................................................ 124Appendix XIX: Intensive IAQ consent form............................................................................................. 125Appendix XIX: Intensive Air Pollution Monitoring Questionnaire: Quarterly Visit (ENGLISHVERSION)................................................................................................................................................... 127Appendix XX: Intensive Air Pollution Monitoring Questionnaire: Quarterly Visit (SPANISHVERSION)................................................................................................................................................... 135Appendix XXI: Form: Intensive Time-Activity Assessment, Observation (English)............................... 143Appendix XXII: Form: Intensive Time-Activity Assessment, Observation (Spanish)............................. 145Appendix XXIII: Form: Intensive Time-Activity Assessment, Evaluation (English) (forthcoming) ...... 159Appendix XXIV: Form: Intensive Time-Activity Assessment, Evaluation (Spanish).............................. 160Appendix XXV: Form: Intensive IAQ monitoring: Quality Control Sheet for Carbon Monoxide TubeReadings (English) ...................................................................................................................................... 165Appendix XXVI: Form: Intensive IAQ monitoring: Quality Control Sheet for Carbon Monoxide TubeReadings (Spanish) ...................................................................................................................................... 166Appendix XXVII: Form: Intensive IAQ monitoring: Carbon Monoxide Tube Readings (English) ........ 167Appendix XXVIII: Form: Intensive IAQ monitoring: Carbon Monoxide Tube Readings (Spanish) ...... 168Appendix XXIX: Form: Intensive IAQ monitoring: Record of Carbon Monoxide Tube Readings(English)....................................................................................................................................................... 169Appendix XXX: Form: Intensive IAQ monitoring: Record of Carbon Monoxide Tube Readings(Spanish) ...................................................................................................................................................... 172Appendix XXXI: Form: Intensive IAQ monitoring: Continous Minivol Monitoring (English) .............. 175Appendix XXXII: Form: Intensive IAQ monitoring: Continuous Minivol Monitoring (Spanish) .......... 176Appendix XXXIII: Form: Intensive IAQ monitoring: Particulate Measurements with PAS-500 Pumps(English)....................................................................................................................................................... 177Appendix XXXIV: Form: Intensive IAQ monitoring: Particulate Measurements with PAS-500Pumps (Spanish) .......................................................................................................................................... 178Appendix XXXV: Form: Intensive IAQ monitoring: Continuous Particulate Measurements (English) . 179Appendix XXXVI: Form: Intensive IAQ monitoring: Continuous Particulate Measurements(Spanish) ...................................................................................................................................................... 1801

Appendix XXXVII: Form: Intensive IAQ monitoring: PM 1 Measurements (English)............................. 181Appendix XXXVIII: Form: Intensive IAQ monitoring: PM 1 Measurements (Spanish).......................... 183Appendix XXXIX: Form: Intensive IAQ monitoring: PM Measurements with UCB-P1 Monitor(English)....................................................................................................................................................... 184Appendix XL: Form: Intensive IAQ monitoring: PM Measurements with UCB-P1 Monitor (Spanish) 185Appendix XLI: Weekly Questionnaire, Children (English)...................................................................... 186Appendix XLII: Weekly Questionnaire, Children (Spanish).................................................................... 193Appendix XLIII: Medical Evaluation Form (long), Children (English).................................................... 199Appendix XLIV: Medical Evaluation Form (long), Children (Spanish) ................................................... 211Appendix XLV: Medical Evaluation Form (short, skin and eyes), Children (English) ............................ 222Appendix XLVI: Medical Evaluation Form (short, skin and eyes), Children (Spanish) .......................... 225Appendix XLVII: Anthropometry Form (English) .................................................................................... 228Appendix XLVIII: Anthropometry Form (Spanish)................................................................................... 229Appendix XLIX: Weekly Questionnaire, Pregnant Women (English)...................................................... 230Appendix L: Weekly Questionnaire, Pregnant Women (Spanish) ............................................................ 232Appendix LI: Behavioral Changes Related to Postpartum "Reposo" Stage (English).............................. 234Appendix LII: Behavioral Changes Related to Postpartum "Reposo" Stage (Spanish)............................ 238Appendix LIII: Medical Evaluation Form: Survey of Maternal Health, Prenatal Visit (English)............ 242Appendix LIV: Medical Evaluation Form: Survey of Maternal Health, Prenatal Visit (Spanish) ........... 245Appendix LV: Hospital Follow-up Form (English) ................................................................................... 248Appendix LVI: Hospital Follow-up Form (Spanish).................................................................................. 249Appendix LVII: Hospital Referral Form (English) .................................................................................... 250Appendix LVIII: Hospital Referral Form (Spanish) .................................................................................. 251Appendix LIX: Standard Verbal Autopsy Questionnaire (English) .......................................................... 252Apendix LX: Standard Verbal Autopsy Questionnaire (Spanish) ............................................................. 271Appendix LXI: ARI Child Death Report Form (English only).................................................................. 291Appendix LXII: Form for Households that Drop Out of Study (English)................................................. 292Appendix LXIII: Form for Households that Drop Out of Study (Spanish) ............................................... 293Appendix LXIV: Heart Rate Variability Study: Baseline Questionnaire (English).................................. 294Appendix LXV: Heart Rate Variability Study: Baseline Questionnaire (Spanish)................................... 297Appendix LXVI: Heart Rate Variability Study: Follow-up Questionnaire (English)............................... 300Appendix LXVII: Heart Rate Variability Study: Follow-up Questionnaire (Spanish) ............................. 307Appendix LXVIII: Health Surveillance Flow Chart .................................................................................. 314Appendix LXIX: VALIDATION OF MAM TERMINOLOGY ............................................................... 315Appendix LXX. HOBO CO Calibration..................................................................................................... 326Appendix LXXI. Fuel Use Survey (English DRAFT) ............................................................................... 3292

Appendix I: Blinding of Doctors (10_01_02)This document summarizes the current consensus, after circulation of drafts anddiscussions at conference calls.In additions to the team discussions, the DSMB (Data safety monitoring board) raisedthis issue, and recommended blinding.We realize the practical and administrative challenges of trying to keep one or bothdoctors blinded throughout the study, but have decided to try to do what is practicallypossible to get the clinical evaluation done as blindly as possible. A final decision is stillto be made regarding the option of keeping Sergio (the MD who has been with the projectfor a while) realistically blinded. This document is based on blinding of only one of thedoctors.Blinding of only one doctor (The new one): House by house supervision will be lead by Nazario, and supported byVicente. Sergio will be acting as an unblinded Field MD, doing house-visits topatients and helping Nazario as needed. The new, blinded MD will also be in the field, but only to deal withadministrative problems and doing data quality controls by reviewingforms. All patients referred to a doctor through weekly visits will be offeredtransportation to the nearest “Centro de Convergencia”, or the nearestcommunity facility, where the blinded MD will do clinical examinations. The following additional efforts to increase objectivity for the doctor willbe included:o Pulse oximetry of all suspected pneumonia caseso Computerized auscultation, where all findings can be downloadedinto a computer and analyzed objectively and blinded.How will this work?o Best case: With 500 HH & 0.5 episodes of ALRI/year/child, therewill be less than one case a day at average. If we include suspectedcases of ALRI, wheezing that does not fit into the IMCI, severediarrhea and other severe disease among the

Possible to restrict analysis to only blinded time-periods,and also to use the blinded periods to evaluate theunblinded ones.o If the blinded doctor has time, he will also try to deal with other,less severe disease, disease among family members, neighbors etc.There will be cooperation with the SLHC. The unblinded doctorwill help if necessary. Efforts will be made to try to schedule theseappointment to a clinic in the headquarter. The blinded doctor canalso participate in anthropometry (children will be brought in),blinded reading of AP tubes etc.o Budget: No extra transportation costs. Nazario’s salary will have tobe increased with at least $250/month, as he will take oversupervision tasks from the blinded doctor.4

Appendix III: Verbal Consent Form“Particulate Air Pollution Exposures and Childhood Acute Respiratory Infections in Guatemala:A Randomized Intervention”Introduction & PurposeHello. My name is _______________. I (we) work with Universidad del Valle de Guatemala,and the Medical Entomology Research Unit, US Centers for Diseases Control and Prevention,and the University of California, Berkeley. We are studying the health of young children relatedto wood smoke in the home. Wood smoke maybe a health risk to those who breathe it for manymonths and years. This research will look at the health benefits of reduced wood smokeexposure. Since you have (or soon will have) a child less than 1 year, we would like to invite youto join the study.DescriptionThe study will last for 3 years. Each household in the study will be in one of two groups. Onegroup will be given an improved cook stove (Plancha) at the start of the study. The other groupwill get the same improved stove, at the end of the study or when your child is 18 months old.A lottery will tell us which group you will be in. If during the study we find that the stovereduces child respiratory infection, all participants will receive a Plancha. Although there is noproof that the Plancha increases wood smoke exposure, if we find it to be unhealthy, we willstop the study and discuss other options with you.ProceduresIf you want to join the study, we will ask you to join over a period of approximately 2 years.This will involve a first visit about an hour. During this first visit we will ask you about yourcooking methods and the health of your family. You may choose not to answer any question forany reason. We will measure smoke in your kitchen 4 times per year over the study period. Eachmeasurement will last one day. We will also measure your child’s exposure to smoke during oneday at the start of the study and every 3 months after. To do so, we will clip a small plastic tubeon your baby’s shirt to collect smoke for 24 hours. There is no known risk of hanging this tubeon your baby’s shirt. Our visits will not disrupt your normal home activities. Each week duringthe next 12-18 months we will come visit your house. We will ask if anyone in your home had arespiratory illness, diarrhea, and other childhood illnesses including burns during the last week.These short visits will take less than ten minutes each. Also, we will weigh and measure yourchild during the first visit and every three months after. We will ask you where your child spendsmost of the time during the day. Depending on which group you in we will also install animproved cook stove at the start of the study, or at the end, when your child is 18 months old,free of charge. We will also teach you how to use the improved cook stove. During the weeklyvisits, if your stove needs repair, we will take care of it. If you are pregnant, after you deliver,we would like to know your child’s birth-weight. Should your child die during the study, wewould like to ask you many questions about the illness that caused your child to die, and some ofthese may be sensitive.Risks & Benefits6

If this stove turns out to be an improvement it will benefit you and your family. The information yougive us will help in learning the effects of smoke on health. If you decide to be e in the study, you willget an improved cook stove free of charge, regular maintenance and repair of cook stove at no cost. Also,you will get training in use of the stove. No matter which group you are in, if we find that your child has arespiratory disease, he (she) will also get free out patient medical care and, if needed, we will refer yourchild to the nearest National Hospital for treatment. If you are in the group that does not get an improvedstove at the start there will be no new risks from being part of this group. If you did not get an improvedstove at the start of the study, we will give you one at the end.When the study is done, we will present the results to the community.There is no penalty if you decide not to join the study or if you wish to stop part way through thestudy.ConfidentialityThe results of the study will be kept private to the extent allowed by the law. To protect yourprivacy, we will keep the records under a code number rather than by name. We will keep therecords in locked rooms and only study staff will be allowed to look at them. Your name orother private data will not appear when we discuss this study publicly or when we publish theresults.Cost/PaymentThe improved stove installation and the tests we do for this study will be free.Right to Refuse or WithdrawThe decision to take part in this project is completely up to you. If you have questions for me (us) duringthe interview, ask them at any time. Also, if you want to stop at any time, just let me (us) know. You donot have to answer any questions that you do not wish to answer. There is no penalty if you do not wantto join the study or if you wish to stop part way through the study. If you choose to be in the study, youstill can at any time during the course of this study, revoke your consent and withdraw from the studywithout penalty. If you do choose to withdraw, you will keep the stove or will receive one at the end thestudy depending on the study group you were first assigned.Persons to ContactIf you have more questions about the project, you may contact Dr. Byron Arana, Co-Director, Center forHealth Studies, Universidad del Valle, Tel. 364-0336, or Dr. Kirk Smith, Berkley University, Tel 1-510-643-0793. If you have other questions related to your rights as a subject in this study, you may contactLic. Celia Cordon, who is member of the Ethics Committee at the Universidad del Valle, at Tel. 369-0791, during working hours, or at the following address 18 Avenida 11-95, Zona 15 VH III, Guatemala.For making phone calls, you can use the community telephones located in your community or in a nearbycommunity where a deal has been made to provide you, free of cost, access to our phone numbers. Youmay also contact the University of California at Berkeley’s, Committee for Protection of Human Subjectsat 510/642-7461, subjects@uclink.berkeley.edu.7

Appendix IV. Baseline Questionnaire-1 (BLQ1) SPANISH VERSIONCuestionario de Línea Basal No. 1Exposición a Partículas Contaminantes en el Aire e Infecciones RespiratoriasAgudas en Niños en Guatemala: Un estudio de intervención aleatorio.El consentimiento informado ha sido leído y explicado al participante (padres del niño 6 meses o mujerembarazada). Las implicaciones de su participación voluntaria, la naturaleza, duración y propósito delestudio de investigación; los métodos y la forma como será llevado a cabo el estudio; Y losinconvenientes y peligros en los que tal vez pudiera verse envuelto han sido explicados al participante.Se le ha dado a los padres del participante o mujer embarazada la oportunidad de preguntar cualquierduda que tuvieran con respecto al estudio en el cual participaran. Todas las dudas que tuvieron fueronrespondidas hasta que la mujer embarazada o padres del niño 6 meses estuvieron completamentesatisfechos con la respuesta.Firma del entrevistador: ___________________________Fecha: __________________Notas para el Entrevistador:1. Todas las instrucciones para los entrevistadores están en negrillas o en mayúsculas y enparéntesis. Estas instrucciones no deben ser leídas al entrevistado.2. Las preguntas basadas en la observación del entrevistador en lugar de preguntársela alentrevistado están indicadas en mayúsculas.3. En caso que no sea necesario realizar algunas preguntas; esto le será indicado al entrevistadorcon la frase: “Pase a la pregunta...”. Si esta indicación no se menciona, seguir a la preguntasiguiente.4. Para cada pregunta favor responder con al menos una opción (“NS” = “No sabe” y “NR” = “Noresponde”)5. Todas las opciones de las preguntas de selección múltiple deben ser leídas al entrevistado paraque él elija la respuesta.6. Esta entrevista debe realizársele a la madre del niño 6 meses (o mujer embarazada),preferentemente. Puede entrevistar al esposo, siempre y cuando, la madre del niño queserá parte del estudio este presente.A: DETALLES DE LA ENTREVISTAA1. ID DE LA VIVIENDA: _________A2. Iniciales del entrevistador: _________ Código del Entrevistador: ______________A3. FECHA DE LA ENTREVISTA: ____ / ____ / ______dd mm aaaaA4. DIRECCION: ____________________ ___________________ComunidadMunicipioA5. HORA DE INICIO DE LA ENTREVISTA: ________________8

B: ESTRUCTURA DEL HOGARB1. Nombre del padre: (Ti tb’i t-tata nex)_______________ __________________ _______________ _______________Primer Nombre Segundo Nombre Apellido Paterno Apellido MaternoEdad: (Jte te tab’q’e) ________ añosB2. Nombre de la madre: (titb’i txub’aj)_______________ __________________ _______________ _______________Primer Nombre Segundo Nombre Apellido Paterno Apellido MaternoEdad: (Jte te tab’q’e) ________ añosB3. ¿Esta usted embarazada? (At tala o tz’ok tz’aq)1 Sí (PASAR A LA PREGUNTA B3.1)2 Posiblemente/ No esta segura (PASAR A LA PREGUNTA B3.1)3 No (PASAR A LA PREGUNTA B4)9 NR (PASAR A LA PREGUNTA B4)B3.1 Cuantos meses de embarazo tiene o cree tener, si es que no esta segura?(Jten xjaw toknin tz’aq tala) _____mesesB4. ¿Cuantos niños de 6 meses tiene y viven en esta casa? _____ niños(Jten nex te jun q’ij jun xjaw kab’e xjaw oxe xjaw kyaja xjaw jwe qaq xjaw najle toj ja).EN EL CASO NO EXISTA MUJER EMBARAZA (PREGUNTA B3 = 3); NI NIÑOS DE 6MESES (B4 = 0), ANOTAR LA RAZÓN Y FINALIZAR LA ENCUESTA.Razón por la cual no existe en esta casa una mujer embarazada o un niño de 6 meses:______________________________________________________________________B5. Personas que habitan en la vivienda (Jten kyb’aja najla tzalu’n tu’n kyjotlixa)(LLENAR LA TABLA QUE APARECE A CONTINUACIÓN):[Esta Tabla es para corroborar los datos obtenidos en el censo. Asegurarse de que en la columnadel parentesco la relación consanguínea o política sea respecto a la madre del niño que será partedel estudio o respecto a la mujer embarazada][Tome en cuanta que si en la casa existen dos mujeres embarazadas, o dos niños de diferentemadre de 6 meses, o una mujer embarazada y un niño de 6 meses; ENTONCES deberá llenaruna encuesta para cada uno]9

ID01*Nombre/ / /Primer Nombre Segundo Nombre Primer Apellido Segundo Apellido*Anotar primero a la madre del niño de 6 meses o mujer embarazada.ParentescoEdadGénero02030405060708091011121314151617B5.1 En total cuantas personas viven acá: (Jten kyb’aja at tu’n tkyaquilxa at toj ja)Niños 12 años: _______Niños >12 años y Adultos: _______C: ESTRUCTURA DE LA VIVIENDAC1. [MARCAR CON UNA “X” LA CASILLA QUE CORRESPONDA. HACER USO DE LOSDIAGRAMAS QUE APRECEN DEBAJO DE ESTA PREGUNTA PARA ESCOGER LA MEJOROPCION] OBSERVAR SI LA VIVIENDA SE COMPONE DE... (Tzen tzin toka ja...)1 Una estructura única con la cocina como un cuarto separado por una pared o entrepaño entreella y el área principal y /o dormitorio (s).(Jun ja watb’il ex ja n b’inchita wab’j noq jun txol tkux)2 Una estructura única con la cocina como parte del área principal y dormitorio (s).(Jun ja mixti txol binchin watb’il ex ja n b’inchita wab’j)10

3 Más de una estructura, con la cocina separada del área principal y dormitorio (s); dentro de unaestructura cerrada.(Kab’e ja pa’n kyten jun watbel ex jun ja nb’inchite wab’j)4 Más de una estructura, con la cocina separada del área principal y dormitorio (s); dentro de unaestructura parcialmente abierta (sin al menos una pared).(Kab’e ja pa’n kyten jun watbel ex binchibil wabj mixti txe tok)Diagramas para ayudar al entrevistador con la pregunta C1El símbolo indica la localización de la estufa.1 Una estructura únicaB)Casa2 Una estructura única2 Una estructura únicaC)Cocina dentro del la casaprincipal, separada enparte, de otros cuartos (1)Cocina dentro de la casa y enla misma habitación donde seduerme(2)Casa3 Más de una estructuraD)CasaCocinaCocina fuera de la casaprincipal (encerrada poruna estructura) (3)4 Más de una estructuraCasaCocina fuera de la casa principalen un área con al menos unapared completamente abierta(4).11

D: UTILIZACIÓN DE DIFERENTES COMBUSTIBLES Y COSTOSAnote el tipo, cantidad y costo de los combustibles utilizados para todos los propósitos que serequieran en la casa (Cocinar, alumbrar, calentarse, preparar la comida de los animales, etc) Asítambién el tiempo que utilizan para colectar dichos combustibles (cuando así sea el caso).TIPO DE COMBUSTIBLE¿Qué utilizan paracocinar, calentarse, etc?(Ti naj b’in tetzq’ajsb’il exmaq’tzbil)1 Caña del elote, haba o col2 Olote3 Leña4 Carbón5 Queroseno6 Gas propane7 Otro(Especifique): _________Ordene Loscombustiblesutilizados del 1 al 7;siendo 1 el másutilizado y 7 elmenos utilizado(Al kyexixtenajb’in tu’n tetzq’aj sb’il tway)¿Cuánto de cadacombustibleutiliza, enpromedio, almes?(Jnichaq nb’ajtoj xjaw tijonb’ajoknen)(manojos)(costales)(tareas)(cargas)(litros)(libras)¿Cuánto pagapor cadacombustible almes?(Quetzales)(Jtetzin puaqnb’aj tun tojxjaw)¿Cuánto tiempoa la semanainvierte encolectar elcombustible?(Jnitzin amb’ilnxi ti’j tuntknet)E: SANEAMIENTOE1. Que hace usted con la basura de su casa la mayoría de las veces? (Tzen ntena te tz’is tu’n)(MARQUE TODOS LOS QUE APLICAN)1 La tira en su terreno o sus alrededores2 La entierra3 La quema4 Otro (ESPECIFIQUE): __________________E2. ¿Qué tipo de sanitario tiene en su casa? (Tzen t- tz’albila najb’in)1 Letrina2 No tiene3 Otro (ESPECIFIQUE): __________________E3. ¿De donde traen (PRINCIPALMENTE) el agua para tomar que utilizan en su casa?(Jan ntzaje tk’way chew a najb’in toj ja, toj q’ijil ex jb’alil)VERANOINVIERNO1 Agua entubada 1 Agua entubada2 Chorro público (Llena cántaro) 2 Chorro público (Llena cántaro)3 Pozo de garrucha 3 Pozo de garrucha4 Pozo natural (de nacimiento) 4 Pozo natural (de nacimiento)5 5 Agua de lluvia6 Agua directamente tomada de rió oarroyo6 Agua directamente tomada de rió oarroyo7 Comprada de un camión cisterna 7 Comprada de un camión cisterna8 Otro (ESPECIFIQUE): ____________ 8 Otro (ESPECIFIQUE): ____________12

E4. ¿Hierve usted el agua antes de tomarla? (Tzun nkux t-tz’q’ajsinte a’ tzen nxi tk’wan)1 Sí, siempre2 Sí, algunas veces3 No8 NS9 NRE5 ¿Tiene Ud. los siguientes animales ya sea como mascotas o animales de granja?(At tzin talin tzenqi lo)¿Algunas veces mantiene a estosMARQUE UNACASILLAanimales dentro de la casa?(Atkutzin nchi okxja talin lo tuja)(MARCAR UNICAMENTE EN ESTACOLUMNA SI LA RESPUESTA EN LACOLUMNA ANTERIOR FUE: “Sí”)Aves de corral (Eky’) 1 Sí 2 No 1 Sí 2 NoGanado (Wakx) 1 Sí 2 No 1 Sí 2 NoCabras (Chib) 1 Sí 2 No 1 Sí 2 NoCerdos ( Kuch) 1 Sí 2 No 1 Sí 2 NoOvejas (Rit) 1 Sí 2 No 1 Sí 2 NoCaballos, mulas, burros (Chej) 1 Sí 2 No 1 Sí 2 NoPerro (Tx’yan) 1 Sí 2 No 1 Sí 2 NoGato (Wix) 1 Sí 2 No 1 Sí 2 NoPalomas (Xuch) 1 Sí 2 No 1 Sí 2 NoOtros (ESPECIFIQUE): (Juntltxuk)_______________1 Sí 2 No 1 Sí 2 NoE6 ¿Ha tenido usted en los últimos 2 años goteras de agua del techo o paredes de su casa principal?(Tzuntzin ntz’ujin tjay tuka kab’e abq’e ma b’aj)1 Sí2 No8 NS9 NRF: ESTADO SOCIOECONOMICOF1. Cuantos cuartos posee su vivienda (Sin tomar en cuenta la cocina, si esta no es parte de laestructura de la casa principal) (Jte’n elnin te tja nyajin b’i’nchb’il wab’j) ______ cuartosF2. La casa donde vive es: (Aja ja najliy noq majni noq chjon o tekuy)1 Prestada2 Rentada o alquilada3 Propia4 Otro (ESPECIFIQUE) _____________F3. Aproximadamente, ¿Cuántos años tiene su casa principal?(Jten ab’q’e tb’atlen kyjaj watb’il ma tij) ______ años 8 NSF4. ¿Cuántas personas ayudan económicamente con el mantenimiento del hogar?(Jte xjal nmojen te k’achb’el toj kyja’y)_______ Personas13

F5. ¿Cuál(es) es(son) el(los) principal (es) trabajo(s) que realiza(n) usted y los que viven en su hogarpara obtener ingresos económicos? (Alkye tnejil aq’untl nb’ant te jyol puaq)(SELECCIONE LA TRES MÁS IMPORTANTES ORDENANDOLAS DE 1 A 3. SIENDO 1 LA MÁSIMPORTANTE Y 3 LA MENOS IMPORTANTE)1 Cultiva en su propia tierra2 Cultiva tierra ajena/ arrendada (Jornalero)3 Empleado del sector público o privado4 Actividades comerciales (comerciante)5 Artesano (ESPECIFIQUE) _______________6 No Responde7 Otro (ESPECIFIQUE) _______________F5.1. Su familia recibe dinero de familiares que trabajan en Estados Unidos?(Tzun n-ul sman puaq tey kyun talqiy mo ti iteka tey aya nchi aq’nen toj juntl najb’el)1 Sí2 No8 NS9 NRF6. ¿Usted pose alguno de los siguientes aparatos ó vehículos?(At tzin te jni tk’uxb’il toj tjay)F6.1. Radio Si No NS NRF6.2 Televisión Si No NS NRF6.3 Refrigerador Si No NS NRF6.4 Bicicleta Si No NS NRF6.5 Moto Si No NS NRF6.6 Carro (Pick-up) Si No NS NRG: CONSUMO DE TABACOG1. (A la madre o embarazada): ¿Usted fuma o ha fumado alguna vez cigarros?(B’an te sich’in jalen ex ojtxe)1 Nunca he fumado (PASE A LA PREGUNTA G2)2 Fume, pero ya no lo hago (PASE A LA PREGUNTA G1.1)3 Fumo actualmente (PASE A LA PREGUNTA G1.2)G1.1 (SI ES UNA EX FUMADORA), ¿Hace cuanto tiempo dejo de fumar?( Qa nsich’in taqe ojtxe jtojin tkyijnin sich’ tun) _______ meses ________ años (PASE A LAPREGUNTA G2)G1.2 (SI FUMA ACTUALMENTE), ¿Aproximadamente cuántos cigarros fuma usted al día?(Jten tsich’i nb’aj toj jun q’ij) _______ cigarrosG1.2.1.¿Usted fuma dentro de la casa? (Tzun nsich’inte toj ja)1 Nunca2 Ocasionalmente14

3 Casi a diario pero pocos cigarros ( hasta 2)4 Casi a diario muchos cigarros (mas de 2)G2. ¿Su esposo o alguna otra persona fuma actualmente DENTRO de la vivienda?(Tzun nsich’in tchmila mo juntl xjal najle toj ja)1 Sí (COMPLETE LA TABLA)2 No (PASE A LA SECCION H)Relación delfumador con lamadre:¿Con quéfrecuencia fumadentro de la casa?(¿ Jtechaq majnsich’in toj tjay?)ESPOSO ______________ ______________ ______________1 Raras veces(Noqx ja junjin maj)2 Casi a diariopero pocos cigarros(hasta 2)(Ch’ime chq’al menia ila’ sich’)3 Casi a diariomuchos cigarros(mas de 2)(ch’ime ch’q’al exila’ sich’)1 Raras veces 1 Raras veces 1 Raras veces2 Casi a diariopero pocoscigarros (hasta 2)3 Casi a diariomuchos cigarros(mas de 2)2 Casi a diariopero pocoscigarros (hasta 2)3 Casi a diariomuchos cigarros(mas de 2)2 Casi a diariopero pocoscigarros (hasta 2)3 Casi a diariomuchos cigarros(mas de 2)H: MIGRACIONH1. ¿Durante el resto de este año y el próximo viajará a la costa (o a otro lugar) a trabajar?(Kyoj xjaw tu’n te’l ab’q’e exsin juntl ab’q’e kxela aq’nel)1 Sí (PASE A LA PREGUNTA H1.1)2 No (PASE A LA SECCION I)8 NS (PASE A LA SECCION I)9 NR (PASE A LA SECCION I)H1.1. ¿Por cuantos meses se van a trabajar a la costa (o a otro lugar)?(Jten xjaw nchexa aq’nel toj mlaj mo toj juntl tnam)________ mesesH1.2. ¿Los niños 6 meses viajan también?(Majxsin ne’x mux te qaq xjaw kxel toj mlaj kyuk’iy) 1 Sí 2 No 8 NS 9 NRH1.3. ¿La madre del niño 6 meses o la mujer embarazada viaja también?(Tzun nxi tnane nex a at tal mux te qaq xjaw mo a’ ch’ix tanq’in aq’nil toj mlaj)1 Sí 2 No 8 NS 9 NRI: EL NIÑO Y SU CUIDADO(LAS SIGUIENTES PREGUNTAS DEBERAN SER RESPONDIDAS EXCLUSIVMANTE POR LAMADRE DEL NIÑO 6 MESES. SI ES UNA MUJER EMBARZADA PASAR A LA SECCION J)15

I1. Para madres con niño (o niños en el caso de gemelos) 6 meses de edad:Niño 1 Niño 2I1.1 Fecha de nacimiento(Tin tajlal xjaw tanq’in nexyek’intza tu’j)____/____/______ 1 Fe de edadDD / MM / AAAA____/____/______ 1 Fe de edadDD / MM / AAAAI1.2 Si no saben la fecha denacimiento anotar la edad quela madre cree que tiene ensemanas(Qa mi b’in tajlal q’ij tetanq’lin nex q’mamtza jtesemana)I1.3 ¿Dónde tuvo a su niño?(Jan sanq’ina tnexa tojtzintjay mo ja’j q’mantza)I1.4 ¿Le da de pecho a suniño?(Tzun nxi tq’on tmix nex)(SI LA RESPUESTA FUE LAOPCION 2 ó 3 PASE A LAPREGUNTA I1.5; SI NO PASE ALA PREGUNTA I2)I1.5 ¿Qué alimentos le da a suhijo?(Tin juntl tk’wa nex nxitq’on)_________ semanas2 Carné devacunación3 Cree1 En la casa2 En el hospital3 En un servicio de salud4 Otro ___________1 Sí, exclusivamente2 Sí, parcialmente3 No9 NR1 Leche fresca de vaca2 Granos, cereales, arroz (atoles)3 Frutas, vegetales4 Carnes5 Otros (ESPECIFIQUE):_______________________________ semanas2 Carné devacunación3 Cree1 En la casa2 En el hospital3 en un servicio de salud4 Otro ___________1 Sí, exclusivamente2 Sí, parcialmente3 No9 NR1 Leche fresca de vaca2 Granos, cereales, arroz (atoles)3 Frutas, vegetales4 Carnes5 Otros (ESPECIFIQUE):___________________I2. ¿Cuándo usted esta cocinando, generalmente, donde se encuentra su bebe?(Tzen nb’iachin wab’j tuja jan ta nex tun)1 En mi espalda (PASE A LA PREGUNTA I2.1)2 Dentro de la cocina, pero no en mi espalada Describa donde pone al niño: _________________( PASE A LA PREGUNTA I2.1)3 No en la cocina: en la cama (cuando la cocina está APARTE de la casa principal) ( PASE ALA PREGUNTA I3)4 No en la cocina: en la cama (cuando la cocina está DENTRO de la casa principal) (PASE ALA PREGUNTA I3)5 En otro lugar (ESPECIFIQUE)_________________________ (PASE A LA PREGUNTA I3)9 NR (PASE A LA PREGUNTA I3)I2.1. ¿Hasta Qué edad permanece el niño con usted en la cocina?(Jte xjaw nten nex tuk’iy toj tjay ja nb’inchin wab’j) _________ meses ó1 Hasta que nazca otro niñoI3. Además de preparar la comida para su familia, ¿Semanalmente cocina en otro lugar?(Tzen nb’aj b’inchin wab’j tjay tuzn nxiy b’inchil wab’j toj juntl ja)1 Sí (PASE A LA PREGUNTA I3.1)2 No (PASE A LA PREGUNTA I4)8 NS (PASE A LA PREGUNTA I4)9 NR (PASE A LA PREGUNTA I4)16

I3.1. ¿Lleva a su niño con usted cuando cocina en otro lugar?(Tzun nxi tiqin nex tzen nxiy b’inchil wab’j toj juntl ja)1 Sí, siempre2 Sí, a veces3 NoI4. ¿Hace usted fuego en su casa o cerca de ella semanalmente para otro propósito que no sea cocinar?(Tzun nkub’ k’antsit tq’aq’a toj tjay mo twutz tpenja toj jun jte q’ij exsin nya te b’inchibil twaytun toka)1 Sí3 No8 NSI5. REGISTRO DE VACUNACIONES(SOLICITAR A LA MADRE EL CARNE DE VACUNACIÓN Y ANOTAR EN LA TABLA (S) LASFECHAS EN QUE EL NIÑO (S) RECIBIO LA DOSIS RESOPECTIVA DE CADA VAUNA)(YEK’INTZA TU’J NEX WEY JA TZ’IB’INKUXA JA’ NCHI OKA T-VACUNA)Niño No.1BCGDPTPOLIOSPR (Sarampión)1 2 3 4Niño No.2 (En el caso de que existan gemelos)1 2 3 4BCGDPTPOLIOSPR (Sarampión)I6. MEDIDAS ANTROPOMÉTRICAS DEL NIÑO BAJO ESTUDIO(ESTA TABLA SE LLENARA EL DIA QUE SE REGRESE A LA COMUNIDAD A REALIZAR LAANTROPOMETRÍA)Fecha: _____/_____/_____dd mm aaaaNiño No. 1PESO ALTURA P/H A/E P/E123PromedioNiño No. 2 (En el caso de que existan gemelos)PESO ALTURA P/H A/E P/E123Promedio17

J: INDICADORES DE CALIDAD DE VIDAJ1. ¿Cuándo usted cocina, el humo irrita sus ojos?(Tzen nb’inchin tway n-chi ex kyaqix twutza tun sib’)1 Siempre2 Algunas veces3 Nunca8 NS9 NRJ2. ¿Cuándo usted cocina o inmediatamente después, padece de dolor de cabeza?(Tzenku nb’aj b’inchin wab’j tzun ntzaj chon twiy)1 Siempre2 Algunas veces3 Nunca8 NS9 NRJ3. ¿Cuándo usted cocina, el humo le hace toser o irrita su garganta?(Tzen nb’inchin tway tzun ntza’j sjo’l tija tun sib’ mo ntzaj xkatj tqula)1 Siempre2 Algunas veces3 Nunca8 NS9 NRJ4. ¿Cuándo usted cocina o inmediatamente después, padece de dolor de espalda?(Tzen nb’aj b’inchin wabj tzun ntzaj cho’n tzkyltija)1 Siempre2 Algunas veces3 Nunca8 NS9 NRHora de Finalización de la entrevista: _____________________EntrevistaIniciales del entrevistador: _______________Firma del entrevistador: ________________Revisión de la entrevistaFirma del supervisor:_____________________ Fecha de la revisión: _________________AntropometríaIniciales del operador: ____________________ Firma del operador: ________________Supervisión de la mediciónFirma del supervisor:_____________________ Fecha de la revisión: _________________Ingreso de datos18

Firma Digitador # 1: _________________Firma Digitador # 2: _________________Revisión del ingreso de datosFirma del supervisor:_____________________ Fecha de la revisión: _________________19

H. Calidad del Aire dentro de la CocinaH1. ID. Casa: ______________H2. Iniciales de la persona que coloco el equipo: _________Código: _________H4. Fecha y hora en que el equipo fue colocado (en la que se abrió el tubo):_____/____/_____dd / mm / aaaa____: ____hh : mmH5. Anotar en la siguiente tabla el número de identificación para cada equipo:EQUIPOTubo en la MadreID(###)OBSERVACIONESTubo en el Bebé No. 1Tubo en el Bebé No.2Otro – Describir________________________________EntrevistaAGRACECER POR LA INFORMACIÓN AL ENTREVISTADO- FIN DE LA ENTREVISTAIniciales del entrevistador: _______________Firma del entrevistador: ________________Ingreso de datosFirma Digitador # 1: _________________Firma Digitador # 2: _________________Revisión del ingreso de datosFirma del supervisor:_____________________ Fecha de la revisión: _____________20

Appendix V. Baseline Questionnaire-1 (BLQ1) ENGLISH VERSIONProject: “Particulate Air Pollution Exposure and Childhood Acute RespiratoryInfections in Guatemalan Children: A Randomized Intervention Trial”The informed consent has been read and explained to the participant (parents of children ≤ 6 months ofage and/or pregnant woman). The implications of their voluntary participation, nature, duration, purposesof the research study, methodology to be used, form in which the study will be conducted and theinconveniences and risks in which they might be involved, have all been explained to the participant.Parents of the participants and/or pregnant women have been given every opportunity to ask questionsand clear up any doubts they might have with respect to the study in which they will participate. Allconcerns expressed by the parents of the participants and/or the pregnant woman have been addressedand the participants are completely satisfied with the answers.Signature of the interviewer: _______________________ Date__________________Notes for the Interviewer:1. All instructions for interviewers are shown in bold, capital letters, or in parenthesis.These instructions must not be read to the person being interviewed.2. Questions based on observations on the part of the interviewer have been written incapital letters and must not be addressed to the participants.3. When a question is not necessary, indications to “Proceed or go to question #….”appear. When this indication does not appear, the interviewer should continue with thefollowing question.4. Each question should have at least one option marked: (“NK” = “Not known” and “NR” =“No response”)5. All questions with multiple selection options must be read to the participant to allow himto select an option.6. This interview should preferably be conducted with mothers of children 6 monthsold (or with pregnant women). Husbands can also be interviewed but only whenthe mother of the child is present.A: INTERVIEW DETAILSA1. HOUSEHOLD ID: _________A2. Interviewer’s Initials: _________ Interviewer Code: ______________A3. DATE OF INTERVIEW: ____ / ____ / ______dd mm yyyA4. ADDRESS: ____________________ ___________________CommunityMunicipalityINTERVIEW START TIME: ________________21

B: HOUSEHOLD MEMBERSB1. Name of the father:_______________ __________________ _______________ _______________First Name Second Name Paternal Surname Maternal SurnameAge:________ yearsB2. Name of the mother:_______________ __________________ _______________ _______________First Name Second Name Paternal Surname Maternal SurnameAge:________ yearsB3. Are you pregnant?1 Yes (GO TO QUESTION B3.1)2 Possibly/ Not sure (GO TO QUESTION B3.1)3 No (GO TO QUESTION B4)9 NR (GO TO QUESTION B4)B3.1 How many months pregnant are you, or if you are not sure, how many months doyou believe you might be? _________ monthsB4. How many children 6 months old live in this house? _____ children.IF THERE ARE NO PREGNANT WOMAN LIVING IN THE HOUSE (QUESTION B3 = 3);OR NO CHILDREN 6 MONTHS OF AGE (B4 = 0), WRITE DOWN AN EXPLANATIONAND FINISH THE INTERVIEW.Reason why no pregnant woman or child aged 6 months old live in the house:B5.B5. Persons who live in the house (FILL IN THE TABLE BELOW):[This Table is to corroborate the data obtained during the census. When filling the columnpertaining kinship, consanguinity or political relationship, make sure this relationship refers to themother of the child or pregnant woman participating in the study][Note: If within this household there are two pregnant women or two children 6 months of agewith different mothers or one pregnant woman and one child 6 months of age, A SEPARATEQUESTIONNAIRE SHOULD BE COMPLETED FOR EACH22

IDName/ / /First Name Second Name First Surname Second SurnameKinshipAgeGender01**Write down first the mother of the child 6 months old or pregnant woman.0203040506070809101112131415B5.1 In total, how many people live here: Children 12 years of age: _______Children >12 years of age and Adults: _______C: HOUSEHOLD STRUCTURAL CHARACTERISTICSC1. [MARK WITH AN “X” THE CORRESPONDING BOX. USING THE DIAGRAMS BENEATH THISQUESTION TO CHOOSE THE BEST OPTION] OBSERVE IF THE HOUSE HAS THE FOLLOWING... ]1 Is a single structure with the area for cooking located in a another room and separated by a wallor partition from the other main areas and/or bedroom (s).2 A single structure where the cooking area is in the same area (room) as the rest of the livingareas/bedroom(s).3 More than one structure, where the cooking areas is separate from the living area and thebedroom(s); within a closed structure.4 More than one structure, where the cooking area is separate from the main areas and bedroom(s); within a partially open structure (without at least one wall).23

Diagrams to help interviewer answer question C1The symbol indicates the place where cooking facilities are located.1One single structureB)HouseCooking facilities inside themain area, separated inpart from other rooms (1)2 One single structureC)Cooking facilities inside thehouse in the same roomwhere people sleep(2)House3 More than one structureD)HouseCooking facilitiesCooking facilities outsidethe main house (enclosedby a structure) (3)4 More than one structureHouseCooking facilities outside the mainhouse enclosed in an area with atleast one wall open or missing(4).24

D: USE OF HOUSEHOLD FUEL AND THEIR COSTSWrite down the type, quantity and cost of fuel used for all household purposes (cooking,lighting, heating, food preparation for animals, etc.) and the amount of time required forthe collection of those combustibles (when applicable).TYPE OF FUELWhat do you use forcooking, heating, etc?1 Corn stalks, limabeans or cabbage scraps2 Corn cobs3 Wood4 Charcoal5 Kerosene6 Propane gas7 Other(Specify): _________Rank the fuels from 1to 71= most used and7 = least usedHow much ofeach fuel do youuse in an averagemonth?(handfuls)(sacks)(bunches)(loads)(liters)(pounds)How much doyou pay foreach fuel permonth?(Quetzales)How much timedo you spendeach monthcollecting thisfuel?E: SANITATIONE1. What do you do with the garbage from your home? (MARK ALL THAT ARE APPLICABLE)1 Throw it away on his/her land or in an area nearby2 Bury it3 Burn it4 Other (SPECIFY): __________________E2. What kind of sewage disposal do you have in your house?1 Latrine2 None3 Other (SPECIFY): __________________E3. Where do you get the drinking water used in your home? (MAIN SOURCE)SUMMERWINTER1 Pipe water 1 Pipe water2 Public fountain (fills up recipient) 2 Public fountain (fills up recipient)3 Well with pulley 3 Well with pulley4 Natural well (spring) 4 Natural well (spring)5 5 Rain water6 Water directly taken from a river ora stream6 Water directly taken from a river ora stream7 Bought from a cistern truck 7 Bought from a cistern truck8 Other (SPECIFY): ____________ 8 Other (SPECIFY): ____________E4. Do you boil your water before drinking it?1 Yes, always2 Yes, sometimes3 No8 NK9 NR25

E5 Do you have any of the following animals at home either as pets or farm animals?Do any of these animals sometimes goMARK BOX inside the house? (MARK ONLY IN THISCOLUMN IF THE REPLY TO THE FIRSTQUESTION WAS: “Yes”)Poultry 1 Yes 2 No 1 Yes 2 NoCattle 1 Yes 2 No 1 Yes 2 NoGoats 1 Yes 2 No 1 Yes 2 NoPigs 1 Yes 2 No 1 Yes 2 NoSheep 1 Yes 2 No 1 Yes 2 NoHorses, mules, donkeys 1 Yes 2 No 1 Yes 2 NoDogs 1 Yes 2 No 1 Yes 2 NoCats 1 Yes 2 No 1 Yes 2 NoPigeons 1 Yes 2 No 1 Yes 2 NoOther (SPECIFY):_______________1 Yes 2 No 1 Yes 2 NoE6 In the last two years have you had any leakages from the roof or the walls in your principal dwellingarea?1 Yes2 No8 NK9 NRF: SOCIOECONOMIC STATUSF1. How many rooms does your house have? (Do not take into account the cooking area if it is not withinthe main structure) ______ roomsF2. The house where you live is:1 Borrowed2 Rented or leased3 Owned4 Other (SPECIFY) _____________F3. How old (approximate years) is your house? ______ years 8 NKF4. How many persons provide economic support for your house?_____ PersonsF5. What type(s) of work you and the persons who live in your house do to obtain income?(SELECT THE THREEE MOST IMPORTANT AND RANK FROM 1 TO 3, 1= THE MOST IMPORTANTAND 3 =THE LEAST IMPORTANT)1 Cultivates own land2 Cultivates someone else’s land/ leases out his/her labor (Jornalero)3 Employed by the public or private sectors4 Commercial activities (comerciante)5 Handicrafts (SPECIFY) _______________6 No response7 Other (SPECIFY) _______________26

F6. Do you own any of the following appliances or vehicles?F6.1. Radio Yes No NK NRF6.2 Television Yes No NK NRF6.3 Refrigerator Yes No NK NRF6.4 Bicycle Yes No NK NRF6.5 Motorcycle Yes No NK NRF6.6 Car (Pick-up) Yes No NK NRG: TOBACCO USEG1. (Ask mother or pregnant woman): Do you smoke or have you smokedcigarettes?1 Never smoked (GO TO QUESTION G2)2 Used to smoke, not any more (GO TO QUESTION G1.1)3 Smokes now (GO TO QUESTION G1.2)G1.1 (IF SHE IS AN EX SMOKER), How long ago did you quit smoking? ________ years (GOTO QUESTION G2)G1.2 (IF PRESENTLY SMOKING) Approximately how many cigarettes a day do yousmoke?______ cigarettesG1.3. Do you smoke inside your house?1 Never2 Occasionally3 Almost every day but only a few cigarettes (up to 2)4 Almost daily many cigarettes (more than 2)G2. Does your husband or any other person at home smoke INSIDE the house?1 Yes (COMPLETE THE FOLLOWINGTABLE)2 No (GO TO SECTION H)Relationship ofthe smoker withthe mother:HUSBAND ______________ ______________ ______________1 Rarely 1 Rarely 1 Rarely 1 RarelyHow frequentlydoes thesmoker smokeinside thehouse?2 Almost daily butonly a fewcigarettes (up to 2)2 Almost dailybut only a fewcigarettes (up to2)2 Almost daily butonly a fewcigarettes (up to 2)2 Almost daily butonly a fewcigarettes (up to 2)27

3 Almost daily,many cigarettes(more than 2)3 Almost daily,many cigarettes(more than 2)3 Almost daily,many cigarettes(more than 2)3 Almost daily,many cigarettes(more than 2)H: MIGRATIONH1. During the remainder of this year or next year, are you planning to go to the coast (or somewhereelse) to work?1 Yes (GO TO QUESTION H1.1)2 No (GO TO SECTION I)8 NK (GO TO SECTION I)9 NR (GO TO SECTION I)H1.1. How many months do you spend working at the coast (or somewhere else)? ________monthsH1.2. Do children 6 months also travel? 1 Yes 2 No 8 NK 9 NRH1.3. Do mothers with children aged 6 months old or pregnant women also travel?1 Yes 2 No 8 NK 9 NRI: CHILD CARE(THE FOLLOWING QUESTIONS SHOULD BE ANSWERED EXCLUSIVELY BY MOTHERS OFCHILDREN 6 MONTHS OLD. FOR PREGNANT WOMAN GO TO SECTION J)I1. For mothers of one single child or twins aged 6 monthsChild 1 Child 2I1.1 Date or birth ____/____/______ 1 Birth certif.. ____/____/______ 1 Birth certif..DD / MM / YYYY 2 VaccineRecord3 BelievesDD / MM / YYYY 2 VaccineRecord3 BelievesI1.2 If date of birth is unknownwrite down the age in weeksthat the mother believes the_________ weeks_________ weekschild hasI1.3 Where was your childborn?I1.4 Do you breastfeed yourchild?(IF THE ANSWER WAS OPTION2 or 3 GO TO QUESTION J1.5;IF NOT, GO TO QUESTION J2)1 In the home2 In the hospital3 In the health service post4 Other ___________1 Yes, exclusively2 Yes, partially3 No9 NR1 In the home2 In the hospital3 In the health service post4 Other ___________1 Yes, exclusively2 Yes, partially3 No9 NRI1.5 What kinds of food do youfeed your child?1 Fresh cow’s milk2 Grains, cereals, rice (atoles)3 Fruits, vegetables4 Meats5 Other (SPECIFY):______________________ Fresh cow’s milk2 Grains, cereals, rice (atoles)3 Fruits, vegetables4 Meats5 Other (SPECIFY):______________________I2. While you are cooking, where is your baby most of the time?1 On my back (GO TO QUESTION I2.1)2 Inside the kitchen but not on my back28

Describe where the child is placed: _________________( GO TO QUESTION I2.1)3 Not in the kitchen, in the bed (when the kitchen is SEPARATE from the principal house)(GO TO QUESTION I3)4 Not in the kitchen, in the bed (when the kitchen is INSIDE the main house) (GO TOQUESTION I3)5 In another place (SPECIFY)_________________________ (GO TO QUESTION I3)8 NK (GO TO QUESTION I3)9 NR (GO TO QUESTION I3)I2.1Until what age does the baby stays with you in the kitchen? _________ months or1 Until another baby is bornI3. In addition to preparing meals for your family, is there any other place where you cook during theweek?1 Yes (GO TO QUESTION I3.1)2 No (GOT TO QUESTION I4)8 NK (GO TO QUESTION I4)9 NR (GOT TO QUESTION I4)I3.1. Do you take your baby along when you cook at another placer?1 Yes, always2 Yes, sometimes3 NoI4. Do you build a fire in your house or near it on a weekly basis for some other reason than to cook?1 Yes2 No8 NKI5. VACCINATION RECORDS(REQUEST THE VACCINATION CARD FROM THE MOTHER AND WRITE DOWN THE DATES INWHICH THE CHILD OR CHILDREN RECEIVED THEIR RESPECTIVE VACCINATION DOSES)Child No.1BCGDPTPOLIOSPR (Measles)Child No.2 (if twins)BCGDPTPOLIOSPR (Measles)1 2 3 41 2 3 4I4. ANTHROPOMETRIC MEASURES OF THE CHILDREN IN THE STUDY(THIS TABLE MUST BE COMPLETED ON THE DAY YOU RETURN TO THE COMMUNITY TOCONDUCT THE ANTHROPOMETRY)Date: _____/_____/_____dd mm yyyy29

Child No. 1123AverageWEIGHT HEIGHT P/H A/E P/EChild No. 2 (If twins)WEIGHT HEIGHT P/H A/E P/E123AverageJ: QUALITY OF LIFE INDICATORSJ1. When you are cooking, do your eyes get irritated?1 Always2 Sometimes3 Never8 NK9 NRJ2. When you are cooking or immediately after, do you get a headache?1 Always2 Sometimes3 Never8 NK9 NRJ3. When you are cooking, does the smoke make you cough or irritate your throat?1 Always2 Sometimes3 Never8 NK9 NRJ4. When cooking or immediately after, does your back hurts?1 Always2 Sometimes3 Never8 NK9 NRInterview stop time: _____________________InterviewInterviewer’s initials: _______________Interviewer’s signature: ________________30

Interview ReviewSupervisor’s signature:_________________Review Date: _________________AnthropometryOperator’s initials: ____________________Operator’s signature: ________________Supervision of anthropometric measurementsSupervisor’s signature:___________________ Review Date: _________________Data EntryData Entry # 1 Signature: _______________Data Entry # 2 Signature: _________________Data Entry ReviewSupervisor’s signature:___________________ Review Date: _________________31

H. Air Quality inside KitchenH1.Household ID_______________H2. Initials of fieldworker that placed equipment:_________ Code:__________H4. Time and Date that equipment was installed (or when CO tube was opened):_____/____/_____dd / mm / yyyy____: ____hh : mmH5. Note in table the ID number for equipment/tubes:EQUIPMENTMother’s TubeID(###)OBSERVATIONSBaby No. 1 TubeBaby No.2 TubeOther_ Describe________________________________THANK PARTICIPANT FOR COOPERATION- - END OF INTERVIEWInterviewInterviewer’s initials: _______________Interviewer’s signature: ________________Data EntryData Entry # 1 Signature: _______________Data Entry # 2 Signature: _________________Data Entry ReviewSupervisor’s signature:___________________Review Date: _________________32

Appendix VI. Baseline Questionnaire-2 (BLQ2) SPANISH VERSIONCuestionario de Línea Basal Número 2Mediciones y Preguntas relacionadas con la Calidad del AireProyecto: “Exposición a Partículas Contaminantes en el Aire e InfeccionesRespiratorias Agudas en Niños en Guatemala: Un estudio de intervenciónaleatorio”Notas para el Entrevistador:1. Todas las instrucciones para los entrevistadores están en negrillas o en mayúsculas y enparéntesis. Estas instrucciones no deben ser leídas al entrevistado.2. Las preguntas basadas en la observación del entrevistador (en lugar de preguntárselas alentrevistado) están indicadas en mayúsculas.3. Para cada pregunta favor responder con al menos una opción (“NS” = “No sabe” y “NR” = “Noresponde”)4. Todas las opciones de las preguntas de selección múltiple deben ser leídas al entrevistado paraque él elija la respuesta.5. Las mediciones del exterior de la casa y/o la cocina deben hacerse entre dos personas yutilizando una cinta métrica.6. Esta entrevista deberá hacérsele UNICAMENTE a la madre del niño 6 meses (o mujerembarazada),A: DETALLES DE LA ENTREVISTAA1. ID DE LA VIVIENDA:_________A2. Iniciales del entrevistador: _________ Código del Entrevistador:______________A3. FECHA DE LA ENTREVISTA: ____ / ____ / ______dd mm aaaaA4. DIRECCION: ____________________ ___________________ComunidadMunicipioA5. NOMBRE DEL JEFE DE FAMILIA:_______________ __________________ _______________ _______________Primer Nombre Segundo Nombre Apellido Paterno Apellido MaternoA6. HORA DE INICIO DE LA ENTREVISTA:__________________B: DETALLES DE LA CONTRUCCION DE LA VIVIENDA Y UTILIZACIÓN DE ENERGIA[OBSERVAR Y ESCOGER LA(S) MEJOR(ES) OPCION(ES) PARA LAS PREGUNTAS B1 A B4 DEAMBAS TABLAS Y PREGUNTAR AL ENTREVISTADO PARA RESPONDER LAS PREGUNTAS B5 YB6;].33

A:Casa principal/ dormitorios* (esta incluye lacocina como parte de la estructura principal dela casa)B: Cocina (UNICAMENTE completar cuandola cocina este separada de la casa principal)Variable Opciones Código Variable Opciones CódigoB1. TechoB2. ParedB3. PisoB4. Tipo deestufaB5.¿Quéutilizan paraalumbrarse?B6. ¿Quéutiliza paracalentar sucuarto?Pajón 1 B1c. Pajón 1Lámina, Tejalita o 2 Techo Lámina, Tejalita o 2DuralitaDuralitaTeja de Barro 3 Teja de Barro 3Terraza 4 Terraza 4Otro5Otro5(Especifique:) _________(Especifique:) ________Caña o varas 1 B2c. Caña o varas 1Tapial 2 Pared Tapial 2Bajareque 3 Bajareque 3Adobe 4 Adobe 4Madera 5 Madera 5Block o ladrillo 6 Block o ladrillo 6Otro7Otro7(Especifique:) _________(Especifique:) ________Tierra 1 B3c. Piso Tierra 1Madera 2 Madera 2Cemento (Torta, Mosaico) 3 Cemento (Torta, Mosaico) 3Otro4Otro4(Especifique:) _________(Especifique:) ________Ningún tipo 1 B4c. Tipo Ningún tipo 1Fogón abierto (3 piedras) 2 de estufa Fogón abierto (3 piedras) 2Fogón abierto (pollo) 3 Fogón abierto (pollo) 3Plancha 4 Plancha 4Estufa mejorada 5 Estufa mejorada 5Estufa de gas6Estufa de gas6funcionandofuncionandoNinguna 1 B5c. Ninguna 1Fogón Abierto 2 ¿Qué Fogón Abierto 2utilizan paraCandelas 3 Candelas 3alumbrarse?Candil 4 Candil 4Lámparas de gas(Tipo COLEMAN)5 Lámparas de gas(Tipo COLEMAN)5Electricidad 6Electricidad 6Nada 1 B6c. ¿Qué Nada 1Se obtiene del calor del 2 utiliza para Se obtiene del calor del 2fogón con que se cocinacalentar su fogón con que se cocinacocina?Se usa un fogón abierto 3 Se usa un fogón abierto 3además del que tienepara cocinarademás del que tienepara cocinarOtro(Especifique:) _________4Otro(Especifique:) ________434

* Se refiere al dormitorio (cuarto) donde duerme el bebeC. USO DEL CHUJ O TAMASCALC1. ¿Posee Chuj o tamascal en su casa? 1 Si (PASE A # C1.1)(At-tzin te tchuj) 2 No (PASE A LA SECCION D)8 NS (PASE A LA SECCION D)9 NR (PASE A LA SECCION D)C1.1. ¿Cuantas veces al mes lo utiliza?(Jten maj n-oknen tun toj xjaw) ___________ veces al mesC1.2. ¿Con cual de los siguientes materiales lo calienta?(Titzin n-ajb’in tu’n tmaq’te tchuja)(MARQUE TODOS LOS QUE APLICAN)1 Carbón2 Leña3 Desperdicio de cosechas (Olote ó Caña de elote, haba o col)4 Basura de la casa5 Otro (ESPECIFIQUE)______________C1.3. ¿Entra usted con su bebe al Chuj después que se ha calentado?(Tzuntzin nokx t-nexa chujil tuk’iy)1 Siempre2 Algunas veces3 Nunca4 Otro (ESPECIFIQUE): __________________D. DONDE DUERME EL BEBESi existe bebé: (SI NO PASE A SECCION E)D1. ¿Duerme el bebé en la cocina?1 Sí¿A qué edad empezó? ______semanas¿Por cuanto tiempo? _______ meses2 No (PASE A # D1.1)D1.1¿El bebé durmió alguna vez en la cocina?1 Sí¿A qué edad emepezó? _______ semanas¿Por cuanto tiempo? ________ meses2 NoE: ASPECTOS ESTRUCTURALES DE LA COCINA QUE AFECTAN SU VENTILACION(OBSERVAR Y MEDIR) (Estas medidas son de la cocina tanto si se encuentra dentro de laestructura de la casa principal como si esta separada de la misma)35

E1. (OBSERVAR EL ESPACIO ENTRE PARED Y TECHO). Estos espacios son:1Cerrados completamente2Parcialmente abiertos3Completamente abiertosE2. ¿Generalmente usted mantiene abierta(s) o cerrada(s) la(s) ventana(s) de su cocina mientrasesta cocinando? (Majxsin jqonqe t-ventana mo jpunqej tzen nb’inchin wab’j)VENTANA DESAYUNO ALMUERZO CENANINGUNA1 Abierta Cerrada Abierta Cerrada Abierta Cerrada2 Abierta Cerrada Abierta Cerrada Abierta Cerrada3 Abierta Cerrada Abierta Cerrada Abierta Cerrada4 Abierta Cerrada Abierta Cerrada Abierta Cerrada5 Abierta Cerrada Abierta Cerrada Abierta CerradaE3. Ventanas. Registre en la tabla la información que se solicita de cada ventana:VENTANA DIMENSIÓN **1 cm2 cm3 cm4 cm5 cm**(Medir la ventana de forma diagonal tal y como indicael dibujo de arriba y anotar la medida en centímetros )E4. Dimensiones de la cocina (SÍ LA COCINA ESTA UBICADA DENTRO DE LA CASA, MEDIR LASDIMENSIONES DE LA CASA PRINCIPAL)LargoFondoAltura desde elsuelo al espacioente techo yparedAltura desde elsuelo hasta elpunto mas altodel techo(a)(b)(c)(d)metroscdNota: si la cocina tiene techo plano el mismo valorde (c) será el de (d).ab36

F. CALIDAD DEL AIRE DENTRO DE LA COCINAF1. ID Casa ___ ___ ___F.2 Dirección: ____________________ ___________________ComunidadMunicipioF3. Iniciales de la persona que retiró el equipo: _________Código: ___ ___F4. Fecha y hora en que el equipo fue retirado (En que se tapó el tubo):___ / ___ / ___ ___: ___dd / mm / aaaa hh / mmEQUIPOTubo en la MadreTubo en el Bebé No. 1Tubo en el Bebé No.2Otro (Describir):ID(Pegar Etiqueta en el espacio)OBSERVACIONESF5. OBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA: (En el caso que no le sea posible alentrevistador observar, entonces pregunte a la madre)F5.1 ¿Dónde estaba la mamá cuando el encuestador llegó?1 En la cocina2 Otra parte de la casa3 Afuera4Otro (describir) __________________________________8 NSF5.2 Si hay bebé, ¿Dónde estaba cuando el encuestador llegó?1 En la cocina2 En otra parte de la casa3 Afuera4 Otro (describir) ________________________8 NSF5.3¿Está encendido el fuego? 1 SÍ2 NoF6. OBSERVE: ¿El equipo (Tubo) fue cambiado del lugar donde se puso originalmente?EQUIPOF6.1 Tubo en lamadre (mujerembarazada)F6.2 Tubo en el bebéNo.1MARQUEUNACASILLA1Sí 2No F6.51Sí 2No F6.6(SI LA RESPUESTA EN LA COLUMNA ANTERIORFUE SÍ):¿Dónde encontró ubicado el equipo (Tubo)?37

F6.3 Tubo en el bebé 1Sí 2No F6.7No.2F6.4 Otro (Describir): 1Sí 2No F6.8F7. OBSERVE: ¿Cree usted que está funcionado el equipo (Tubo)?EQUIPOF7.1 Tubo en lamadre (mujerembarazada)F7.2 Tubo en el bebéNo.1F7.3 Tubo en el bebéNo.2MARQUEUNACASILLA1Sí 2No F7.51Sí 2No F7.61Sí 2No F7.7F7.4 Otro (Describir): 1Sí 2No F7.8(SI LA RESPUESTA EN LA COLUMNA ANTERIOR FUE NO):Describa el estado en que encontró el equipo (tubo):PREGUNTAR ACERCA DEL DIA ANTERIOR (EL DIA DE AYER):F.8 Para cada una de las comidas que se cocinaron en esa casa el día anterior y las cuales estándescritas en la primera columna de la tabla, pregunte:F8.1 ¿Cuántas tortillas se hicieron? La señora debe tomar en cuenta tanto las que se comieron como lasque sobraron o se vendieron y anotar la cantidad en la columna: No. de TortillasF8.2 ¿Para cuántas personas cocinaron? Anotar la cantidad en la columna: No. de PersonasF8.3¿Cuántas horas pasó encendido el fuego? Anotar la cantidad en la columna: No. De HorasF8.4 Del total de horas que estuvo encendido el fuego, ¿Cuántas horas paso el bebé o la mujerembarazada dentro de la cocina? Anotar la cantidad en la columna: No. de horas que el niño oembarazada pasó en la cocina mientras el fuego estuvo encendidoF8.5 Del total de horas que el bebé pasó dentro de la cocina, ¿Cuántas horas estuvo sobre la espalda dela persona que cocinó? Anotar la cantidad en la columna: No. de horas que el bebé pasa en la espaldade la persona que cocinóTIEMPO DECOMIDANo. deTortillasNo. dePersonasNo. deHoras queel fuegoestuvoencendidoNo. de horas que elniño o embarazadapasó en la cocinamientras el fuegoestuvo encendidoNo. de horas queel bebé pasa en laespalda de lapersona quecocinóDesayuno(Qlixje)Almuerzo(Q’ijtl)Cena(Qale)Nixtamal(Butx)Otro(Alkye juntl)(ESPECIFICQUE):38

___________PREGUNTAR DESDE QUE SE DEJO EL TUBO (HACE DOS DIAS):F9. Desde que se le puso el tubo al bebe (o a usted) hace dos días:(Tej so’k tub tij nex mo qa tija ma b’ant kab’e q’ij):F9.1 ¿Se ha usado el Chuj (tamascal)? (O tz’okninxe tchuja)1 Sí2 NoF9.2 ¿Se ha quemado basura cerca de la casa? (On kub’ patitxe tz’is tk’atz tjay)1 Sí2 NoF9.3 ¿Cuántos cigarros se han fumado dentro de la casa principal o la cocina?(Jte’n sich’ ob’ajxe tu’n toj nim ja mo b’inchbi’l wab’j)1 Ninguno2 De 1 a 23 3 o másF9.4 ¿Se ha usado el candil en la casa principal o la cocina?(On tz’okninxe candil tu’n toj tjay)1 Sí2 NoF9.5 ¿Se han encendido candelas dentro de la casa principal o la cocina? (Tzun nkub’ k’antsittq’aq’a toj tjay mo twutz tpenja toj jun jte q’ij exsin nya te b’inchbil tway tun toka)1 Sí2 NoF9.6 ¿Ha habido actividades especiales en la casa (fiestas, tiempos de comida en los que no secocinó porque la familia salió, etc.)? (On b’ajxe jun chmab’il a nim toklin toj tjay)1 Sí (PASE A LA PREGUNTA F9.6.1)2 No (FINALICE LA ENCUESTA)F9.6.1 Describa la actividad especial:(T’i chaq chmab’l a nim toklin) _____________________AGRACECER POR LA INFORMACIÓN AL ENTREVISTADO- FIN DE LA ENTREVISTAHora de Finalización de la entrevista: _____________________EntrevistaIniciales del entrevistador: _______________Revisión de la entrevistaFirma del supervisor:_____________________Supervisión equipo calidad del aireFirma del supervisor:_____________________Firma del entrevistador: ________________Fecha de la revisión: _________________Fecha de la revisión: _________________39

Ingreso de datosFirma Digitador # 1: _________________Revisión del ingreso de datosFirma del supervisor:_____________________Firma Digitador # 2: _________________Fecha de la revisión: _________________40

Appendix VII. Baseline Questionnaire-2 (BLQ2) ENGLISH VERSIONBaseline Questionnaire No. 2Measures and Questions related to Air QualityProject: “Particulate Air Pollution Exposure and Childhood Acute RespiratoryInfections in Guatemalan Children: A Randomized Intervention Trial.”Notes for the Interviewer:1. All instructions for interviewers are shown in bold, capital letters, or in parenthesis. Theseinstructions must not be read to the person being interviewed.2. Questions based on observations on the part of the interviewer have been written in capital lettersand must not be addressed to the participants.3. Each question should have at least one option marked: (“NK” = “Not known” y “NR” = “Noresponse”)4. All questions with multiple choice options must be read to the participant to allow him to select anoption.5. Two people should do the measurements of the house exterior and/or the kitchen. A measuringtape should be used.6. This interview should preferably be conducted with mothers of children 6 months old (orwith pregnant women).A: INTERVIEW DETAILSA1. HOUSEHOLD ID: _________A2. Interviewer’s Initials: _________ Interviewer’s Code: ______________A3. DATE OF INTERVIEW: ____ / ____ / ______dd mm yyyyA4. ADDRESS: ____________________ ___________________CommunityMunicipalityA5. NAME OF HEAD OF HOUSEHOLD:_______________ __________________ _______________ _______________First Name Second Name Paternal Surname Maternal SurnameA6. INTERVIEW START TIME: _________________________B: DETAILS OF HOUSE CONSTRUCTION AND ENERGY USE[OBSERVE AND CHOOSE THE BEST OPTION(S) TO ANSWER QUESTIONS B1 TO B4 ON THETWO TABLES BELOW AND ASK PARTICIPANTS FOR ANSWERS TO QUESTIONS B5 AND B6].41

A: Main house / bedrooms (includes cookingarea as part of the main structure of the house)B: Cooking area (complete ONLY whencooking area is separate from the mainhouse)Variable Options Code Variable Options CodeB1. RoofB2. WallsB3. FloorB4. Type ofstove(cookingfacility)B5.LightingSourceB6.HeatingSourceCoarse straw 1 Coarse straw 1Aluminum, Tejalita or 2 B1c. Roof Aluminum, Tejalita o 2DuralitaDuralitaTile 3 Tile 3Terrace 4 Terrace 4Other5Other5(Specify:) _________(Specify:) ________Cane or sticks 1 B2c.Walls Cane or sticks 1Fence/partition 2 Fence/partition 2Bajareque 3 Bajareque 3Adobe 4 Adobe 4Wood 5 Wood 5Cinderblock or brick 6 Cinderblock or brick 6Other7Other7(Specify) _________(Specify:) ________Earth 1 B3c. Floor Earth 1Wood 2 Wood 2Cement (slab or tile) 3 Cement (slab or tile) 3Other4Other4(Specify:) _________(Specify:) ________None 1 B4c. Type None 1Open fire (3 stones) 2 of stove Open fire (3 stones) 2Open fire (pollo) 3 (cooking Open fire (pollo) 3Iron plate (plancha) 4 facility) Iron plate (plancha) 4Improved stove 5 Improved stove 5Gas stove 6Gas stove 6None 1 B5c. None 1Open fire 2 Lighting Open fire 2Candles 3 Source Candles 3Homemade gas lamp 4 Homemade gas lamp 4(bottle/gas/cloth)(bottle/gas/cloth)Gas lamp (COLEMANtype)5 Gas lamp (COLEMANtype)5Electricity 6Electricity 6Nothing 1 B6. Nothing 1Heat is obtained from theopen fire used forcooking2 HeatingSourceHeat is obtained from theopen fire used forcooking2Another open fire is used 3Another open fire is used 3in addition to the onein addition to the oneused for cookingused for cooking42

Other(Specify:) _________4 Other(Specify:) ________C. USE OF CHUJ OR TAMASCAL (NATIVE STEAM BATH)C1. Do you have a Chuj or tamascal bath at home? 1 Yes (GO TO # C1.1)2 No (GO TO SECTON D)8 NK (GO TO SECTION D)9 NR (GO TO SECTION D)4C1.1. How many times during the month do you use it? ___________ times/monthC1.2. Which of the following do you use to heat it?(MARK ALL THAT APPLY)1 Charcoal2 Wood3 Agricultural waste products (Corn cobs or cane, fava bean shells orcabbage)4 Trash from the house5 Other (SPECIFY)______________C1.3. Do you bring your baby into the tamascal after the fire has been lit inside?1 Always2 Sometimes3 Never4 Other (SPECIFY): __________________D. WHERE DOES THE BABY SLEEP?If there is a baby in the house: (OTHERWISE GO TO SECTION E)D1. Does the baby sleep in the cooking area? 1 Yes At what age did s/he start?____weeksFor how long?_____months2 No (GO TO #D1.1)8 NK (GO TO SECTION D)9 NR (GO TO SECTION D)D1.1. Has the baby ever slept in the kitchen?1 YesAt what age did s/he start?____weeksFor how long?_____months2 NoE: STRUCTURAL ASPECTS OF THE “KITCHEN” THAT AFFECT VENTILATION(OBSERVE AND MEASURE) (These measures belong to the “kitchen” located either within themain structure of the house or as a separate structure)E1. (OBSERVE SPACES BETWEEN WALLS AND ROOF). These spaces are:1Completely closed2Partially open3Completely openE2. Do you usually keep your kitchen windows open or closed while you are cooking?WINDOW BREAKFAST LUNCH DINNERNONE1 Open Closed Open Closed Open Closed2 Open Closed Open Closed Open Closed3 Open Closed Open Closed Open Closed4 Open Closed Open Closed Open Closed43

5 Open Closed Open Closed Open ClosedE3. Windows. Record on the table below the information requested for each window:WINDOW DIMENSIÓN **1 cm2 cm3 cm4 cm5 cm**(Measure the window diagonally as shown in thedrawing above and write down measurements incentimeters )E4. Dimensions of the kitchen (IF THE KITCHEN IS LOCATED INSIDE THE HOUSE, MEAURE THEDIMENSIONS OF THE MAIN HOUSE)LengthDepthHeight from thefloor to the spacebetween the roofand the wallHeight from thefloor to thehighest point ofthe roof(a)(b)(c)(d)meterscdNote: if the kitchen has a flat roof (c) will have thesame value as (d).abF. QUALITY OF THE AIR INSIDE THE KITCHENF1. HOUSEHOLD ID: _________F2. ADDRESS: ____________________ ___________________CommunityMunicipalityF3. Initials of the person who removed the equipment: _________Code: _________F4. Date and hour of removal of equipment (When CO tube was capped):_____/____/_____ ____: ____dd / mm / yyyy hrs : minEquipmentMother’s TubeBaby’s Tube (No. 1)Baby’s Tube (No. 2)Other (Describe):ID(place sticker in this space)OBSERVATIONS44

F5. OBSERVE IMMEDIATELY UPON ARRIVING IN THE HOUSE: (If interviewer was not able toobserve, ask the mother)F5.1 Where was the mother when the interviewer arrived?1 In the kitchen2 In another part of the house3 Outside4 Other (SPECIFY)______________8 NKF5.2 If there is a baby at home, where was the baby when the interviewer arrived?1 In the kitchen2 In another part of the house3 Outside4 Other (SPECIFY)______________8 NKF5.3 Was the fire burning? 1 Yes 2 NoF6. OBSERVE: Was the equipment (CO tube) moved from its original position?EQUIPMENTMARK ONE BOXF6.1 Tube for the mother 1 Yes 2 No E6.5(pregnant woman)F6.2 Baby’s Tube (No. 1) 1 Yes 2 No E6.6(IF THE ANSWER TO THE PREVIOUSQUESTION WAS YES):Where did you find the equipment (CO Tube)?F6.3 Baby’s Tube (No. 2) 1 Yes 2 No E6.7F6.4 Other (Describe): 1 Yes 2 No E6.8F7. OBSERVE: Do you think the equipment is working?EQUIPMENTMARK ONE BOXF7.1 Tube for the mother 1 Yes 2 No E7.5(pregnant woman)F7.2 Baby’s Tube (No. 1) 1 Yes 2 No E7.6(IF THE ANSWER TO THE PREVIOUSQUESTION WAS NO):In what condition did you find the equipment(CO Tube)?F7.3 Baby’s Tube (No. 2) 1 Yes 2 No E7.7F7.4 Other (Describe): 1 Yes 2 No E7.8ASK ABOUT YESTERDAY:45

F.8 For each of the meals that were cooked in the house yesterday that are described in the firstcolumn of the table below, ask:F8.1 How many tortillas were made? The participant should include all the tortillas the family ate as wellas any that were left over after cooking as well as those she made to sell. Write the total quantity in thecolumn: No. of Tortillas.F8.2 How many people did she cook for? Write the total number in the column: No. of Persons.F8.3 How long was the fire lit? Write the total hours in the column: No. of hours fire was litF8.4 During the total period the fire was lit, how many hours were the baby and/or the woman in thecooking area? Note the hours in the column: No. of hours the child or pregnant woman was inkitchen while fire was litF8.5 Of all the hours the baby spent in the cooking area, how many hours was the baby on the back ofthe person who cooked? Note the number of hours in the column: No. of hours that the baby was onthe cook’s backMEALTIME No. of Tortillas No. of Persons No. of hoursfire was litNo. of hoursthe child orpregnantwoman wasin kitchenwhile firewas litNo. of hoursthat the babywas on thecook’s backBreakfastLunchDinnerNixtamalOther(Specify):ASK ABOUT TIME SINCE TUBE WAS LEFT (TWO DAYS AGO):F9.Since the tube was placed on the baby (or you) two days ago:F9.1 Have you used the Chuj (tamascal)?1Yes2 NoE9.2 Has any trash been burned near the house?1 Yes2 NoE9.3 How many cigarettes have been smoked inside the main house or the kitchen?1 None2 From 1 to 23 3 or moreE9.4 Have you used a homemade gas lamp (bottle, gas, cloth) inside the main house or thekitchen?1 Yes46

2 NoE9.5 Have any candles been lit inside the main house or the kitchen?1 Yes2 NoE9.6 Have there been any special activities in the house (i.e. parties, when no cooking took placebecause the family went out)?1 Yes (GO TO QUESTION F9.6.1)2 No (TERMINATE INTERVIEW)E9.6.1 Describe the special activity: _____________________THANK THE PARTICIPANT FOR THE INFORMATION PROVIDED AND END INTERVIEWTime interview ended _____________________InterviewInterviewer’s initials: _______________Interviewer’s signature: ________________Interview ReviewSupervisor’s signature:_________________Review date: _________________Air Quality Equipment SupervisorSupervisor’s signature:_________________Review date: _________________Data EntryData Entry # 1 Signature: _______________Data Entry # 2 Signature: _________________Data Entry ReviewSupervisor’s signature:_________________Review date: _________________47

Appendix VIII: Baseline Questionnaire-3 (BLQ3) SPANISH VERSIONBLQ3: ESTUDIO SOBRE LA SALUD DEL ADULTO, ASMA Y ALERGIASVISITA DOMICILIARA. INTRODUCCIÓN Y CONSENTIMIENTO:Pregunta Respuesta CódigoA1 Grupo GRUPO A (00-12)GRUPO B (00-18)A2 ID (casa) A3 ID (mujer) -AA4 ID Entrevistador A5 Fecha dd /mm /aaA6 Consentimiento No = 1Sí = 2SINTOMAS RESPIRATORIOS CRONICOSB. TOS: (SJO’L)Pregunta Respuesta CódigoB1 ¿Ud. Tose o ha tosido mucho?¿Tzun n-sjolin mo o sjolin ma nintz maj?No = 1Sí = 2Si “NO”, pase a la sección C (Flema)B2 ¿Ud. Tose o ha tosido al levantarse por las mañanas? No = 1B3B4¿Tzun n-sjolin mo o sjolin aj tjawey junjin qlexje?Si, SI: ¿Desde hace cuánto tiempo ha estadotosiendo al levantarse por las mañanas?¿Jtexe q’ij toknin ten sjo’l tija aj tjawey tzen qlexje?Si, SI: ¿Durante ese tiempo que tan seguido toseal levantarse por las mañanas?¿Chq’al n-tzaj sjol aj tjawey?Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2B5B6B7¿Ud. tose o ha tosido durante el día?¿tzun n-sjolin mo o sjolin tzen q’ijl?Si, SI: ¿Desde hace cuánto tiempo ha estadotosiendo durante el día?¿Jtexe q’ij toknin ten sjo’l tija a-qijtl?Si, SI: ¿Durante ese tiempo que tan seguido tosedurante el día?¿Chq’al n-tzaj sjol tija tzen q’ijl?No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =248

B8B9B10¿Ud. Tose o ha tosido durante la noche?¿Tzun n-sjolin mo o sjolin tzen qnik’in?Si, SI: ¿Desde hace cuánto tiempo ha estadotosiendo durante la noche?¿jtexe q’ij toknin ten sjol tija tzen qnik’en?Si, SI: ¿Durante ese tiempo que tan seguido tosedurante la noche?¿Chq’al n-tzaj sjol tija tzen qnik’en?No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2C. FLEMA: (XLOQ)Pregunta Respuesta CódigoC1 ¿Ud. saca flema o ha sacado flemas mucho?¿Tzun njatz xloq mo o jatz nim xloq tun?Si “NO”, no siga con las preguntas de esta secciónNo = 1Sí = 2C2C3C4C5C6C7C8¿Ud. saca o ha sacado flemas al levantarse por lasmañanas?¿Tzun njatz mo o jatz xloq tu’n aj tjawey?Si, SI: ¿Desde hace cuánto tiempo lleva sacandoflemas al levantarse por las mañanas?¿Jtexe q’ij toklen ten n-jatz txloqa tzen qlexje?Si, SI: ¿Durante ese tiempo que tan seguido sacaflema al levantarse por las mañanas?¿chqaltzin njatz txloqa tzen njawey qlexje?¿Ud. saca o ha sacado flemas durante el día?¿Tzun njatz mo o jatz txloqa tzen q’ijl?Si, SI: ¿Desde hace cuánto tiempo lleva sacandoflemas durante el día?¿Jtexa q’ij toklen ten xloq a njatz tzen q’ijl?Si, SI: ¿Durante ese tiempo que tan seguido sacaflemas durante el día?¿Chq’al njatz txloqa tzen q’ijl?¿Ud. saca o ha sacado flemas durante la noche?¿Tzun njatz mo o jatz txloqa tzen qnik’en?No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2No = 1Sí = 2C9C10Si, SI: ¿Desde hace cuánto tiempo lleva sacandoflemas durante la noche?¿Jtexa q’ij toklen ten njatz txloqa tzen qnik’en?Si, SI: ¿Durante ese tiempo que tan seguido sacaflemas durante la noche?¿Chq’al njatz txloqa tzen qnik’en?Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =249

Si la respuesta es “no” para las preguntas: B1 y C1; PASE a la Sección E (Asma Rinitis yEczema)Si la respuesta es “si”, para las preguntas: B.1 y/o C.1, CONTINÚE en la Sección D (Periodosen los que empeora la tos y la flema)D. PERIODOS EN LOS QUE EMPEORA LA TOS (SJO’L) Y LA FLEMA (XLOQ):D1Pregunta Respuesta Código¿En los últimos 12 meses, ha tenido períodos en los cuales No = 1EMPEORO la tos Y la flema?Sí = 2¿Toja ab’q’e xjawel b’aj at q’ij n-xiy to il tu’n sjol tuk’a xloq?D2D3D4→Si NO, pasar a la sección E (Asma, Rinitis y Eczema)Si, SI: ¿Desde hace cuanto tiempo ha tenidoperíodos en los cuales EMPEORO la tos Y laflema?¿Jte maj’ o txiy toj il tun sjol tuj’a xloq?Si, SI: ¿Durante los últimos 12 meses, ha tenidomás de uno de estos períodos en los cualesEMPEORO la tos Y la flema?¿Toja abq’e xjawel b’aj jte maj xiy toj il tun sjol exxloq ?¿Ha tenido dificultad para respirar en los periodos en loscuales la tos Y la flema EMPEORARON?¿At junjen maj penex njatza txewa te txiy toj il tun sjol exxloq?Pocos días =1Una a dos semanas=2Tres semanas omás =3No = 1Sí = 2No = 1Sí = 2E. ASMA, RINITIS Y ECZEMA:E1Pregunta Respuesta Código¿Alguna vez le ha silbado el pescuezo cuando respira? No = 1¿At jun maj o tzolen tqula?Sí = 2E2E3→Si la respuesta es NO, pase a E3¿En los últimos 12 meses, ha tenido ataques en los cuales lesilvaba el pescuezo?¿Toja abq’e xjawel-b’aj at jun maj oklen tzol qul tija?¿En los últimos 12 meses, ha despertado en la mañana con lasensación de opresión en el pecho?¿Toja abq’e xjawel b’aj o ja sak’pajxiy jun maj qlixje penixnjatza txewa?No = 1Sí = 2No = 1Sí = 250

E4Pregunta Respuesta Código¿Alguna vez el doctor o enfermera le han diagnosticado No = 1Asma?Sí = 2¿At jun maj o tza q’man tey tun Doctor o Enfermera qa atasma tija?E5E6¿Alguna vez ha tenido salpullido (erupción) con picazón en lapiel, que aparecía y desaparecía, por al menos 6 meses?¿At jun maj o-tzaj xjo’s tija (n-sputen) ex n-metzen tija n-tzajxen-elxe naj a nwe qaq xjaw?→Si la respuesta es “NO”, pase a la pregunta E8¿En los últimos 12 meses, usted ha tenido este salpullido conpicazón?¿At jun majtoja abq’e xjawel o-tzaj xjo’s tija a-tzunxex n-metzen?No = 1Sí = 2No = 1Sí = 2E7E8E9¿En algún momento ha tenido este salpullido con picazón enalguno de los siguientes lugares?(a)Pliegue del codo, (b)atrás de las rodillas, (c)pliegue deltobillo, (d)debajo de los nalgas, (e)o alrededor del cuello,orejas y ojos¿At jun maj o-tzaj xjos a-nmetzen ti’ja plaj?(a)Tcheky tq’ob’a (b)Txpaq’ch tqan, (c)Twonsi tqan, (d)Tij t-xopa, (e)Tij tqula txquin ex twutza.¿Alguna vez ha tenido problemas de estornudos, mocos Onariz tapada cuando NO tenía catarro o gripe?¿At jun maj o tzaj metzin toj t-txan mo xpon t-txan tzen nti’chon-wi tija?→Si la respuesta es “NO”, pase a la sección F¿En los últimos 12 meses, ha tenido problemas de estornudos,mocos o nariz tapada cuando NO tenía catarro o gripe?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon-wi’tija?No = 1Sí = 2No = 1Sí = 2No = 1Sí = 2F. DOLOR DE CABEZA Y ARDOR DE OJOS:F1Pregunta Respuesta Código¿En el último mes ha tenido dolores de cabeza? No = 1¿Toja xjaw xbaj tzaj te tchon twi’ ?Sí = 2F2Si, SI: ¿ Durante ese tiempo que tanseguido ha tenido dolores de cabeza?¿ Chaq’al n-tzaj tchon twiy?Todos los días = 1La mayoría de los días de lasemana =2Pocos días a la semana = 3Una vez por semana = 4Menos de una vez porsemana = 551

F3Pregunta Respuesta CódigoSi, SI: ¿Qué tan fuertes son los dolores Muy fuertes = 1de cabeza?Regulares = 2¿Tzentzin tchon twiy?Suaves = 3F4F5F6F7¿En el último mes ha tenido ardor de ojos u ojosllorosos?¿Toja xjaw xb’aj ma chi julin twutza mo nchitalinj?→Si la respuesta es NO, pase a la sección GSi, SI: ¿ Durante ese tiempo que tanseguido ha tenido ardor de ojos u ojosllorosos?¿Chq’al nchi julin mo nchi talin twutza?Pregunte y observe:Si le lloran los ojos,¿Cómo es la secreción?Qaninxa ex kayinka:¿Qa ntalin twutz ¿tzen kayin tal twutz?→Si, la respuesta es= 1: Pasar a la sección GSi, la respuesta es =2: la secreción esamarilla o verdosa y pegajosa ¿Haceque no pueda despegar sus ojos cuandose despierta?Si, la respuesta es =2:¿Q’an o txaxkayin txa twutza minjqet aj tja wey?→Si, SI: Refiera al medico del estudioNo = 1Sí = 2Todos los días = 1La mayoría de los días de lasemana =2Pocos días a la semana = 3Una vez por semana = 4Menos de una vez porsemana = 5Clara, acuosa = 1Amarilla o verdosa ypegajosa = 2No = 1Sí = 2G. DOLOR DE ESPALDA:G1Pregunta Respuesta Código¿Durante el último mes ha tenido dolores de No = 1espalda?Sí = 2¿Toja xjaw xbaj o chon tzkeltija?G2G3→Si la respuesta es “NO”, pase a la sección HSi, SI: ¿ Durante ese tiempo, que tanseguido ha tenido dolores de espalda?¿Chq’altzin n-tzaj tchon tzkeltija?Si, SI: ¿Qué cosas hacen que le duelamás la espalda?¿Ti n-kub’ tb’inchin tzen n-oqkten tijachol?Todos los días = 1La mayoría de los días dela semana =2Pocos días a la semana = 3Una vez por semana = 4Menos de una vez porsemana = 5Cargar leña = 1Lavar ropa = 2Cocinar = 3Otro (especifique) = 452

G4G5Pregunta Respuesta CódigoSi, SI: ¿Los dolores han sido tan fuertes No = 1que ha dejado de hacer sus oficios? Si =2 (especifique en lasiguiente casilla)¿Aj t-tzaj tchon tija mi n-aq’nila tun?Describa como el dolor afecta sus oficios:H. TRAFICO:H1Pregunta Respuesta Código¿De lunes a viernes, con qué frecuencia Nunca = 1pasan camiones por los caminos Casi nunca =2cercanos a su casa?Algunas veces durante el día = 3Casi todo el día = 4¿T’kiaqil q’ij nchi b’et car ja tkub’a tjay?I. ASMA, RINITIS Y ECZEMA (PADRE): (SI ES MADRE SOLTERA PASAR A LA SECCIÓN J)De ser posible entrevistar al padre del niño bajo estudio. Si no se encuentra, entonces preguntar ala madre del niño:I1Pregunta Respuesta Código¿Alguna vez le ha silbado el pescuezo cuando respira? No = 1¿At jun maj o tzolin tqul tchmila?Sí = 2I2→Si la respuesta es “NO”, pase a la pregunta I3¿En los últimos 12 meses, ha tenido ataques en los cuales lesilvaba el pescuezo?¿Toja abq’e xjawel at jun maj okten tzolin qul tij (a)?No = 1Sí = 2I3I4I5¿En los últimos 12 meses, ha despertado en la mañana con lasensación de opresión en el pecho?¿Toja abq’e xjawel o jasak’pajxi jun maj penix njatza t-xew?¿Alguna vez el doctor o enfermera le han diagnosticadoAsma?¿At jun maj o-tza q’man tey tun Doctor o Enfermera qa atasma tij (a)?¿Alguna vez ha tenido salpullido (erupción) con picazón en lapiel, que aparecía y desaparecía, por al menos 6 meses?¿At jun maj o-tzaj xjo’s tija (n-sputen) ex n-metzen n-tzajxen-elxe naj a nwe qaq xjaw?→Si la respuesta es “NO”, pase a la pregunta I8No = 1Sí = 2No = 1Sí = 2No = 1Sí = 253

I6Pregunta Respuesta Código¿ En los últimos 12 meses, usted ha tenido este salpullido con No = 1picazón?Sí = 2¿ At jun maj toja ab’q’e xjawel o-tzaj xjos tija a-tzunxexn-metzen?I7I8I9¿En algún momento ha tenido este salpullido con picazón enalguno de los siguientes lugares?(a)Pliegue del codo, (b)atrás de las rodillas, (c)pliegue deltobillo, (d)debajo de las nalgas, (e)o alrededor del cuello,orejas y ojos¿At jun maj o-tzaj xjos a – nmetzen ti’ja plaj?(a)Tcheky tq’ob’a, (b)txpaq’ch tqan, (c)Twonsi tqan, (d)Tijt-xopa, (e)Tij tqula txquin ex twutza.¿Alguna vez ha tenido problemas de estornudos, mocos Onariz tapada cuando NO tenía catarro o gripe?¿At jun maj o tzaj metzin toj t-txan mo xpon t-txan tzen nti’chon-wi tij (a)?→Si la respuesta es “NO”, pase a la pregunta J1¿En los últimos 12 meses, ha tenido problemas de estornudos,mocos o nariz tapada cuando NO tenía catarro o gripe?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon witija?No = 1Sí = 2No = 1Sí = 2No = 1Sí = 2J. PREGUNTAS RELACIONADAS CON EL NIÑO DEL ESTUDIO: (SI ES MUJER EMBARAZADAPASAR A LA SECCION K)J1Pregunta Respuesta Código¿Alguna vez le ha silbado el pescuezo a su niño No = 1cuando respira?Sí = 2¿At jun maj o tzolin tqulja tala?J2J3→Si la respuesta es “NO”, por favor pase a lapregunta J3Si, SI:¿Cuantos ataques en los cuales le hasilbado el pescuezo ha tenido su niño (a) ensu vida?¿Jtexe maj n tzaj tzolin qul tija tala tuk’atanq’len?¿Aproximadamente, qué tan seguido baña al niño (a)ya sea con esponja o en bañito?¿Chq’al n-okx tala chujel mo noq n-ichin?Ninguno = 11-3 = 24-12 = 3Más de 12 = 4Rara vez = 1Una vez al mes = 2Una vez a la semana=3Diario =454

K. PREGUNTAS QUE SE DEBERAN REPETIR POR CADA UNO DE LOS HERMANOS < 15 AÑOS:(SI LA MADRE NO TIENE MAS NIÑOS QUE EL DEL ESTUDIO PASAR A SECCION M)K1 ID DEL HERMANO(A):ID del niño y edad en añosEdadCódigo de IDK2 PREGUNTAS AMBIENTALES ADICIONALES:Pregunta Respuesta CódigoNo = 1Sí = 2K2.1 ¿Ha vivido su niño (a) en la misma casa toda suvida?¿Antza najlen tala tuk-a titzja?K2.2 ¿Durante los primeros 12 meses de la vida desu niño (a) Ud. acostumbraba darleacetaminofen para bajarle la fiebre?¿A-te tel ab’q’e tala xi tq’on acetaminofen tuntkub’ kyaq tij?→Si la respuesta es “NO”, por favor pase ala pregunta K2.4K2.3 ¿Durante los últimos 12 meses, que tan seguidole dio acetaminofen a su niño (a)?¿Toja ab’q’e xbaj chq’al xi tq’on acetaminofente?K2.4 ¿Durante los primeros 12 meses de la vida desu niño (a) le dio antibióticos a su niño (a)?¿Te s-el ab’q’e tala xi tq’on antibiotico te tala?No = 1Sí = 2Nunca = 1Al menos una vez al año =2Al menos una vez al mes =3No = 1Sí = 2K3 PREGUNTAS MEDULARES SOBRE ASMA:Pregunta Respuesta CódigoNo = 1Sí = 2K3.1 ¿Alguna vez en el pasado a su niño (a) le hasilbado el pescuezo cuando respiraba?¿At jun maj tzolin tqul tala?→ Si la respuesta es “NO”, por favor pase ala pregunta K3.6K3.2 ¿ Durante los últimos 12 meses a su niño (a) leha silbado el pescuezo?¿Toja ab’q’e xb’aj tzolin tqulja tala ?→ Si la respuesta es “NO”, por favor pase ala pregunta K3.6K3.3 ¿ Durante los últimos 12 meses, cuántosataques en los que le silba el pescuezo hatenido su niño (a)?¿Toja ab’q’e xb’aj jte maj tzaj tzolin qul tij tala?No = 1Sí = 2Ninguno = 11-3 = 24-12 = 3> 12 = 455

Pregunta Respuesta CódigoK3.4 ¿Durante los últimos 12 meses con quefrecuencia, más o menos, se ha interrumpido elsueño de su niño (a) debido a que le silva elpescuezo?Nunca se ha despertado consilbidos en el pescuezo = 1Menos de una nochea la semana =2¿Toja ab’q’e xb’aj jte maj el twatlja tala tun tzolin Una o más noches porqul?semana =3K3.5K3.6¿En los últimos 12 meses los silbidos en elpescuezo de su niño (a) han sido tantos que nopuede decir más de una o dos palabrasseguidas sin tomar aire?¿Toja ab’q’e xb’aj a tala penix nb’anta tyolin tuntzolin qul?¿Alguna vez el doctor o enfermera le handiagnosticado Asma a su niño (a)?¿At jun maj o tzaj q’man tun Doctor o Enfermeraqa at asma tij tala?No = 1Sí = 2No = 1Sí = 2K3.7 ¿Durante los últimos 12 meses le ha silbado elpescuezo a su niño durante o después de hacerejercicio?¿Toja ab’q’e xb’aj n-tzaj tzolin qul tij tala tzen n-rinen?K3.8 ¿Durante los últimos 12 meses, ha tenido suniño (a) tos seca durante la noche, SIN habertenido al mismo tiempo catarro o una infecciónrespiratoria?¿Toja ab’q’e xb’aj o tzaj tzqij sjol tij tala qnik’enexsin nti chon-wi tij?No = 1Sí = 2No = 1Sí = 2K4 PREGUNTAS MEDULARES SOBRE RINITIS:Pregunta Respuesta CódigoK4.1 ¿Ha tenido su niño alguna vez problemas con estornudos Onariz tapada O mocos SIN tener catarro o gripe?¿At jun maj o-tzaj tij tala xpon t-txan a nti chon-wi’ tij?No = 1Sí = 2→ Si la respuesta es “NO”, por favor pase a la sección K5K4.2 ¿En los últimos 12 meses ha tenido su niño problemas conestornudos O nariz tapada O mocos SIN tener catarro o gripe?¿Toja ab’q’e xb’aj xpet t-txan tala te ntitaq chon-wi tij?→ Si la respuesta es “NO”, por favor pase a la sección K5K4.3 ¿En los últimos 12 meses, el problema de la nariz se ha vistoacompañado de ardor de ojos y ojos llorosos?No = 1Sí = 2No = 1Sí = 2¿Toja ab’q’e ab’aj tzen n-xpet t-txan tzun njulin twutz monchitalin twutz?→ Si la respuesta es “NO”, por favor pase a la sección K556

K4.4Pregunta Respuesta Código¿Durante cuál de los últimos 12 meses tuvo este problema?(Subraye la respuesta y anote el código)¿Alkye xjaw te’ ab’q’e xb’aj te t-tzaj tij?Enero =1Febrero =2Marzo =3Abril =4Mayo =5Junio =6Julio =7Agosto =8Septiembre =9Octubre =10Noviembre =11Diciembre =12K5 PREGUNTAS MEDULARES SOBRE ECZEMA:Pregunta Respuesta CódigoK5.1 ¿Alguna vez ha tenido su niño (a)salpullido (erupción) conpicazón en la piel, que aparecía y desaparecía; por almenos 6 meses?No = 1Sí = 2¿At jun maj tij tala O-tzaj xjo’s (n-sputen) ex n-metzen n-tzajxe n-elxe naj a nwe qaq xjaw?→ Si la respuesta es “NO”, por favor pase a la secciónLK5.2 ¿ En algún momento, durante los últimos 12 meses, suniño (a) ha tenido ese salpullido con picazón?¿ At jun maj toja ab’q’e xb’aj o tzaj xjos tija tala a-tzunxexn-metzen?→ Si la respuesta es “NO”, por favor pase a la secciónLK5.3 ¿En algún momento ha tenido este salpullido con picazónen alguno de los siguientes lugares?No = 1Sí = 2No = 1Sí = 2(a)Pliegue del codo, (b)atrás de las rodillas, (c)pliegue deltobillo, (d)debajo de las nalgas, (e)o alrededor del cuello,orejas y ojos¿At jun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a, (b)txpaq’ch tqan, (c)twonsil tqan, (d)Tij t-xopa, (e)tijtqul txquin ex twutza.K5.4 ¿Que edad tenía su niño (a), cuando le dio este salpullidocon picazón por primera vez?¿Jtetaq ab’q’e tala te tzaj xjos tij a-tzunx n-metzen tnejelmaj?K5.5 ¿En los últimos 12 meses, ha desaparecido completamenteel salpullido?Menos de 2 años =1De 2-4 años = 25 años o mas = 3No = 1Sí = 2¿Toja ab’q’e xjawel o-naja xjos tij te-junmajx?L. PREGUNTAS QUE SE DEBERAN REPETIR POR CADA UNO DE LOS HERMANOS < 09 AÑOS:L1. ID DEL HERMANO(A):57

ID del niño y edad en añosEdadCódigoL2. QUEMADURAS Y ESCALDADURAS:Pregunta Respuesta CódigoNo = 1Si = 2L2.1 ¿Durante los últimos 6 meses hasufrido su niño (a) alguna quemadura(con algún objeto o líquido caliente)?¿Toja tqaqen xjaw o tzey jun maj talatuk’a kyqa mojqa tuk’a q’aq’?L2.2 Si Si, ¿que tan grave?¿Jni tzey?→ Si la respuesta es “NO”, por favorpase a la pregunta L2.4Leve (no hay cicatriz) = 1Moderada (cicatriz más pequeña que unamoneda de 1Q) = 2Grave (cicatriz más grande que unamoneda de 1Q) = 3Si es Grave (3) Mida el tamaño de lacicatriz y anote su superficie:_____ X _____ cms.L2.3 Y, ¿cómo se quemó?Y, ¿Tzen tzeya?Cayó en el fogón = 1Se quemó con un objeto caliente = 2Se derramó un recipiente con líquidocaliente (Ej. agua) = 3Otro = 4 (Especifique)L2.4 ¿Alguna vez, anterior a los últimos 6meses, se ha quemado su niño (a)?¿Toja tqaqen xjaw o-tzey tala jun maj?No =1Leve (no hay cicatriz) =2Moderada (cicatriz más pequeña que unamoneda de 1Q) = 3Grave (cicatriz más grande que unamoneda de 1Q) = 4Si es Grave (4) Mida el tamaño de lacicatriz y anote su superficie:_____ X _____ cms.L2.5 Si fue grave (código = 4)¿Que edad tenía cuando sequemó?¿qa nim tzey te jtetaq tab’q´e tet-tzey?L2.6 ¿Cómo se quemó?¿Tzen tzeya?Edad (años)Se cayó en el fogón = 1Se quemó con un objeto caliente = 2Se derramó un recipiente con líquidocaliente (Ej. agua) = 3Otro = 4 (Especifique)58

M. ESPIROMETRIA: (Ha realizarse únicamente a la madre del niño que participa en el estudio)RespuestaM1 ID Operador CódigoM2 ID espirómetro M3 Fecha de nacimiento dd / mm/ aaM4 Estatura de la mujer cmM5 Peso de la Mujer Kg.M6 ¿Esta embarazada la madre? No = 1Sí = 2M7 Fecha en que se realizó la espirometría dd / mm/ aaM8 Hora en la que se realizó la espirometríahh mmM9 El supervisor estuvo presente No = 1Sí = 2M1. CATARRO CON TOS RECIENTE:M1.1 ¿En los últimos días ha tenido catarro contos?RespuestaNo = 1Sí, durante las ultimas dossemanas = 2Sí, por más dos semanas = 3CódigoM2. RESULTADOS DE LA ESPIROMETRIA: (Con un máximo de 8 soplidos)Soplido#1Buen soplido = 1Comienzo lento = 2Poco esfuerzo = 3Final abrupto = 4Tos = 5Mala técnica = 6Soplido muy corto = 7Operador AparatoMicroloopFEV1Resultado Mejor = 12 da mejor = 2FVCResultado Mejor = 12 da mejor = 223456759

8Calcule SOLAMENTE utilizandolos valores de los buenossoplidos, la diferencia entre elprimero y el segundo mejor LITROS LITROSM2. CONTROL DE CALIDAD DE LA ESPIROMETRIA:RespuestaM2.1 Por lo menos 3 buenos soplidos No = 1Sí = 2CódigoM2.2 FEV1: ¿La diferencia entre el mejor y el segundo mejor valores menor de 0.20 litros?M2.3 FVC: ¿La diferencia entre el mejor y el segundo mejor valor esmenor de 0.20 litros?No = 1Sí = 2No = 1Sí = 2M2.4 Si no es posible lograr un buen soplido describa la razón :M2.5 Si la señora no realizó la espirometría describa el motivo:N. MONÓXIDO DE CARBONO EN ALIENTO:RespuestaN1 ¿Hace cuanto tiempo cocinó por última vez?Fechadd/mm/aa(Anotar Primero la fecha y luego la hora)Horahh:mmN2 ID Monitor CO MCO- -CódigoN3 Hora de inicio de la medición Horahh:mmN4 Resultado de las medicionesPPM 1PPM 2PPM 3O. REFERENCIA DE LA MADRE:RespuestaO1 Referencia No = 1Médico del estudio = 2Centro de Salud = 3Código60

O2Razón para referirla (Describa)EntrevistaAGRADECER POR LA INFORMACIÓN AL ENTREVISTADO- FIN DE LA ENTREVISTAIniciales del entrevistador: _______________Firma del entrevistador: ________________Revisión de la entrevistaFirma del supervisor:_____________________ Fecha de la revisión: _________________Supervisión de la mediciónFirma del supervisor:_____________________ Fecha de la revisión: _________________Ingreso de datosFirma Digitador # 1: _________________Firma Digitador # 2: _________________Revisión del ingreso de datosFirma del supervisor:_____________________ Fecha de la revisión: _________________OBSERVACIONES:61

Appendix IX: Baseline Questionnaire-3 (BLQ3) ENGLISH VERSIONBLQ3: STUDY OF ADULT HEALTH, ASTHMA AND ALLERGIESHOME VISITA. INTRODUCTION AND CONSENT:Question Answer CodeA1 Group GROUP A (00-12)GROUP B (00-18)A2 ID (home)A3A4ID (woman)ID InterviewerA5 Date dd /mm /yyA6 Consent No = 1Yes = 2CHRONIC RESPIRATORY SYMPTOMSB. COUGH: (SJO’L)Question Answer CodeB1 Do you cough or have you coughed a lot?¿Tzun n-sjolin mo o sjolin ma nintz mouj?If “NO”, go to section C (Phlegm)No = 1Yes = 2B2B3B4B5Do you cough or have you coughed when getting up in themorning?¿Tzun n-sjolin mo o sjolin aj tjawey janjin qlexje?IF, Yes: Since how long ago have you beencoughing when getting in the morning?¿Jtexe q’ij toknin ten sjo’l tija aj tjawey tzen qlexje?If, Yes: During this time, how often do you coughwhen getting up in the morning?¿Chq’al n-tzaj sjol aj tjawey?Do you cough or have you coughed during the day?¿Tzun n-sjolin mo o sjolin tzen q’ijl?No = 1Yes = 2Less than 3 months = 1Around 3 months =2More than three months= 3Frequently = 1Once in a while = 2No = 1Yes = 2B6B7If, Yes: Since how long ago have you beencoughing during the day?¿Jtexe q’ij toknin ten sjo’l tija a-qijtl?If, Yes: During this time, how often do you coughduring the day?¿Chq’al n-tzaj sjol tija tzen q’ijl?Less than 3 months = 1Around 3 months =2More than three months= 3Frequently = 1Once in a while = 262

B8B9B10Do you cough or have you coughed during the night?¿Tzun n-sjolin mo o sjolin tzen qnik’in?If, Yes: Since how long ago have you beencoughing during the night?¿jtexe q’ij toknin ten sjol tija tzen qnik’en?If, Yes: During this time, how often do you coughduring the night?¿Chq’al n-tzaj sjol tija tzen qnik’en?No = 1Yes = 2Less than 3 months = 1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2C. FLEMA: (XLOQ)Question Answer CodeC1 Do you produce or have you produced a lot of phlegm?¿Tzun njatz xloq mo o jatz nim xloq tun?No = 1Yes = 2C2C3C4C5C6C7C8C9C10→ If “NO” go to section D (Periods of Cough withPhlegm)Do you produce or have you produced phlegm whengetting up in the morning?¿Tzun njatz mo o jatz xloq tu’n aj tjawey?If, Yes: For how long have you been producingphlegm when getting up in the morning?¿Jtexe q’ij toklin ten n-jatz txloqa tzen qlexje?If, Yes: During this time, how often do you producephlegm when getting u in the morning?¿chqaltzin njatz txloqa tzen njawey qlexje?Do you produce or have you produced phlegm during theday?¿Tzun njatz mo o jatz txloqa tzen q’ijl?If, Yes: Since how long ago have you beenproducing phlegm during the day?¿Jtexa q’ij toklen ten xloq a njatz tzen q’ij?If, Yes: During this time, how often do you producephlegm during the day?¿Chq’al njatz txloqa tzen q’ijl?Do you produce or have you produced phlegm during thenight?¿Tzun njatz mo o jatz txloqa txloqa tzen qnikén?If, Yes: Since how long ago have you beenproducing phlegm during the night?¿Jtexa q’ij toklen ten njatz txloqa tzen qnik’en?If, Yes: During this time, how often do you producephlegm during the night?¿Chq’al njatz txloqa tzen qnik’en?No = 1Yes = 2Less than 3 months = 1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2No = 1Yes = 2Less than 3 months = 1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2No = 1Yes = 2Less than 3 months = 1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 263

If the answer is “No” for the questions B.1 and C.1: GO TO Section E (Asthma, Rhinitis andEczema).If the answer is “Yes” for the questions B.1 and/or C.1: CONTINUE with Section D (Periods inwhich cough and phlegm get worse).D. PERIODS IN WHICH THE COUGH (SJO’L) AND PHLEGM (XLOQ) GET WORSE:Question Answer CodeD1 During the past 12 months, have you had periods in whichthe cough and phlegm GETS WORSE?¿Toja ab’q’e xjawel b’aj at q’ij n-xiy to il tu’n sjol tuk’a xloq?No = 1Yes = 2D2D3D4→If NO, go to section E (Asthma, Rhinitis and Eczema)If, Yes: How long has it been since you had periodsin which the cough and phlegm GETS WORSE?¿Jte maj’ o txiy tun il tun sjol tuj’a xloq?If, Yes: During the last 12 months, have you hadmore than one of these periods in which the coughand phlegm GETS WORSE?¿Toja abq’e xjawel b’aj jte maj xiy taj il tun sjol exxloq ?Have you had difficulty breathing during the periods inwhich the cough or phlegm GET WORSE?¿At junjen maj penex njatza txewa te txiy tojil tun sjol exxloq?A few days =1One to two weeks =2Three weeks ormore =3No = 1Yes = 2No = 1Yes = 2E. ASTHMA, RHINITIS AND ECZEMA:Question Answer CodeE1 Has your neck ever whistled?¿At jun maj o tzolen tqula?→If the answer is NO, go to E3No = 1Yes = 2E2E3During the past 12 months, have you once had attacks inwhich your neck whistles?¿Toja abq’e xjawel-b’aj at jun maj oklen tzol qul tija?During the past 12 months, have you once woken up in themorning with the sensation of a pressure on your chest?¿Toja abq’e xjawel b’aj o ja sak’pajxiy jun maj qlixje penixnjatza txewa?No = 1Yes = 2No = 1Yes = 264

Question Answer CodeE4Has the doctor or nurse ever diagnosed you with Asthma?¿At jun maj o tza q’man tey tun Doctor o Enfermera qa atasma tija?No = 1Yes = 2E5E6Have you ever had on your skin an itchy rash that appearedand disappeared for periods that lasted a total of at least 6months?¿At jun maj o-tzaj xjo’s tija (n-spufen) n-mtzen tija n-tzajxe n-elxe naj a nwe qaq xjaw?→If the answer is “NO”, go to question E8Have you had this itchy rash at any moment during the last 12months?¿At jun majtoja abq’e xjawel o-tzaj xjo’s tija a-tzunxex n-metzen?No = 1Yes = 2No = 1Yes = 2E7E8E9Have you ever had this itchy rash in any of the followingplaces?(a)Fold of your elbow, (b)Behind your knee, (c)Fold of yourankle, (d)Below your buttocks, (e)or Around your neck, earsand eyes¿At jun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a (b)Txpaq’ch tqan, (c)Twonsi tqan, (d)Tij t-xopa, (e)Tij tqula txquin ex twutza.Have you ever had problems with sneezing, mucus or blockednose when you DID NOT have a cold or flu?¿Atjun maj o tzaj metzin loj t-txan mo xpon t-tzan tzen nti’chon-wi’tija?→If the answer is “NO”, go to question F1During the past 12 months, have you had problems withsneezing, mucus or blocked nose when you DID NOT have acold or flu?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon-wi’tija?No = 1Yes = 2No = 1Yes = 2No = 1Yes = 2F. HEADACHE AND BURNING EYES:Question Answer CodeF1 During the past month, have you hadheadaches?¿Toja xjaw xbaj tzaj te tchon twi’ ?No = 1Yes = 2F2F3If, Yes: How often have you hadheadaches during this time?¿ Cha’al n-tzaj tchon twiy?If, Yes: How strong are the headaches?¿Tzentzn tchon twiy?Every day = 1Most days of the week =2A few days per week = 3Once per week = 4Less than once per week = 5Very strong = 0Average = 1Mild = 265

Question Answer CodeF4 During the past month, have you had burningeyes, watery eyes?¿Toja xjaw xb’aj ma chi julin twutza mo nchitalinj?No = 1Yes = 2F5F6If, Yes: During this time, how often haveyou had burning eyes or watery eyes?¿Chq’al nchi julin mo nchi talin twutza?Ask and observe:If your eyes water, what is the secretionlike?Qaninxa ex kayinka:¿Qa ntalin twutz ¿tzen kayin tal twutz?Every day = 1Most days of the week =2A few days per week = 3Once per week = 4Less than once per week = 5Clear, aqueous = 1Yellow, green, sticky = 2F7If the answer = 2: the secretion isyellow or greenish and sticky, Does itmake it so you cannot open your eyeswhen you wake up?If, Yes =2: ¿Q’an o txax kayin txa twutzaminjqet aj tja wey?→ If, Yes: Refer to Health CenterNo = 1Yes = 2G. BACK PAIN:Question Answer CodeG1 Have you had back pain during the past month?¿Toja xjaw xbaj o chon tzkeltija?No = 1Yes = 2G2G3If the answer is “No”, go to section HIf, Yes: During this time, how often haveyou had back pain?¿Chq’altzin n-tzaj tchon tzkeltija?If, Yes: What things make your back hurtmore?¿Ti n-kub’ tb’inchin tzen n-oqkten tijachol?Every day = 1Most days of the week =2A few days per week = 3Once per week = 4Less than once per week =5Carrying Wood = 1Washing Clothes= 2Cooking = 3Other (specify) = 4G4G5If, Yes: Have the back pain been sostrong that that you have stopped doingyour duties?¿Aj t-tzaj tchon tija mi n-aq’nila tun?Describe how the pain affects your duties:No = 1Yes =2 (specify in thefollowing box)66

H. TRAFFIC:Question Answer CodeH1 From Mondays to Fridays, howfrequently do trucks pass by the roadswhere you live?¿T’kiaqil q’in nchi b’et car ja tkub’a tjay?Never = 1Almost never =2A few times during the day = 3Almost all day = 4ASTHMA, RHINITIS Y ECZEMA (FATHER): (IF SINGLE MOTHER, GO ON TO SECTION J)If possible, interview father of the child under study. If he is not found, then ask the child’smother:Question Answer CodeI1 Has your neck ever whistled?¿At jun maj o tzolen tqula?→If the answer is NO, go to I3No = 1Yes = 2I2I3I4I5I6During the past 12 months, have you once had attacks inwhich your neck whistles?¿Toja abq’e xjawel-b’aj at jun maj oklen tzol qul tija?During the past 12 months, have you once woken up in themorning with the sensation of a pressure on your chest?¿Toja abq’e xjawel b’aj o ja sak’pajxiy jun maj qlixje penixnjatza txewa?Has the doctor or nurse ever diagnosed you with Asthma?¿At jun maj o tza q’man tey tun Doctor o Enfermera qa atasma tija?Have you ever had on your skin an itchy rash that appearedand disappeared for periods that lasted a total of at least 6months?¿At jun maj o-tzaj xjo’s tija (n-spufen) n-mtzen tija n-tzajxe n-elxe naj a nwe qaq xjaw?→If the answer is “NO”, go to question I8Have you had this itchy rash at any moment during the last 12months?¿At jun majtoja abq’e xjawel o-tzaj xjo’s tija a-tzunxex n-metzen?No = 1Yes = 2No = 1Yes = 2No = 1Yes = 2No = 1Yes = 2No = 1Yes = 2I7Have you ever had this itchy rash in any of the followingplaces?(a)Fold of your elbow, (b)Behind your knee, (c)Fold of yourankle, (d)Below your buttocks, (e)or Around your neck, earsand eyes¿At jun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a (b)Txpaq’ch tqan, (c)Twonsi tqan, (d)Tij t-xopa, (e)Tij tqula txquin ex twutza.No = 1Yes = 267

Question Answer CodeHave you ever had problems with sneezing, mucus or blocked No = 1I8 nose when you DID NOT have a cold or flu?¿Atjun maj o tzaj metzin loj t-txan mo xpon t-tzan tzen nti’chon-wi’tija?Yes = 2I9→If the answer is “NO”, go to question J1During the past 12 months, have you had problems withsneezing, mucus or blocked nose when you DID NOT have acold or flu?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon-wi’tija?No = 1Yes = 2J. QUESTIONS RELATED TO THE CHILD IN THE STUDY: (IF MOTHER IS PREGNANT, GO ON TOSECTION K)Question Answer CodeJ1 Has your child’s neck ever whistled?No = 1Yes = 2¿At jun maj o tzolin tqulja tala?J2J3→If the answer is”NO,” please go to question J3If, Yes: How many attacks in which their neckhas whistled has your child had in their life?¿Jtexe maj n tzaj tzolin qul tija tala tuk’atanq’len?How often do you bath your child, be it with a spongeor in a tub?¿Chq’al n-okx tala chujel mo noq n-ichin?None = 01-3 = 14-12 = 2More than 12 = 3Rarely = 1Once per month = 2Once or twice perweek = 3Daily =4K. QUESTIONS THAT SHOULD BE REPEATED FOR EACH OF THE SIBLINGS < 15 YEARS: (IF THEMOTHER DOES NOT HAVE ANY MORE CHILDREN IN THE STUDY, GO TO SECTION M)K1 BROTHER/SISTER ID:Child IDAge in Years(as of last birthday)CodeK2 ADDITIONAL ENVIRONMENTAL QUESTIONS:Question Answer CodeK2.1 Has your child lived in the same house for allhis/her life?¿Antza najlen tala tuk-a titzja?No = 1Yes = 268

Question Answer CodeK2.2 During the first 12 months of your child’s life, didyou usually give him/her acetaminophen toreduce his/her fever?¿A-te tel ab’q’e tala xi tq’on acetaminofen tuntkub’ kyaq tij?→ If the answer is “NO,” please go toquestion K2.4No = 1Yes = 2K2.3 During the past 12 months, more or less, howoften did you give acetaminophen to your child?¿Toja ab’q’e xbaj chq’al xi tq’on acetaminofente?K2.4 Did you give antibiotics to your child during thefirst 12 months of your child’s life?¿Te s-el ab’q’e tala xi tq’on antibiotico te tala?Never = 1At least once per year =2At least once per month =3No = 1Yes = 2K3 “MEDULARES” QUESTIONS ABOUT ASTHMA:Question Answer CodeK3.1 Has your child’s neck ever whistled in the past?¿At jun maj tzolin tqul tala?→ If the answer is “NO,” please go toquestion K3.6No = 1Yes = 2K3.2 Has your child’s neck whistled during the past12 months?¿Toja ab’q’e xbaj tzolin tqulja tala ?→If the answer is”NO,” please go to questionK3.6K3.3 How many attacks in which their neck haswhistled has your child had during the past 12months?¿Toja ab’q’e xb’aj jte maj tzaj tzolin qul tij tala?No = 1Yes = 2None = 11-3 = 24-12 = 3> 12 = 4K3.4 During the past 12 months, how frequently,more or less, has your child’s sleep beeninterrupted due to his/her neck whistling?¿Toja ab’q’e xb’aj jte maj el twatlja tala tun tzolinqul?K3.5K3.6During the past 12 months, have the whistles inyou’re your child’s neck been so bad that he/shecannot say more than one or two words in a rowwithout taking a breath?¿Toja ab’q’e xb’aj a tala penix nb’anta tyolin tuntzolin qul?Has the doctor or nurse ever diagnosed yourchild with Asthma?¿At jun maj o tzaj q’man tun Doctor o Enfermeraqa at asma tij tala?K3.7 During the past 12 months, has your child’s neckever whistled during or after doing exercise?¿Toja ab’q’e xb’aj n-tzaj tzolin qul tijtala tzen n-rinen?He/she has never woken upwith whistling in the neck = 1Less than one night per week= 2One or more nights per week =3No = 1Yes = 2No = 1Yes = 2No = 1Yes = 269

Question Answer CodeK3.8 During the past 12 months, has your child haddry cough during the night, without having had acold or respiratory infection at the same time?¿Toja ab’q’e xb’aj o tzaj tzqij sjol tij tala qnik’enexsin nti chon-wi tij?No = 1Yes = 2K4 “MEDULARES” QUESTIONS ABOUT RHINITIS:Question Answer CodeK4.1 Has your child ever had problems with sneezing or blockednose and mucus WITHOUT having a cold or flu?¿At jun maj o-tzaj ti tala xpon t-txan a nti chon-wi’ tij?No = 1Yes = 2→If the answer is “NO,” please go to section K5K4.2 During the past 12 months, has your child had problems withsneezing or blocked nose and mucus WITHOUT having a coldor flu?¿Toja ab’q’e xb’aj xpet t-txan tala te ntitaq chon-wi tij?→If the answer is “NO,” please go to section K5K4.3 In the past 12 months, have you seen the nose problemaccompanied by burning eyes or tearing eyes?No = 1Yes = 2No = 1Yes = 2¿Toja ab’q’e ab’aj tzen n-xpet t-txan tzun njulin twutz monchitalin twutz?K4.4→If the answer is “NO,” please go to section K5During which of the past 12 months did he/she have this problem?(Underline the answer and note code number)¿Alky xjaw te’ ab’q’e xb’aj te t-tzaj tij?January =1February =2March =3April =4May =5June =6July =7August =8September =9October =10November =11December =12K5 “MEDULARES” QUESTIONS ABOUT ECZEMA:Question Answer CodeK5.1 Has your child ever had on his/her skin an itchy rash thatappeared and disappeared for periods that lasted a total ofat least 6 months?No = 1Yes = 2¿Atjun maj tij tala O-tzaj xjo’s (n-spulen) n-metzen n-tzajxen-elxe nai a nwe qaq xjaw?→If the answer is “NO,” please go to section L70

Question Answer CodeK5.2 Has your child had this itchy rash at any moment during thelast 12 months?¿ At jun maj toja ab’q’e xbaj o tzaj xjos tija tala a-tzunxexn-metzen?No = 1Yes = 2→If the answer is “NO,” please go to section LK5.3 Has your child ever had this itchy rash in any of thefollowing places?(a)Fold of the elbow, (b)Behind the knee, (c)Fold of theankle, (d)Below the buttocks, (e)or Around the neck, earsand eyes¿Atjun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a, (b)txpaq’ch tqan, (c)twonsl tqan, (d)Tij t-xopa, (e)tijtqul txquin ex twutza.K5.4 How was old was your child when he/she first got this itchyrash?¿Jtetaq ab’q’e tala te tzaj xjos taj a-tzunx n-metzen tnejelmaj?K5.5 During the past 12 months, has the rash disappearedcompletely?No = 1Yes = 2Less than 2 years =1From 2-4 years = 25 years or more = 3No = 1Yes = 2¿Toja ab’q’e xjawel o-naja xjos tij te-junmajx?L. QUESTIONS THAT SHOULD BE REPEATED FOR EACH ONE OF THE SIBLINGS LESS THAN 9YEARS:L1. ID OF SIBLING:Child IDAge in years(as of last birthday)CodeL2. BURNS AND SCALDINGS:Question Answer CodeL2.1 During the past 6 months, has yourchild suffered a burn (with a hot objector liquid)?¿Toja tqaqen xjaw o tzey jun maj talatuk’a kyqa mojqa tuk’a q’aq’?No = 1Yes = 2→If the answer is “NO,” please go toquestion L2.4L2.2 If YES, how serious?¿Jni tzey?Light (there is no scar) = 1Moderate (scar smaller than a Q1 coin) =2Serious (scar larger than a Q1 coin) = 3 If it is serious (3) measure the sizeof the scar and note its dimensions:____ x _____ cms.71

Question Answer CodeL2.3 And how did he/she getburned?Y, ¿Tzen tzeya?He/she fell in the fire = 1He/she was burned with a hot object = 2A container with hot water was spilled = 3Other (specify) = 4L2.4 At any time before your child reached 6months, was s/he burned?¿Toja tqaqen xjaw o-tzey tala jun maj?No = 0Light (there is no scar) = 1Moderate (scar smaller than a Q1 coin) =2Serious (scar larger than a Q1 coin) = 3 If it is serious (3) measure the sizeof the scar and note its dimensions:____ x _____ cms.L2.5 If it was serious (code = 3),how old was he/she whenburned?¿qa nim tzey te jtetaq tb’q’e tet-tzey?L2.6 How was he/she burned?¿Tzen tzeya?Age (years)He/she fell in the fire = 1He/she was burned with a hot object = 2A container with hot water was spilled = 3Other (specify) = 4M. SPIROMETRY: (To the mother of study child)M1Operator IDAnswerCodeM2Spirometer IDM3 Date of Birth dd / mm / yyM4 Height of woman cmM5 Weight of woman kgM6 Is the mother pregnant? No = 1Yes = 2M7 Date spirometry performeddd / mm / yyM8 Time spirometry performedhh mmM9 Supervisor was present No = 1Yes = 2M1. RECENT COLD WITH COUGH:Question Answer Code72

Question Answer CodeM1.1 Have you had a cold with cough in recentdays?No = 1Yes, during the past two weeks= 2Yes, for more than two weeks =3M2. SPIROMETRY RESULTS: (With a maximum of 8 blows)Blow #1Good blow = 1Slow start = 2Little force = 3Abrupt ending = 4Cough = 5Bad technique = 6Short blow = 7Operator MicroloopApparatusFEV1Result Best = 12 nd best = 2FVCResult Best = 12 nd best = 22345678Calculate the difference betweenthe first and second bestattempts ONLYM2. SPIROMETRY QUALITY CONTROL:LITERSLITERSAnswerM2.1 At least three good blows No = 1Yes = 2M2.2 FEV1: Is the difference between the best and second best less No = 1than 0.20 liters?Yes = 2M2.3 FVC: Is the difference between the best and second best less No = 1than 0.20 liters?Yes = 2M2.4 If it is not possible to achieve a good blow describe the reason?Code73

M2.5 If the woman did not perform the spirometry, describe the reason:AnswerCodeN. BREATH CARBON MONOXIDE:N1N2How long has it been since you last cooked?CO Monitor IDAnswerDatedd/mm/yyTimehh:mmCodeN3 Measurement Start Time Timehh:mmN4 Measurement ResultsPPMPPMPPMO. MOTHER’S REFERRAL:AnswerO1 Referral No = 1Study Doctor = 2Health Center = 3O2 Reason for referral (Describe)CodeTHANK INTERVIEWEE FOR HER PARTICIPATION – END OF INTERVIEWInterviewInterviewer Initials: _______________Interviewer Signature: ________________Interview CheckSupervisor Signature:_____________________ Date of check: _________________Measurement SupervisionSupervisor Signature:_____________________ Date of revision: _________________Data Entry74

Data Enterer #1 Signature: _________________ Data Enterer #2 Signature: _________________Data Entry CheckSupervisor Signature:_____________________ Date of check: _________________OBSERVATIONS:75

Appendix X: 6 Month Assessment Follow-up Questionnaire "AAA" SpanishA. INTRODUCCIÓN :ESTUDIO SOBRE LA SALUD DEL ADULTO, ASMA Y ALERGIASEvaluación semestralPregunta Respuesta CódigoA1 Grupo GRUPO A (00-12)GRUPO B (00-18)A2 ID (casa) A3 ID (mujer) A4 ID Entrevistador A5 Fecha dd /mm /aaSíntomas Respiratorios CrónicosNotas para el entrevistador: Al realizar estas preguntas es importante que se recuerde a la señoraque estas preguntas se refieren a las molestias que ella o algún miembro de su familia hayantenido desde la ultima vez que se le visitóB. TOS: (SJO’L)Pregunta Respuesta CódigoB1 ¿En los últimos 6 meses, Ud. Tose o ha tosido mucho?¿Tzun n-sjolin mo o sjolin ma nintz maj?No = 1Sí = 2Si “NO”, pase a la sección C (Flema)B2 ¿Ud. Tose o ha tosido al levantarse por las mañanas? No = 1B3B4¿Tzun n-sjolin mo o sjolin aj tjawey junjin qlexje?Si, SI: ¿Desde hace cuánto tiempo ha estadotosiendo al levantarse por las mañanas?¿Jtexe q’ij toknin ten sjo’l tija aj tjawey tzen qlexje?Si, SI: ¿Durante ese tiempo que tan seguido toseal levantarse por las mañanas?¿Chq’al n-tzaj sjol aj tjawey?Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2B5B6B7¿Ud. tose o ha tosido durante el día?¿tzun n-sjolin mo o sjolin tzen q’ijl?Si, SI: ¿Desde hace cuánto tiempo ha estadotosiendo durante el día?¿Jtexe q’ij toknin ten sjo’l tija a-qijtl?Si, SI: ¿Durante ese tiempo que tan seguido tosedurante el día?¿Chq’al n-tzaj sjol tija tzen q’ijl?No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =276

B8B9B10¿Ud. Tose o ha tosido durante la noche?¿Tzun n-sjolin mo o sjolin tzen qnik’in?Si, SI: ¿Desde hace cuánto tiempo ha estadotosiendo durante la noche?¿jtexe q’ij toknin ten sjol tija tzen qnik’en?Si, SI: ¿Durante ese tiempo que tan seguido tosedurante la noche?¿Chq’al n-tzaj sjol tija tzen qnik’en?No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2C. FLEMA: (XLOQ)Pregunta Respuesta CódigoC1 ¿En los últimos 6 meses, Ud. saca flema o ha sacadoflemas mucho?¿Tzun njatz xloq mo o jatz nim xloq tun?Si “NO”, no siga con las preguntas de esta secciónNo = 1Sí = 2C2C3C4C5C6C7C8¿Ud. saca o ha sacado flemas al levantarse por lasmañanas?¿Tzun njatz mo o jatz xloq tu’n aj tjawey?Si, SI: ¿Desde hace cuánto tiempo lleva sacandoflemas al levantarse por las mañanas?¿Jtexe q’ij toklen ten n-jatz txloqa tzen qlexje?Si, SI: ¿Durante ese tiempo que tan seguido sacaflema al levantarse por las mañanas?¿Chqaltzin njatz txloqa tzen njawey qlexje?¿Ud. saca o ha sacado flemas durante el día?¿Tzun njatz mo o jatz txloqa tzen q’ijl?Si, SI: ¿Desde hace cuánto tiempo lleva sacandoflemas durante el día?¿Jtexa q’ij toklen ten xloq a njatz tzen q’ijl?Si, SI: ¿Durante ese tiempo que tan seguido sacaflemas durante el día?¿Chq’al njatz txloqa tzen q’ijl?¿Ud. saca o ha sacado flemas durante la noche?¿Tzun njatz mo o jatz txloqa tzen qnik’en?No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2No = 1Sí = 2Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Seguido = 1De vez en cuando =2No = 1Sí = 2C9Si, SI: ¿Desde hace cuánto tiempo lleva sacandoflemas durante la noche?¿Jtexa q’ij toklen ten njatz txloqa tzen qnik’en?Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 377

C10Si, SI: ¿Durante ese tiempo que tan seguido sacaflemas durante la noche?¿Chq’al njatz txloqa tzen qnik’en?Seguido = 1De vez en cuando =2Si la respuesta es “no” para las preguntas: B1 y C1; PASE a la Sección E (Asma Rinitis yEczema)Si la respuesta es “si”, para las preguntas: B.1 Y/O C.1, CONTINÚE en la Sección D (Periodosen los que empeora la tos y la flema)D. PERIODOS EN LOS QUE EMPEORA LA TOS (SJO’L) Y LA FLEMA (XLOQ):D1D2D3D4Pregunta Respuesta CódigoNo = 1Sí = 2¿En los últimos 6 meses, ha tenido períodos en los cualesEMPEORO la tos Y la flema?¿Toja ab’q’e xjawel b’aj at q’ij n-xiy to il tu’n sjol tuk’a xloq?→Si NO, pasar a la sección E (Asma, Rinitis y Eczema)Si, SI: ¿Desde hace cuanto tiempo ha tenidoperíodos en los cuales EMPEORO la tos Y laflema?¿Jte maj’ o txiy toj il tun sjol tuj’a xloq?Si, SI: ¿Durante los últimos 6 meses, ha tenidomás de uno de estos períodos en los cualesEMPEORO la tos Y la flema?¿Toja abq’e xjawel b’aj jte maj xiy toj il tun sjol exxloq ?¿Ha tenido dificultad para respirar en los periodos en loscuales la tos Y la flema EMPEORARON?¿At junjen maj penex njatza txewa te txiy toj il tun sjol exxloq?Pocos días =1Una a dossemanas =2Tres semanas omás =3No = 1Sí = 2No = 1Sí = 2E. ASMA, RINITIS Y ECZEMA:E1Pregunta Respuesta Código¿En los últimos 6 meses, ha tenido ataques en los cuales le No = 1silvaba el pescuezo?Sí = 2¿Toja abq’e xjawel-b’aj at jun maj oklen tzol qul tija?E2¿En los últimos 6 meses, ha despertado en la mañana con lasensación de opresión en el pecho?¿Toja abq’e xjawel b’aj o ja sak’pajxiy jun maj qlixje penixnjatza txewa?No = 1Sí = 278

E3Pregunta Respuesta Código¿ En los últimos 6 meses el doctor o enfermera le hanNo = 1diagnosticado Asma?Sí = 2¿At jun maj o tza q’man tey tun Doctor o Enfermera qa atasma tija?E4¿En los últimos 6 meses, usted ha tenido salpullido conpicazón?¿At jun majtoja abq’e xjawel o-tzaj xjo’s tija a-tzunxex n-metzen?No = 1Sí = 2E5E6¿En algún momento ha tenido este salpullido con picazón enalguno de los siguientes lugares?(a)Pliegue del codo, (b)atrás de las rodillas, (c)pliegue deltobillo, (d)debajo de los nalgas, (e)o alrededor del cuello,orejas y ojos¿At jun maj o-tzaj xjos a-nmetzen ti’ja plaj?(a)Tcheky tq’ob’a (b)Txpaq’ch tqan, (c)Twonsi tqan, (d)Tij t-xopa, (e)Tij tqula txquin ex twutza.¿En los últimos 6 meses ha tenido problemas de estornudos,mocos o nariz tapada cuando NO tenía catarro o gripe?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon-wi’tija?No = 1Sí = 2No = 1Sí = 2F. DOLOR DE CABEZA Y ARDOR DE OJOS:F1Pregunta Respuesta Código¿En el último mes ha tenido dolores de cabeza? No = 1¿Toja xjaw xbaj tzaj te tchon twi’ ?Sí = 2F2F3F4Si, SI: ¿ Durante ese tiempo que tanseguido ha tenido dolores de cabeza?¿ Chaq’al n-tzaj tchon twiy?Si, SI: ¿Qué tan fuertes son los doloresde cabeza?¿Tzentzin tchon twiy?¿En el último mes ha tenido ardor de ojos u ojosllorosos?¿Toja xjaw xb’aj ma chi julin twutza mo nchitalinj?→Si la respuesta es “NO”, pase a la secciónGTodos los días = 1La mayoría de los días de lasemana =2Pocos días a la semana = 3Una vez por semana = 4Menos de una vez porsemana = 5Muy fuertes = 1Regulares = 2Suaves = 3No = 1Sí = 279

F5F6Pregunta Respuesta CódigoSi, SI: ¿ Durante ese tiempo que tan Todos los días = 1seguido ha tenido ardor de ojos u ojos La mayoría de los días de lallorosos?semana =2Pocos días a la semana = 3¿Chq’al nchi julin mo nchi talin twutza? Una vez por semana = 4Menos de una vez porsemana = 5Pregunte y observe:Si le lloran los ojos,¿Cómo es la secreción?Qaninxa ex kayinka:¿Qa ntalin twutz ¿tzen kayin tal twutz?Clara, acuosa = 1Amarilla o verdosa ypegajosa = 2F7→Si, la respuesta es = 1: Pasar a la secciónGSi, la respuesta es =2: la secreción esamarilla o verdosa y pegajosa ¿Haceque no pueda despegar sus ojos cuandose despierta?Si, la respuesta es =2:¿Q’an o txaxkayin txa twutza minjqet aj tja wey?→Si, SI: Refiera al medico del estudioNo = 1Sí = 2G. DOLOR DE ESPALDA:G1Pregunta Respuesta Código¿Durante el último mes ha tenido dolores de No = 1espalda?Sí = 2¿Toja xjaw xbaj o chon tzkeltija?G2G3G4→Si la respuesta es “NO”, pase a la sección HSi, SI: ¿ Durante ese tiempo, que tanseguido ha tenido dolores de espalda?¿Chq’altzin n-tzaj tchon tzkeltija?Si, SI: ¿Qué cosas hacen que le duelamás la espalda?¿Ti n-kub’ tb’inchin tzen n-oqkten tijachol?Si, SI: ¿Los dolores han sido tan fuertesque ha dejado de hacer sus oficios?¿Aj t-tzaj tchon tija mi n-aq’nila tun?Todos los días = 1La mayoría de los días dela semana =2Pocos días a la semana = 3Una vez por semana = 4Menos de una vez porsemana = 5Cargar leña = 1Lavar ropa = 2Cocinar = 3Otro (especifique) = 4No = 1Si =2 (especifique en lasiguiente casilla)80

G5Pregunta Respuesta CódigoDescriba como el dolor afecta sus oficios:H. CONSUMO DE TABACO:Pregunta Opciones RespuestaH1 ¿Ha fumado cigarrillos durante los últimos 6meses?No = 1Sí = 2Tojja’ qaq xjaw o tziky’ o bajxa’ sich’ tu’n?H2Si, SI:¿Cuántos cigarrillos por día fumanormalmente?# cigs / díaH3Jte sich’ nbaj tu’n junjun q’ij?¿Fuma alguna otra persona dentro de la casay/o cocina?Tzun nsichin junxil xjal toj tjay?No = 1Sí = 2H4Si, SI:¿Cuántos cigarrillos por día sefuman normalmente en total?Jte sich nb’aj tun toj jun q’ij toj tjay?# cigs / díaI. ASMA, RINITIS Y ECZEMA (PADRE): (SI ES MADRE SOLTERA PASAR A LA SECCIÓN J)De ser posible entrevistar al padre del niño bajo estudio. Si no se encuentra, entonces preguntar ala madre del niño:I1Pregunta Respuesta Código¿En los últimos 6 meses, ha tenido ataques en los cuales le No = 1silvaba el pescuezo?Sí = 2¿Toja abq’e xjawel at jun maj okten tzolin qul tij (a)?I2I3I4¿En los últimos 6 meses, ha despertado en la mañana con lasensación de opresión en el pecho?¿Toja abq’e xjawel o jasak’pajxi jun maj penix njatza t-xew?¿ En los últimos 6 meses el doctor o enfermera le handiagnosticado Asma?¿At jun maj o-tza q’man tey tun Doctor o Enfermera qa atasma tij (a)?¿ En los últimos 6 meses, usted ha tenido salpullido conpicazón?¿ At jun maj toja ab’q’e xjawel o-tzaj xjos tija a-tzunxexn-metzen?No = 1Sí = 2No = 1Sí = 2No = 1Sí = 281

I5Pregunta Respuesta Código¿En algún momento ha tenido este salpullido con picazón en No = 1alguno de los siguientes lugares?Sí = 2I6(a)Pliegue del codo, (b)atrás de las rodillas, (c)pliegue deltobillo, (d)debajo de las nalgas, (e)o alrededor del cuello,orejas y ojos¿At jun maj o-tzaj xjos a – nmetzen ti’ja plaj?(a)Tcheky tq’ob’a, (b)txpaq’ch tqan, (c)Twonsi tqan, (d)Tijt-xopa, (e)Tij tqula txquin ex twutza.¿En los últimos 6 meses ha tenido problemas de estornudos,mocos o nariz tapada cuando NO tenía catarro o gripe?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon witija?No = 1Sí = 2J. PREGUNTAS RELACIONADAS CON EL NIÑO DEL ESTUDIO: (SI ES MUJER EMBARAZADAPASAR A LA SECCION L)J1Pregunta Respuesta Código¿ En los últimos 6 meses le ha silbado el pescuezo a No = 1su niño cuando respira?Sí = 2¿At jun maj o tzolin tqulja tala?J2J3→Si la respuesta es “NO”, por favor pase a lapregunta J3Si, SI:¿Cuantos ataques en los cuales le hasilbado el pescuezo ha tenido su niño (a) enlos últimos 6 meses?¿Jtexe maj n tzaj tzolin qul tija tala tuk’atanq’len?¿Aproximadamente, qué tan seguido baña al niño (a)ya sea con esponja o en bañito?¿Chq’al n-okx tala chujel mo noq n-ichin?Ninguno = 11-3 = 24-12 = 3Más de 12 = 4Rara vez = 1Una vez al mes = 2Una vez a la semana=3Diario =4K. PREGUNTAS QUE SE DEBERAN REPETIR POR CADA UNO DE LOS HERMANOS < 15 AÑOS:(SI LA MADRE NO TIENE MAS NIÑOS QUE EL DEL ESTUDIO PASAR A SECCION M)K1 ID DEL HERMANO(A):ID del niño y edad en añosEdadCódigo de IDK2 PREGUNTAS AMBIENTALES ADICIONALES:82

Pregunta Respuesta CódigoK2.1 ¿Durante los últimos 6 meses, que tan seguidole dio acetaminofen a su niño (a)?¿Toja ab’q’e xbaj chq’al xi tq’on acetaminofente?Nunca = 1Al menos una vez al año =2Al menos una vez al mes =3K3 PREGUNTAS MEDULARES SOBRE ASMA:Pregunta Respuesta CódigoNo = 1Sí = 2K3.1 ¿ Durante los últimos 6 meses a su niño (a) leha silbado el pescuezo?¿Toja ab’q’e xb’aj tzolin tqulja tala?→ Si la respuesta es “NO”, por favor pase ala pregunta K3.5K3.2 ¿ Durante los últimos 6 meses, cuántos ataquesen los que le silba el pescuezo ha tenido su niño(a)?¿Toja ab’q’e xb’aj jte maj tzaj tzolin qul tij tala?K3.3 ¿Durante los últimos 6 meses con quefrecuencia, más o menos, se ha interrumpido elsueño de su niño (a) debido a que le silva elpescuezo?¿Toja ab’q’e xb’aj jte maj el twatlja tala tun tzolinqul?K3.4K3.5¿En los últimos 6 meses los silbidos en elpescuezo de su niño (a) han sido tantos que nopuede decir más de una o dos palabrasseguidas sin tomar aire?¿Toja ab’q’e xb’aj a tala penix nb’anta tyolin tuntzolin qul?¿ En los últimos 6 meses el doctor o enfermerale han diagnosticado Asma a su niño (a)?¿At jun maj o tzaj q’man tun Doctor o Enfermeraqa at asma tij tala?K3.6 ¿Durante los últimos 6 meses le ha silbado elpescuezo a su niño durante o después de hacerejercicio?¿Toja ab’q’e xb’aj n-tzaj tzolin qul tij tala tzen n-rinen?Ninguno = 11-3 = 24-12 = 3> 12 = 4Nunca se ha despertado consilbidos en el pescuezo = 1Menos de una nochea la semana =2Una o más noches porsemana =3No = 1Sí = 2No = 1Sí = 2No = 1Sí = 2K4.PREGUNTAS MEDULARES SOBRE RINITIS:Pregunta Respuesta CódigoK4.1 ¿En los últimos 6 meses ha tenido su niño problemas conestornudos O nariz tapada O mocos SIN tener catarro o gripe?¿Toja ab’q’e xb’aj xpet t-txan tala te ntitaq chon-wi tij?No = 1Sí = 2→ Si la respuesta es “NO”, por favor pase a la sección K583

Pregunta Respuesta CódigoNo = 1K4.2 ¿En los últimos 6 meses, el problema de la nariz se havisto acompañado de ardor de ojos y ojos llorosos?Sí = 2K4.3¿Toja ab’q’e ab’aj tzen n-xpet t-txan tzun njulin twutzmonchi talin twutz?→ Si la respuesta es “NO”, por favor pase a la sección K5¿Durante cuál de los últimos 6 meses tuvo este problema?(Subraye la respuesta y anote el código)¿Alkye xjaw te’ ab’q’e xb’aj te t-tzaj tij?Enero =1Febrero =2Marzo =3Abril =4Mayo =5Junio =6Julio =7Agosto =8Septiembre =9Octubre =10Noviembre =11Diciembre =12K5 PREGUNTAS MEDULARES SOBRE ECZEMA:Pregunta Respuesta CódigoK5.1 ¿ En algún momento, durante los últimos 6 meses, su niño(a) ha tenido ese salpullido con picazón?¿ At jun maj toja ab’q’e xb’aj o tzaj xjos tija tala a-tzunxexn-metzen?No = 1Sí = 2→ Si la respuesta es “NO”, por favor pase a la secciónLK5.2 ¿En algún momento, durante los últimos 6 meses, hatenido este salpullido con picazón en alguno de lossiguientes lugares?No = 1Sí = 2(a)Pliegue del codo, (b)atrás de las rodillas, (c)pliegue deltobillo, (d)debajo de las nalgas, (e)o alrededor del cuello,orejas y ojos¿At jun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a, (b)txpaq’ch tqan, (c)twonsil tqan, (d)Tij t-xopa, (e)tijtqul txquin ex twutza.K5.3 ¿Que edad tenía su niño (a), cuando le dio este salpullidocon picazón por primera vez?¿Jtetaq ab’q’e tala te tzaj xjos tij a-tzunx n-metzen tnejelmaj?K5.4 ¿En los últimos 6 meses, ha desaparecidocompletamente el salpullido?Menos de 2 años =1De 2-4 años = 25 años o más = 3No = 1Sí = 2¿Toja ab’q’e xjawel o-naja xjos tij te-junmajx?84

L. PREGUNTAS QUE SE DEBERAN REPETIR POR CADA UNO DE LOS HERMANOS < 09 AÑOS:L1. ID DEL HERMANO(A):ID del niño y edad en añosEdadCódigoL2. QUEMADURAS Y ESCALDADURAS:Pregunta Respuesta CódigoNo = 1Si = 2L2.1 ¿Durante los últimos 6 meses hasufrido su niño (a) alguna quemadura(con algún objeto o líquido caliente)?¿Toja tqaqen xjaw o tzey jun maj talatuk’a kyqa mojqa tuk’a q’aq’?L2.2 Si Si, ¿que tan grave?¿Jni tzey?→ Si la respuesta es “NO”, por favorpase a la sección MLeve (no hay cicatriz) = 1Moderada (cicatriz más pequeña que unamoneda de 1Q) = 2Grave (cicatriz más grande que unamoneda de 1Q) = 3Si es Grave (3) Mida el tamaño de lacicatriz y anote su superficie:_____ X _____ cms.L2.3 Y, ¿cómo se quemó?Y, ¿Tzen tzeya?Cayó en el fogón = 1Se quemó con un objeto caliente = 2Se derramó un recipiente con líquidocaliente (Ej. agua) = 3Otro = 4 (Especifique)M. ESPIROMETRIA: (Ha realizarse únicamente a la madre del niño que participa en el estudio)RespuestaM1 ID Operador CódigoM2 ID espirómetro M3 Fecha de nacimiento dd / mm/ aaM4 Estatura de la mujer cmM5 Peso de la Mujer KgM6 ¿Esta embarazada la madre? No = 1Sí = 2M7 Fecha en que se realizó la espirometría dd / mm/ aaM8Hora en la que se realizó la espirometríahhmm85

RespuestaM9 El supervisor estuvo presente No = 1Sí = 2M10 Si es una repetición: Razón por la cual se esta La duración de losrepitiendo la espirometríasoplidos de la primerasesión fueron < de 6segundos = 1La diferencia entre FEV1y/o FVC fue 0.20 Litros= 2No se logro obtener almenos 2 buenos soplidos= 3Otra razón = 4CódigoM1. CATARRO CON TOS RECIENTE:M1.1 ¿En los últimos días ha tenido catarro contos?Kyoto twi’pen q’ij o tzajxe cho’nwi’ ti’ja tuk’asjo’l?M2. USO DE TEMASCAL:M2.1 ¿Utiliza usted el temascal?Tzun noken chuj tu’n?M2.2 SI, SI: ¿Cuándo fue la última vezque utilizó el Temascal?Qa tzu’n jtojetzin token chuj tu’n tetwi’pen maj?RespuestaNo = 1Sí, durante las ultimas dossemanas = 2Sí, por más dos semanas = 3RespuestaNo = 1Sí = 2dd / mm/ aahh:mmCódigoCódigo86

M3. RESULTADOS DE LA ESPIROMETRIA: (Con un máximo de 8 soplidos)Soplido#1Buen soplido = 1Comienzo lento = 2Poco esfuerzo = 3Final abrupto = 4Tos = 5Mala técnica = 6Soplido muy corto = 7Operador AparatoMicroloopFEV1Resultado Mejor = 12 da mejor = 2FVCResultado Mejor = 12 da mejor = 22345678Calcule SOLAMENTE utilizandolos valores de los buenossoplidos, la diferencia entre elprimero y el segundo mejorM4. CONTROL DE CALIDAD DE LA ESPIROMETRIA:LITROSLITROSRespuestaM4.1 Por lo menos 3 buenos soplidos No = 1Sí = 2M4.2 FEV1: ¿La diferencia entre el mejor y el segundo mejor valor No = 1es menor de 0.20 litros?Sí = 2M4.3 FVC: ¿La diferencia entre el mejor y el segundo mejor valor es No = 1menor de 0.20 litros?Sí = 2M4.4 Si no es posible lograr un buen soplido describa la razón:CódigoM4.5 Si la señora no realizó la espirometría describa el motivo:87

N. MONÓXIDO DE CARBONO EN ALIENTO:RespuestaN1 ¿Hace cuanto tiempo cocinó por última vez?Fechadd/mm/aa(Anotar Primero la fecha y luego la hora)Horahh:mmN2 ID Monitor CO MCO- -CódigoN3 Hora de inicio de la medición Horahh:mmN4 Resultado de las medicionesPPM 1PPM 2PPM 3O. REFERENCIA DE LA MADRE:RespuestaO1 Referencia No = 1Médico del estudio = 2Centro de Salud = 3O2 Razón para referirla (Describa)CódigoP. MONITOR CONTINUO PARA MONOXIDO DE CARBONO (HOBO):P1ID delmonitorChequeoDía 3Batería(%)Nombre del archivoChequeode lagraficavalidezinicialesP288

AGRADECER POR LA INFORMACIÓN AL ENTREVISTADO- FIN DE LA ENTREVISTAEntrevistaIniciales del entrevistador: _______________Firma del entrevistador: ________________Revisión de la entrevistaFirma del supervisor:_____________________ Fecha de la revisión: _________________Supervisión de la mediciónFirma del supervisor:_____________________ Fecha de la revisión: _________________Ingreso de datosFirma Digitador # 1: _________________Firma Digitador # 2: _________________Revisión del ingreso de datosFirma del supervisor:_____________________ Fecha de la revisión: _________________OBSERVACIONES: (Incluir iniciales, fecha y hora)89

Appendix XI: 6 Month Assessment Follow-up Questionnaire "AAA" EnglishA. INTRODUCTION AND CONSENT:STUDY OF ADULT HEALTH, ASHMA AND ALLERGIESSix monthly assessmentQuestion Answer CodeA1 Group GROUP A (00-12)GROUP B (00-18)A2 ID (home)A3A4ID (woman)ID InterviewerA5 Date dd /mm /yyCHRONIC RESPIRATORY SYMPTOMSNotes for the interviewer: when you ask the fallowing questions it is very important that youremind the woman that these questions refer to the symptoms/ complaints that she and/or herfamily may have had since the last time you visited the house.B. COUGH: (SJO’L)Question Answer CodeB1 During the past 6 months, Do you cough or have youcoughed a lot?¿Tzun n-sjolin mo o sjolin ma nintz mouj?If “NO”, go to section C (Phlegm)No = 1Yes = 2B2B3B4B5Do you cough or have you coughed when getting up in themorning?¿Tzun n-sjolin mo o sjolin aj tjawey janjin qlexje?IF, Yes: Since how long ago have you beencoughing when getting in the morning?¿Jtexe q’ij toknin ten sjo’l tija aj tjawey tzen qlexje?If, Yes: During this time, how often do you coughwhen getting up in the morning?¿Chq’al n-tzaj sjol aj tjawey?Do you cough or have you coughed during the day?¿Tzun n-sjolin mo o sjolin tzen q’ijl?No = 1Yes = 2Less than 3 months =1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2Occasionally = 3No = 1Yes = 2B6If, Yes: Since how long ago have you beencoughing during the day?¿Jtexe q’ij toknin ten sjo’l tija a-qijtl?Less than 3 months =1Around 3 months = 2More than threemonths = 390

B7B8B9B10If, Yes: During this time, how often do you coughduring the day?¿Chq’al n-tzaj sjol tija tzen q’ijl?Do you cough or have you coughed during the night?¿Tzun n-sjolin mo o sjolin tzen qnik’in?If, Yes: Since how long ago have you beencoughing during the night?¿jtexe q’ij toknin ten sjol tija tzen qnik’en?If, Yes: During this time, how often do you coughduring the night?¿Chq’al n-tzaj sjol tija tzen qnik’en?Frequently = 1Once in a while = 2Occasionally = 3No = 1Yes = 2Less than 3 months =1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2Occasionally = 3C. FLEMA: (XLOQ)Question Answer CodeC1 During the past 6 months, Do you produce or have youproduced a lot of phlegm?¿Tzun njatz xloq mo o jatz nim xloq tun?→ If “NO” go to section D (Periods of Cough withPhlegm)No = 1Yes = 2C2C3C4C5Do you produce or have you produced phlegm whengetting up in the morning?¿Tzun njatz mo o jatz xloq tu’n aj tjawey?If, Yes: Since how long ago have you beenproducing phlegm when getting up in the morning?¿Jtexe q’ij toklin ten n-jatz txloqa tzen qlexje?If, Yes: During this time, how often do you producephlegm when getting u in the morning?¿chqaltzin njatz txloqa tzen njawey qlexje?Do you produce or have you produced phlegm during theday?¿Tzun njatz mo o jatz txloqa tzen q’ijl?No = 1Yes = 2Less than 3 months =1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2Occasionally = 3No = 1Yes = 2C6C7C8If, Yes: Since how long ago have you beenproducing phlegm during the day?¿Jtexa q’ij toklen ten xloq a njatz tzen q’ij?If, Yes: During this time, how often do you producephlegm during the day?¿Chq’al njatz txloqa tzen q’ijl?Do you produce or have you produced phlegm during thenight?¿Tzun njatz mo o jatz txloqa txloqa tzen qnikén?Less than 3 months =1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2Occasionally = 3No = 1Yes = 291

C9C10If, Yes: Since how long ago have you beenproducing phlegm during the night?¿Jtexa q’ij toklen ten njatz txloqa tzen qnik’en?If, Yes: During this time, how often do you producephlegm during the night?¿Chq’al njatz txloqa tzen qnik’en?Less than 3 months =1Around 3 months = 2More than threemonths = 3Frequently = 1Once in a while = 2Occasionally = 3If the answer is “No” for all the questions: B1 and, GO TO a la Section E.If the answer is “Yes”, for the questions: B.1, and/or C.1 CONTINUE with Section D.D. PERIODS IN WHICH THE COUGH (SJO’L) AND PHLEGM (XLOQ) GET WORSE:Question Answer CodeD1 During the past 6 months, have you had periods in whichthe cough and phlegm GETS WORSE?¿Toja ab’q’e xjawel b’aj at q’ij n-xiy to il tu’n sjol tuk’a xloq?No = 1Yes = 2D2D3D4→If NO, go to section E (Asthma, Rhinitis and Eczema)If, Yes: How long has it been since you had periodsin which the cough and phlegm GETS WORSE?¿Jte maj’ o txiy tun il tun sjol tuj’a xloq?If, Yes: During the last 12 months, have you hadmore than one of these periods in which the coughand phlegm GETS WORSE?¿Toja abq’e xjawel b’aj jte maj xiy taj il tun sjol exxloq ?Have you had difficulty breathing during the periods inwhich the cough or phlegm GET WORSE?¿At junjen maj penex njatza txewa te txiy tojil tun sjol exxloq?A few days =1One to two weeks =2Three weeks ormore =3No = 1Yes = 2No = 1Yes = 2E. ASTHMA, RHINITIS AND ECZEMA:Question Answer CodeE1 During the past 6 months, have you once had attacks in whichyour neck whistles?¿Toja abq’e xjawel-b’aj at jun maj oklen tzol qul tija?No = 1Yes = 2E2During the past 6 months, have you once woken up in themorning with the sensation of a pressure on your chest?¿Toja abq’e xjawel b’aj o ja sak’pajxiy jun maj qlixje penixnjatza txewa?No = 1Yes = 292

Question Answer CodeDuring the past 6 months ,Has the doctor or nurse ever No = 1E3 diagnosed you with Asthma?¿At jun maj o tza q’man tey tun Doctor o Enfermera qa atasma tija?Yes = 2E4Have you had itchy rash at any moment during the last 6months?¿At jun majtoja abq’e xjawel o-tzaj xjo’s tija a-tzunxex n-metzen?No = 1Yes = 2E5E6Have you ever had this itchy rash in any of the followingplaces?(a)Fold of your elbow, (b) Behind your knee, (c)Fold of yourankle, (d)Below your buttocks, (e)or Around your neck, earsand eyes¿At jun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a (b)Txpaq’ch tqan, (c)Twonsi tqan, (d)Tij t-xopa, (e)Tij tqula txquin ex twutza.During the past 6 months, have you had problems withsneezing, runny or blocked nose when you DID NOT have acold or flu?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon-wi’tija?No = 1Yes = 2No = 1Yes = 2F. HEADACHE AND BURNING EYES:Question Answer CodeF1 During the past month, have you hadheadaches?¿Toja xjaw xbaj tzaj te tchon twi’ ?No = 1Yes = 2F2F3F4F5If, Yes: How often have you hadheadaches during this time?¿ Cha’al n-tzaj tchon twiy?If, Yes: How strong are the headaches?¿Tzentzn tchon twiy?During the past month, have you had burningeyes, watery eyes?¿Toja xjaw xb’aj ma chi julin twutza mo nchitalinj?If, Yes: During this time, how often haveyou had burning eyes or watery eyes?¿Chq’al nchi julin mo nchi talin twutza?Every day = 1Most days of the week =2A few days per week = 3Once per week = 4Less than once per week = 5Very strong = 0Average = 1Mild = 2No = 1Yes = 2Every day = 1Most days of the week =2A few days per week = 3Once per week = 4Less than once per week = 593

Question Answer CodeF6Ask and observe:If your eyes water, what is the secretionlike?Qaninxa ex kayinka:¿Qa ntalin twutz ¿tzen kayin tal twutz?Clear, aqueous = 1Yellow, sticky = 2F7→ If, the answer is 1, go to section GIf the answer = 2: the secretion isyellow or greenish and sticky, Does itmake it so you cannot open your eyeswhen you wake up?Si, respuesta =2: ¿Q’an o txax kayintxa twutza minjqet aj tja wey?→ If, Yes: Refer to study doctorNo = 1Yes = 2G. BACK PAIN:Question Answer CodeG1 Have you had back pain during the past month?¿Toja xjaw xbaj o chon tzkeltija?No = 1Yes = 2G2If, Yes: During this time, how often haveyou had back pain?¿Chq’altzin n-tzaj tchon tzkeltija?Every day = 1Most days of the week =2A few days per week = 3Once per week = 4Less than once per week =G3If, Yes: What things make your back hurtmore?¿Ti n-kub’ tb’inchin tzen n-oqkten tijachol?5Carrying Wood = 1Washing Clothes= 2Cooking = 3Other (specify) = 4G4G5If, Yes: Have the back pains been sostrong that that you have stopped doingyour duties?¿Aj t-tzaj tchon tija mi n-aq’nila tun?Describe how the pain affects your duties:No = 1Yes =2 (specify in thefollowing box)H. TOBACCO SMOKING:Question Answer CodeH1 Have you smoked cigarettes during the past 6 months?Tojja’ qaq xjaw o tziky’ o bajxa’ sich’ tu’n?No = 1Yes = 2H2If, Yes: How many cigarettes per day do youusually smoke?Jte sich’ nbaj tu’n junjun q’ij?# Cigarettes/day94

Question Answer CodeH3 There are someone else that smoke inside the houseand/or the kitchen?Tzun nsichin junxil xjal toj tjay?No = 1Yes = 2H4If, Yes: How many cigarettes per day do theyusually smoke?How many cigarettes per day do you usuallysmoke?# Cigarettes/dayI. ASTHMA, RHINITIS Y ECZEMA (FATHER):If possible, interview father of the child under study. If he is not found, then ask the child’smother:Question Answer CodeI1 During the past 6 months, have you once had attacks in whichyour neck whistles?¿Toja abq’e xjawel-b’aj at jun maj oklen tzol qul tija?No = 1Yes = 2I2I3I4During the past 6 months, have you once woken up in themorning with the sensation of a pressure on your chest?¿Toja abq’e xjawel b’aj o ja sak’pajxiy jun maj qlixje penixnjatza txewa?During the past 6 months, Has the doctor or nurse diagnosedyou with Asthma?¿At jun maj o tza q’man tey tun Doctor o Enfermera qa atasma tija?Have you had itchy rash at any moment during the last 6months?¿At jun majtoja abq’e xjawel o-tzaj xjo’s tija a-tzunxex n-metzen?No = 1Yes = 2No = 1Yes = 2No = 1Yes = 2I5I6Have you ever had this itchy rash in any of the followingplaces?(a)Fold of your elbow, (b)Behind your knee, (c)Fold of yourankle, (d)Below your buttocks, (e)or Around your neck, earsand eyes¿At jun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a (b)Txpaq’ch tqan, (c)Twonsi tqan, (d)Tij t-xopa, (e)Tij tqula txquin ex twutza.During the past 6 months, have you had problems withsneezing, mucus or blocked nose when you DID NOT have acold or flu?¿Toja ab’qe xjawel-baj o xpet jun maj te t-txan te n-ti chon-wi’tija?No = 1Yes = 2No = 1Yes = 2J. PREGUNTAS RELACIONADAS CON EL NIÑO DEL ESTUDIO:95

Question Answer CodeJ1 During the past 6 months, Has your child’s neck everwhistled?No = 1Yes = 2¿At jun maj o tzolin tqulja tala?J2J3→If the answer is”NO,” please go to question J3If, Yes: How many attacks in which their neckhas whistled has your child had in their life?¿Jtexe maj n tzaj tzolin qul tija tala tuk’atanq’len?How often do you bath your child, be it with a spongeor in a tub?¿Chq’al n-okx tala chujel mo noq n-ichin?None = 01-3 = 14-12 = 2More than 12 = 3Rarely = 1Once per month = 2Once per week = 3Daily =4K. QUESTIONS THAT SHOULD BE REPEATED FOR EACH OF THE BROTHERS < 15 AÑOS:K1 BROTHER/SISTER ID:Child IDAge in Years(as of last birthday)CodeK2 ADDITIONAL ENVIRONMENTAL QUESTIONS:Question Answer CodeK2.1 During the past 6 months, how often did yougive acetaminophen to your child?¿Toja ab’q’e xbaj chq’al xi tq’on acetaminofente?Never = 1At least once per year =2At least once per month =3K3 MAIN QUESTIONS ABOUT ASTHMA:Question Answer CodeK3.1 Has your child’s neck whistled during the past 6months?¿Toja ab’q’e xbaj tzolin tqulja tala ?→If the answer is”NO,” please go to questionK3.5No = 1Yes = 2K3.2 How many attacks in which their neck haswhistled has your child had during the past 6months?¿Toja ab’q’e xb’aj jte maj tzaj tzolin qul tij tala?None = 01-3 = 14-12 = 2> 12 = 3K3.3 During the past 6 months, how frequently, moreor less, has your child’s sleep been interrupteddue to his/her neck whistling?¿Toja ab’q’e xb’aj jte maj el twatlja tala tun tzolinqul?He/she has never woken upwith whistling in the neck = 0Less than one night per week= 1One or more nights per week =296

Question Answer CodeDuring the past 6 months, have the whistles in No = 1K3.4 you’re your child’s neck been so bad that he/shecannot say more than one or two words in a rowwithout taking a breath?¿Toja ab’q’e xb’aj a tala penix nb’anta tyolin tuntzolin qul?Yes = 2K3.5Has the doctor or nurse ever diagnosed yourchild with Asthma?¿At jun maj o tzaj q’man tun Doctor o Enfermeraqa at asma tij tala?No = 1Yes = 2K3.6 During the past 6 months, has your child’s neckever whistled during or after doing exercise?¿Toja ab’q’e xb’aj n-tzaj tzolin qul tijtala tzen n-rinen?No = 1Yes = 2K4 MAIN QUESTIONS ABOUT RHINITIS:Question Answer CodeK4.1 During the past 6 months, has your child had problems withsneezing runny or blocked nose WITHOUT having a cold or flu?¿Toja ab’q’e xb’aj xpet t-txan tala te ntitaq chon-wi tij?No = 1Yes = 2→If the answer is “NO,” please go to section K5K4.2 In the past 6 months, have you seen the nose problemaccompanied by burning eyes or tearing eyes?No = 1Yes = 2K4.3¿Toja ab’q’e ab’aj tzen n-xpet t-txan tzun njulin twutzmonchi talin twutz?During which of the past 6 months did he/she have this problem?(Underline the answer)¿Alky xjaw te’ ab’q’e xb’aj te t-tzaj tij?(Underline the answer)January =1February =2March =3April =4May =5June =6July =7August =8September =9October =10November =11December =12K5 MAIN QUESTIONS ABOUT ECZEMA:Question Answer CodeK5.1 Has your child had this itchy rash at any moment during thelast 6 months?¿ At jun maj toja ab’q’e xbaj o tzaj xjos tija tala a-tzunxexn-metzen?No = 1Yes = 2→If the answer is “NO,” please go to section L97

Question Answer CodeK5.2 Has your child during the last 6 months had this itchy rashin any of the following places?(a)Fold of the elbow, (b)Behind the knee, (c)Fold of theankle, (d)Below the buttocks, (e)or Around the neck, earsand eyes¿Atjun maj o-tzaj xjos a-nmetzen tija plaj?(a)Tcheky tq’ob’a, (b)txpaq’ch tqan, (c)twonsl tqan, (d)Tij t-xopa, (e)tijtqul txquin ex twutza.No = 1Yes = 2K5.3 How old was your child when he/she first got this itchyrash?¿Jtetaq ab’q’e tala te tzaj xjos taj a-tzunx n-metzen tnejelmaj?K5.4 During the past 6 months, has the rash disappearedcompletely?¿Toja ab’q’e xjawel o-naja xjos tij te-junmajx?Less than 2 years =1From 2-4 years = 25 years or more = 3No = 1Yes = 2L. BURNS AND SCALDS: (Only for children less than 9 years)L1. CHILD IDChild IDAge in years(as of last birthday)CodeL2. BURNS AND SCALDS:Question Answer CodeL2.1 During the past 6 months, has yourchild suffered a burn (with a hot objector liquid)?¿Toja tqaqen xjaw o tzey jun maj talatuk’a kyqa mojqa tuk’a q’aq’?No = 1Yes = 2→If the answer is “NO,” please go tosection ML2.2 If YES, how serious?¿Jni tzey?Light (there is no scar) = 1Moderate (scar smaller than a Q1 coin) = 2Serious (scar larger than a Q1 coin) = 3→If was serious (3) measure the size ofthe scare and write it down the surfacemeasure:______ X _______ cm98

Question Answer CodeL2.3 And, ¿how did he/she getburned?Y, ¿Tzen tzeya?He/she fell in the fire = 1He/she was burned by some hot object = 2A container with a hot liquid (Ex. water) wasspilled = 3Other = 4 (specify)___________________________________M. SPIROMETRY: (to the mother of the study child)M1Operator IDAnswerCodeM2Spirometer IDM3 Date of Birth dd / mm / yyM4 Height of woman cmM5 Weight of woman kgM6 Is the mother pregnant? No = 1Yes = 2M7 Date spirometry performeddd / mm / yyM8 Time spirometry performedhh : mmM9 The supervisor was present No = 1Yes = 2M10 If this is a repetition: Reason why the sprirometryis been repeatedThe length of the blows in thefirst session were < of 6 secs. =1The difference between FEV1and/or FVC was 0.20 liters =2It couldn’t be possible get atleast two good blows = 3Other reason = 4M1. RECENT COLD WITH COUGH:Question Answer CodeM1.1 Have you had a cold with cough in recentdays?No = 0Yes, during the past two weeks= 1Yes, for more than two weeks =2M2. TEMASCAL USE:Question Answer Code99

Question Answer CodeM2.1M2.2Do you use the Temascal?If, Yes: When was the last time you use theTemascal?No = 1Yes = 2dd / mm / yyhh :mmM3. SPIROMETRY RESULTS:(With a maximum of 8 blows)Blow #1Good blow = 1Slow start = 2Little force = 3Abrupt ending = 4Cough = 5Bad technique = 6Short blow = 7Operator MicroloopAparatusFEV1Result Best = 12 nd best = 2FVCResult Best = 12 nd best = 22345678Calculate ONLY using the valuesof he good blows the differencebetween the first and secondbest LITERS LITERSM4. SPIROMETRY QUALITY CONTROL:AnswerM2.1 At least three good blows No = 1Yes = 2M2.2 FEV1: Is the difference between the best and second best less No = 1than 0.20 liters?Yes = 2M2.3 FVC: Is the difference between the best and second best less No = 1than 0.20 liters?Yes = 2Code100

M2.4 If it is not possible to achieve a good blow describe the reason?AnswerCodeN. BREATH CARBON MONOXIDE:N1N2How long has it been since you last cooked?CO Monitor IDAnswerDatedd/mm/yyTimehh:mmCodeN3 Measurement Start Time Timehh:mmN4 Measurement ResultsPPMPPMPPMO. MOTHER’S REFERRAL:AnswerO1 Referral No = 1Study Doctor = 2Health Center = 3O2 Reason for referral (Describe)CodeP. CO CONTINUOS MONITOR (HOBO):HOBO IDCheckDay 3Battery(%)File nameGraphiccheckValidityInitialsP1P2THANK INTERVIEWEE FOR THE INFORMATION – END OF INTERVIEW101

InterviewInterviewer Initials: _______________Interviewer Signature: ________________Interview CheckSupervisor Signature:_____________________ Date of check: _________________Measurement SupervisionSupervisor Signature:_____________________ Date of revision: _________________Data EntryData Enterer #1 Signature: _________________ Data Enterer #2 Signature: _________________Data Entry CheckSupervisor Signature:_____________________ Date of check: _________________OBSERVATIONS: (Please include initials, date and time)102

Appendix XII. Overview of IAQ MonitoringAbout two-thirds of participants are recruited in utero at second trimester or later and one-thirdas babies less than 4 months old. All households use open wood fires for cooking, most inseparate kitchens but many in the main house. Households are randomly assigned with equalprobability to the intervention group or the control group. In the former, improved stoves withflues (planchas) are installed immediately after recruitment, although taking a month to drybefore use. The households in the control group receive their planchas when they retire from thestudy, which occurs when the child reaches 18 mo old. Traditionally, the youngest child in thefamily is carried on the mother’s back nearly all waking hours until it starts to walk, whichoccurs at about 18 mo old. If another baby is born first, however, the younger baby will becarried preferentially.Although thousands of chemicals are found in combustion pollution mixtures like woodsmoke,the air pollution literature has come to focus on small particles (PM 1.0 , PM 2.5 ) as the bestindicator of health hazard. In addition, however, we monitor CO becauseof its own special impacts on health;it is produced by somewhat different mechanisms in the fire; andit can serve as a useful indicator of particle exposures.In association with monitoring the principal health outcome, acute lower respiratory disease(pneumonia) in the children, the main purposes of the exposure assessment for the main studyare todetermine the extent that the kitchen levels of wood smoke are changed by the intervention.determine the personal exposures of the babies so that an exposure-response relationship canbe determined.There are a number of secondary purposes, including, inter alia, to determinethe exposure of the mothero during cookingo over 24 hourso in relation to her babythe size distribution of particles in the smoke under different circumstanceswhether CO is a valid surrogate for PMo kitchen levelso personal exposureso of different sizes (PM 1.0 , PM 2.5 , TSP)o emitted from different stove typesthe relationship between mean, median, and peak measures of pollutionthe accuracy, reliability, and general validity of new exposure assessment tools including:o New continuous datalogging particle monitor, the UCBo Use of breath CO measurements as a biomarker of exposure103

Monitoring duration: To reduce intra-household variability and increase the capability toassociate household characteristics with indoor levels, the standard monitoring period is 48hours, unless stated otherwise.Following first here are brief descriptions of the main monitoring elements. This is followed bymore detailed tabular summaries of the exact equipment being used, the QA/QC procedures, andlists of written protocols and questionnaires/monitoring forms (most available in both Englishand Spanish)..The main sampling scheme is as follows:Extensive monitoring: Starting with a baseline before intervention, every household ismonitored every 3 months ~ 500 households. The fieldworkers who conduct the weeklyhealth surveys place the equipment and a member of the IAQ team picks it up.o CO diffusion tubes are worn by mother and child (if born). They are pinned onthe shoulder or upper chest area.o Starting in August 2003, a UCB PM monitor is placed in every kitchen. A plate isput into the kitchen by the IAQ team using its standard protocol (see below underintensive monitoring). The field workers need only twist the UCB on the plate.o Short time-activity questionnaire is administeredIntensive monitoring: Starting with a baseline before intervention, every eighth householdis monitored every 3 months ~ 64 households. Kitchen monitors are placed at 1.5 m inheight at about one meter from the edge of the combustion area of the stove and at least onemeter from doors or large windows. Bedroom monitors are placed at the same height nearthe bed. Outdoor monitors are placed at the same height in the area near the house wherethe family washes dishes/clothes.o CO diffusion tubes are worn by mother and child (if born) and placed in kitchen.o Onset/HOBO continuous CO monitors are worn by mother and placed in kitchen,(10%) bedroom, and (10%) outdoors. These monitors are placed in a cloth bagslung over the shoulder.o SKC pump with cyclone set for PM 1.0 is placed in kitchen, (25%) bedroom, and(25%) outdoors.o SKC pump with cyclone set for PM 2.5 is placed in kitchen, (25%) bedroom, and(25%) outdoors.o UCB monitor is placed in kitchen (measures temperature, humidity, and ~ PM 1.0and ~PM 2.5 )o PAS mini-pump for TSP is placed on mother and in kitchen for 24 hourso CO breath tests are done on mother at start, 24 hours, and 48 hourso Detailed time-activity questionnaires are administered after 24 and 48 hours everyother session (every 6 months)Dieta monitoring: There is a tradition of mothers and their recently delivered babiesspending many days in the kitchen next to the fire, perhaps being relieved of their normal104

esponsibilities. As exposures could be extremely high during this period, an effort is madeto conduct an extensive or intensive monitoring (depending on the household designation)during this period. Sometimes this involves an extra session.Temescal monitoring: Nearly every household in some study villages has a small mudwalledchamber outside the house where rocks are heated with a woodfire once a week forbathing. After the fire is out, but while smoldering charcoal still remains, the family strips,enters, and sprinkles water on the rocks to produce a sauna-like interior environment. Aspecial study is being designed to obtain an idea of the exposure implications of this activity.Household/stove/fuel parameters determined by questionnaireLocationExtensiveHousesIntensiveHousesStove use andconditionStove location KitchenVentilationFuel type/useWeekly Baseline Baseline BaselineWeekly Every 6 mo Every 6 mo Every 6 moIn addition, there are currently two principal side studies (add-ons) that have their own exposureassessment requirements:Adult pulmonary study: In association with lung-function testing, the exposures of adultwomen in the project households are determined every 3 months by use of CO breath testsand personal Onset/HOBO CO monitors.Cardiovascular study: In association with holter monitoring of heart electrical signals,exposures to older adults in the project households are determined by personal monitoringfor PM 2.5 (integrated) and continuous PM 1.0 and CO and kitchen continuous monitoring forPM 1.0 and CO. CO breath tests are also conducted.105

Tabular SummaryE = Extensive monitoring – all houses every three months.I = Intensive monitoring – 64 houses every three months, 32 in each intervention armB = Baseline – all houses before intervention, repeated every 12 monthsC = Cardiovascular study among 100 women over 40 yearsA = Adult pulmonary function studyPollution Monitoring – all for 48 hours unless notedLocation 1. CO- 2. CO- 3. CO- 4. PM-Integrated5. PM-Integrated Continuous Breath PM 1.0 PM 2.5 TSP Continuous*Child E, I ? ?Mother E, I I I, A I (4b)Kitchen I I, C I (4a) I (4a) I (4b) I (5), C (5)Bedroom 10% of I 25% I 25% I (4a)(4a)Outdoor 10% of I 25% I 25% I (4a)(4a)Other Adult C C C (6) C (5)* Also measures temperature and humidity.? Will consider on older childrenEquipmentGastec 1 DL diffusion tubes – 200 ppm-hOnset HOBO CO monitorsMicro Medical MicroCO Meter – 3 times each session: at start, at 24 h, at end4a. SKC 224-PCXR8 programmable pump, BGI SCC1.062 cyclone for PM 1.0 and PM 2.5 , 37mmTeflon filter. All 24-hour. Two consecutive 24-hour measures in kitchen.4b. Spectrex PAS-500 pump, 25mm Teflon filter – 24 hours (no size cut – TSP)UCB Prototype-2 ionization/photoelectric/temperature/humidity monitor. Once per day use ofcommercial continuous PM monitor in kitchens (e.g., Dust Trak)Casella Apex Personal Air SamplerHousehold Questionnaire/ObservationsLocationExtensiveHousesIntensiveHousesStove use andconditionStove location KitchenVentilationFuelWeekly B B BWeekly 6 mo 6 mo 6 mo106

Time/ActivityVery Short Form:location and fireupon arrivalShort Form:by specificactivitiesFrequency E B I-6 moLong Form:location and fire by ½ hourSummary QA/QC Plan for Exposure AssessmentsCalibration and Co-location of Pollution Equipment. Balanced between Open Fire andPlancha householdsFrequency COintegrated*COcontinuousCObreathPM-integrated** PMcontinuousEvery Use C (pump flow)*** C (zeroing)Every 3 mo C, L/V L L/VEvery 6 moCOf duplicates 10% 10%* See tube reading protocol below** See separate filter handling/weighing/blank protocol*** See pump flow calibration belowC = calibrationL = multi-device co-locationV = Validation with commercial continuous monitors PM – MIE personal DataRam, Casella Microdust Pro, TSI DustTrak 8520. Usualpractice is to use 1.0 m size selection CO – Draeger PAC-IIITube reading As much as possible, tubes used from one manufactured batch Millimeter scale used under standard seating and lighting conditions (sunlamp) Three independent readings by different IAQ staff Average of closest two used as established point Millimeter measure of stain converted to ppm-hr equivalents using quadratic equation.Pump flow Rotometer used in field to calibrate flow with filter in place before and after sampling. Rotometer calibrated against bubble meter (Gilibrator) every month Gilibrator used in laboratory to calibrate Spectrex PAS-500 and Casella Apex with filter inplaceSupervising IAQ field activities At least 20% of fieldworker observations during intensive monitoring At least 25% second day checks of extensive monitoring tube placement107

Intensive Time/Activity Observations Random 5% on-site 8-hour household observations Electronic personal location sensor under developmentAdditional Validation for Pollution Measurements Relationship among PM size ranges in different locations Relationship of CO levels with various PM size ranges in different locationsList of ProtocolsData file naming conventionsFilter handling and weighingSKC pump calibration and deployment Indoors OutdoorsPAS-500 pump calibration and deployment Personal AreaOnset HOBO CO calibrationOnset HOBO CO launching, deployment, and downloading Personal Area Co-locationDiffusion tube placement, reading, and handling Personal AreaP-1 launching, zeroing, placement, and downloading Area Co-locationMini-Vol calibration and deploymentCO breath testingTSI Dust TrakCasella MicrodustMIE DataRamSidePakList of Questionnaires/Monitoring FormsBLQ-1 (includes start of Extensive baseline monitoring)BLQ-2 (includes end of Extensive baseline monitoring) Short form: time/activity108

Diffusion tubesIntensive (slightly different versions for baseline and post-baseline) Long form: time/activity Diffusion tubes SKC pumps, filters, cyclones PAS-500 pumps, filters Onset HOBO CODieta FormExtensive (post-baseline) Very short form: time/activity Diffusion tubesPlancha logPost-baseline household surveySections from the above forms are also used in the Adult Pulmonary Study and Cardiovascular Study.Additional Information about Extensive Baseline Assessment and use of COdiffusion tubesExtensive IAQ monitoring will be done in each of the 500 households at baseline. The FWs willplace the tubes at the end of BLQ-1 and they will be picked up two days later by the FW at thetime BLQ-2 is administered.Field Workers: Boxes containing pre-labeled tubes in holders and other supplies will be givento the FW Supervisors by the IAQ team at the start of each week.The fresh holder/tubes will be carried in a sealed box, which is opened at the house for one tobe removed at random. The time and tube ID are noted on the BLQ form and then the tube isbroken open by the FW. The extra piece of glass is put back in the box, which is then closed.Any rough edges on the open end of the tube will be smoothed by the FW using fine sandpaperand the tube pulled down such that it is nearly flush with the top of the holder.It will then be pinned to the upper garment of the baby in cooperation with the mother such thatit does not interfere with normal activities. Placement should such that the baby cannot reach itwith mouth or hands. The mother will be asked to remove the holder and place it nearby whenthe baby is bathed or put down to sleep. When the baby is taken up again, the holder should berepined. The FW should guide the mother and, if available, the father in practicing removal andrepinning of the holder.Although the tube will ideally be placed in such a way that it is not covered by outer clothingduring the monitoring period, our studies have shown that there is no significant interferencewith the results if one or two layers of cloth cover the tube. Thus, advise the family that it is bestto keep the tube with the baby if they leave the home, such as when going to the market. Letthem know, however, that it is okay to cover the tube with clothing so as not to attract attention.109

If for some reason (for example a sick or newborn baby) the mother does not want to place thetube on the baby, ask to place the tube on the mother’s upper blouse instead. All otherprocedures remain the same. This change should be noted on the forms.If a tube breaks during opening, it should be replaced with another holder/tube from the box. Ifneeded, one of the extra tubes found in the box can be put into a holder.The family will be told that someone may come to check on the tube on the next day, and that itwill definitely be removed on the 2 nd day when the FW returns to tell them the result of the stovelottery and to do the BLQ-2.At removal, the tube will be left in the holder and capped. It is then placed back in the box. Thetime will be noted on the BLQ-2 and the questions administered. The box of holders/tubes willbe brought back to HQ and given to the IAQ team at the end of each work day.Equipment: For baseline extensive IAQ monitoring, each day the FWs will leave HQ with a boxcontaining sufficient holder/tubes, caps, and sandpaper to cover all households expected to berecruited that day.Pregnant women: A portion of the households will contain pregnant women rather thanbabies. In these cases, the tube will be placed on the upper blouse of the woman. All otherprocedures will remain the same.IAQ Team: Sufficient labeled tubes will be placed in holders and placed in boxes for the FWs atthe start of each week. Included will be caps, sandpaper, and a few extra tubes to allow forbreakage.After the FWs return the boxes and BLQ-2s, the forms will be examined that day if possible, butin no case later than 24 hours, to be sure they have been filled out fully and correctly and thatthe tube IDs match. If any have serious problems, as determined by the IAQS, the completemeasurement process will be repeated.Preferably that day, but in no case later than 24 hours, the tube will be removed from its holderand read independently by two members of the IAQ team at a standard location and understandard lighting in the IAQ lab. (See protocol in Appendix XX.) The IAQS will examine theresults and if they differ by more than 25%, he will request a third reading by a third person. Allthree readings will be entered in the database. After all readings, the capped tube will be storedin a sealed plastic box in the refrigerator for at least 6 months.110

Appendix XIII. Extensive Air Pollution Monitoring: Quarterly Visit (ENGLISH)(forthcoming)111

Appendix XIV. Extensive Air Pollution Monitoring: Quarterly Visit (SPANISH)EXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE E INFECCIONES RESPIRATORIASAGUDAS EN NIÑOS EN GUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIOMONITOREO EXTENSIVO DE CONTAMINACIÓN DEL AIRE: VISITA TRIMESTRALCOMUNIDAD # # # # #CASA # # #___ ___ ___ ___ ______ ___ ___PREGUNTAS Y OBSERVACIONES AL COLOCAR LOS EQUIPOSA.1 No. de Encuestador # #A.2 Fecha dd / mm / aaA.3 Hora hh : mmOBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA:(Para A4 y A5, en el caso que no le sea posible al entrevistador observar, entonces pregunte a la madre)A4.En la cocina cocinando = 1¿Dónde estaba la mamá cuando elencuestador llegó?En la cocina no cocinando = 2Otra parte de la casa = 3Afuera = 4Otro (describir) = 5A4.1 A4. fue: Observación = 1A5.Si hay bebé, ¿Dónde estaba cuandoel encuestador llegó?Respuesta de la Madre = 2En la cocina sobre la espalda de la cocinera = 1En la cocina no sobre espalda de la cocinera = 2En otra parte de la casa = 3Afuera = 4Otro (describir) = 5A5.1 A5. fue: Observación = 1Respuesta de la Madre = 2A6.¿Está encendido el fuego?Sí, Fuego Abierto = 1No = 2SÍ, Plancha = 3COLOCAR LOS TUBOS:A7.Fecha y hora en que los equipos fueron colocados(Cuando se abrieron los tubos):dd / mm / aahh : mmA8.1 Identificación del Tubo en la Madre xxx - ### - xxxA8.2 Identificación del Tubo en el Bebé No. 1 xxx - ### - xxxA8.3 Identificación del Tubo en el Bebé No. 2 xxx - ### - xxxA8.4 Otro – DescribirOBSERVACIONES (Anotar sus iniciales y la fecha): _______________________________________________________________112

____________________________________________________________________________________________________________________________________________________________________________________________________________________COMUNIDAD # # # # #CASA # # #___ ___ ___ ___ ______ ___ ___DESPUÉS DE 48 HORAS: PREGUNTAS Y OBSERVACIONES AL COLECTAR LOS EQUIPOSF.1 No. de Encuestador (# #)F.2¿Cuándo llegó el(la) encuestador(a) ala casa?Fecha (dd/mm/aa)Hora (hh:mm)OBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA:(Pare F4 y F5, en el caso que no le sea posible al entrevistador observar, entonces pregunte a la madre)F4.En la cocina cocinando = 1¿Dónde estaba la mamá cuando elencuestador llegó?En la cocina no cocinando = 2Otra parte de la casa = 3Afuera = 4Otro (describir) = 5F4.1 F4. fue: Observación = 1F5.Si hay bebé, ¿Dónde estaba cuando elencuestador llegó?Respuesta de la Madre = 2En la cocina sobre la espalda de la cocinera = 1En la cocina no sobre la espalda de la cocinera = 2En otra parte de la casa = 3Afuera = 4Otro (describir) = 5F5.1 D5. fue: Observación = 1Respuesta de la Madre = 2F6.¿Está encendido el fuego?Sí, Fuego Abierto = 1No = 2SÍ, Plancha = 3F7. ¿Algún tubo fue cambiado del lugardonde se puso originalmente?Sí = 1 (ANOTAR EN OBSERVACIONES)No = 2F8. ¿Cree usted que están funcionado lostubos?Sí = 1No = 2 (ANOTAR EN OBSERVACIONES)F9. PREGUNTE: ¿Se quitaron los tubos delbebé o la madre durante el tiempo desdeque les dejamos los tubos hace dosdías?Sí = 1 (LLENE EL CUADRO ABAJO)No = 2 (PASE A LA PREGUNTA E)TUBOS QUE LAS PERSONAS QUITARON (Puede ser más de una vez durante los dos días):F9.1 ID del Equipo F9.2 ¿Por cuálrazón?F9.3 ¿Dónde lo dejaron?Cocina = 1Casa principal = 2Afuera = 3Otro = 4 (especificar)F9.4 Fecha(dd/mm/aa)F9.5 Hora(hh:mm)F9.1.1 F9.2.1 F9.3.1 F9.4.1 F9.5.1 F9.6.1F9.6¿Cuántotiempo?F9.1.2 F9.2.2 F9.3.2 F9.4.2 F9.5.2 F9.6.2113

F9.1.3 F9.2.3 F9.3.3 F9.4.3 F9.5.3 F9.6.3COLECTA DE TUBOS GASTECF10.1 Tubo de la MadreID(Pegar Etiqueta)Hora en la quese tapó eltubo(hh : mm)OBSERVACIONESF10.2 Tubo del Bebé No. 1Si hay gemelos:F10.3 Tubo del Bebé No.2OBSERVACIONES (Anotar sus iniciales y la fecha): ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Revisión del formularioFirma del supervisor de CAI:_____________________Fecha de la revisión: _________________Ingreso de datosFirma Digitador # 1: ________________Firma Digitador # 2: ________________Revisión del ingreso de datosFirma del supervisor:_____________________Fecha de la revisión: _________________114

Appendix XV. Randomization ProtocolBackgroundFive hundred households with either children under 6 months of age or pregnant women will beenrolled in the ARI/indoor air study and followed until the child is 18 months of age. Eachfamily will be randomized to receive at the start of the study either an improved cook stovecalled a Plancha (the intervention arm) or nothing (the control arm). The families in the controlgroup will receive a Plancha as they retire from the study. The probability that a family will berandomized to either one or the other group is exactly one-half.In addition to the basic randomization to either treatment or control arm, 60 households, 30 ineach study arm, will be selected for intensive indoor air quality (IAQ) monitoring during thestudy period. This process will be random such that one out of every eight of the 500 primaryhouseholds will be chosen. Since the primary households are already assigned to intervention orcontrol arm randomly, the selection of the subset for intensive IAQ is also random. Householdsthus selected for IAQ monitoring will be invited to participate and provide additional informedconsent.BLOCKED RANDOMIZATIONRandomization will be blocked to ensure that the intervention and control groups are equallydistributed at any given point as the study progresses. This will ensure that within a particularblock of assigned households there will be equal numbers in both treatment arms. This alsoremoves the issue of potential temporal factors that might affect differences in the two studyarms. Balance of the number of households in the two study arms increases power of the study.Blocking will be achieved by determining a set block number. Within this block number therewill be equal numbers allocated to intervention and to control arms of the study. The order ofgroup assignments for each household recruited will be generated randomly prior to assignmentby the study biostatistician at UC Berkeley. The study secretary who is stationed atMERTU/Universidad del Valle in Guatemala City will keep this order of randomizedassignments.At the end of each day the Field Project Manager (FPM) will collect the baseline questionnaires(BLQs) for households recruited by the field workers (FWs). The household ID numbers will beassigned and recorded in an Excel spreadsheet. The FPM will then call the study secretary atMERTU who will read off the list of blocked randomized assignments to either arm of the study.The FPM will record each assignment in the spreadsheet.Generation of random assignmentsThe study biostatistician at UC Berkeley will generate a list of blocked randomized groupassignments using appropriate statistical software (Splus). This list will be kept at MERTU withthe study secretary under lock-and-key; no field personnel will have access to it. The blocking115

factor will remain unknown to study investigators and to field personnel until data collection hasbeen completed.Concealment of AllocationDuring assignment of households to either intervention or control arms of the study it will becritical to blind staff members who are responsible for recruitment of households (“allocationblinding”). The blinded staff members will NOT know what the order of random numbers is tobe (whether increasing or decreasing) for selection into each arm of the study.There will be at least three unblinded staff: two from the core UC Berkeley team and one fromthe field team. It is critical that unblinded staff has NO CONTACT with households in any waybefore allocation, and that they take great care to keep any information about how treatmentassignments will be done away from blinded study staff. Unblinded staff will be responsible fordetermining the block number and order of randomized assignment to intervention or controlarms.During the rest of the fieldwork after allocation, it will be impossible to blind as to treatment armany staff member who visits the households. All HH questionnaires, IAQ monitoring forms,medical records, and so on, however, will not have any indication of which treatment arm thehousehold belongs to reduce the potential for bias during data handling at the HQ (i.e. data entrystaff will be blinded). As much as possible, data collection forms will not contain anyinformation regarding study assignment for the particular HH. This will allow the FPM andsupervisors to make blinded decisions about matters that may affect the primary outcomes of thestudy such as whether a Q or an IAQ session needs to be re-done, based solely on review of Qsand forms from the field, which are all blinded as to treatment arm.Procedure for Group Assignment1. Once households have been recruited for the study, i.e. they have provided informed consentto participate and have been administered the baseline questionnaire, they will be randomizedto either the intervention or the control group.2. At the end of each day of recruiting the household ID numbers will be collected from all thefield workers by the FPM. She will call the secretary at MERTU in Guatemala City who willprovide the order of group assignments.3. The randomized list of household IDs with the assignment of intervention and control groupswill be recorded by the FPM in an Excel spreadsheet and communicated to the FWs. Thefield personnel will be responsible for informing the households of their “lottery” pick resultsand confirming their willingness to participate in the study at the second HH visit during therecruitment phase.4. The field team will then coordinate an appointment (convenient for the HH) for stoveinstallation with the manufacturer (Tasprovi) for the households in the intervention arm whowill be receiving Planchas. Houses in which stoves are to be installed will be identified with116

a sign posted on the outside wall of the house and the location of the house (on a map) willbe faxed to Tasprovi. This sign will be removed after installation of the stove.Replacement of HouseholdsIn the event that a household decides not to participate prior to weekly data collection, they willbe dropped from the study but NOT counted as a drop out. Replacement households will berecruited so that the number of households recruited is 500 at the end of the recruitment phase.If a household drops out anytime after the first two weeks of the weekly surveillance, they willbe considered a drop out and this fact will be taken into account in the intention-to-treat analysis.Because of potential sample size needs, we will replace those households that drop out anytimeduring the recruitment phase through the second weekly surveillance visit with a replacementhousehold. Replacement households will be assigned to either intervention or control group inthe same randomized manner as that for primary households. Reasons for drop out or refusal toparticipate will be recorded to determine whether differences exist between the intervention andcontrol groups and to make certain that there is no consistent pattern, which may be indicative ofbias. For control households, stoves will be provided to them if they drop out during the weeklysurveillance phase of the study.Procedure for Intensive IAQ MonitoringSixty households, 30 in each study arm, will be recruited to have intensive IAQ monitoring inaddition to the basic study. Four additional HHs will be recruited to allow for dropouts. One outof every eight of the 500 households that have been randomized will be invited to participate inthe IAQ portion of the study. The FPM will select the households for IAQ in the mannerdescribed below.1. Every day, after randomization, lists of household IDs will be ordered according to the dateof recruitment separately for the intervention or control arms by the FPM.2. Every eighth household in each study arm will be selected for inclusion for the Intensive IAQmonitoring. A separate consent form will be administered for this portion of the study. If ahousehold declines participation, the next household on the list will be selected but the orderof selection will not be changed for future households.3. The process of selection will be repeated every night for every set of eight householdsaccrued during randomization in each group until 32 have been recruited from each arm. TheIAP team will administer consents and conduct monitoring activities as households areenrolled during the recruitment phase.117

Appendix XVI: Weekly Plancha Log (English Version)MunicipalityWEEKLY EVALUATIONUSE AND PHYSICAL STATE OF PLANCHACommunity_________________________________Date (dd/mm/yy)Start Time_____/______/______ (hh:mm)Interviewer Code InitialsHousehold______:_______-AskQuestion Answer Code0. Are you using the “plancha” for cooking? Yes = 1No = 20.1 How frequently do you use it? Always =1Sometimes = 2Never = 30.2 If the answer was sometimes (2) or never (3),then ask:Why don’t you use it?______________1. Upon brief inspection, is the “plancha” in good shape? Yes = 1No = 2If the answer is Yes (code 1) go to question 2. If the answer is No (code 2) doquestions 1.1.1 to 1.1.51.1 What is the problem?ObserveAsk1.1.1 Is the base cracked or broken? Yes = 1No = 21.1.2 Is the chimney cracked or broken? Yes = 1No = 21.1.3 Is there a missing piece? Yes = 11.1.4 Does smoke come out?(If smoke comes out, describe from whichpart of the stove smoke is coming out)1.1.5 Any other problem?(Describe)No = 2Yes = 1No = 2____________________Yes = 1No = 2______________________2. Do you continue using the open fire? Yes = 1No = 2If the answer is No (code 2) go to question 3. If the question is Yes (code 1) doquestions 2.1 to 2.32.1 What do you use it for?2.1.1 Food for the family Yes = 1No = 22.1.2 Food for the animals Yes = 1No = 2118

Question Answer Code2.1.3 Heating water Yes = 1No = 22.1.4 Space heating Yes = 1No = 22.1.5 Other purpose (Describe)____________________2.2 Where is the fire lit?Kitchen = 1Other place in thehouse =2Outside = 3Other =4(If it is in another place [code 4], describe):____________________2.3 How many times per day do you use the open fire? Less than one = 1One = 2Two =3More than two = 43. Is the family happy with the “plancha?” Yes = 1No = 2If the answer is Yes (code 1) go to question 4. If the question is No (code 2) do thequestions 3.1.1 to 3.1.53.1 What is the problem?3.1.1 Kitchen gets smoky Yes = 1No = 23.1.2 Burns too much wood Yes = 1No = 23.1.3 Does not heat enough Yes = 1No = 23.1.4 Chimney is blocked Yes = 1No = 23.1.5 Any other problem?(Describe)____________________4. Is the “plancha” being used appropriately? Yes = 1No = 2If the answer is Yes (code 1) finish the interview. If the answer is No (code 2) doquestions 4.1.1 to 4.1.5.4.1 What is the problem?Observe4.1.1 One or more pothole covers are not placed while Yes = 1the fire is litNo = 24.1.2 The firewood comes out the potholes or door of Yes = 1the combustion chamberNo = 24.1.3 The door of the combustion chamber is open Yes = 1No = 24.1.4 The tube of the chimney is full of soot and the Yes = 1smoke returnsNo = 24.1.5 Any other problem?(Describe)____________________“IF THE PLANCHA IS NOT BEING USED APPROPRAITELY, IT S THE OBLIGATION OF THE INTERVIEWER TOTRAIN THE WOMAN ON ITS GOOD USE AND MAINTENANCE”Finish Time (hh:mm): _________________119

InterviewInterviewer Initials: _______________ Interviewer Signature: ________________ReviewSupervisor Signature: __________________Date of Review: _________________Data EntryData Enterer Signature: ______________________Date Entered: ________________120

Appendix XVII: Weekly Plancha Log (Spanish Version)EVALUACIÓN SEMANALUTILIZACIÓN Y ESTADO FÍSICO DE LA PLANCHAMunicipio_________________Comunidad________________ViviendaFecha (dd/mm/aa)Hora de inicio_____/______/______ (hh:mm)Entrevistador Código Iniciales______:_______-PreguntePregunta Respuesta Código0. ¿Esta utilizando la plancha para cocinar ? Sí = 1No = 20.1 ¿Con cuanta frecuencia la utiliza? Siempre =1Algunas veces = 2Nunca = 30.2 Si la respuesta fue algunas veces (2) onunca(3); entonces pregunte:¿Por qué razón no la utiliza?____________________1. ¿A simple vista, se encuentra la plancha en buen Sí = 1estado?No = 2Si la respuesta es Si(código 1) pasar a la pregunta2. Si la respuesta es No (código2) hacer las preguntas 1.1.1 a 1.1.51.1 ¿Cuál es el problema?ObservePregunte1.1.1 ¿Esta rajada o quebrada la base? Sí = 1No = 21.1.2 ¿Esta rajada o quebrada laSí = 1chimenea?No = 21.1.3 ¿Falta alguna pieza? Sí = 1No = 21.1.4 ¿Sale humo?Sí = 1(Si sale humo describa de que parte de la No = 2estufa se esta saliendo el humo)____________________1.1.5 ¿Algún otro problema?Sí = 1No = 2(Describa)______________________2. ¿Sigue utilizando el fogón abierto? Sí = 1No = 2Si la respuesta es No (código 2) pasar a la pregunta 3. Si la respuesta es Si(código 1) hacer las preguntas 2.1 a la 2.32.1 ¿Para qué lo utiliza?2.1.1 Comida para la familia Sí = 1No = 22.1.2 Comida para los animales Sí = 1No = 2121

Pregunta Respuesta Código2.1.3 Calentar Agua Sí = 1No = 22.1.4 Calentar el ambiente Sí = 1No = 22.1.5 Otro propósito (Describa)____________________2.2 ¿En qué lugar hace el fuego?La cocina = 1Otro lugar de lacasa =2Afuera = 3Otro =4(Si es en otro lugar [código 4], describa):____________________2.3 ¿Cuántas veces al día utiliza el fogón abierto? Menos de una = 1Una = 2Dos =3Más de dos = 43. ¿La familia esta contenta con la plancha? Sí = 1No = 2Si la respuesta es Si(código 1) finalizar la encuesta. Si la respuesta es No (código2) hacer las preguntas 3.1 a la 1.53.1 ¿Cuál es el problema?3.1.1 Ahuma la cocina Sí = 1No = 23.1.2 Gasta mucha leña Sí = 1No = 23.1.3 No calienta lo suficiente Sí = 1No = 23.1.4 La chimenea esta tapada Sí = 1No = 23.1.5 ¿Algún otro problema?(Describa)Si existe algún problema con la plancha:3.2 ¿Están de acuerdo en que llegue alguien,la próxima semana, a repararla?3.2.1 ¿Qué día sería más convenientepara la familia hacer la reparación?Hora de Finalización (hh:mm): _____________________________________Sí = 1No = 2Lunes = 1Martes = 2Miércoles = 3Jueves = 4Viernes = 5Sábado = 6EntrevistaIniciales del entrevistador: _______________Firma Entrevistador: ________________RevisiónFirma de Supervisor: __________________Ingreso de DatosFirma Digitador: ______________________Fecha de Revisión: _________________Fecha Ingreso: ________________122

Appendix XVII: Form: Supervision of Stove Construction (ENGLISH VERSION)SUPERVISION OF STOVE CONSTRUCTION ARI-UC PROJECTName of Supervisor: _________________________Address CommunityNo. ofHouseSTOVEFinishedIn processLOCATIONthe samenewChimneyREVIEW OFCOMPONENTSPlanchaBaseDiscsApproval PROBLEMS ENCOUNTERED123

Appendix XVIII: Intensive IAQ Plancha LogTo be done at time of equipment pick-upInterviewer______________Household ID _______________ Date (dd mm yy)_________Time (hh mm)__________1. (Obs) Is the stove apparently in good physical shape? Yes/No1.a. If no, what is the problem? (Circle as many as apply)Cracked/broken stove?Cracked/broken chimney?Part missing?Smoking? (observed when lit)Other?Describe ______________________2. Ask the family if they used the plancha for all meals during the monitoring period?Yes/No2.a. If no, why? _____________________2.c. If no, where else did you cook (mark with X)?Day 1 Day 2 Day 3Meal B L D B L D B L DBaby (PW) Y N Y N Y N Y N Y N Y N Y N Y N Y NPlanchaOpen fire in kitchenOpen fire in houseOpen fire outsideOther (describe)124

Appendix XIX: Intensive IAQ consent formVerbal Consent Form: Intensive IAP MonitoringParticulate Air Pollution Exposures and Childhood Acute Respiratory Infections in Guatemala: ARandomized InterventionIntroduction and PurposeGood (morning/afternoon). My name is __________. I (we) work with Universidad del Valle, theMedical Entomology Research Unit of the US Centers for Disease Control and Prevention, and theUniversity of California, Berkeley. Thanks for agreeing to participate in our study of the health of youngchildren in relation to wood smoke in the home. Along with sixty other households, you have beenselected for more frequent and detailed smoke measurements to help us study what is contained in thesmoke.DescriptionThis addition to the main study will last up to 2 years, the same as the time for the main study. All sixtyselected households will be asked to participate in the same activities. The measurements for smoke andthe questions that will be asked are in addition to the basic study to which all participants have agreed.ProceduresIf you would like to join this detailed study of wood smoke, every 3 months (4 times per year) we will askyou about stove use in your household and the activities and location of your child each day during aperiod of 2 days to 1 week. You may choose not to answer any question for any reason. Also 4 times peryear, we would like to measure smoke in your kitchen, other rooms in your household, and the outdoorpatio during the same period. The equipment for measuring smoke is approximately the size of a smallwatermelon and makes a quiet humming sound. Using small glass tubes that are contained in safe plasticholders clipped to you’re your blouse and your baby’s shirt (demonstrate), we would also like to measurethe smoke you and your child breathe. We would also ask you to blow through a small machine tomeasure the smoke in your breath at the beginning and end of the measurement period.Risks & BenefitsYour participation in this additional part of the study will provide more complete information abouthousehold smoke. This will allow us to learn more about the effects of smoke on health. When the studyis done, the results form this additional smoke study will be presented to your community.There is no known risk of hanging the tube on yours or your child’s shirt, leaving the battery-operated airpollution equipment inside and outside your home, or blowing into the monitor. Nothing comes out ofdevices, they only absorb a small amount of smoke. While they are in your house, you do not have to doanything special, just go about your daily tasks as you normally would.ConfidentialityTo protect your privacy, we will keep the records under a code number rather than by name. We willkeep the records in locked rooms and only the study staff will be allowed to look at them. Your name andother personal information will not appear when we discuss this study publicly or when we publish theresults.Cost/Payment125

The information from the smoke tests will be given to you free. A small gift will be offered to familiesparticipating in the smoke study.Right to Refuse or WithdrawThe decision to take part in this smoke study is completely up to you. You are welcome to continueparticipating in the main child health study, even if you refuse to participate in the smoke study. If youhave questions for me (us) during the smoke study, you may ask at any time. Also, if you want to stop atany time, just let me (us) know. There is no penalty if you do not want to join the study or if you wish tostop part way through the study.Persons to ContactIf you have more questions about the project, you may contact Dr. Byron Arana, Co-Director, Center forHealth Studies, Universidad del Valle in Guatemala City, Tel. 364-0336, or Dr. Kirk Smith, University ofCalifornia, Berkeley in the USA, Tel 1-510-883-9917. If you have other questions related to your rightsas a subject in this study, you may contact Lic. Celia Cordon, who is member of the Ethics Committee atthe Universidad del Valle, at Tel. 369-0791, during working hours, or at the following address 18Avenida 11-95, Zona 15 VH III, Guatemala. For making phone calls, you can use the communitytelephones located in your community or in a nearby community where a deal has been made to provideyou, free of cost, access to our phone numbers. You may also contact the University of California atBerkeley’s, Committee for Protection of Human Subjects at 1-510/642-7461,subjects@uclink.berkeley.edu.126

Appendix XIX: Intensive Air Pollution Monitoring Questionnaire: QuarterlyVisit (ENGLISH VERSION)EXPOSURE TO PARTICULATE AIR POLLUTION AND ACUTE RESPIRATORY INFECTIONS AMONGGUATEMALAN CHILDREN: A RANDOMIZED INTERVENTINO STUDYINTENSIVE AIR POLLUTION MONITORING: MASTER FORMQUARTERLY VISIT(# # # # #)COMMUNITYHOME (# # #)___ ___ ___ ___ ______ ___ ___VISIT # 1: QUESTIONS AND OBSERVATIONS DURING EQUIPMENT SETUPA.1 Field Worker (# #)A.2When did the field worker arrive at thehome?Date (dd/mm/yy)Hour (hh:mm)OBSERVE IMMEDIATELY UPON ARRIVING AT THE HOME:(For A4 and A5, if it is not possible for the field worker to observe, then ask the mother)A4.In the kitchen, cooking = 1Where was the mother when theinterviewer arrived?In the kitchen, not cooking = 2Another part of the house = 3Outside = 4Other (describe) = 5A4.1 A4. was: Observation = 1Mother’s response = 2A5.If there is a baby, where was he/shewhen the field worker arrived?In the kitchen, on the back of the cook = 1In the kitchen, not on the back of the cook = 2Another part of the house = 3Outside = 4Other (describe) = 5A5.1 A5. was: Observation = 1Mother’s response = 2A6. Is the fire lit? Yes, Open fire = 1No = 2Yes, Plancha = 3B. BREATH CARBON MONOXIDE (CO)B1.When did you last finish cooking?Date (dd/mm/yy)Time (hh:mm)B2.B2.1Do you smoke?When did you last smoke?Yes = 1No = 2 (GO TO QUESTION B3)Date(dd/mm/yy)Time (hh:mm)B3. Breath CO Monitor ID (# # #)B4. Time of Start of Measurements (hh : mm)127

B5.1 Measure 1 (ppm) (# # #)B5.2 Measure 2 (ppm) (# # #)B5.3 Measure 3 (ppm) (# # #)C. MONITORS LOCATED IN VARIOUS MICROENVIRONMENTS AND PEOPLE(Indicate the number of each type of monitor for each person and place)Infant Mother Kitchen Bedroom OutsideCO Difusion TubeC1.1 C2.1 C3.1 C4.1 C5.1CO-Hobo (hco) C1.2 C2.2 C3.2 C4.2 C5.2CO-Draeger (dco) C1.3 C.2.3 C3.3 C4.3 C5.3Prototype-1 (p1b) C1.4 C2.4 C3.4 C4.4 C5.4PM1 Cyclone - Filter C1.5 C2.5 C3.5 C4.5 C5.5DustTrak (DT) C1.6 C2.6 C3.6 C4.6 C5.6DataRam (DR) C1.7 C2.7 C3.7 C4.7 C5.7Casella C1.8 C2.8 C3.8 C4.8 C5.8TSP – Mini-Pump(PAS 500)C1.9 C2.9 C3.9 C4.9 C5.9OBSERVATIONS (Include initials and date): __________________________________________________________________________________________________________________________________________128

VISIT # 2: SUPERVISION OF MONITORS AND BREATH COD.1 Field Worker (# #)D.2When did the field worker arrive at thehome?Date (dd/mm/yy)Hour (hh:mm)OBSERVE IMMEDIATELY UPON ARRIVING AT THE HOME:(For D4 and D5, if it is not possible for the field worker to observe, then ask the mother)D4.In the kitchen, cooking = 1Where was the mother when theinterviewer arrived?In the kitchen, not cooking = 2Another part of the house = 3Outside = 4Other (describe) = 5D4.1 A4. was: Observation = 1D5.If there is a baby, where was he/shewhen the field worker arrived?Mother’s response = 2In the kitchen, on the back of the cook = 1In the kitchen, not on the back of the cook = 2Another part of the house = 3Outside = 4Other (describe) = 5D5.1 A5. was: Observation = 1Mother’s response = 2D6. Is the fire lit? Yes, Open fire = 1No = 2Yes, Plancha = 3D7. OBSERVE: Where any of the monitorsmoved from the location they wereoriginally placed?D8. Do the monitors seem to befunctioning correctly?D9. ASK: Were the tubes, Hobo CO ormini-pumps on the mother or childtaken off since they were placedyesterday?MONITORS THAT THE PARTICIPANTS REMOVED:D9.1 Monitor ID D9.2 Why? D9.3 Where did theyleave it?Kitchen = 1Main house = 2Outside = 3Other = 4 (specify)Yes = 1 (NOTE IN OBSERVATIONS)No = 2Sí = 1No = 2 (NOTE IN OBSERVATIONS)Yes = 1 (FILL TABLE BELOW)No = 2 (GO TO QUESTION E)D9.4 Date(dd/mm/yy)D9.5 Time(hh:mm)D9.1.1 D9.2.1 D9.3.1 D9.4.1 D9.5.1 D9.6.1D9.6¿How long?(hours)D9.1.2 D9.2.2 D9.3.2 D9.4.2 D9.5.2 D9.6.2D9.1.3 D9.2.3 D9.3.3 D9.4.3 D9.5.3 D9.6.3D9.1.4 D9.2.4 D9.3.4 D9.4.4 D9.5.4 D9.6.4E. BREATH CARBON MONOXIDE129

E1.When did you last finish cooking?Date (dd/mm/yy)Time (hh:mm)E2.1 If answered “Yes” to B2,When did you last smoke?Date (dd/mm/yy)Time (hh:mm)E3. Breath CO Monitor ID (# # #)E4. 1 Time of Start of Measurements (hh : mm)E5.1 Measure 1 (ppm) (# # #)E5.2 Measure 2 (ppm) (# # #)E5.3 Measure 3 (ppm) (# # #)OBSERVATIONS (Include monitor ID, place where it was placed, where it was found and in what condition): _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________130

VISIT # 3: QUESTIONS AND OBSERVATIONS WHILE COLLECTING EQUIPMENTF.1 Field Worker (# #)F.2When did the field worker arrive at thehome?Date (dd/mm/yy)Hour (hh:mm)OBSERVE IMMEDIATELY UPON ARRIVING AT THE HOME:(For F4 and F5, if it is not possible for the field worker to observe, then ask the mother)F4.In the kitchen, cooking = 1Where was the mother when theinterviewer arrived?In the kitchen, not cooking = 2Another part of the house = 3Outside = 4Other (describe) = 5F4.1 A4. was: Observation = 1F5.If there is a baby, where was he/sheWhen the field worker arrived?Mother’s response = 2In the kitchen, on the back of the cook = 1In the kitchen, not on the back of the cook = 2Another part of the house = 3Outside = 4Other (describe) = 5F5.1 A5. was: Observation = 1Mother’s response = 2F6. Is the fire lit? Yes, Open fire = 1No = 2Yes, Plancha = 3F7. OBSERVE: Where any of the monitorsmoved from the location they wereoriginally placed?F8. Do the monitors seem to befunctioning correctly?F9. ASK: Were the tubes, Hobo CO ormini-pumps on the mother or childtaken off since they were placedyesterday?MONITORS THAT THE PARTICIPANTS REMOVED:F9.1 Monitor ID F9.2 Why? F9.3 Where did theyleave it?Kitchen = 1Main house = 2Outside = 3Other = 4 (specify)Yes = 1 (NOTE IN OBSERVATIONS)No = 2Sí = 1No = 2 (NOTE IN OBSERVATIONS)Yes = 1 (FILL TABLE BELOW)No = 2 (GO TO QUESTION E)F9.4 Date(dd/mm/yy)F9.5 Time(hh:mm)F9.1.1 F9.2.1 F9.3.1 F9.4.1 F9.5.1 F9.6.1F9.6¿How long?(hours)F9.1.2 F9.2.2 F9.3.2 F9.4.2 F9.5.2 F9.6.2F9.1.3 F9.2.3 F9.3.3 F9.4.3 F9.5.3 F9.6.3F9.1.4 F9.2.4 F9.3.4 F9.4.4 F9.5.4 F9.6.4131

G. BREATH CARBON MONOXIDE.G1.When did you last finish cooking?G2.1 If answered “Yes” to B2,When did you last smoke?Date (dd/mm/yy)Time (hh:mm)Date (dd/mm/yy)Time (hh:mm)G3. Breath CO Monitor ID (# # #)G4. Time of Start of Measurements (hh : mm)G5.1 Measure 1 (ppm) (# # #)G5.2 Measure 2 (ppm) (# # #)G5.3 Measure 3 (ppm) (# # #)I. QUESTIONS I1 TO I6 REFER TO THE TIME SINCE THE MONITORS WERE PLACED TWO DAYS AGO.I1.I1.2.1Since the monitors were placed two days ago,was the temascal used?When was the temascal used?Yes = 1No = 2 (GO TO QUESTION I2)Date (dd/mm/yy)Time (hh:mm)I1.3.1I1.2.2I1.3.2I1.2.3I1.3.3Did the baby or pregnant woman go intothe temascal?When was the temascal used?Did the baby or pregnant woman go intothe temascal?When was the temascal used?Did the baby or pregnant woman go intothe temascal?Yes = 1No = 2Date (dd/mm/yy)Time (hh:mm)Yes = 1No = 2Date (dd/mm/yy)Time (hh:mm)Yes = 1No = 2I2. Since the monitors were placed two days ago,was trash burned near (

I3.2.2 Where? Kitchen = 1Bedroom = 2I3.4.2 How many cigarettes? #I3.5.2 Near the baby? Yes = 1No = 2I3.2.3 Where? Kitchen = 1Bedroom = 2I3.4.3 How many cigarettes? #I3.5.3 Near the baby? Yes = 1No = 2I3.2.4 Where? Kitchen = 1Bedroom = 2I3.4.4 How many cigarettes? #I3.5.4 Near the baby? Yes = 1No = 2I4. Since the monitors were placed two days ago,was a kerosene lamp used in the kitchen or inthe bedroom?I4.1.1 Where? Kitchen = 1Bedroom = 2I4.3.1 How long? #. # (hours)I4.1.2 Where? Kitchen = 1Bedroom = 2I4.3.2 How long? #. # (hours)I4.1.3 Where? Kitchen = 1Bedroom = 2I4.3.3 How long? #. # (hours)I4.1.4 Where? Kitchen = 1Bedroom = 2I4.3.4 How long? #. # (hours)Yes = 1No = 2 (GO TO QUESTION I5)I5. Since the monitors were placed two days ago,was the baby or pregnant woman near a fire inanother house?I5.2.1 How long? #. # (hours)15.3.1 What type type of stove does the otherhouse have?I5.2.2 How long? #. # (hours)Yes = 1No = 2 (GO TO QUESTION I6)Open fire = 1Plancha = 2Other = 3 (Specify _______________)15.3.2 What type type of stove does the otherhouse have?Open fire = 1Plancha = 2Other = 3 (Specify _______________)133

I6. Since the monitors were placed two days ago,have there been any special activities in thehouse (parties, meals that were not cookedbecause the family went away, etc)?I6.1When?Yes = 1No = 2 (END OF INTERVIEW)Date (dd/mm/yy)Time (hh:mm)I6.2 Describe activity:OBSERVATIONS (Incluid initials, name and equipment ID, location and conditions of equipment_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________THANK PARTICIPANT FOR INFORMATION – END OF INTERVIEWForm RevisionSignature IAP Supervisor:_____________________Date: _________________Data EntrySignature Data Enterer # 1: ________________Signature Data Enterer # 2: ________________Revision of Data EntrySupervisor Signature:_____________________Date: _________________134

Appendix XX: Intensive Air Pollution Monitoring Questionnaire: QuarterlyVisit (SPANISH VERSION)EXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE E INFECCIONES RESPIRATORIASAGUDAS EN NIÑOS EN GUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIOMONITOREO INTENSIVO DE CONTAMINACIÓN DEL AIRE: FORMULARIO PRINCIPALVISITA TRIMESTRAL(# # # # #)COMUNIDADCASA (# # #)___ ___ ___ ___ ______ ___ ___VISITA No. 1: PREGUNTAS Y OBSERVACIONES AL COLOCAR LOS EQUIPOSA.1 No. de Encuestador (# #)A.2¿Cuándo llegó el(la) encuestador(a) ala casa?Fecha (dd/mm/aa)Hora (hh:mm)OBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA:(En el caso que no le sea posible al entrevistador observar, entonces pregunte a la madre)A4. ¿Dónde estaba la mamá cuando elencuestador llegó?En la cocina cocinando = 1En la cocina no cocinando = 2Otra parte de la casa = 3Afuera = 4Otro (describir) = 5A4.1 A4. fue: Observación = 1Respuesta de la Madre = 2A5. Si hay bebé, ¿Dónde estaba cuando elencuestador llegó?En la cocina sobre la espalda de la cocinera = 1En la cocina no sobre la espalda de la cocinera = 2En otra parte de la casa = 3Afuera = 4Otro (describir) = 5A5.1 A5. fue: Observación = 1Respuesta de la Madre = 2A6. ¿Está encendido el fuego? Sí, Fuego Abierto = 1No = 2SÍ, Plancha = 3B. MONOXIDO DE CARBONO EN EL ALIENTO.B1. ¿Hace cuánto tiempo terminó decocinar la última vez?Fecha(dd/mm/aa)Hora (hh:mm)B2. ¿Usted fuma? Sí = 1B2.1 ¿Hace cuánto tiempo terminó defumar por última vez?No = 2 (PASE A LA PREGUNTA B3)Fecha(dd/mm/aa)Hora (hh:mm)B3. ID del monitor para CO en el aliento (# # #)135

B4. Hora de Empezar Medidas (hh : mm)B5.1 Medida 1 (ppm) (# # #)B5.2 Medida 2 (ppm) (# # #)B5.3 Medida 3 (ppm) (# # #)C. EQUIPOS COLOCADOS EN VARIOS LUGARES(Indicar en la casilla el número de aparatos colocados en cada persona o lugar)Bebé Madre Cocina Cuarto AfueraCO-TuboC1.1 C2.1 C3.1 C4.1 C5.1CO-Hobo (hco) C1.2 C2.2 C3.2 C4.2 C5.2CO-Draeger (dco) C1.3 C.2.3 C3.3 C4.3 C5.3Prototipo-1 (p1b) C1.4 C2.4 C3.4 C4.4 C5.4PM - FiltroC1.5 C2.5 C3.5 C4.5 C5.5(ciclón y bomba)DustTrak (DT) C1.6 C2.6 C3.6 C4.6 C5.6DataRam (DR) C1.7 C2.7 C3.7 C4.7 C5.7Casella C1.8 C2.8 C3.8 C4.8 C5.8PM – Mini-Bomba(PAS 500)C1.9 C2.9 C3.9 C4.9 C5.9OBSERVACIONES (Anotar sus iniciales y la fecha): __________________________________________________________________________________________________________________________________________136

VISITA No. 2: SUPERVISIÓN DE EQUIPOS Y MEDIDAS DEL CO EN EL ALIENTOD.1 No. de Encuestador (# #)D.2¿Cuándo llegó el(la) encuestador(a) ala casa?Fecha (dd/mm/aa)Hora (hh:mm)OBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA:(Para D4 y D5, en el caso que no le sea posible al entrevistador observar, entonces pregunte a la madre)D4.En la cocina cocinando = 1¿Dónde estaba la mamá cuando elencuestador llegó?En la cocina no cocinando = 2Otra parte de la casa = 3Afuera = 4Otro (describir) = 5D4.1 D4. fue: Observación = 1D5.Si hay bebé, ¿Dónde estaba cuando elencuestador llegó?Respuesta de la Madre = 2En la cocina sobre la espalda de la cocinera = 1En la cocina no sobre la espalda de la cocinera = 2En otra parte de la casa = 3Afuera = 4Otro (describir) = 5D5.1 D5. fue: Observación = 1Respuesta de la Madre = 2D6.¿Está encendido el fuego?Sí, Fuego Abierto = 1No = 2SÍ, Plancha = 3D7. OBSERVAR: ¿Algún equipo fuecambiado del lugar donde se pusooriginalmente?Sí = 1 (ANOTAR EN OBSERVACIONES)No = 2D8. ¿Cree usted que está funcionado elequipo?Sí = 1No = 2 (ANOTAR EN OBSERVACIONES)D9. PREGUNTE: ¿Se quitaron los tubos,el Hobo o la Mini-Bomba del bebé ola madre durante el tiempo desde quese colocaron los equipos el día de ayer?Sí = 1 (LLENE EL CUADRO ABAJO)No = 2 (PASE A LA PREGUNTA E)EQUIPOS QUE LAS PERSONAS QUITARON:D9.1 ID del Equipo D9.2 ¿Por cuál razón?? D9.3 ¿Dónde lo dejaron?Cocina = 1Casa principal = 2Afuera = 3Otro = 4 (especificar)D9.4 Fecha(dd/mm/aa)D9.5 Hora(hh:mm)D9.1.1 D9.2.1 D9.3.1 D9.4.1 D9.5.1 D9.6.1D9.6¿Cuánto tiempo?(# horas)D9.1.2 D9.2.2 D9.3.2 D9.4.2 D9.5.2 D9.6.2D9.1.3 D9.2.3 D9.3.3 D9.4.3 D9.5.3 D9.6.3D9.1.4 D9.2.4 D9.3.4 D9.4.4 D9.5.4 D9.6.4137

E. MONOXIDO DE CARBONO EN EL ALIENTO.E1. ¿Hace cuánto tiempo terminó de cocinarla última vez?E2.1 Si contestó “Sí” a B2,¿Hace cuánto tiempo terminó de fumarpor última vez?Fecha(dd/mm/aa)Hora (hh:mm)Fecha(dd/mm/aa)Hora (hh:mm)E3. ID del monitor del CO en el aliento (# # #)E4. 1 Hora de Empezar Medidas (hh : mm)E5.1 Medida 1 (ppm) (# # #)E5.2 Medida 2 (ppm) (# # #)E5.3 Medida 3 (ppm) (# # #)OBSERVACIONES (Incluir nombre del equipo, lugar donde se ubicó y/o condiciones en que se encontró): __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________138

VISITA No. 3: PREGUNTAS Y OBSERVACIONES AL COLECTAR LOS EQUIPOSF.1 No. de Encuestador (# #)F.2¿Cuándo llegó el(la) encuestador(a) ala casa?Fecha (dd/mm/aa)Hora (hh:mm)OBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA:(Para F4 y F5, en el caso que no le sea posible al entrevistador observar, entonces pregunte a la madre)F4.En la cocina cocinando = 1¿Dónde estaba la mamá cuando elencuestador llegó?En la cocina no cocinando = 2Otra parte de la casa = 3Afuera = 4Otro (describir) = 5F4.1 F4. fue: Observación = 1Respuesta de la Madre = 2F5.Si hay bebé, ¿Dónde estaba cuando elencuestador llegó?En la cocina sobre la espalda de la cocinera = 1En la cocina no sobre la espalda de la cocinera = 2En otra parte de la casa = 3Afuera = 4Otro (describir) = 5F5.1 D5. fue: Observación = 1Respuesta de la Madre = 2F6.¿Está encendido el fuego?Sí, Fuego Abierto = 1No = 2SÍ, Plancha = 3F7. OBSERVAR: ¿Algún equipo fue cambiadodel lugar donde se puso originalmente?Sí = 1 (ANOTAR EN OBSERVACIONES)No = 2F8. ¿Cree usted que está funcionado elequipo?Sí = 1No = 2 (ANOTAR EN OBSERVACIONES)F9. PREGUNTE: ¿Se quitaron los tubos,el Hobo o la Mini-Bomba del bebé ola madre durante el tiempo desde queles visitamos el día de ayer?Sí = 1 (LLENE EL CUADRO ABAJO)No = 2 (PASE A LA PREGUNTA E)EQUIPOS QUE LAS PERSONAS QUITARON:F9.1 ID del Equipo F9.2 ¿Por cuálrazón?F9.3 ¿Dónde lo dejaron?Cocina = 1Casa principal = 2Afuera = 3Otro = 4 (especificar)F9.4 Fecha(dd/mm/aa)F9.5 Hora(hh:mm)F9.1.1 F9.2.1 F9.3.1 F9.4.1 F9.5.1 F9.6.1F9.6¿Cuántotiempo?(# horas)F9.1.2 F9.2.2 F9.3.2 F9.4.2 F9.5.2 F9.6.2F9.1.3 F9.2.3 F9.3.3 F9.4.3 F9.5.3 F9.6.3F9.1.4 F9.2.4 F9.3.4 F9.4.4 F9.5.4 F9.6.4139

G. MONOXIDO DE CARBONO EN EL ALIENTO.G1.¿Hace cuánto tiempo terminó de cocinar laúltima vez?Fecha(dd/mm/aa)Hora (hh:mm)G2.1Si contestó “Sí” a B2, ¿Hace cuánto tiempoterminó de fumar por última vez?Fecha(dd/mm/aa)Hora (hh:mm)G3. ID del monitor del CO en el aliento (# # #)G4. Hora de Empezar Medidas (hh : mm)G5.1 Medida 1 (ppm) (# # #)G5.2 Medida 2 (ppm) (# # #)G5.3 Medida 3 (ppm) (# # #)I. LAS PREGUNTAS I1 HASTA I6 SE REFIEREN AL TIEMPO DESDE QUE SE COLOCARON LOSEQUIPOS HACE DOS DÍAS,I1.I1.2.1¿Desde que se colocaron los equiposhace dos días, se usó un temascal?¿Cuándo se usó el temascal?Sí = 1No = 2 (PASE A LA PREGUNTA I2)Fecha (dd/mm/aa)Hora (hh:mm)I1.3.1I1.2.2I1.3.2I1.2.3I1.3.3¿Entró el bebé o la madreembarazada?¿Cuándo se usó el temascal?¿Entró el bebé o la madreembarazada?¿Cuándo se usó el temascal?¿Entró el bebé o la madreembarazada?Sí = 1No = 2Fecha (dd/mm/aa)Hora (hh:mm)Sí = 1No = 2Fecha (dd/mm/aa)Hora (hh:mm)Sí = 1No = 2I2. ¿Desde que se colocaron los equipos hacedos días, se quemó basura cerca (

I3.2.2 ¿Dónde? Cocina = 1Cuarto = 2I3.4.2 ¿Cuántos cigarrillos? #I3.5.2 ¿Cerca al bebé? Sí = 1No = 2I3.2.3 ¿Dónde? Cocina = 1Cuarto = 2I3.4.3 ¿Cuántos cigarrillos? #I3.5.3 ¿Cerca al bebé? Sí = 1No = 2I3.2.4 ¿Dónde? Cocina = 1Cuarto = 2I3.4.4 ¿Cuántos cigarrillos? #I3.5.4 ¿Cerca al bebé? Sí = 1No = 2I4. ¿ Desde que se colocaron los equiposhace dos días, se usó un candil(lámpara de kerosina con mecha)en la cocina o cuarto?I4.1.1 ¿Dónde? Cocina = 1Cuarto = 2I4.3.1 ¿Cuánto tiempo? #. # (horas)I4.1.2 ¿Dónde? Cocina = 1Cuarto = 2I4.3.2 ¿Cuánto tiempo? #. # (horas)I4.1.3 ¿Dónde? Cocina = 1Cuarto = 2I4.3.3 ¿Cuánto tiempo? #. # (horas)I4.1.4 ¿Dónde? Cocina = 1Cuarto = 2I4.3.4 ¿Cuánto tiempo? #. # (horas)Sí = 1No = 2 (PASE A LA PREGUNTA I5)I5. ¿ Desde que se colocaron los equiposhace dos días, estuvo el bebé o mujerembarazada cerca a un fuego en otra casa?I5.2.1 ¿Por cuánto tiempo? #. # (horas)Sí = 1No = 2 (PASE A LA PREGUNTA I6)15.3.1Fuego Abierto = 1¿Qué tipo de estufa tiene la otra casa? Plancha = 2Otro = 3 (Especifique ____________)I5.2.2 ¿Por cuánto tiempo? #. # (horas)15.3.2¿Qué tipo de estufa tiene la otra casa?Fuego Abierto = 1Plancha = 2Otro = 3 (Especifique ____________)141

I6. ¿Desde que se colocaron los equipos hacedos días, ha habido actividades especiales enla casa (fiestas, tiempos de comida en los queno se cocinó porque la familia salió, etc.)?I6.1¿Cuándo?Sí = 1No = 2 (FINALICE LA ENCUESTA)Fecha (dd/mm/aa)Hora (hh:mm)I6.2 Describir la actividad:OBSERVACIONES (Incluir iniciales, nombre y ID del equipo, lugar donde se ubicó y/o condiciones en que se encontró): _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________AGRADECER POR LA INFORMACIÓN AL ENTREVISTADO- FIN DE LA ENTREVISTARevisión del formularioFirma del supervisor de CAI:_____________________Fecha de la revisión: _________________Ingreso de datosFirma Digitador # 1: ________________Firma Digitador # 2: ________________Revisión del ingreso de datosFirma del supervisor:_____________________Fecha de la revisión: _________________142

Appendix XXI: Form: Intensive Time-Activity Assessment, Observation (English)Example (A) – For mother living in a home with the kitchen and sleeping area in the same building. She has a young child whousually stays with her (on her back mostly) when cooking, but sleeps at home in the day cared for by an older sibling for part of thetime that the mother is outdoors in the fields. Mother and child visit a friend’s home during the morning, where the fire is not lit. Inthe evening after cooking, time is spent in the kitchen with the fire dying down, finally going out at 22.00 hrs. The mother and childthen go to the sleeping room.12 midnight to 14.00 hrs12m 04-00 05.00 06.00 07.00 08.00 09.00 10.00 11.00 12.00 13.00n15 minute periods1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4Status of FireNot alightBurning wellSmoulderingMother activityIn kitchen - cookingIn kitchen - otherOther room (integral)Main house (separate)OutdoorsOther house – fire litOther house – no fireChild activityIn kitchen on m’s backIn kitchen other placeOther room (integral)Main house (separate)Outdoors143

Other house – fire litOther house – no fireExample (A) – continued14.00 hrs to Midnight14.00 15.00 16.00 17.00 18.00 19.00 20.00 21.00 22.00 23.0015 minute periods1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4Status of FireNot alightBurning wellSmoulderingMother activityIn kitchen - cookingIn kitchen - otherOther room (integral)Main house (separate)OutdoorsOther house – fire litOther house – no fireChild activityIn kitchen on m’s backIn kitchen other placeOther room (integral)Main house (separate)OutdoorsOther house – fire litOther house – no fire144

Appendix XXII: Form: Intensive Time-Activity Assessment, Observation (Spanish)EXPOSICIÓN A CONTAMINACIÓN DEL AIRE E INFECCIONES RESPIRATORIAS AGUDAS EN LA NIÑEZGUATEMALTECA: UN ESTUDIO DE INTEREVENCIÓN ALEATORIOOBSERVACIÓN DE TIEMPO Y ACTIVIDADESMunicipio(##) ___ ___Comunidad(###) ___ ___ ___Casa(###) ___ ___ ___Nombre de la observadoraFechaOBSERVAR Y LLENAR LA TABLA CON LOS NUMEROS DE MINUTOS PARA INDICAR LAS ACTIVIDADES DE LA MADRE Y EL NIÑO.LA HORA05: 06: 07: 08: 09: 10: 11: 12: 13: 14:00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30ESTADO DEL FUEGO Fuego encendido afueraACTIVIDADES DE LA MADRE En cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)145

OBSERVACIONES (incluir iniciales y fecha):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________OBSERVAR Y LLENAR LA TABLA CON LOS NUMEROS DE MINUTOS PARA INDICAR LAS ACTIVIDADES DE LA MADRE Y EL NIÑO.LA HORA15: 16: 17: 18: 19: 20:00 30 00 30 00 30 00 30 00 30 00 30ESTADO DEL FUEGO Fuego encendido afueraACTIVIDADES DE LA MADRE En cocina En cuarto conectado a lacocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina En cuarto conectado a lacocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)OBSERVACIONES (incluir iniciales y fecha):______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________146

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA EL BEBE? SI EL BEBE ESTA ENCONCINA, DONDE?5:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________6:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________6:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________147

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?7:15ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ _______________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________7:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro _______________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________8:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro _____________________________148

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?8:45ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ____________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________9:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro _______________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________9:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida _________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________149

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?10:15ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________10:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida ______________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________11:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida ______________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________150

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?11:45ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________12:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________12:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________151

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?13:15ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________13:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida ______________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________14:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________152

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?14:45ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________15:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________15:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________153

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?16:15ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________16:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro _______________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________17:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________154

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?17:45ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________18:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________18:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________155

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?19:15ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________19:45ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________20:15ڤ Bastante ڤSolo brasas ڤNada ڤCocina cerca (< 1 m) ڤCocina lejos (> 1 m) ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ____________________________________ڤTortillas ڤOtra comida __________________________________________________________________ڤNo ڤCocina ڤCuarto conectado ڤCuarto aparte ڤAfuera ڤOtro ________________________________________ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________156

AL ENTRAR A LA COCINA, OBSERVAR:HORA FUEGOENCENDIDO?DONDE ESTA LA MADRE? LA MADRE ESTA COCINANDO? DONDE ESTA ELBEBE?20:45ڤ Bastante ڤCocina cerca (< 1 m) ڤ Tortillas ڤCocina ڤCocina lejos (> 1 m) ڤCuarto conectado ڤSolo brasas ڤ Cuarto conectado ڤ Otra comida ڤCuarto aparte ڤCuarto aparte ______________________ڤ Afuera ڤNada ڤAfuera ______________________ڤ Otro ڤOtro ______________________ ________________________________________________________ڤ No ____________________SI EL BEBE ESTA ENCONCINA, DONDE?ڤEspalda madre ڤEspalda otra cocinandoڤEspalda otra no cocinandoڤNivel del piso ڤEn alto ڤOtro ______________OBSERVACIONES (incluir iniciales y fecha):_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________INICIALES CC: __________FECHA: ____ / ____ / ____157

Municipio(##) ___ ___Comunidad(###) ___ ___ ___Casa(###) ___ ___ ___Nombre de la observadoraFechaOBSERVAR Y LLENAR LA TABLA CON LOS NUMEROS DE MINUTOS PARA INDICAR LAS ACTIVIDADES DE LA MADRE Y EL NIÑO.LA HORAESTADO DEL FUEGO Fuego encendido afueraACTIVIDADES DE LA MADRE En cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)05: 06: 07: 08: 09: 10: 11: 12: 13: 14:00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30OBSERVACIONES (incluir iniciales y fecha): __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________158

Appendix XXIII: Form: Intensive Time-Activity Assessment, Evaluation (English) (forthcoming)159

Appendix XXIV: Form: Intensive Time-Activity Assessment, Evaluation (Spanish)EXPOSICIÓN A CONTAMINACIÓN DEL AIRE E INFECCIONES RESPIRATORIAS AGUDAS EN LA NIÑEZ GUATEMALTECA: UN ESTUDIODE INTEREVENCIÓN ALEATORIOEVALUACIÓN DE TIEMPO Y ACTIVIDADESMunicipio(##) ___ ___Comunidad(###) ___ ___ ___Casa(###) ___ ___ ___Parte 1Parte 2No. deEncuestadorFechaHoraMARCAR CON “X” PARA INDICAR LAS ACTIVIDADES DE LA MADRE Y EL NIÑO EMPEZANDO EN LA MADRUGADA EL DÍA DESPUÉS DE DEJAR LOSEQUIPÓS HASTA LA HORA DE RECOGER LOS EQUIPOS. CADA CASILLA REPRESENTA EL PERIODO DE 30 MINUTOS EMPEZANDO CON LA HORAINDICADA EN LA PRIMERA FILA.160

Media noche (00:00) hasta dos de la tarde (14:00) el día después de dejar los equiposLA HORA 12:00- 04: 05: 06: 07: 08: 09: 10: 11: 12: 13:04:00 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30ESTADO DEL FUEGO Fuego encendido en cocina Fuego encendido afueraACTIVIDADES DE LA MADRE En cocina - cocinando En cocina – no cocinando En cuarto conectado a lacocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina – espalda mama En cocina - otro lugar En cuarto conectado a lacocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)161

Dos de la tarde (14:00) el día después de colocar los equipos hasta la media noche (00:00)LA HORA14: 15: 16: 17: 18: 19: 20: 21: 22: 23:00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30ESTADO DEL FUEGO Fuego encendido en cocina Fuego encendido afueraACTIVIDADES DE LA MADRE En cocina - cocinando En cocina – no cocinando En cuarto conectado a la cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina – espalda mama En cocina - otro lugar En cuarto conectado a la cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)OBSERVACIONES (incluir iniciales y fecha):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________162

Media noche (00:00) hasta dos de la tarde (14:00) el día de recoger los equiposLA HORA 12:00- 04: 05: 06: 07: 08: 09: 10: 11: 12: 13:04:00 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30 00 30ESTADO DEL FUEGO Fuego encendido en cocina Fuego encendido afueraACTIVIDADES DE LAMADRE En cocina - cocinando En cocina – no cocinando En cuarto conectado a lacocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina – espalda mama En cocina - otro lugar En cuarto conectado a lacocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)OBSERVACIONES (incluir iniciales y fecha):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________163

Dos de tarde (14:00) hasta seis de la tarde (18:00) el día de recoger los equiposLA HORA14: 15: 16: 17:00 30 00 30 00 30 00 30ESTADO DEL FUEGO Fuego encendido en cocina Fuego encendido afueraACTIVIDADES DE LA MADRE En cocina - cocinando En cocina – no cocinando En cuarto conectado a la cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)ACTIVIDADES DEL NIÑO En cocina – espalda mama En cocina - otro lugar En cuarto conectado a la cocina En casa principal (aparte) Afuera Otro lugar (Anotar abajo)OBSERVACIONES (incluir iniciales y fecha):_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________INICIALES CC: __________FECHA: ____ / ____ / ____164

Appendix XXV: Form: Intensive IAQ monitoring: Quality Control Sheet for Carbon Monoxide Tube Readings(English)MUNICIPALITYCOMMUNITY___ ______ ___ ___HOUSEHOLD(###) ___ ___ ___PARTICULATE AIR POLLUTION EXPOSURE AND CHILDHOODACUTE RESPIRATORY INFECTIONS IN GUATEMALA: ARANDOMIZED INTERVENTION TRIALINTENSIVE MONITORING OF IAP:CARBON MONOXIDEPLACEMENT: DATE (dd/mm/yy) ______ / ______ / ______ HOUR (hh:mm) ______ : ______INITIALESDAY 1INITIALS DAY 2INITIALSDAY 3RETRIEVAL: DATE (dd/mm/yy) ______ / ______ / ______ HOUR (hh:mm) ______ : ______ NOTE IN OBSERVATIONS SECTION IF MONITORS WERE NOT PLACED OR RETRIEVED AT THE SAME TIME (WITHIN 15 MINUTES)PASSIVE DIFFUSION TUBESSITETUBE IDLABEL TUBE CHECK: DAY 2 TUBE CHECK: DAY 3(###)BABYMOTHERKITCHENCONTINUOUS MONITORS FOR CO (HOBO, DRAEGER)SITE MONITOR ID CHECKDAY 2CHECKDAY 3MOTHERBATTERY(%)FILE NUMBERGRAPHICCHECKSECURITY COPYINITIALSKITCHENKITCHEN MONITORS: HEIGHT = _____ _____ _____ cm DISTANCE FROM STOVE = _____ _____ _____ cmOBSERVATIONS (Include initials, date and time:____________________________________________________________________________FORM REVIEW: INITIALS _______________ DATE _______________165

Appendix XXVI: Form: Intensive IAQ monitoring: Quality Control Sheet for Carbon Monoxide Tube Readings(Spanish)MUNICIPIOEXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE EINFECCIONES RESPIRATORIAS AGUDAS EN NIÑOS EN___ ___COMUNIDADGUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIO___ ___ ___CASAMONITOREO INTENSIVO DE CAI:(###) ___ ___ ___MONOXIDO DE CARBONOCOLOCAR: FECHA (dd/mm/aa) ______ / ______ / ______ HORA (hh:mm) ______ : ______RECOGER: FECHA (dd/mm/aa) ______ / ______ / ______ HORA (hh:mm) ______ : ______INICIALESDIA 1INICIALESDIA 2INICIALESDIA 3* ANOTAR EN OBSERVACIONES SI NO TODOS LOS MONITORES SE COLOCARON Y SE RECOGIERON A LAS MISMAS FECHAS Y HORAS (ENTRE 15 MINUTOS).TUBOS DE DIFUSION PASIVASITIOID DEL TUBO ETIQUETA CHEQUEO DEL TUBO: DIA 2 CHEQUEO DEL TUBO: DIA 3(###)BEBEMADRECOCINAMONITORES CONTINUOS PARA CO (HOBO, DRAEGER)SITIO ID DELMONITORCHEQUEODIA 2CHEQUEODIA 3MADREBATERIA(%)NOMBRE DEL ARCHIVOCHEQUEO DELA GRAFICACOPIA DESEGURIDADINICIALESCOCINAMONITORES EN COCINA: ALTURA = _____ _____ _____ cm DISTANCIA DE LA ESTUFA = _____ _____ _____ cmOBSERVACIONES (Incluir iniciales, fecha y hora):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________166

Appendix XXVII: Form: Intensive IAQ monitoring: Carbon Monoxide Tube Readings (English)CONTROL SHEET FOR CARBON MONOXIDE TUBE READINGS READ TUBES WITHIN 24 HOURS OF RETRIEVAL NOTE IDENTIFICATION NUMBERS OF TUBOS THAT ARE NOT CAPPEDRETRIEVAL EXT/INT NO. OF READING 1 READING 2 READING 3DATETUBESDATE INITIALS DATE INITIALS DATE INITIALSڤEXT ڤINT ڤEXT ڤINT ڤEX ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT OBSERVATIONS167

Appendix XXVIII: Form: Intensive IAQ monitoring: Carbon Monoxide Tube Readings (Spanish)HOJA DE CONTROL DE LECTURAS DE TUBOS PARA MONÓXIDO DE CARBONOLEER TUBOS ANTES DE 24 HORAS DESPUÉS DE RECOGER.ANOTAR IDENTIFICACIONES DE TUBOS QUE SE ENCUENTRAN DESTAPADOS.FECHADERECOGEREXT/INTڤEXT ڤINT ڤEXT ڤINT ڤEX ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT ڤEXT ڤINT NO. DETUBOSLECTOR 1 LECTOR 2 LECTOR 3FECHA INICIALES FECHA INICIALES FECHA INICIALESOBSERVACIONES168

Appendix XXIX: Form: Intensive IAQ monitoring: Record of Carbon MonoxideTube Readings (English)PARTICULATE AIR POLLUTION EXPOSURE AND CHILDHOOD ACUTE RESPIRATORY INFECTIONS INGUATEMALA: A RANDOMIZED INTERVENTION TRIALڤEXTENSIVE ڤINTENSIVE ڤPOSTPARTUM PHASE RETRIEVAL DATE:RECORD OF CARBON MONOXIDE TUBESFIELDWORKER ID NO.DATE OF TUBE READINGTIME OF TUBE READING1GASTEC TUBE ID READING (mm) OBSERVATON23456789101112131415161718192021222324169

25GASTEC TUBE ID READING (mm) OBSERVATON2627282930313233343536373839404142434445464748495051525354555657585960170

PARTICULATE AIR POLLUTION EXPOSURE AND CHILDHOOD ACUTE RESPIRATORY INFECTIONS INGUATEMALA: A RANDOMIZED INTERVENTION TRIALRECORD OF CARBON MONOXIDE TUBESDATA ENTRY BYDATE OF DATA ENTRYFILE NAME171

Appendix XXX: Form: Intensive IAQ monitoring: Record of Carbon MonoxideTube Readings (Spanish)PARTICULATE AIR POLLUTION EXPOSURE AND CHILDHOOD ACUTE RESPIRATORY INFECTIONS INGUATEMALA: A RANDOMIZED INTERVENTION TRIALڤEXTENSIVE ڤINTENSIVE ڤPOSTPARTUM PHASE RECORD OF CARBON MONOXIDE TUBESRETRIEVAL DATE:FIELDWORKER ID NO.DATE OF TUBE READINGTIME OF TUBE READING1GASTEC TUBE ID READING (mm) OBSERVATON23456789101112131415161718192021222324172

25GASTEC TUBE ID READING (mm) OBSERVATION2627282930313233343536373839404142434445464748495051525354555657585960173

PARTICULATE AIR POLLUTION EXPOSURE AND CHILDHOOD ACUTE RESPIRATORY INFECTIONS INGUATEMALA: A RANDOMIZED INTERVENTION TRIALDATA ENTRY BYDATE OF DATA ENTRYFILE NAMERECORD OF CARBON MONOXIDE TUBES174

Appendix XXXI: Form: Intensive IAQ monitoring: Continous Minivol Monitoring (English)COMMUNITY(#####)HOUSEHOLD(###)PARTICULATE AIR POLLUTION EXPOSURE ANDCHILDHOOD ACUTE RESPIRATORY INFECTIONS IN GUATEMALA:A RANDOMIZED INTERVENTION TRIALINITIALSVISITS 1INITIALSVISITS 2FLOWMETERIDINTENSIVE MONITORING OF IAP:CONTINUOUS MINIVOL MONITORSINITIALSVISIT 3Site Filter ID InitialReadingFinalReadingPlacementDatePlacementTimeInitialFlowFinalFlowRetrievalDateRetrievalTimeFilter Label ID* Site codes: 2 = mother, 3 = kitchen, 4 = bedroom, 5 = outside, on patio, 6 = outside, in village, 7 = other person, 8 = other place.OBSERVATIONS (Include initials and date):__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________FORM REVIEW: INITIALS _______________ DATE _______________175

Appendix XXXII: Form: Intensive IAQ monitoring: Continuous Minivol Monitoring (Spanish)COMUNIDAD(#####)CASA(###)ID DELFLUJOMETROEXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE E INFECCIONESRESPIRATORIAS AGUDAS EN NIÑOS ENGUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIOMONITOREO INTENSIVO DE CAI:MONITORES CONTINUOS PARA MINIVOLINICIALESVISITA 1INICIALESVISITA 2INICIALESVISITA 3SitioId delfiltroLecturaInicialLecturafinalFecha deColocarHora deColocarFlujoInicioFlujoFinalFecha deRecogerHora deRecogerEtiqueta del Filtro* Códigos para sitios: 2 = madre, 3 = cocina, 4 = cuarto, 5 = afuera en patio, 6 = afuera en pueblo, 7 = otra persona, 8 = otro lugar.OBSERVACIONES (Incluir iniciales y fecha): _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________176

Appendix XXXIII: Form: Intensive IAQ monitoring: Particulate Measurements with PAS-500 Pumps (English)COMMUNITY(#####)INITIALSVISITS 1HOUSEHOLD(###)PARTICULATE AIR POLLUTION EXPOSURE ANDCHILDHOOD ACUTE RESPIRATORY INFECTIONS IN GUATEMALA:A RANDOMIZED INTERVENTION TRIALINITIALSVISITS 2FLOWMETERIDINTENSIVE MONITORING OF IAP:TOTAL PARTICULATE MEASUREMENTS UIT PAS-500 PUMPSINITIALSVISIT 3KITCHEN (CODE = 3)Pas-500 IDFilter IDPlacementDatePlacementTimeInitialFlowFinalFlowRetrievalDateRetrievalTimeFilter Label IDMOTHER (CODE = 2)Pas-500 IDFilter IDPlacementDatePlacementTimeInitialFlowFinalFlowRetrievalDateRetrievalTimeFilter Label IDOTHER SITE OR PERSON (SPECIFY __________________________________________ CODE = _______)Pas-500 ID Filter IDPlacementDatePlacementTimeInitialFlowFinalFlowRetrievalDateRetrievalTimeFilter Label ID* Site Codes: 2 = mother, 3 = kitchen, 4 = bedroom, 5 = outside, on patio, 6 = outside, in village, 7 = other person, 8 = other place.OBSERVATIONS (Include initials and date): __________________________________________________________________________________________________________________________________________________________________________________________________FORM REVIEW: INITIALS _______________ DATE _______________177

Appendix XXXIV: Form: Intensive IAQ monitoring: Particulate Measurements with PAS-500 Pumps (Spanish)COMUNIDAD(#####)EXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE E INFECCIONESRESPIRATORIAS AGUDAS EN NIÑOS ENINICIALESVISITA 1CASA(###)GUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIOINICIALESVISITA 2ID DELFLUJOMETROMONITOREO INTENSIVO DE CAI:MEDIDAS DE PARTICULAS TOTALES CON LAS BOMBAS PAS-500INICIALESVISITA 3COCINA (CODIGO = 3)ID dePas-500ID delFiltroFecha deColocarHora deColocarFlujoInicioFlujoFinalFecha deRecogerHora deRecogerEtiqueta del FiltroMADRE (CODIGO = 2)ID de ID delPas-500 FiltroFecha deColocarHora deColocarFlujoInicioFlujoFinalFecha deRecogerHora deRecogerEtiqueta del FiltroOTRO SITIO O PERSONA (ESPECIFICAR __________________________________________ CODIGO = _______)ID dePas-500ID delFiltroFecha deColocarHora deColocarFlujoInicioFlujoFinalFecha deRecogerHora deRecogerEtiqueta del Filtro* Códigos para sitios: 2 = madre, 3 = cocina, 4 = cuarto, 5 = afuera en patio, 6 = afuera en pueblo, 7 = otra persona, 8 = otro lugar.OBSERVACIONES (Incluir iniciales y fecha): _______________________________________________________________________________________________________________________________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________178

Appendix XXXV: Form: Intensive IAQ monitoring: Continuous Particulate Measurements (English)COMMUNITY(#####)HOUSEHOLD(###)FLOWMETERIDPARTICULATE AIR POLLUTION EXPOSURE ANDCHILDHOOD ACUTE RESPIRATORY INFECTIONS IN GUATEMALA:A RANDOMIZED INTERVENTION TRIALINTENSIVE MONITORING OF IAP:CONTINUOUS PARTICULATE MEASUREMENTSINITIALSVISITS 1INITIALSVISITS 2INITIALSVISIT 3Monitor(cm1, dr1,dt1)Site* ParticleSizeFilter IDPlacementDatePlacementTimeInitialFlowFinalFlowTotalTimeRetrievalTimeRetrievalHourFilter Label ID* Codes for sites: 2 = mother, 3 = kitchen, 4 = bedroom, 5 = outside, on patio, 6 = outside, in village, 7 = other person, 8 = other place.Are the monitors together with other equipment in site indicated above? ڤ Yes ڤ No (Describe in observations)OBSERVATIONS (Include initials and date): ___________________________________________________________________________________________________________________________________________________________________________________________________FORM REVIEW: INITIALS _______________ DATE _______________179

Appendix XXXVI: Form: Intensive IAQ monitoring: Continuous Particulate Measurements (Spanish)COMUNIDAD(#####)CASA(###) ___ ___ ___ID DELFLUJOMETROEXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE E INFECCIONESRESPIRATORIAS AGUDAS EN NIÑOS ENGUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIOMONITOREO INTENSIVO DE CAI:MONITORES CONTINUOS PARA PARTICULASINICIALESVISITA 1INICIALESVISITA 2INICIALESVISITA 3Monitor(cm1, dr1,dt1)Sitio* TamañodePartículaID delFiltroFecha deColocarHora deColocarFlujoInicioFlujoFinalTiempoTotalFecha deRecogerHora deRecogerEtiqueta del Filtro* Códigos para sitios: 2 = madre, 3 = cocina, 4 = cuarto, 5 = afuera en patio, 6 = afuera en pueblo, 7 = otra persona, 8 = otro lugar.Los monitores están juntos con los otros equipos en el sitio indicado? ڤ Sí ڤ No (Describir en observaciones)OBSERVACIONES (Incluir iniciales y fecha): ____________________________________________________________________________________________________________________________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________180

Appendix XXXVII: Form: Intensive IAQ monitoring: PM 1 Measurements (English)INTENSIVE MONITORING: PM 1COMMUNITY(#####)HOUSEHOLD(###) ___ ___ ___ PLACEMENT DATE (dd/mm/yy): ____ / ____ / ____FLOWMETER IDRETRIEVAL DATE: ____ / ____ / ____ TIME (hh:mm): ____ : ____INITIALSVISIT 1INITIALSVISIT 2INITIALSVISIT 3SiteFilterIDPump IDCycloneIDStart Time(hh:mm)FlowVisit1FlowVisit2FlowVisit3TotalTimeFlowTimeFilter ID LabelValidityKitchenBedroomPatioMotherCyclone height in kitchen = ____ ____ ____ cm Distance from cyclone to the stove = ____ ____ ____ cmDistance from patio monitor to kitchen = ____ ____ m Distance from bedroom monitor to child’s bed = ____ ____ ____ cmQUALITY CONTROL MEASURES (QC) CO-LOCATION SITE = __________ BLANK SITE = __________Start Time Flow Flow Flow Total Flow Filter Label IDQC measure FilterIDPump ID Cyclone (hh:mm)IDVisit1Visit2Visit3Time TimeCo-locationValidityBlankOBSERVATIONS (Include initials and date): ___________________________________________________________________________________________________________________________________________________________________________________________________181

FORM REVIEW: INITIALS _______________ DATE _______________182

Appendix XXXVIII: Form: Intensive IAQ monitoring: PM 1 Measurements (Spanish)MONITOREO INTENSIVO: PM 1COMUNIDAD(#####)CASA(###) ___ ___ ___ FECHA DE COLOCAR (dd/mm/aa): ____ / ____ / ____ID DELFLUJOMETRO FECHA DE RECOGER: ____ / ____ / ____ HORA (hh:mm): ____ : ____INICIALESVISITA 1INICIALESVISITA 2INICIALESVISITA 3SitioIDdelFiltroIDde laBombaIDdelCiclónHora deEmpezar(hh:mm)FlujoVisita1FlujoVisita2FlujoVisita3TiempoTotalTiempode flujoEtiqueta del FiltroValidezCocinaCuartoPatioMadreAltura de ciclón en cocina = ____ ____ ____ cm Distancia del ciclón a la estufa = ____ ____ ____ cmDistancia del monitor en el patio a la cocina = ____ ____ m Distancia del monitor en el cuarto a la cama del niño = ____ ____ ____ cmMEDIDAS DE CONTROL DE CALIDAD (CC) LUGAR DEL DOBLE = __________ LUGAR DEL BLANCO = __________Tipo de CC IDdelFiltroIDde laBombaIDdelCiclónHora deEmpezar(hh:mm)FlujoVisita1FlujoVisita2FlujoVisita3TiempoTotalTiempode flujoEtiqueta del FiltroValidezDobleBlancoOBSERVACIONES (Incluir iniciales y fecha): _______________________________________________________________________________________________________________________________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________183

Appendix XXXIX: Form: Intensive IAQ monitoring: PM Measurements with UCB-P1 Monitor (English)COMMUNITY(#####)INITIALSVISITS 1HOUSEHOLD(###)PARTICULATE AIR POLLUTION EXPOSURE ANDCHILDHOOD ACUTE RESPIRATORY INFECTIONS IN GUATEMALA:A RANDOMIZED INTERVENTION TRIALINITIALSVISITS 2FLOWMETERIDINTENSIVE MONITORING OF IAP:PARTICULATE MONITORING WITH UCB1. INITIATE (LAUNCH, DELAYED START) UCB ID DATE (dd/mm/yy) HOUR (hh:mm)INITIALSVISIT 32. CALIBRATION OF BASELINE BEFORE UCB ID DATE (dd/mm/yy) INITIAL HOUR (hh:mm) FINAL HOUR (hh:mm)(>20 MIN)3. MEASUREMENTUCB ID PLACEMENTDATE(dd/mm/yy)PLACEMENTHOUR(hh:mm)HEIGHT(cm)DISTANCEFROM STOVE(cm)CHECKDAY 2CHECKDAY 3RETRIEVALDATE(dd/mm/yy)RETRIEVALTIME(hh:mm)4. CALIBRATION OF BASELINE AFTER(>20 MIN)UCB ID DATE (dd/mm/yy) INITIAL HOUR (hh:mm) FINAL HOUR (hh:mm)5. READOUTUCB ID BATTERY (%) FILE NAME GRAPHIC CHECK SECURITY COPY INITIALSOBSERVATIONS (Include initials, date and hour):__________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________184

Appendix XL: Form: Intensive IAQ monitoring: PM Measurements with UCB-P1 Monitor (Spanish)MUNICIPIO___ ___COMUNIDAD(###) ___ ___ ___CASA(###) ___ ___ ___EXPOSICIÓN A PARTÍCULAS CONTAMINANTES EN EL AIRE E INFECCIONESRESPIRATORIAS AGUDAS EN NIÑOS ENGUATEMALA: UN ESTUDIO DE INTERVENCIÓN ALEATORIOMONITOREO INTENSIVO DE CAI:MONITOR DE PARTÍCULAS UCB)1. INICIAR (LAUNCH, DELAYED START) UCB ID FECHA (dd/mm/aa) HORA (hh:mm)INICIALESDIA 1INICIALESDIA 2INICIALESDIA 32. CALIBRACIÓN DE LINEA BASAL ANTES UCB ID FECHA (dd/mm/aa) HORA INICIAL (hh:mm) HORA FINAL (hh:mm)(>20 MIN)3. MEDICIÓNUCB IDFECHA DECOLOCAR(dd/mm/aa)HORA DECOLOCAR(hh:mm)ALTURA(cm)DISTANCIA ALA ESTUFA(cm)CHEQUEODIA 2CHEQUEODIA 3FECHA DERECOGER(dd/mm/aa)HORA DERECOGER(hh:mm)4. CALIBRACIÓN DE LINEA BASAL DESPUÉS(>20 MIN)UCB ID FECHA (dd/mm/aa) HORA INICIAL (hh:mm) HORA FINAL (hh:mm)5. BAJAR DATOS (READOUT)UCB ID BATERIA (%) NOMBRE DEL ARCHIVO CHEQUEO DE GRÁFICA COPIA DE SEGURIDAD INICIALESOBSERVACIONES (Incluir iniciales, fecha y hora): ______________________________________________________________________________________REVISIÓN DEL FORMULARIO: INICIALES _______________ FECHA _______________185

Appendix XLI: Weekly Questionnaire, Children (English)WEEKLY QUESTIONNAIREMunicipality________________Community___________________HouseholdDate (dd/mm/yy)Start time_____/______/______ (hh:mm)Interviewer Code Initials-Age______ (m) _____ (d)______:_______INSTRUCTIONS: If the child is less than 2 months, start with section “A”; Otherwise, start in section “B”.ASK THESE QUESTIONS IF CHILD IS LESS THAN 2 MONTHS (Section A)A: POSSIBLE SERIOUS BACTERIAL INFECTIONAsk andObserveObserve(Make surethat thechild is calmand lyingdown)Ask and/or observe Response Action CodeA1 Is the child sick? No = 0Yes = 1A2 Did the child have convulsions? No = 0YES REFERYes = 1A3 Has the child had a runny or stuffy nose? No = 0A3.1- Even if s/he is better, howmany days did the runny/stuffy noselast?A4 Count child’s respiration rate for oneminute using a watchYes = 1# days# Resp./ minuteA4.1- If you counted ≥ 60# Resp./ minute ≥ 60 REFERrespirations in one minute, countagainA5 Are there intracostal retractions of the No = 0YES REFERthorax?Yes = 1A6 Is there nasal flaring? No = 0YES REFERYes = 1A7 Is the child grunting? No = 0YES REFERYes = 1A8 Is the fontanelle bulging? No = 0YES REFERYes = 1A9 Is the umbilicus red or with pus? No = 0Yes = 1A9.1 If the umbilicus is red and has No = 0YES REFERpus, is the surrounding skin red?A10 Measure the axillary temperature (If theT° is greater than 38°C or less than 35°C Yes=1)Yes = 1No = 0Yes = 1A11 Does the child have skin pustules? No = 0Yes (Few) = 1Yes (Many andextensive) = 2YES REFERMany andExtensive REFER186

Ask and/or observe Response Action CodeA1 Is the skin yellow (jaundice)? No = 0YES REFERYes = 1A13 Is the child lethargic or unconscious(fainting)?No = 0Yes = 1A14 Does the child move less than normal? No = 0Yes = 1A15 Is there purulent discharge from theeyes?A16 Does the child have stridor?(Observe and listen)A17 Is the child wheezing? (Observe andlisten)A18 Does the child have a prolongedexpiratory phase?(Observe and listen)No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1QUESTIONS TO ASK OF CHILDREN 2 MONTHS OR OLDER (Sections B to D)B: GENERAL DANGER SIGNSYES REFERYES REFERYES REFERYES REFERYES REFERYES REFERAskObserveAsk and/or observe Response Action CodeB1 Is the child sick? No = 0Yes = 1B2 Did the child have convulsions? No = 0Yes = 1B3 Could s/he breastfeed or drink liquids? No = 0Yes = 1B4 Is the child vomiting a lot? No = 0Yes = 1B5 Is the child worn out, lethargic orunconscious?No = 0Yes = 1If YES to any ofthe answers REFERC: RESPIRATORY PROBLEMSAskAsk and/or observe Response Action CodeC1 Has the child had cough or difficultybreathing?No = 0Yes (Nowbetter) = 1Yes (Present) =2C1.1- If YES, how many days has thechild had cough or difficulty breathing? # daysC1.2- Is the cough only at night? No = 0Yes = 1C2 Does the child have a runny or stuffy nose? No = 0Yes = 1C2.1- Even if s/he is better, how manydays did the runny/stuffy nose last? # daysC3 Is the child wheezing? No = 0YES REFERYes = 1187

If only C2 (Has runny/stuffy nose) is Yes (Code = 1), classify as a cold and move on to section “D”. If insteadC1 (Cough or difficulty breathing) and/or C3 (Wheezing) are Yes (Code = 1 o 2); ask questions C4 to C8C4 Count respiration rate for one minute 2 - 12 months: rapid rateRapid= 50 or greater# Resp./ minute Respiration Rate 12 months or less, rapid rate REFER= 40 or greaterC5 Are there intracostal retractions of the No = 0YES REFERObservethorax?Yes = 1C6 Does the child have stridor?No = 0YES REFER(Observe and listen)Yes = 1C7 Is the child wheezing? (Observe and listen) No = 0YES REFERD: FEVERC8 Does the child have a prolonged expiratoryphase?(Observe and listen))Yes = 1No = 0Yes = 1YES REFERAsk and/or observe Response Action CodeD1 Measure axillary temperature (If the T° is No = 0Observe greater than 38°C Yes=1)Yes = 1If D1 is Yes (Code = 1) ask questions D2 to D4; If No (Code = 0) move on to section “E”.D2 Does the child have nuchal rigidity? No = 0YES REFERYes = 1ObserveD3 Is there petechiae? No = 0YES REFERYes = 1YES REFERD4 Does the child have a generalizedmaculopapular rash?No = 0Yes = 1ASK THESE QUESTIONS OF ALL CHILDREN (Sections E through I)E: EAR PROBLEMSAskObserveAsk and/or observe Response Action CodeE1 Does the child have ear pain? No = 0YES REFERYes = 1E2 Is there any discharge from the ear? No discharge = 0 DischargeYes discharge = 1 observed E3 Is there numbness behind the ear?No numbness = 0Yes numbness = 1REFERNumbness REFERF: DIARREAAskAsk and/or observe Response Action CodeF1 Does the child have diarrhea? No = 0Yes = 1If F1 is YES (Code = 1) ask questions F1.1 to F6; If No (Code = 0) move on to section “G”.F1.1- If YES, for how many days?# daysIf more than 14days REFER188

ObserveG: BURNSF2 Is there blood in the stool? No = 0Yes = 1F3 General condition of the child Normal (Alert) =0Lethargic orunconscious = 1Fussy or irritable = 2No = 0F4 Does the child have sunken eyes? Yes = 1F5 Pinch the abdominal skin. Does it staypinched or return to normal (elasticity)?F6 Offer the child liquids(Do not give liquids to children less than 2months)Rapid = 0Slowly = 1Very slowly (> 2seconds) = 2Takes fluids well = 0Can’t drink, or drinksvery little = 1Drinks quickly andappears thirsty = 2Yes REFERIf dehydrated orseverelydehydratedREFERIf has at least 2 ofthese signs ormore:-Sunken eyes,-Reduced skinelasticity,-Impatient orirritable REFERAsk and/or observe Response Action CodeG1 Since my last visit, has the child No = 0YES REFERbeen burned with a liquid or object (fire,etc.)Yes = 1G1.1 If YES, * Minor burn = 1 If the burn is minorAsk Treat in theSerious burn =2 house with homeremediesIf the burn isserious REFER* If the response is YES you should fill in the Burn QuestionnaireH: OTHER PROBLEMS THE CHILD MIGHT HAVE189

I: SUMMARY OF THE MANAGEMENT OF THE CHILDResponse Description of the Illness and Treatment CodeI1 Classify Healthy child = 0Minor illness = 1Illness that requires astudy doctor’sintervention = 2I2 ActionI2.1- Did themother takethe child to ahealth center?Doesn’t require specificactions = 0Home management = 1Referred to study doctor= 2If the answer to question I2 is “Referred to doctor” (Code = 2) go on to question I2.1; If not, goto section “J”.Yes = 0No = 1QUESTIONS TO ASK OF ALL MOTHERS (Sections J through K)J: MOTHER’S RESPIRATORY PROBLEMSAskSince my last visit have you Responsehad . . .J1 Sore throat? No = 02 or more days in a row= 1Something else =2J2 Stuffy or runny nose? No = 02 or more days in a row= 1Something else =2J3 Cough (If she has chronic No = 0cough, has it gotten worse)? 2 or more days in a row= 1J4 Phlegm (If she has chronicphlegm, has it gotten worse?Something else =2No = 02 or more days in a row= 1Something else =2J5 Wheeze? No = 02 or more days in a row= 1Something else =2J6 Do you wake up at nightwith chest heaviness?No = 02 or more days in a row= 1Something else =2If “something else”describe….Code190

K: : SUMMARY OF THE MANAGEMENT OF THE MOTHERResponse Description of the Illness and Treatment CodeK1 Classify Healthy mother = 0Minor illness = 1Illness that requiredreferral to study doctor =2K2 ActionNo specific actionsrequired = 0Management at home = 1Referred to study doctor= 2L: IF THE CHILD IS DECEASEDDate of death:______________________Probable cause of death:_________________________Survey end time (hh:mm): _________________InterviewerInterviewer’s Initials:________________ ___Interviewer’s Signature: ________________ReviewSupervisor’s Signature: __________________Date of Review: _________________Data EntryData Entry No.1 Signature: _________________Data Entry No. 2 Signature: _________________Date of First Data Entry: ________________Date of Second Data Entry: _______________191

Appendix XLII: Weekly Questionnaire, Children (Spanish)CUESTIONARIO SEMANALMunicipioComunidadVivienda-________________ ___________________Fecha (dd/mm/aa)Hora de inicio_____/______/______ (hh:mm)Entrevistador Código InicialesEdad______ (m) _____ (d)______:_______INSTRUCCIONES: Si el niño tiene 2 meses o menos iniciar en la sección “A”; Si no iniciar en la sección“B”.PREGUNTAS A REALIZAR EN NIÑOS MENORES DE 2 MESES (Sección A)A: POSIBLE INFECCION BACTERIAL GRAVEPregunte yobserveObserve(Asegúreseque el niñoeste enreposo)Pregunta y/o observación Respuesta Acción CódigoA1 ¿Esta el niño enfermo? No = 0Sí = 1A2 ¿Tuvo ataques de tembladeraNo = 0SI REFIERA(Tzun nlulen)?Sí = 1A3 ¿Ha tenido el niño mocos (Txan) o lanariz tapada (Xpon txan)?No = 0Sí = 1A3.1- ¿Aún cuando este mejor,cuantos días ha durado o duró? # díasA4 Contar las respiraciones por minuto # Resp./ minutousando un relojA4.1- Si contó 60 por minuto o más, # Resp./ minuto ≥ 60 repita el conteoREFIERAA5 ¿Hay retraimiento de la pared torácica? No = 0SI REFIERASí = 1A6 ¿Hay aleteo nasal? No = 0SI REFIERASí = 1A7 ¿Tiene quejido? No = 0SI REFIERASí = 1A8¿Esta la fontanela abombada? No = 0SI REFIERASí = 1A9¿Esta el ombligo rojo o saliendo pus No = 0(Poj)?Sí = 1A9.1 Si el ombligo esta rojo o No = 0SI REFIERAsaliéndole pus, ¿lo rojo se extiende a Sí = 1la piel?A10 Tome la temperatura axilar(Si la T° es No = 0SI REFIERAmayor de 38°C ó menor de 35°C Sí=1) Sí = 1A11¿Tiene pústulas en la piel? No = 0Sí (Pocas) = 1Sí (muchas óextensas) = 2A12¿Tiene la piel amarilla (ictericia)? No = 0Sí = 1Muchas yextensas REFIERASI REFIERA193

Pregunta y/o observación Respuesta Acción CódigoA13¿Esta letárgico o inconsciente (Ma tzel No = 0SI REFIERAtnablMa ku numtzaj)? (desmayado)Sí = 1A14¿Se mueve menos de lo normal? No = 0Sí = 1A15¿Sale secreción purulenta de los ojos? No = 0Sí = 1A16¿Tiene estridor?(Observe y escuche)A17¿Le silva el pescuezo (sibilancias)(Nxwisen)? (Observe y escuche)A18¿Tiene espiración prolongada?(Observe y escuche)No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1SI REFIERASI REFIERASI REFIERASI REFIERASI REFIERAPREGUNTAS A REALIZAR EN NIÑOS DE 2 MESES O MÁS (Secciones B a la D)B: SIGNOS GENERALES DE PELIGROPregunteObservePregunta y/o observación Respuesta Acción CódigoB1 ¿Esta el niño enfermo? No = 0Sí = 1B2 ¿Ha tenido ataques de tembladera (Tzunnlulen)? (convulsiones)B3 ¿No puede beber (Tzun kwan) o mamar(Mixin)?B4 ¿Tiene arrojadera (Tzun jaw xab jotz)?(vomita todo)B5 ¿Esta rendido o privado (Ma tzel tnab l Maku numtzaj)? (letárgico o inconsciente)No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1Si SI acualquiera REFIERALOC: PROBLEMAS RESPIRATORIOSPreguntePregunta y/o observación Respuesta Acción CódigoC1 ¿Ha tenido el niño tos (Sjol) o le cuestarespirar (Chux tun tztatz txew)?No = 0SÍ (Ahora mejor)= 1SÍ (Actualmente)= 2C1.1- Si SI, ¿Cuántos días ha tenido elniño tos o dificultad para respirar? # díasC1.2- ¿La tos solamente es durantela noche?No = 0Sí = 1C2 ¿Ha tenido el niño mocos (Txan) o la nariztapada (Xpon txan)?No = 0Sí = 1C2.1- ¿Aún cuando este mejor,cuantos días ha durado o duró? # díasC3 ¿Le silva el pescuezo ( Nxwisen)? No = 0SI REFIERASí = 1194

Sí únicamente C2 (Tiene mocos) es Sí (Código = 1) clasifique como resfriado y pase a la sección “D”. Si porel contrario C1 (Tos o dificultad para respirar) y/o C3 (Le silva el pescuezo) son Sí (Código = 1 o 2);realice las preguntas C4 a la C8C4 Contar las respiraciones por minuto 2 - 12 meses: respiración rápidaRespiración= 50 o más# Resp./ minuto rápida 12 meses o más, respiración rápidaREFIERA= 40 o másC5 ¿Hay retraimiento de la pared torácica? No = 0SI REFIERAObserveSí = 1C6 ¿Hay estridor? (Observe y escuche) No = 0SI REFIERASí = 1C7 ¿ Le silva el pescuezo ( Nxwisen)?No = 0SI REFIERAD: FIEBRE(sibilancias) (Observe y escuche)C8 ¿Le cuesta sacar el aire?(espiración prolongada) (Observe y escuche)Sí = 1No = 0Sí = 1SI REFIERAPregunta y/o observación Respuesta Acción CódigoD1 Tome la temperatura axilar(Si la T° es No = 0Observar mayor de 38°C Sí=1)Sí = 1Si D1 es Sí (Código = 1) realice las preguntas D2 a D4; Si No (Código = 0) pase a la sección “E”.D2 ¿Hay rigidez de nuca? No = 0SI REFIERASí = 1ObserveD3 ¿Tiene petequias? No = 0SI REFIERASí = 1Si REFIERAD4 Presenta una erupción maculo papulargeneralizada (ronchas o granitos)No = 0Sí = 1PREGUNTAS A REALIZAR EN TODOS LOS NIÑOS (Secciones E a la I)E: PROBLEMAS DE OIDOPregunteObservePregunta y/o observación Respuesta Acción CódigoE1 ¿Tiene el niño dolor de oído No = 0Si REFIERA(Nchon xqin)?Sí = 1E2 ¿Sale materia del oído (Poj)? No se observa Se observa materiamateria = 0 REFIERASe observa materia =1E3 ¿Hay tumefacción detrás del oído?No hay tumefacción =0Hay tumefacción = 1Tumefacción REFIERA195

F: DIARREAPreguntePregunta y/o observación Respuesta Acción CódigoF1 Tiene el niño asientos ( Nel/neelen)?(diarrea)No = 0Sí = 1Si F1 es Sí (Código = 1) realice las preguntas F1.1 a F6; Si No (Código = 0) pase a la sección “G”.F1.1- Si SI, ¿ Desde hacecuantos días?# díasF2 ¿Hay sangre en las heces (popó)? No = 0Sí = 1F3 Condiciones generales del niño Normal (Alerta) =0Letárgico oInconsciente = 1Intranquilo o irritable= 2No = 0F4 ¿Tiene los ojos hundidos?Sí = 1F5 Pellizque la piel del abdomen.¿Regresa?F6 Ofrezca líquidos al niño.( No dar líquidos a menores de 2 meses)Rápido = 0Lentamente = 1Muy lentamente (> 2segundos) = 2Buena mamada = 0No puede beber obebe muy poco = 1Bebe ávidamente ycon sed = 2Si más de 14 días REFIERASi REFIERASi deshidratado oseveramentedeshidratado REFIERASi tiene al menos 2de estos signos, omás:-Ojos hundidos,-Piel regresalentamente,-Impaciente oirritable REFIERAG: QUEMADURASPreguntePregunta y/o observación Respuesta Acción CódigoG1 Desde mí última visita, se haquemado (Matzey) el niño con algúnlíquido u objeto (Ej. Fuego, etc.)No = 0Sí = 1Si REFIERAG1.1 -Si SI, * Quemadura leve = 1Quemadura seria ograve =2*Si la respuesta es si debe llenar el cuestionario para quemadurasH: OTROS PROBLEMAS DEL NIÑOSi la quemadura esleve Trátela encasa con remedioscaserosSi la quemadura esseria REFIERA196

I: RESUMEN DEL MANEJO DEL NIÑORespuesta Descripción de Enfermedad y Tratamiento CódigoI1 Clasifique Niño sano = 0Enfermedad menor = 1Enfermedad que refiereal médico dele studio = 2I2 ActúeI2.1- ¿Lamadre llevó alniño al centrodeconvergencia?No requiere accionesespecíficas = 0Manejo en casa = 1Se refiere al médico delestudio = 2Si en la pregunta I2 la respuesta es “Se refiere al médico del estudio” (Código = 2) pasar apregunta I2.1; Si no pasar a la sección “J”.Sí = 0No = 1PREGUNTAS A REALIZAR A TODAS LAS MADRES (Secciones J a la K)J: PROBLEMAS RESPIRATORIOS EN LA MADREPregunteDesde mi ultima visita, hapadecido de . . .J1 Dolor de garganta (NchonTqul)J2 Secreción o congestiónnasalJ3 Tos (Sjol) (Si tiene toscrónica, ¿Ha empeorado latos?)J4 Flemas (Nloqen tkul) (Sitiene flemas crónicas, ¿Hanempeorado las flemas?)J5 ¿Le silva el pescuezo(Nxwisen)?J6 ¿Despierta en la noche consensación de opresión en elpecho?RespuestaNo = 02 o más días seguidos =1Otro patrón =2No = 02 o más días seguidos =1Otro patrón =2No = 02 o más días seguidos =1Otro patrón =2No = 02 o más días seguidos =1Otro patrón =2No = 02 o más días seguidos =1Otro patrón =2No = 02 o más días seguidos =1Otro patrón =2Si “Otro patrón”(Describa)Código197

K: RESUMEN DEL MANEJO DE LA MADRERespuesta Descripción de Enfermedad y Tratamiento CódigoK1 Clasifique Madre sana = 0Enfermedad menor = 1Enfermedad que refiereal médico del estudio = 2K2 ActúeNo requiere accionesespecíficas = 0Manejo en casa = 1Se refiere al médico delestudio = 2L: SI EL NIÑO FALLECIO, INDIQUEFecha de defunción:______________________ Causa probable de muerte:______________________Hora de Finalización (hh:mm): _________________EntrevistaIniciales del entrevistador: _______________RevisiónFirma de Supervisor: __________________Ingreso de DatosFirma Digitador No.1: _________________Firma Digitador No. 2: _________________Firma Entrevistador: ________________Fecha de Revisión: _________________Fecha Primer Ingreso: __________________Fecha Segundo Ingreso: __________________198

Appendix XLIII: Medical Evaluation Form (long), Children (English)ARI-UC-UVG STUDYMEDICAL EVALUATION FORMA: CHILD’S INFORMATION AND REASON FOR CONSULT1. ID (child)2. Community3. Age4. Date of birth5. Date of visit6. Referred by Field worker = 1Self referral = 2Other (specify) = 37. Reason for Consult: 1.2.B: HISTORY OF PRESENT ILLNESS1. Illness duration Days2. Is the child eating or breastfeeding less thannormal?No = 0A little = 1A lot = 23 Does the child have a runny/stuffy nose? No = 0Yes = 13.1 Did this start with a cold? No = 0Yes = 1Days3.2 If YES, when did it start?4. Does the child have a cough? No = 0Yes = 14.1 If YES, when did the cough start? Days4.2 What kind of cough?4.3 When does s/he cough?Dry = 1Wet = 2During the day = 1During the night = 2Day and night = 3199

5. Have you heard whistles and wheezes? No = 0Yes = 15.1 If YES, when did it start? Days6. Does the child have Diarrhea? No = 0Yes = 1If YES had diarrhea:6.1When did this diarrhea episode begin? Days ago6.2 Blood in stool?No = 0Yes = 17. Has the child had fever? No = 0Yes = 1Days7.1 If YES, when did it start?8. Has the child had convulsions? No = 0Yes = 19. Has the child vomited? No = 0Yes = 1Days9.1 If YES, when did it start?Times per day9.2 How frequently?10. Does the child have ear problems? No = 0Yes = 1If YES:10.1 Is there discharge from the ear?10.2 If there is discharge, for how long?11. Ask the mother if the child has been seen by anurse, doctor or other health worker for this problem(reason for consult)No = 0Yes = 1DaysNo = 0Yes = 111.1 If YES, by whom? Study doctors = 1Health center = 2Private doctor = 3Curandero (folk healer) = 4Pharmacy = 5Other _______________200

12. Review the child’s medical record from UVG forrecent and significant medical problemsPHYSICAL EXAMC: General Exam1. Respiratory RateRespirations per minute(observe in relaxed child)2. Appearance Normal = 0Ill = 1Gravely Ill = 23. Level of Orientation Responds = 0Diminished = 1Lethargic-Unexpressive = 2Does not respond = 34. Fussy-Irritable No = 0Irritable, but can be calmed =1Irritable, unable to be calmed= 2No = 05. Nuchal rigidityYes = 16. Fontanelle Closed = 0Normal (flat) = 1Bulging= 2Depressed, sunken = 37. Nasal flaring No = 0Yes = 18. Nasal secretions No / very little = 0Clear = 1Purulent = 29. Red eyes No = 0Right = 1Left = 2Bilateral = 3Deleted: k201

No = 010. Ocular dischargeClear = 1Purulent = 211. Pallid conjuntiva No = 0Mild = 1Severe = 212. Pallid palmar surfaces No = 0Mild = 1Severe= 2D: Respiratory system/thorax1. Central cyanosis No = 0Yes = 12. Stridor No = 0Yes = 13. Grunting No = 0Yes= 14. Accessory muscle useNo = 0Yes = 15. Intracostal/ subcostal retractions, thoracic wallNo = 0Mild = 1Severe = 26 Rales No = 0Left = 1Right = 2Bilateral = 37. Prolonged expiratory phase No = 0Yes = 18. Wheezing No = 0Only in expiratory phase= 1Heard in both expiratory andinspiratory phases = 29. Rhonchi No = 0Left = 1Right = 2Bilateral = 310. Decreased breath sounds No = 0Left = 1Right = 2Bilateral = 3202

11. Referred bronchial breath sounds No = 0Left = 1Right = 2Bilateral = 312. Standard auscultation findings with regular Indicate when performed:stethoscope (document information in thecomputer)13. Localized auscultation (perform when atypicalbreath sounds suggest pneumonia, rhonchi or rales)14. Cough during examUpper Right= 1Lower Right = 2Upper Left = 3Middle Left = 4No = 0Yes = 114.1 If YES, describe nature of cough:Dry = 1Wet = 2Barking cough = 3Paroxysmal cough = 4E: Other Exams1. If the child has diarrhea:1.1 Sunken eyes?1.2 Is the child thirsty, drinking avidly?No = 0Yes = 1No = 0Yes = 1Can’t evaluate = 21.3 Skin turgor: elasticity of skin fold Rapidly returns = 0Slowly = 1Very slowly = 22. Capillary fill time < 3 seconds = 0> 3 seconds = 13. Bilateral pedal edema No = 0Yes = 14. Severely emaciated child No = 0Yes = 15. Presence of rash? No = 0Yes = 1203

5.1 If YES, is it localized or generalized?5.2 Pruritic5.3 Type5.4 InterpretationLocalized = 1(specify) ____________Generalized = 2Absence of pruritus = 0Pruritus = 1Not able to evaluate = 2Macular = 1Papular = 2Pustular = 3 Dry = 6Eczema = 1Mycotic = 2Viral = 3Vesicular = 4Petequial = 5Bacterial = 4Diaper Rash= 5Other (specify):6. Otoscope exam (Right ear)6.1 Purulent discharge No = 0Yes = 16.2 Able to evaluate tympanic membrane No = 0If YES answer 6.2.1 to 6.2.3Yes = 16.2.1 Erythema No = 0Yes = 1No = 06.2.2 BulgingYes = 1No = 06.2.3 PerforatedYes = 17. Otoscope exam (Left ear)7.1 Purulent discharge No = 0Yes = 17.2 Able to evaluate tympanic membrane No = 0If YES answer 6.2.1 to 6.2.3Yes = 17.2.1 Erythema No = 0Yes = 1No = 07.2.2 BulgingYes = 1No = 07.2.3 PerforatedYes = 18. Swelling behind ear No = 0Right mastoid = 1Left mastoid = 2Bilateral = 39. Inflammed oropharynx No = 0Erythematous, no purulence= 1Erythematous, purulence = 2204

10. Axillary temperature11. Weight KgF: OTHER CLINICAL FINDINGSSystemFindings1. Cardiovascular No = 0Yes = 12. Abdomen /GI No = 0Yes = 13. Genitourinary No = 0Yes = 14. Musculoskeletal No = 0Yes = 15. Nervous No = 0Yes = 16. Other No = 0Yes = 1o CG: PULSE OXIMETRYReading Inadequate = 0Adequate = 1(%)Oxygen SaturationPulse(pulse/minute)H: PRELIMINARY DIAGNOSIS (Prior to X-Ray Results)Respiratory Illnesses Upper respiratory illness (rhinitis, common cold) No = 0Yes = 1 Otitis media No = 0Yes = 1 Laringo-tracheal bronchitis No = 0Yes = 1 Pneumonia No = 0Yes: possible = 1Yes: definitive = 2205

Respiratory illness with wheezing (ReactiveAirway Disease)Other diagnoses1.No = 0Yes: possible = 1Yes: definitive = 22.I: MANAGEMENTReferralsAmbulatory patient without X-Rays = 1Ambulatory patient with X-Rays = 2Referred for hospitalization = 3If patient was referred for hospitalizationMedications1.Accepted = 1Rejected = 22.3.Other AdviceDoctor’s NameDoctor’s SignatureJ: CHEST X-RAY FINDINGSType of reference forChest X-RayNumber of X-RayAmbulatory Patient = 1Hospitalized = 2[Number]X-Ray Findings Normal No = 0Yes = 1Lobular orSegment InfiltrateNo = 0Right = 1Left = 2Bilateral = 3206

X-Ray Findings Diffuse Infiltrate No = 0Yes = 1Pleural Effusion No = 0Yes = 1Hyperinflation No = 0Yes = 1Other(specify)K: INFORMATION TO BE COMPLETED IF CHILD IS HOSPITALIZEDAdmission date(dd/mm/yyyy)___/___/____Discharge date(dd/mm/yyyy)___/___/____Final Diagnosis (1)Final Diagnosis (2)Final Diagnosis (3)Final Results Survived = 1Died = 2Discharge against medical orders No = 0Yes = 1L: FINAL DIAGNOSIS [With X-Rays, and (if hospitalized) information from hospital]Respiratory Illnesses Upper respiratory illness (rhinitis, common cold) No = 0Yes = 1 Otitis media No = 0Yes = 1 Laringo-tracheal bronchitis No = 0Yes = 1 Pneumonia No = 0Yes: possible = 1Yes: definitive = 2Respiratory illness with wheezing (Reactiveairway disease)No = 0Yes: possible = 1Yes: definitive = 2207

Other diagnoses1.2.3.Doctor’s NameDoctor’s SignatureM: RSV EXAMExam for Respiratory Syncytial Virus (RSV) Not indicated = 0Done = 1Negative = 0If exam was done, results were…Positive = 1Not interpretable = 2208

N. BURN REGISTRY FORM1. ID. (child)2. Date of birth/ age3. Date of visit4. Referred by Field worker = 1None = 2Other (specify) = 35. Type of lesion Burn from hot object = 1Burn from hot liquid = 2Both = 36. When did this problem start? Days ago7. Describe injured area: Front8. Describe injured area: Back9. Degree of burn: First degree = 1Second degree = 2Third degree = 310. Treatment11. Educational plan209

Data EntryData Entry Signature #1: _________________Data Entry Signature #2: ________________Date of Entry #1: _________________Date of Entry #2: _________________210

Appendix XLIV: Medical Evaluation Form (long), Children (Spanish)ESTUDIO ARI-UC-UVGHOJA DE EVALUACION MEDICAA: INFORMACION DEL NIŇO Y MOTIVO DE CONSULTA1. ID (niño)2. Comunidad3. Edad4. Fecha de nacimiento5. Fecha de visita6. Referido por Trabajador de campo = 1Auto referencia = 2Otro (Especifique) = 37. Motivo de Consulta: 1.2.B: HISTORIA DE LA ENFERMEDAD ACTUAL1. Duración de la enfermedad Días2. Ha disminuido el niño hoy la ingesta de alimentos olactancia materna?3. ¿Ha tenido la nariz tapada / secreción de nariz? No = 0Si = 13.1 ¿Ocurrió esto con una gripe? No = 0Si = 1Días3.2 Si SI, ¿desde cuando hace?4. ¿Tiene el niño tos? No = 0Si = 14.1 Si SI, ¿desde cuando hace? DíasNo = 0Levemente = 1Severamente = 24.2 ¿Qué tipo de tos?4.3 ¿Cuándo se presenta la tos?Seca = 1húmeda = 2Durante el día = 1Durante la noche = 2Ambos = 3211

5. Ha escuchado usted Piídos o Sibilancias No = 0Si = 15.1 Si SI, ¿desde cuando hace? Días6. ¿Tiene el niño Diarrea? No = 0Si = 1Si SI tuvo diarrea:6.1¿Cuándo empezó este episodio de Diarrea? Días atrás6.2 ¿Sangre en heces?No = 0Si = 17. ¿Ha tenido fiebre el niño? No = 0Si = 1Días7.1 Si, SI, ¿desde cuando hace?8. ¿Ha convulsionado el niño? No = 0Si = 19. ¿Ha vomitado el niño? No = 0Si = 1Días9.1 Si SI, ¿desde cuando hace?Veces por día9.2 ¿Cuan frecuente?10. ¿Tiene el niño problemas con el oído? No = 0Si = 1Si SI:10.1 ¿Ha habido secreción del oído?No = 0Si = 110.2 ¿Si ha habido secreción, por cuantotiempo?Días11. Preguntar a la madre si el niño ha sido visto por No = 0este problema (motivo de consulta) por alguna Si = 1enfermera, medico o algún otra personal de salud11.1 Si SI, ¿ Quien? Doctores del estudio = 1Puesto-Centro Salud = 2Medico privado = 3Curandero = 4Farmacia = 5Otro _______________12. Revisar el cané UVG del niño por problemasmédicos recientes e importantes212

EXAMEN FISICOC: Examen General:1. Frecuencia respiratoriarespiraciones /minuto(observada, niño en reposo)2. Apariencia Normal = 0Enfermo = 1Grave = 23. Alerta – Nivel de atención Responde = 0Disminuido = 1Letárgico-Inexpresivo = 2No responde = 34. Inquieto-Irritable No = 0Irritado pero tranquilizable =1Irritado no tranquilizable =2No = 05. Rigidez de cuelloSi = 16. Fontanela Cerrada = 0Normal (plana) = 1Abombada = 2Deprimida = 37. Aleteo Nasal No = 0Si = 18. Secreción nasal No / muy poco = 0Clara = 1Purulenta = 29. Ojos rojos No = 0Derecho = 1Izquierdo = 2Bilateral = 3No = 010. Secreción ocularClara = 1Purulenta = 211. Palidez de conjuntivas No = 0Leve = 1Severa = 212. Palidez palmar No = 0Leve = 1Severa = 2Deleted: k213

D: Sistema respiratorio /tórax1. Cianosis central No = 0Si = 12. Estridores No = 0Si = 13. Quejidos No = 0Si = 14. Uso de músculos accesorios5. Retraimiento de la pared torácica (tirajesubcostal)No = 0Si = 1No = 0Leve = 1Severo = 26. Estertores crepitantes No = 0Izquierda = 1Derecha = 2Bilateral = 37. Expiración prolongara No = 0Si = 18. Sibilancias No = 0Sonido espiratorio solo = 1Sonido espiratorio einspiratorio = 29. Roncus No = 0Izquierdo = 1Derecho = 2Bilateral = 310. Disminución de los ruidos respiratorios No = 0Izquierda = 1Derecha = 2Bilateral = 311. Respiración bronquial No = 0Izquierdo = 1Derecho = 2Bilateral = 312. Hallazgos de la auscultación con el estetoscopioestándar (guardar la info. en la computadora)13. Auscultación localizada (a realizarse cuandohay sonidos atípicos sugestivos de neumonía roncuso crepitaciones)Marque cuando se hallarealizado:Superior derecha = 1Inferior derecha = 2Superior izquierda = 3Inferior izquierda = 4214

14. Tos durante el examen14.1 Si SI, describa la naturalezaNo = 0Si = 1Seca = 1Húmeda = 2Tos perruna = 3Tos paroxística = 4E: Otros exámenes1. Si el niño tiene diarrea:1.1 ¿Ojos hundidos?1.2 ¿Esta el niño sediento, bebe conavidez?1.3 Turgencia de la piel: retorna elpliegueNo = 0Si = 1No = 0Si = 1No se puede evaluar = 2Rápidamente = 0Lentamente = 1Muy lentamente = 22. Llenado capilar < 3 segundos = 0> 3 segundos = 13. Edema de ambos pies No = 0Si = 14. Niño severamente emaciado (consumido) No = 0Si = 15. ¿Tiene Rash? No = 0Si = 15.1 Si SI, ¿Es localizado o generalizado?5.2 Prurito5.3 Tipo5.4 InterpretaciónLocalizado = 1(especifique) ____________Generalizado = 2Ausencia de prurito = 0Prurito = 1No evaluable = 2Macular = 1Papular = 2Pústular = 3Eczema = 1Micótico = 2Viral = 3Otro (especifique):Vesicular = 4Petequial = 5Seco = 6Bacterial = 4Pañalitis = 5215

6. Otoscopia (oído derecho)6.1 Secreción Purulenta No = 0Si = 16.2 Tímpano evaluableNo = 0Si SI responda 6.2.1 al 6.2.3Si = 16.2.1 Tímpano eritematoso No = 0Si = 1No = 06.2.2 AbombadoSi = 1No = 06.2.3 PerforadoSi = 17. Otoscopia (oído izquierdo)7.1 Secreción Purulenta No = 0Si = 17.2 Tímpano evaluableNo = 0Si SI responda 7.2.1 al 7.2.3Si = 17.2.1 Tímpano eritematoso No = 0Si = 1No = 07.2.2 AbombadoSi = 1No = 07.2.3 PerforadoSi = 18. Hinchazón detrás del oído No = 0Mastoides derecha = 1Mastoides izquierda = 2Bilateral = 39. Orofaringe inflamada No = 0Eritematosa, no purulenta = 1Eritematosa, purulenta = 210. Temperatura axilaro C11. Peso KgF: OTROS HALLAZGOS CLINICOSSistemahallazgos1. Cardiovascular No = 0Si = 12. Abdomen /GI No = 0Si = 13. Genito-urinario No = 0Si = 1216

4. Músculo-esquelético No = 0Si = 15. Nervioso No = 0Si = 16. Otros No = 0Si = 1G: OXIMETRIA DE PULSOLectura Inadecuada = 0Adecuada = 1(%)Saturación de OxigenoPulso(pulsaciones / minuto)H: DIAGNOSTICO PROVISIONAL (Previo a resultados de Rayos X)Enfermedades respiratorias Enfermedad respiratoria superior (rinitis, catarrocomún)No = 0Si = 1 Otitis media No = 0Si = 1 Laringo-traqueo-bronquitis No = 0Si = 1 Neumonía No = 0Si: posible = 1Si: definitivo = 2 Enfermedad respiratoria con sibilancias No = 0Si: posible = 1Si: definitivo = 2Otros diagnósticos1.2.I: MANEJOReferenciaPaciente ambulatorio sin Rayos-X = 1Paciente ambulatorio con Rayos-X = 2Referencia para hospitalaria = 3217

Si hay referencia hospitalariaMedicamentos1.Aceptada = 1Rechazada = 22.3.Otros consejosNombre del DoctorFirma del DoctorJ: HALLAZGOS EN LOS RAYOS XTipo de referencia paraRayos-XNumero de Rayos-XHallazgos en losRayos-XPaciente ambulatorio = 1Hospitalizado = 2[Numero]Normal No = 0Si = 1Infiltrado lobular osegmentarioNo = 0Derecha = 1Izquierda = 2Bilateral = 3Infiltrado difuso No = 0Si = 1Derrame pleural No = 0Si = 1Sobredistención No = 0Si = 1Otro(Especifique)K: INFORMACIÓN A LLENAR SI EL NIÑO FUE HOSPITALIZADOFecha de ingresoFecha de egreso(dd/mm/aaaa)(dd/mm/aaaa)___/___/_______/___/____218

Diagnostico final (1)Diagnostico final (2)Diagnostico final (3)Resultado final Sobrevivió = 1Murió = 2Egreso contra indicado No = 0Si = 1L: DIAGNOSTICO FINAL [Con resultado de Rayos X, y (si hospitalizado) información delhospital]Enfermedades respiratorias Enfermedad respiratoria superior (rinitis, catarrocomún)No = 0Si = 1 Otitis media No = 0Si = 1 Laringo-traqueo-bronquitis No = 0Si = 1 Neumonía No = 0Si: posible = 1Si: definitivo = 2 Enfermedad respiratoria con sibilancias No = 0Si: posible = 1Si: definitivo = 2Otras diagnosticos1.2.3.Nombre del DoctorFirma del Doctor219

M: TEST PARA VRSTest para Virus Sincitial Respiratorio (RSV) No indicado = 0Realizado = 1Negativo = 0Sise realizó el examen, resultadoPositivo = 1No interpretable = 2N. HOJA DE REGISTRO PARA QUEMADURAS1. ID. (niño)2. Fecha de nacimiento /edad3. Fecha de la visita4. Referido por Trabajador de campo = 1Ninguno = 2Otro (especifique) = 35. Tipo de lesión Quemadura con objetos calientes = 1Quemadura con líquidos calientes = 2Ambos = 36. ¿Cuándo sucedió el problema? días atrás7. Describa el área dañada: Enfrente8. Describa el área dañada: Atrás220

9. Grado del dañó Primer grado = 1Segundo grado = 2Tercer grado = 310. Tratamiento11. Plan educacionalIngreso de DatosFirma Digitador 1: _________________Firma Digitador 2: _________________Fecha Ingreso1: _________________Fecha Ingreso 2: _________________221

Appendix XLV: Medical Evaluation Form (short, skin and eyes), Children(English)SHORT MEDICAL QUESTIONNAIREEye and Skin DiseasesA: CHILD’S INFORMATION AND REASON FOR VISIT1. ID (child)2. Community3. Age4. Date of birth5. Date of Visit6. Referred by Field worker = 1Self referral = 2Other (Specify) = 38.Reason for Consult:1.2.9. Duration of illness Days222

B. Skin Diseases, exam1. Is there a Rash? No = 0Yes = 1Localized = 11.1 If yes, is it localized or generalized? (specify) ____________Generalized = 2No = 01.2 PruriticYes = 1Unable to evaluate = 21.3 Type1.4 InterpretationMacular = 1Papular = 2Pustular = 3Eczema = 1Mycotic = 2Viral = 3Other (specify):Vesicular = 4Petequial = 5Dry = 6Bacterial = 4Diaper Rash =5C. Eye Diseases, exam1. Red eyes No = 0Right = 1Left = 2Bilateral = 3No = 02. Eye dischargeClear = 1Purulent = 2223

D. Diagnostics1.2.3.E. MANAGEMENTMEDICATIONS1.2.3.4.Other AdviceDoctor’s NameDoctor’s SignatureData EntryData Entry Signature # 1: _________________Data Entry Signature #2: _________________Date of Entry #1: _____________Date of Entry #2: _____________224

Appendix XLVI: Medical Evaluation Form (short, skin and eyes), Children(Spanish)CUESTIONARIO MEDICO CORTOPara enfermedades de ojos y pielA: INFORMACION DEL NIŇO Y MOTIVO DE CONSULTA1. ID (niño)2. Comunidad3. Edad4. Fecha de nacimiento5. Fecha de visita6. Referido por Trabajador de campo = 1Auto referencia = 2Otro (Especifique) = 38. Motivo de Consulta:1.9. Duración de la enfermedad DíasB. Enfermedades de piel1. ¿Tiene Rash? No = 0Si = 1Localizado = 11.1 Si SI, ¿Es localizado o generalizado? (especifique) ____________Generalizado = 2No = 01.2 PruritoSi = 1No evaluable = 21.3 Tipo2.Macular = 1Papular = 2Pustular = 3Eczema = 1Micótico = 2Viral = 3Vesicular = 4Petequial = 5Seco = 6Bacterial = 4Pañalitis = 5225

Otro (especifique):C. Enfermedades oculares, examen1. Ojos rojos No = 0Derecho = 1Izquierdo = 2Bilateral = 32. Secreción ocularD. Diagnósticos1.2.3.E. MANEJOMedicamentos1.2.3.4.Otras consejosNo = 0Clara = 1Purulenta = 2Nombre del DoctorFirma del DoctorIngreso de DatosFirma Digitador 1: _________________Fecha Ingreso1: _________________226

Firma Digitador 2: _________________Fecha Ingreso 2: _________________227

Appendix XLVII: Anthropometry Form (English)Weight Meas. 1 Meas. 2 Meas. 3FinalMeas.Date andTime of BirthHour ofWeightMeas. Sex Observations228

Appendix XLVIII: Anthropometry Form (Spanish)Nombre del niño Peso Talla 1 Talla 2 Talla 3TallafinalFecha y horade Nac.Hora dePesoSexo Observaciones229

Appendix XLIX: Weekly Questionnaire, Pregnant Women (English)WEEKLY QUESTIONNAIREPREGNANT WOMENVersion 2March 2003MunicipalityCommunityHousehold-________________ ________________Date (dd/mm/yy)Start Time_____/______/______ (hh:mm)Interviewer Interviewer Code Interviewer InitialsPregnancy Month______:_______________ (m)INSTRUCTIONSIf by this visit the woman already had her baby, only ask question 12. If it was a spontaneous abortion or miscarriage,only ask question 10. If the woman had a stillbirth, only ask question 11.Response Action CodeQuestion1. Have you had upper abdominal pain duringyour pregnancy?1.1 If yes, do you have this painnow?2. Do you have intense headaches with visionchanges such as flashing lights, double orblurry vision?3. Have you had swelling (edema) below yourknees?3.1 If yes, do you have thisswelling now?4. Do you have burning or pain when youurinate?5. Do you urinate blood or is your urine adarker color?6. Have you had any vaginal bleeding orwatery vaginal discharge during thispregnancy?6.1 If yes, are you bleeding or doyou have watery discharge now?7. Do you have more white or yellow vaginaldischarge than is normal and that is itchy?8. Have you had any vaginal infections duringthis pregnancy?8a.Is your baby moving less than usual?9. Do you have another health problem relatedto this pregnancy?No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1No = 0Yes = 1If YES REFERTO MDIf YES REFERTO MDIf YES REFERTO MDIf YES REFERTO MDIf YES REFERTO MDIf YES REFERTO MDIf YES Educational PlanIf YES REFERTO MDIf YES REFERTO MD230

9.1 If yes, describe it: _____________________10. If the woman had a spontaneous abortion or miscarriage, note date she lost the pregnancy: ____________11. If the baby was a stillbirth, note the date of the delivery: __________________________________________12. Birth date: _______________________________End time (hh:mm): _________________Interviewer:Interviewer’s Initials: _______________Interviewer’s Signature:______________Supervisor Review:Supervisor’s Signature______________Date of Review: _________________Data EntryData Entry No.1 (Signature): _________________Date of first entry: __________________Data Entry No. 2 (Signature): _________________ Date of second entry: __________________231

Appendix L: Weekly Questionnaire, Pregnant Women (Spanish)CUESTIONARIO SEMANALMUJERES EMBARAZADASVersión 213 Marzo de 2003MunicipioComunidadVivienda________________ ________________Fecha (dd/mm/aa)Hora de inicio_____/______/______ (hh:mm)Entrevistador Código Iniciales-Meses de Embarazo________ (m)______:_______INSTRUCIONESSi para esta visita la señora ya tuvo al bebe, contestar únicamente la pregunta 12. Si fue un abortocontestar la pregunta 10 y si la señora tuvo trabajo de parto pero el niño nació muerto contestar la pregunta11.Respuesta Acción CódigoPregunte1. ¿Ha tenido dolores en la boca delestómago en los últimos meses?1.1 Si sí ¿Le dueleactualmente?2. ¿Le duele la cabeza intensamente concambios de la vista como chispitas de luz,visión doble o nublado?3. ¿Se ha hinchado de las rodillas paraabajo?3.1 Si sí ¿Está hinchadaactualmente?4. ¿Siente dolor o ardor cuando orina?5. ¿Ha notado sangre en la orina o quesu orina es un color más oscuro?6. ¿Ha tenido sangrado vaginal o le hasalido agua de su parte vaginal?6.1 Si sí ¿Está sangrando o lesale agua actualmente?7. ¿Ha tenido o tiene más flujo blanco oamarillo de su parte que lo normal juntocon comezón?8.¿Ha tenido infecciones de su partedesde que está embarazada?No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1No = 0Sí = 1Si SI REFIERALOSi SI REFIERALOSi SI REFIERALOSi SI REFIERALOSi SI REFIERALOSi SI REFIERALOSi SI Planeducacional232

8b.¿Se está moviendo su bebé menosque lo normal?9. ¿Tiene algún otro problema de saludrelacionado con su embarazo?No = 0Sí = 1No = 0Sí = 1Si SI REFIERALOSi SI REFIERALO9.1 Si sí, describa _____________________10. Si la señora tuvo un aborto espontáneo, Fecha de la pérdida: _________________________11. Si el bebe nació muerto, Fecha del parto: __________________________________________12. Fecha de nacimiento: _______________________________Hora de Finalización (hh:mm): _________________EntrevistaIniciales del entrevistador: _______________RevisiónFirma de Supervisor: __________________Ingreso de DatosFirma Digitador No.1: _________________Firma Digitador No. 2: _________________Firma Entrevistador: ________________Fecha de Revisión: _________________Fecha Primer Ingreso: __________________Fecha Segundo Ingreso: __________________233

Appendix LI: Behavioral Changes Related to Postpartum "Reposo" Stage(English)BEHAVIORAL CHANGES RELATED TO POSTPARTUM “REPOSO” STAGEMunicipality________________Community___________________HouseholdInterview DateStart time(dd/mm/yy)_____/______/______ (hh:mm)Interviewer Code Initials-______:_______The motivation for the questionnaire is to evaluate how much time the mother spends cooking or near the fire during thepostpartum period known as the “reposo” or “dieta”.A: POSTPARTUM BEHAVIORASKRESPONSEA01. After giving birth, are you accustomed to observing the “resposo or No = 0dieta” (rest period during postpartum phase)?Yes = 1A02. Do you stop cooking for a certain amount of time after giving birth? No = 0 If the answer is “No” go on to question No. 3Yes (partially) = 1Yes (completely) = 2A02.1 After giving birth, how many days do you stop cooking? # of daysCODEA02.2 Where was food cooked for your family during thisperiod?A03. Where do you normally sleep (when not in the rest period during thepostpartum phase)?A04. Do you, or did you, change the place where you sleep after givingbirth, or do you plan to do so when your baby is born? If the answer is “No” go on to question No. 5A04.1 How many days in total (since baby was born/ after babyis born) did you sleep, or will you sleep, in a different place aftergiving birth?In the kitchen (always)= 0In the kitchen(sometimes) = 1In another house(always) = 2In the kitchen = 0In a room connected tothe kitchen = 1In a room separatefrom the kitchen = 2Other (specify) = 3No = 0Yes, I am doing so now= 1Yes, I did during thelast pregnancy = 2Yes, I plan to changewhere I sleep aftergiving birth = 3# of days234

ASKRESPONSEA04.2 Where will you, or did you sleep, after giving birth? In the kitchen = 0In a room connected tothe kitchen = 1In a room separatefrom the kitchen = 2In another kitchen witha plancha = 3In another kitchen withan open fire = 4Other (specify) =5A05. During the day, where do you/ did you/ will you rest after givingbirth?A05.1¿Do you/ did you/ will you make a fire to heat the roomand/or the baby? If the answer is “No” the interview is finishedA05.2 How long do you/ did you/ will you keep the fire going inthe room where you are resting?In the kitchen = 0In a room connected tothe kitchen = 1In a room separatefrom the kitchen = 2In another kitchen witha plancha = 3In another kitchen withan open fire = 4No = 0Yes = 1Less than 2 hours= 0Half a day = 1All day = 2CODEB: LOCATION OF GASTEC TUBESIf the mother is currently in the “reposo” stage of the postpartum phase, complete the information in thissection. Otherwise, go on to section C.B01. Mother’s tubeID(###)Tube start time(hh : mm)OBSERVATIONSB02. Baby’s tube No. 1 If no twins, move on thesection CB03. Baby’s tube No.2C: PERSONAL DATA ABOUT CHILDREN IN STUDYASK RESPONSE CODEC01. Name of child # 1First Name / Second Name/First Last Name/ Second LatName235

ASK RESPONSE CODEC02. Sex of child # 1 If no twins, move on thesection C05Masculine = 0Feminine = 1C03. Name of child # 2First Name / Second Name/First Last Name/ Second LatNameC04. Sex of child # 2 Masculine = 0Feminine = 1C05. Date of birth of child(ren)in studyDD / MM / YYYYC06. Source of informationabout date of birthBirth certificate = 0Vaccine record = 1Mother = 2D: MOTHER’S ETHNIC GROUPAsk Response CodeD01. Do you consider yourself to be indigenous or ladina? Indigenous = 0Ladino = 1Interview End Time (hh:mm): _________________E: GASTEC TUBE COLLECTIONE1. ID Community ___ ___ ___ ___ ___ House ___ ___ ___E2. Initials of Person who retrieved the equipment: _________ Code: ___ ___E3.1 Mother’s TubeID(Apply sticker tospace below)Time tube wassealed(hh : mm)OBSERVATIONSE3.2 Baby’s Tube No. 1 If no twins, move on toquestion E4E3.3 Baby’s Tube No.2236

E4. OBSERVE IMMEDIATELY UPON ARRIVING AT THE HOUSE: (in case interviewer not able toobserve, ask mother)ASK RESPONSE CODEE41. Where was the mother when the interviewer arrived? In the kitchen= 0In another part of thehouse= 1Outside = 2Other (describe) = 3Don’t know = 4E42. Where was the baby when the interviewer arrived? In the kitchen= 0In another part of thehouse= 1Outside = 2Other (describe) = 3Don’t know = 4E3.3 Was the fire lit? No = 0Yes = 1OBSERVATIONS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ReviewSupervisor’s Signature: __________________ Review Date: _________________Data EntryData Entry Signature No. 1_______________Data Entry Signature No. 2______________Date of First Entry: __________________Date of Second Entry: __________________237

Appendix LII: Behavioral Changes Related to Postpartum "Reposo" Stage(Spanish)CAMBIOS EN EL COMPORTAMIENTO RELACIONADOS CON EL REPOSO DESPUÉS DEL PARTOMunicipio________________Comunidad___________________ViviendaFecha de la entrevistaHora de inicio(dd/mm/aa)_____/______/______ (hh:mm)Entrevistador Código Iniciales-______:_______El motivo de este cuestionario es evaluar como el primer periodo después del parto (reposo o dieta) afecta el tiempo quela madre pasa cocinando o cerca del fuego.A: COMPORTAMIENTO EN EL PERIODO DESPUÉS DEL PARTOPREGUNTA RESPUESTA CÓDIGOA01.¿Después de dar a luz acostumbra hacer usted “El reposo o dieta?” No = 0Sí = 1A02.¿Dejó de cocinar por un tiempo después de dar a luz?No = 0 Si la respuesta es “No” pase a la pregunta No. 3Sí (parcialmente) = 1Sí (por completo) = 2A02.1¿Por cuánto tiempo dejó de cocinar después de dar a luz? # de díasA02.2¿Dónde se cocinó la comida para su familia durante ese tiempo? En su cocina (siempre) =0En su cocina(a veces) = 1En otra casa (siempre) =2A03.¿Dónde duerme normalmente (cuando no está en el periododespués de dar a luz)?A04.¿Cambió el lugar donde duerme/ durmió en el periodo después de dar a luzo piensa hacerlo cuando su bebe nazca? Si la respuesta es “No” pase a la pregunta No. 5Cocina propia = 0Cuarto conectado a lacocina = 1Cuarto aparte de lacocina = 2Otro (especificar) = 3No = 0Sí, actualmente = 1Sí, durante el ultimoembarazo = 2Sí pienso cambiarlodespués de dar a luz = 3# de díasA04.1¿Cuántos días en total (desde que nazca/ nació el bebé) va adormir o durmió en un lugar diferente después de dar/ que dio a luz?A04.2¿Dónde duerme / durmió o va a dormir después de dar a luz? Cocina propia = 0Cuarto conectado a lacocina = 1Cuarto aparte de lacocina = 2Otra cocina con plancha =3Otra cocina con fogón = 4Otro lugar (especificar) =5238

PREGUNTA RESPUESTA CÓDIGOA05.¿Durante el día, dónde descansa, descansó, o va a descansardespués de dar a luz?A05.1¿Se hace, hizo o hará fuego para calentar el ambiente y/o albebe? Si la respuesta es “No” terminar la encuestaA05.2¿Cuánto tiempo al día permanece, permaneció o piensamantener encendido el fuego en el cuarto donde descansa/ descansoo descansara?Cocina propia = 0Cuarto conectado a lacocina = 1Cuarto aparte de lacocina = 2Otra cocina con plancha =3Otra cocina con fogón = 4No = 0Sí = 1Menos de 2 horas = 0Medio día = 1Todo el día = 2B: COLOCACIÓN DE TUBOS GASTECSi la madre se encuentra actualmente en reposo completar la información para esta sección de lo contrariopasar a la sección C.B01.Tubo de la MadreID(###)Hora en la quese abrió el tubo(hh : mm)OBSERVACIONESB02.Tubo del Bebé No. 1 si no hay gemelos, pasara la sección CB03.Tubo del Bebé No.2C: DATOS PERSONALES NIÑO (S) DEL ESTUDIOPREGUNTA RESPUESTA CÓDIGOC01. Nombre del niño # 1 delestudioPrimer Nombre / SegundoNombre/ Primer Apellido/Segundo ApellidoC02. Sexo niño # 1 si no hay gemelos, pasar ala pregunta C05C03. Nombre del niño # 2 delestudioPrimer Nombre / SegundoNombre/ Primer Apellido/Segundo ApellidoMasculino = 0Femenino = 1239

PREGUNTA RESPUESTA CÓDIGOC04. Sexo niño # 2 Masculino = 0Femenino = 1C05. Fecha de nacimiento niño(s) del estudioDD / MM / AAAAC06. Fuente de la cual obtuvola fecha de nacimientoFe de edad (certificado de nacimiento) = 0Carné de vacunación = 1Referencia de la madre = 2D: GRUPO ÉTNICO DE LA MADREPregunta Respuesta CódigoD01. ¿Usted se considera indígena o ladina? Indígena = 0Ladino = 1Hora de Finalización (hh:mm): _________________E: COLECTA DE TUBOS GASTECE1. ID Comunidad ___ ___ ___ ___ ___ Casa ___ ___ ___E2. Iniciales de la persona que retiró el equipo: _________ Código: ___ ___E3.1Tubo de la MadreID(Pegar Etiqueta enel espacio)Hora en la quese tapó eltubo(hh : mm)OBSERVACIONESE3.2Tubo del Bebé No. 1 si no hay gemelos, pasara la pregunta E4E3.3Tubo del Bebé No.2240

E4. OBSERVAR INMEDIATAMENTE AL LLEGAR A LA CASA: (En el caso que no le sea posible alentrevistador observar, entonces pregunte a la madre)PREGUNTA RESPUESTA CÓDIGOE41. ¿Dónde estaba la mamá cuando el encuestador llegó? En la cocina = 0Otra parte de la casa =1Afuera = 2Otro (describir) = 3NS = 4E4.2 ¿Dónde estaba el bebe cuando el encuestador llegó? En la cocina = 0Otra parte de la casa =1Afuera = 2Otro (describir) = 3NS = 4E3.3¿Está encendido el fuego? No = 0Sí = 1OBSERVACIONES:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________RevisiónFirma de Supervisor: __________________Ingreso de DatosFirma Digitador No.1: _________________Firma Digitador No. 2: _________________Fecha de Revisión: _________________Fecha Primer Ingreso: __________________Fecha Segundo Ingreso: __________________241

Appendix LIII: Medical Evaluation Form: Survey of Maternal Health, PrenatalVisit (English)Baseline Questionnaire No. 1Survey of Maternal HealthParticulate Air Pollution Exposure and Childhood Acute Respiratory Infections in Guatemala: ARandomized Intervention Trial.A: INTERVIEW DETAILSA1. HOUSEHOLD ID: _________A2. Interviewer initials: _________ Interviewer Code: ______________A3. DATE OF INTERVIEW: ____ / ____ / ______dd mm yyyyA4. ADDRESS: ____________________ ___________________VillageMunicipalityB: PERSONAL INFORMATION ABOUT PARTICIPANT_______________ __________________ _______________ _______________First Name Second Name Paternal Last Name Maternal Last NameAge:________ yearsC: PAST MEDICAL HISTORYPersonal HxPersonal Hx Check:Check:Pulmonary TB 1 Yes 2 No Pulmonary TB 1 Yes 2 NoDiabetes 1 Yes 2 No Diabetes 1 Yes 2 NoHypertension 1 Yes 2 No Hypertension 1 Yes 2 NoMental Illness 1 Yes 2 No Mental Illness 1 Yes 2 NoHeart Disease 1 Yes 2 No Heart Disease 1 Yes 2 NoRenal Illness 1 Yes 2 No Renal Disease 1 Yes 2 NoVenereal1 Yes 2 No Venereal1 Yes 2 NoDiseaseDiseaseAlcoholism 1 Yes 2 No Alcoholism 1 Yes 2 No1 Yes 2 No Anemia 1 Yes 2 No1 Yes 2 No Other 1 Yes 2 NoOBSERVATIONS242

SURGICAL PROCEDURES AND TRAUMATICINJURIES(Description / Dates)GYNECOLOGICAL PROCEDURESG_______ P_________Ab________Cesareans: Yes No #Children Living:_____ Deceased:_____OBSTETRIC HISTORYHemorrhagesVaginalDischargeDysuriaHematuriaLow. Extrem.EdemaFacial EdemaOther:CHECK1 Yes 2 No1 Yes 2 No1 Yes 2 No1 Yes 2 No1 Yes 2 No1 Yes 2 No1 Yes 2 NoOBSERVATIONSCURRENT PREGNANCYLMP ____ / ____ / ______ Doesn’t remember EDC ____ / ____ / ______dd mm yyyy dd mm yyyyPHYSICAL EXAMORAL TEMP.____________ 0 CBP ________________ H.R. __________X’Abdomen: Position: Lateral Transverse Not able to evaluate Presentation: Cephalic Breech Not able to evaluate FH: _________Cms FHT __________x min. Not audible Fetal Movements: YES NO Lower Extremities Normal Edema Pitting Edema 243

URINE EXAM Hemoglobin _________g\dlTestUrobilinogen (mg\dl)Glucose (mg\dl)KetonesBilirubinProtein (mg\dl)NitritesPhBloodSpecific GravityLeukocytesResultsIC:1. Pregnancy _________weeks by LMP2. Pregnancy _________weeks by FH3.________________________________4.__________________________________Risk Category: Normal High Low Impressions____________________________________________________________________________________________________________________________________________________________________________244

Appendix LIV: Medical Evaluation Form: Survey of Maternal Health, PrenatalVisit (Spanish)Cuestionario de Línea Basal No. 1Ficha de Control MaternoExposición a Partículas Contaminantes en el Aire e Infecciones Respiratorias Agudas en Niños enGuatemala: Un estudio de intervención aleatorio.A: DETALLES DE LA ENTREVISTAA1. ID DE LA VIVIENDA: _________A2. Iniciales del entrevistador: _________ Código del Entrevistador: ______________A3. FECHA DE LA ENTREVISTA: ____ / ____ / ______dd mm aaaaA4. DIRECCION: ____________________ ___________________ComunidadMunicipioB: DATOS PERSONALES DE LA ENTREVISTADA_______________ __________________ _______________ _______________Primer Nombre Segundo Nombre Apellido Paterno Apellido MaternoEdad: ________ añosC: ANTECEDENTESFAMILIARES MARQUE PERSONALES MARQUE OBSERVACIONESTB Pulmonar 1 Sí 2 No TB Pulmonar 1 Sí 2 NoDiabetes 1 Sí 2 No Diabetes 1 Sí 2 NoHipertensión 1 Sí 2 No Hipertensión 1 Sí 2 NoEnf. Mental 1 Sí 2 No Enf. Mental 1 Sí 2 NoCardiopatías 1 Sí 2 No Cardiopatías 1 Sí 2 NoEnf. Renal 1 Sí 2 No Enf. Renal 1 Sí 2 NoEnf. Venérea 1 Sí 2 No Enf. Venérea 1 Sí 2 NoAlcoholismo 1 Sí 2 No Alcoholismo 1 Sí 2 No1 Sí 2 No Anemia 1 Sí 2 No1 Sí 2 No Otros 1 Sí 2 No245

QUIRÚRGICOS Y TRAUMÁTICOS(Descripción / Fechas)GINECOLÓGICOSG_______ P_________Ab________Cesareas: Si HV __________No HM_________OBSTETRICOSMARQUEOBSERVACIONESHemorragias 1 Sí 2 NoFlujo Vaginal 1 Sí 2 NoDisuria 1 Sí 2 NoHematuria 1 Sí 2 NoEdema MI 1 Sí 2 NoEdema Cara 1 Sí 2 NoOtros: 1 Sí 2 NoEMBARAZO ACTUALF.U.R. ____ / ____ / ______ No Recuerda F.P.P. ____ / ____ / ______dd mm aaaa dd mm aaaaEXAMEN FISICOT.O. ____________ 0 C P/A ________________ F.C. __________X’Abdomen: Situación: Lateral Transversal No evaluable Presentación: Cefálica Podálica No evaluable A.U. _________Cms F.C.F. __________x mt. No audible Movimientos Fetales: SI NO Miembros inferiores Normal Edema frió Fovea 246

EXAMENES DE ORINA Hemoglobina _________g\dlTestUrobuilinógeno (mg\dl)Glucosa (mg\dl)CetonasBilirrubinasProteínas (mg\dl)NitritosPHSangreDensidadLeucocitosBajo ResultadoIC: 1. Embarazo _________S x FUR2. Embarazo _________S x AU3._________________________________4.__________________________________Tipo de Riesgo: Ninguno Alto Conducta________________________________________________________________________________________________________________________________________________________________247

Appendix LV: Hospital Follow-up Form (English)HOSPITAL FOLLOW-UP FORMClinic-Hospital ID No.________________________Date ______________MERTUG-ARI-UC ID No.__________________Age_______________ Bed_____________ Room________________RX _________________________Admit Date__________________Discharge Date__________________________DIAGNOSTICSADMISSION______________________________________________________________________________________________________DISCHARGE______________________________________________________________________________________________________PROGRESSLABORATORYPRESCRIPTIONSSPECIAL NOTES248

Appendix LVI: Hospital Follow-up Form (Spanish)BOLETA DE EVOLUCION HOSPITALARIAFicha Clinica Hospitalaria No.________________________Fecha ______________ID MERTUG-ARI-UC__________________Edad_______________ Cama________________ Sala________________RX _________________________Fecha Ingreso__________________Fecha Egreso __________________________DIAGNOSTICOSINGRESO______________________________________________________________________________________________________EVOLUCIONEGRESO______________________________________________________________________________________________________LABORATORIOSMEDICAMENTOSESPECIALES249

Appendix LVII: Hospital Referral Form (English)REFERRAL FORMARI-UC PROJECTPatient ID: __________________________ - _________ 01 (mother) 02 (child) 03 (other)Municipality_________________________ Community_______________________Date: ___________________ Hour: ___________________A: ARI-UC Project Doctors HospitalReason for Referral________________________________________________________________________________________________________________________________________________________________________________________________________REFERRAL FORMARI-UC PROJECTPatient ID: __________________________ - _________ 01 (mother) 02 (child) 03 (other)Municipality_________________________ Community_______________________Date: ___________________ Hour: ___________________A: ARI-UC Project Doctors HospitalReason for Referral:______________________________________________________________________________________________________________________________________________________________________________________________________250

Appendix LVIII: Hospital Referral Form (Spanish)BOLETA DE REFERENCIAPROYECTO ARI-UCID Del paciente: __________________________ - _________ 01 (madre) 02 (hijo) 03 (otro)Municipio_________________________ Comunidad_______________________Fecha: ___________________ Hora: ___________________A: Médicos Proyecto ARI-UC HospitalMotivo de Referencia:______________________________________________________________________________________________________________________________________________________________________________________________________BOLETA DE REFERENCIAPROYECTO ARI-UCID Del paciente: __________________________ - _________ 01 (madre) 02 (hijo) 03 (otro)Municipio_________________________ Comunidad_______________________Fecha: ___________________ Hora: ___________________A: Médicos Proyecto ARI-UC HospitalMotivo de Referencia:______________________________________________________________________________________________________________________________________________________________________________________________________251

Appendix LIX: Standard Verbal Autopsy Questionnaire (English)Standard Verbal Autopsy QuestionnaireInstructions to interviewer: Introduce yourself and explain the purpose of your visit. Ask to speak to themother or to another adult caretaker who was present during the illness that leads to death. If this is notpossible, arranger a time to revisit the household when the mother or caretaker will be home.Section 1:Background information on child and household(To be filled before interview)1.1 Address of household _________________________________________________________________________________________________________________________1.2 Name of Child _________________________________________________________________1.3 Identification number of child/household _____________________________1.4 Sex of Child: 1. Male 2. FemaleSection 2: Background information about the interview2.1 Language of interview: ________________________2.2 Interviewer identification number: ______________________________Date of first interview attemptday/month/yearDate and time arranged for second interview attemptDate and time arranged for third interview attemptDate of interviewDate form checked by supervisorDate entered in computerSection 3: Information about caretaker/respondent3.1 What is the name of the main respondent? ________________________________________252

3.2 What is the relationship of main respondent to deceased child? (tick relevant box)1. Mother2. Father3. Grandmother4. Grandfather5. Aunt6. Uncle7. Other male (specify) ______________________8. Other female (specify) _____________________3.3 What is the age of main respondent (in years) ___________3.4 How many years of school did the main respondent complete? ___________3.5 Were other people present at the interview?1. Yes 2. No(If “No”, go to question 3.5.3)3.5.1 Of those present at the interview, which were present at the illness that led to dead/hospitalization? (Tick all relevant boxes)Present atInterviewPresent duringillness1. Mother …………………………………2. Father …………………………………3. Grandmother …………………………4. Grandfather…………….…………….5. Aunt …………….……………………..6. Uncle …………………………………..7. Other male (specify) __________________8. Other female (specify) _________________253

3.5.2 Total number present interview (excluding interviewer) _______________3.5.3 If mother is not present at the interview, is the mother still alive? Yes NoSection 4: Information about the child4.1 Date of birth of child: ___/___/___dd mm yy4.2 What was the date of _____________ death? ___/___/___dd mm yy4.3 Where did _________________ die? (tick relevant box)1. Hospital2. Other health facility3. On route to hospital or health facility4. Home5. Other (specify _________________)4.3.3 For deaths at hospital or health facility, record facility name and address:_____________________________________________________________________________________________________________________________________________________Section 5: Open history question5.1 Could you tell me about ____________ ‘s illness that led to death?Prompt: Was there anything else?Instructions to interviewer- allow the respondent to tell you about the illness in his or her own words. Do notprompt except for asking whether there was anything else after the respondent finishes. Keep promptinguntil the respondent says there was nothing else. While recording, underline any unfamiliar terms.254

Take a moment to tick all items mentioned spontaneously in the open history questionnaire. Use this toguide you through the rest of the questionnaire.5.1.1 Diarrhea ……………………………………………………………………..5.1.2 Cough ………………………………………………………….…………….5.1.3 Fever …………………………………………………………………………5.1.4 Rash …………………………………………………………………….……5.1.5. Injury …………………………………………………………………………5.1.6 Coma …………………………………………………………………………5.1.7 Fit …………………………………………………….……………………….5.1.8 Stiff neck ……………………………………………………………………..5.1.9 Tetanus ………………………………………………………………………5.1.10 Measles ………………………………………………….…………………..5.1.11 Kwashiorkor …………………………………………………………………5.1.12 Marasmus ……………………………………………………………………5.1.13 Difficult breathing ………………………………………………….………..5.1.14 Rapid breathing …………………………………………..…………………5.1.15 Complicated delivery ……………………………………………………….5.1.16 Malformation ………………………………………………….…………….5.1.17 Multiple birth ……………………………………….………………………..5.1.18 Very small at birth ……………………………………………….………….5.1.19 Very thin ……………………………………………………………………..5.1.20 Born early ……………………………………………………………………5.1.21 Pneumonia ……………………………………….………………………….5.1.22 Accident ……………………………………………………….……………..5.1.23 Malaria ……………………………………………………………………….5.1.24 Jaundice …………………………………………………………..…………5.1.25 Other terms (specify _____________________________) …………..255

Note: When developing the country-specific questionnaire, local terms likely to be used by respondentsshould be added to this list.5.2 What was the length of time the child was ill before he/she died? _______ days( Use one month = 2 days to determine the number of months) ________ months5.3 Was care sought outside the home while he/she had this illness?1. Yes 2. No 3. Don’t know( If “No” or “ Don’t know” , go to section 6)5.3.1 (If “yes” ask:) Where or from whom did you seek care? (record all responses)1. Traditional healer …………………………………….…..2. Religious leader ……………………………………….…3. Government hospital …………………………………….4. Community-based practitioner associated with health5. System including trained birth attendants ………….….6. Private physician …………………………………………7. Pharmacy, drug seller, store, market …………….…….8. Other provider …………………………………………….9. Relative, friend (outside household) ……………………After respondent finishes prompt: Did you seek care anywhere else?Keep using this prompt until respondent replies that they did not seek care from anyone else.Note: Above categories should be country specific.Section 6: Accident6.1 Did ____________ die from an injury, accident, poisoning, bite, burn or drowning?1. Yes 2. No 3. Don’t know( If “No” or “Don’t know”, go to section 7)6.1.1 (If “yes” ask): What kind of injury or accident? Allow respondent to answer spontaneously. Ifrespondent has difficulty identifying the injury or accident, read the list slowly.1. Motor vehicle accident2. Fall3. Drowning4. Poisoning5. Bite or sting by venomous animals6. Burn256

7. Violence8. Other injury (specify) __________________6.1.2 How long did______________________ survive after the injury, poisoning, bite, burn or drowning?1. Died within 24 hours2. Died 1 day later moreSection 7: Age determination and reconfirmation7.1 Record the child’s date of birth from question 4.1 ___/___/___dd mm yyRecord child’s date of death from question 4.2___/___/___dd mm yy7.2 Take a moment and calculate the age of the child at the time of death.Read out: I have calculated that _______________ was ______ days (or months or years old asappropriate) at the time of death. Is this correct?If the respondent indicates this is not correct, reconcile the inconsistency by re-checking the child’s date ofbirth and date of death. Make the necessary corrections here and in section 4.7.3 If it is not possible to reconcile the inconsistency, ask:How old was ______________________ at the time of death?1. 28 days or more2. Less than 28 daysIf child died within 24 hours from injury or accident, go to section 10- Treatment and recordsIf child was less than 28 days old at the time of death, go to section 8- Neonatal deathsIf child was 28 days old or more at the time of death, go to section 9-Post-neonatal deathsSection 8: Neonatal deaths8.1 Was the child a singleton or multiple births?(If two more children are born at the same time, it is counted as a multiple birth, even if one or moreof the babies are born dead)1. Singleton2. Multiple8.2 Did this child’s pregnancy end early, on time, or late?1. Early2. On time3. Late4. Don’t know257

8.3 Was the late part of the pregnancy, labour or delivery complicated?1. Yes 2. No 3. Don’t know(If “No” or “Don’t know”, go to question 8.4)8.3.1.1 (If yes ask): What complications occurred during late pregnancy, labour or delivery? (Record allresponses)1. Mother had convulsions2. Child delivered feet first3. Excessive bleeding4. emergency Caesarean section5. Multiple delivery6. Other (specify)___________________8.3.1.2 (After respondent finishes prompt): Was there anything else? (Keep using this prompt until therespondent replies that there were no other complications.)8.4 How many months long was the pregnancy? ____ months8.5 Did the waters break before labour or during labour?1. Before 2. During 3. Waters never broke 4. Don’t know(If waters did not break before, go to question 8.6)8.5.1 (If waters broke before labour ask): How much time before labour did the waters break?1. less than one day2. One day or more8.6 How much time did the labour and delivery take?(Note; labour begins when contractions are no more than 10 minutes apart.)1. Less than 12 hours2. Twelve hours or more8.7 Were there any bruises or marks of injury on ______________’s body at birth?1. Yes 2. No 3. Don’t know8.8 Did he/she have any malformations at birth?1. Yes 2. No 3. Don’t know(If “No” or “Don’t know”, go to question 8.9)8.8.1 (If yes ask): Where were there malformations?1. Head2. Body3. Arms/hands4. Legs/feet258

8.8.2 (After respondent finish her prompt): Were there malformations anywhere else? (Keep using thisprompt until the respondent replies that there were no malformations anywhere else.)8.9 At the time of birth was _________________:1. Very small?2. Smaller than usual?3. About average?4. Larger than usual?8.10 Was ________________ able to breathe after birth?(Note: this does not include gaps or very brief efforts to breathe)1. Yes2. No3. Don’t know8.11 Was ________________ able to suckle (or bottle feed) in a normal way after birth?1. Yes2. No3. Don’t know8.12 Did _________________ stop being able to suckle in a normal way?1. Yes 2. No 3. Don’t know(If “No” or “Don’t know”, go to question 8.13)8.12.1 (If yes ask): How long before he/she died did ______________ stop suckling?1. Less than one day2. One day or more3. Don’t know8.12.2 How long after birth did ________________ stop suckling?1. Less than one day2. One day or more3. Don’t know8.12.3 How long after birth did _________________ stop suckling?1. Less than one day2. One to two days3. Three to seven days4. Eight to 14 days5. Fifteen to 30 days6. Don’t know8.13 Was _______________ able to cry after birth?259

1. Yes2. No3. Don’t know8.14 Did ________________ stop being able to cry?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 8.15)8.14.1 (If yes ask): How long before he/she died did ______________ stop crying?1. Less than one day2. One day or more8.15 During the illness that led to death did _________________ have spasms or convulsions?1. Yes2. No3. Don’t know8.16 During the illness that led to death, did he/she become unresponsive/unconscious?1. Yes2. No3. Don’t know8.17 During the illness that led to death, did he/she have a bulging fontanel?1. Yes2. No3. Don’t know8.18 During the illness that led to death, did he/she have “tetanus” (local words)?1. Yes2. No3. Don’t know8.19 During the illness that led to death did he/she have yellow eyes?1. Yes2. No3. Don’t know8.20 During the illness that led to death, did he/she have redness or drainage from the umbilical cordstump?1. Yes2. No3. Don’t know8.21 During the illness that led to death, did he/she have areas of skin that were red and hot?260

1. Yes2. No3. Don’t know8.22 During the illness that led to death, did he/she have a skin rash with bumps containing pus?1. Yes2. No3. Don’t know8.23 During the illness that led to death, did he/ she have fever?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 8.24)8.23.1 (If fever ask): How many days did the fever last? __________________ days8.24. During the illness that led to death, did he/she have frequent loose or liquid stools?1. Yes2. No3. Don’t know8.25 During the illness that led to death, did he/she have (local terms of diarrhea)?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, for both questions 8.24 and 8.25go to question 8.26)Note: Include here de local terms for diarrhea here.8.25.1 (If frequent or liquid stools or local term for diarrhea, ask):For how many days did he/she have loose or liquid stools? __________ days8.25.2 Do you feel that this represented more loose or liquid stools than usual for that child?1. Yes2. No3. Don’t know8.25.3 Was there visible blood in the loose or liquid stools?1. Yes2. No3. Don’t know8.25.4 During the time with loose or liquid stools did the child drink (insert a list of home-made fluidsrecommended by national CDD program) or ORS?1. Yes261

2. No3. Don’t know8.26 During the illness that led to death, did ___________ have a cough?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 8.27)8.26.1 (If yes ask): For how many days did the cough last? ____________ days8.27 During the illness that led to death, did _____________ have difficult breathing?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 8.28)8.27.1 (If yes ask): For how many days did the difficult breathing last? ________ days8.28 During the illness that led to death, did the child have fast breathing?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 8.29)8.28.1 (If yes ask): For how many days did the fast breathing last? ________ days8.29 During the illness that led to death, did ___________ ever stop breathing for a long time, and tartagain?1. Yes2. No3. Don’t know8.30 During the illness that led to death, did he/ she have in-drawing of the chest?1. Yes2. No3. Don’t know8.31 During the illness that led to death, did he/she have noisy breathing? (Demonstrate each sound)8.31.1 Stridor 1. Yes2. No3. Don’t know8.31.2 Grunting 1. Yes2. No3. Don’t know8.31.3 Wheezing 1. Yes2. No262

3. Don’t know8.32 During the illness that led to death, did his/her nostrils flare with breathing?1. Yes2. No3. Don’t know8.33 During the illness that led to death, did _________________ have pneumonia (local terms)?1. Yes2. No3. Don’t knowNote: When preparing the country-specific questionnaire, include local term for pneumonia.GO TO SECTION 10Section 9: Post-neonatal deaths9.1 During the illness that led to death, did he/she have fever?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.2)9.1.1 (If yes ask): How many days did the fever last? ________ days9.2 During the illness that led to death, did ________ have frequent loose or liquid stools?1. Yes2. No3. Don’t know9.3 During the illness that led to death, did he/she have (local terms of diarrhea)?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, for both questions 9.2 and 9.3 go to question 9.4)9.3.1 (If frequent or loose stools or local terms for diarrhea ask):For how many days did the fast breathing last? ________ daysNote: Include here de local terms for diarrhea here.263

9.3.2 Was there visible blood in the loose or liquid stools?1. Yes2. No3. Don’t know9.3.3 During the time with loose or liquid stools did the child drink (insert a list of home-made fluidsrecommended by national CDD program) or ORS?1. Yes2. No3. Don’t know9.4 During the illness that led to death, did ___________ have a cough?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.5)9.4.1 (If yes ask): For how many days did the cough last? ____________ days9.4.2 Was the cough very severe?1. Yes2. No3. Don’t know9.5 During the illness that led to death, did _____________ have difficult breathing?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.6)9.5.1 (If yes ask): For how many days did the difficult breathing last? ________ days9.6 During the illness that led to death, did the child have fast breathing?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.7)9.6.1 (If yes ask): For how many days did the fast breathing last? ________ days9.7 During the illness that led to death, did he/ she have in-drawing of the chest?1. Yes2. No3. Don’t know264

9.8 During the illness that led to death, did he/she have noisy breathing? (Demonstrate each sound)9.8.1 Stridor 1. Yes2. No3. Don’t know9.8.2 Grunting 1. Yes2. No3. Don’t know9.8.3 Wheezing 1. Yes2. No3. Don’t know9.9 During the illness that led to death, did his/her nostrils flare with breathing?1. Yes2. No3. Don’t know9.10 During the illness that led to death, did ______________ have pneumonia?1. Yes2. No3. Don’t knowNote: When preparing country-specific questionnaires include local terms for pneumonia here.9.11 Did __________ experience any generalized convulsions/fits during the illness that led to death?1. Yes2. No3. Don’t know9.12 Was ________________ unconscious during the illness that led to death?1. Yes2. No3. Don’t know9.13 At any time during the illness that led to death, did ______________ stop being able to grasp?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.14)9.13.1 (If yes, ask): How long before he/she died did the child stop being able to grasp?1. Less than 12 hours2. 12 hours or more265

9.14 At any time during the illness that led to death, did ________________ stop being able to respond toa voice?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.15)9.14.1 (If yes, ask): How long before he/she died did the child stop being able to respond to a voice?1. Less than 12 hours2. 12 hours or more9.15 At anytime during the illness that led to death, did the child stop being able to follow movements withtheir eyes?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.15)9.15.1 (If yes, ask): How long before he/she died did the child stop being able to follow movements withtheir eyes?1. Less than 12 hours2. 12 hours or more9.16 Did ________________ have a stiff neck during the illness that led to death? ( Demonstrate)1. Yes2. No3. Don’t know9.17 Did _____________ have a bulging fontanelle during the illness that led to death?1. Yes2. No3. Don’t know9.18 During the month before he/she died, did __________ have a skin rash?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.19)9.18.1 (If yes, ask) Was the rash all over _____________’s body?1. Yes2. No3. Don’t know9.18.2 Was the rash also on __________________’s face?266

9.18.3 How many days did the rash last? ________________ days9.18.4 Did the rash have blisters containing clear fluid?1. Yes2. No3. Don’t know9.18.5 Did the skin crack/split or peel after the rash started?1. Yes2. No3. Don’t know9.18.6 Was this illness “ measles”?1. Yes2. No3. Don’t know9.19 During the illness that led to death, did _________________ become very thin?1. Yes2. No3. Don’t know9.20 During the illness that led to death, did _____________ have swollen legs or feet?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 9.21)9.20.1 (If yes, ask): How long did the swelling last? Number of weeks ______9.21 During the illness that led to death, did ________’s skin flake off in-patches?1. Yes2. No3. Don’t know9.22 Did ____________________’s hair change in color to a reddish ( or yellowish) color?1. Yes2. No3. Don’t know9.23 Did ___________________ have “kwashiorkor” during the month before he/she died?1. Yes2. No3. Don’t know267

9.24 Did __________________ have “marasmus” during the month before he/she died?1. Yes2. No3. Don’t know9.25 During the illness that led to death, did _____________ suffer from “lack of blood” or “pallor”?1. Yes2. No3. Don’t know9.26 During the illness that led to death, did ______________ have pale palms? (Show photo if possible)1. Yes2. No3. Don’t know9.27 During the illness that led to death, did _______________ have white nails?(Show photo if possible)1. Yes2. No3. Don’t know9.28 During the illness that led to death, did ______________ have swellings in the armpits?1. Yes2. No3. Don’t know9.29 During the illness that led to death, did ______________ have swellings in the groin?1. Yes2. No3. Don’t know9.30 During the illness that led to death, did _______________ have a whitish rash inside the mouth oron the tongue?1. Yes2. No3. Don’t knowSection 10: Treatment and recordsI would like to ask a few questions about any drugs _______________ may have received during the illnessthat led to death.10.1 Did _________________ receive any of the following?10.1.1 Antibiotics 1. Yes2. No268

3. Don’t know10.1.2 Chloroquine 1. Yes2. No3. Don’t know10.1.3 Aspirin 1. Yes2. No3. Don’t know10.2 Do you have any health records that belonged to ______________?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 10.5)10.2.1 (If yes ask): Can I see the health records?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 10.5)If respondent allows you to see the health records, transcribe all the entries within the 12 months before thechild died.10.3 Weights (most recent two)10.3.1 Record the dates of the most recent weight two weights1. ___/___/___ (dd/mm/yy)2. ___/___/___ (dd/mm/yy)10.3.2 Record the most recent two weights10.4 Medical notes1. kg ___._2. kg ___._10.4.1 Record the date of the last note ___/___/___ (dd/mm/yy)10.4.2 Transcribe the note _______________________________________________________10.5 Was a death certificate issued?1. Yes 2. No 3. Don’t know(If “no” or “Don’t know”, go to question 10.7)269

INSTRUCTIONS TO INTERVIEWER – Ask to see death certificate and record whether you have been ableto see it.10.5.1 Able to see death certificate?1. Yes 2. No(if “No”, go to question 10.7)10.6 Record the immediate cause of death from the certificate ________________________________10.6.1 Record the first underlying cause of death from the certificate10.6.2 Record the second underlying cause of death from the certificate10.6.3 Record the third underlying cause of death from the certificate10.6.4 Record the contributing cause (s) of death from the certificateEND OF INTERVIEWTHANK RESPONDENT (S) FOR THEIR COOPERATION270

Apendix LX: Standard Verbal Autopsy Questionnaire (Spanish)CUESTIONARIO ESTANDARIZADO PARA REALIZACIÓN DE LA AUTOPSIA VERBALInstrucciones al entrevistador: Preséntese y explique el propósito de su visita. Pregunte a la madre si puedeplaticar con ella o con la persona que se encuentre y que se haya encargado de cuidar al bebe durante laenfermedad que lo llevó a la muerte. De no ser posible, haga una cita para volver a visitar la casa cuando lamadre o la persona que cuidaba del bebé esté presente.Sección 1:Información general sobre el niño y el hogar(Esta sección debe llenarse antes de la entrevista)1.2 Dirección de la Vivienda: (Municipio##) (Comunidad###) (Número de casa###)____________________ ___________________ _____________________1.3 Nombre del niño: (Primer Nombre) (Segundo Nombre) (Primer Apellido) (Segundo Apellido)___________________ ________________ _________________ ________________1.3 Número de ID del Niño:1.4 Sexo del Niño: 1. Masculino 2. FemeninoSección 2: Información acerca de la entrevista2.3 Idioma en el que se realiza la entrevista: ________________________2.4 No. de ID del entrevistador: ______________________________Fecha de la primera cita para la entrevistadd/mm/aaFecha y hora acordados para el segundo intento deentrevistaFecha y hora acordados para el tercer intento de entrevistaFecha de la entrevistaFecha de revisión del cuestionario por el supervisorFecha de ingreso271

Sección 3: Información acerca de la persona al cuidado del niño/ entrevistado3.2 ¿Cuál es el nombre del entrevistado principal?___________________ ________________ _________________ ________________3.3 ¿Cuál es el parentesco del entrevistado con el niño fallecido? (Cheque en la casilla correspondiente)7. Madre8. Padre9. Abuela10. Abuelo11. Tía12. Tío7. Otro hombre (especifique) __________________8. Otra mujer (especifique) ____________________3.3 ¿Cuál es la edad del entrevistado principal? (en años) ___________3.4 ¿Cuántos años de escuela completó el entrevistado principal? ___________3.6 ¿Había otras personas presentes al momento de la entrevista?1. Sí 2. No(Si “No”, pase a la pregunta 3.5.3)3.5.1 De aquellos presentes durante la entrevista, ¿quienes estuvieron presentes durante laenfermedad que precedió a la muerte/hospitalización? (Cheque todas las casillas queapliquen)Presente en laEntrevistaPresente durantela enfermedad1. Madre…………………………………9. Padre…………………………………10. Abuela…………………………11. Abuelo…………….…………….12. Tía…………….……………………..13. Tío…………………………………..272

14. Otro hombre (especifique)_____________15. Otra mujer (especifique)_____________3.5.3 Número total de personas presentes en la entrevista (sin incluir al entrevistador): ______3.5.4 Si la madre no estuvo presente en la entrevista, ¿La madre aún vive?SíNoSección 4: Información acerca del niño4.1 Fecha de nacimiento del niño: ___/___/___dd mm aa4.4 ¿Cuál fue la fecha de defunción de _____________ ? ___/___/___dd mm aa4.5 ¿Dónde murió _________________ ? (Cheque la casilla que corresponda)1. Hospital6. Otro centro asistencial7. En el camino al hospital o centro asistencial8. Hogar9. Otro (especifique)_________________4.3.3 Para aquellas muertes en el hospital o Centro Asistencial, anote el nombre y dirección del mismo:______________________________________________________________________________________________________________________________________________Sección 5: Pregunta abierta acerca de la historia de la enfermedad5.1 ¿Podría contarme acerca de la enfermedad de ____________ que lo llevó a la muerte?Induzca: ¿Hubo algo más?Instrucciones para el entrevistador: permita al entrevistado que le cuente acerca de la enfermedad con suspropias palabras. No interrumpa a menos que sea para preguntar si hubo algo más después que elentrevistado termine. Siga insistiendo hasta que el entrevistado le diga que no hubo nada más. Mientrastoma nota, subraye cualquier término que no le sea familiar.273

Tome un momento para subrayar todos los términos mencionados espontáneamente en el cuestionario dehistoria abierta. Utilice esto como guía durante la realización del resto del cuestionario:5.1.1 Diarrea………………………………………………………………….…..5.1.4 Tos………………………………………………………….……………….5.1.5 Fiebre…………………………………………………………………………5.1.4 Salpullido ……………………………………………………………………5.1.6. Golpe…………………………………………………………………5.3.6 Coma…………………………………………………………………………5.3.7 Convulsion (Ataque)..……………………………….……………………….5.3.8 Rigidez de cuello………..…………………………………………………..5.3.9 Tétanos…………………………………………………………………….…5.3.10 Sarampión………………………………………………….………………...5.3.11 Kwashiorkor ………………………………………………………………..…5.3.12 Marasmo.. …………………………………….………………………………5.3.13 Dificultad para respirar………………………..……………………………..5.3.14 Respiración rápida………………………………….………..………………5.3.15 Parto complicado…………………………………….……………………….5.3.16 Malformación………………………………………….……….…….……….5.3.17 Nacimiento múltiple…………………………………….….…………..……..5.3.18 Muy pequeño al nacer………………………….………………….………….5.3.19 Muy delgado………………………………………….…………………………..5.3.20 Nació antes de tiempo (Prematuro)…….………………………………………5.3.21 Neumonía…………….…………………….………….………………………….5.3.22 Accidente……….………………………………………………….……………..274

5.3.23 Malaria…………………………………………………………………………….5.3.24 Ictericia...............………………………………………………….…..…………5.3.25 Otros términos (especifique _____________________________) ………..Nota: cuando desarrolle el cuestionario específico para el país, los términos locales usados por losentrevistados deberán ser añadidos a esta lista.5.4 ¿Por cuánto tiempo estuvo enfermo el niño antes de que muriera? _______ días(Usar un mes = 28 días para determinar el número de meses)________ meses5.5 ¿Se le dió atención (cuidado) fuera del hogar mientras estuvo enfermo?1. Sí 2. No 3. No sabe( Si “No” o “ No sabe”, vaya a la sección 6)5.3.1 (Si “sí” pregunte:) ¿Dónde o de quién buscaron atención? (registre todas las respuestas)10. Curandero…………………………..……..………….…..11. Líder religioso…………………………….…………….…12. Hospital público……………………….….……………….13. Personal de salud asociado al sistema de salud incluyendo comadronas capacitadas (guardián desalud, facilitador comunitario etc.)……..….14. Medico Privado ………………………………………….15. Farmacia, vendedor de la farmacia, de la tienda oMercado ……………………………… …………….…….16. Otro proveedor…………………………………………….17. Familiar, amigo (fuera del hogar)………..………………Después de que el entrevistado termine de responder: ¿Buscó atención en algún otro lugar?Continué utilizando esta pregunta hasta que el entrevistado responda que no buscó atención en ningún otrolugarNota: Las categorías arriba mencionadas deben ser específicas para el paísSección 6: Accidente6.1 ¿____________ murió de un golpe, accidente, envenenamiento, mordedura, quemadura o seahogó?1. Sí 2. No 3. No sabe(Si “No” o “No sabe”, vaya a la sección 7)6.1.3 (Si “sí” pregunte): ¿Qué clase de golpe o accidente? Permita al entrevistado responder a la preguntaespontáneamente. Si el entrevistado tiene dificultad identificando si fue un golpe o accidente, lea lalista despacio.1. Accidente automovilístico2. Caída275

3. Ahogamiento4. Envenenamiento5. Picaduras o Mordeduras por AnimalesVenenosos6. Quemadura7. Violencia8. Otro daño (especifique) __________________6.1.4 ¿Cuánto tiempo ______________________ sobrevivió después de la lastimadura, envenenamiento,mordedura, quemadura o ahogamiento?1. Murió en las primeras 24 horas2. Murió 1 día más tardeSección 7: Determinación de la edad y reconfirmación7.1 Registre la fecha de nacimiento de la pregunta 4.1 ___/___/___dd mm aaRegistre la fecha de defunción de la pregunta 4.2___/___/___dd mm aa7.4 Tome un momento y calcule la edad del niño al momento de su muerte.Lea en voz alta: He calculado que _______________ tenia ______ días (o meses o años de edad, comosea apropiado) al momento de su muerte. ¿Es esto correcto?Si el entrevistado indica que no es correcto, arregle la inconsistencia revisando la fecha de nacimiento ymuerte del niño. Haga los cambios necesarios tanto aquí como en la sección 4.7.5 Si no es posible arreglar la inconsistencia, pregunte:¿Qué edad tenía ____________________ al momento de su muerte?1. 28 días o más2. Menos de 28 díasSi el niño murió dentro de las primeras 24 horas consecuentes a un golpe o accidente, vaya a la sección 10-Tratamiento y registroSi el niño tenía menos de 28 días de edad, al momento de su muerte, vaya a la sección 8- MuertesneonatalesSi el niño tenia 28 días de edad o más al momento de su muerte, vaya a la sección 9- Muertes post -neonatales276

Sección 8: Muertes neonatales8.1 ¿El niño nació de un parto simple o múltiple?(Si dos o más niños nacieron al mismo tiempo, se toma como nacimiento múltiple, aun si uno o másde los bebes hayan nacido muertos)1. Simple2. Múltiple8.2 ¿El nacimiento de este niño fue antes de tiempo, a tiempo o tardío?1. Antes2. A tiempo3. Tardío4. No sabe8.24 ¿Fue la última parte del embarazo, la labor o el parto complicado?1. Sí 2. No 3. No sabe(Si “No” o “no sabe”, vaya a la pregunta 8.4)8.24.1.1 (Si “sí” pregunte): ¿Qué complicaciones ocurrieron durante la última parte del embarazo,labor o el parto? (Registre todas las respuestas)1. La madre tuvo convulsiones2. El niño sacó primero los pies3. Sangrado excesivo4. Cesárea de emergencia5. Parto múltiple6. Otro (especifique)___________________8.24.1.2 (Después de que el entrevistado termine pregunte): ¿hubo algo más? (Siga preguntandohasta que el entrevistado responda que no hubo más complicaciones.)8.25 ¿Cuántos meses duró el embarazo? ____ meses8.26 ¿La fuente se rompió antes del la labor o durante la labor?1. Antes 2. Durante 3. No se rompió nunca la fuente 4. No sabe(Si la fuente no se rompió antes, vaya a la pregunta 8.6)8.26.1 (Si la fuente se rompió antes de la labor pregunte): ¿Cuánto tiempo antes de la labor se rompió lafuente?1. Menos de un día2. Un día o más277

8.27 ¿Cuánto tiempo tomaron la labor y el parto?(Nota; la labor inicia cuando las contracciones no están separadas por mas de 10 minutos una de laotra.)1. Menos de 12 horas2. Doce horas o más8.28 ¿Habían golpes o marcas de lesiones en el cuerpo de ______________al nacer?1. Sí 2. No 3. No sabe8.29 ¿Tuvo el/ella alguna malformación al nacer?1. Sí 2. No 3. No sabe(Si “No” o “No sabe”, vaya a la pregunta 8.9)8.29.1 (si “sí” pregunte): ¿Dónde tenía las malformaciones?3. Cabeza4. Cuerpo3. Brazos/manos4. Piernas/pies8.29.2 (Después que el entrevistado termine pregunte): ¿Habían malformaciones en alguna otra parte?(siga utilizando esta pregunta hasta que el entrevistado responda que no habían malformaciones enotro lugar.)8.30 Al momento de su nacimiento _________________era:1. ¿Muy pequeño?2. ¿Más pequeño de lo usual?3. ¿Cerca del promedio?4. ¿Más grande de lo usual?8.31 ¿Fue ________________ capaz de respirar después de nacer?(Nota: esto no incluye interrupciones o muy pocos esfuerzos para respirar)1. Sí2. No3. No sabe8.32 ¿Fue ________________ capaz de mamar (o alimentarse con pacha) de una manera normaldespués del nacimiento?1. Sí2. No3. No sabe8.33 ¿_________________ dejó de ser capaz de mamar de una manera normal?1. Sí 2. No 3. No sabe278

(Si “No” o “No sabe”, vaya a la pregunta 8.13)8.33.1 (Si “sí” pregunte): ¿Cuánto tiempo antes de que ______________ muriera dejó de mamar?1. Menos de un día2. Un día o más3. No sabe8.33.2 ¿Cuánto tiempo después de que ________________ naciera dejó de mamar?1. Menos de un día2. De uno a dos días3. De tres a siete días4. De ocho a 14 días5. De quince a 30 días6. No sabe8.34 ¿_______________ pudo llorar después de que nació?1. Sí2. No3. no sabe8.35 ¿________________ dejó de ser capaz de llorar?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 8.15)8.35.1 (Si “sí” pregunte): ¿Cuánto tiempo antes de que ______________ muriera dejó de llorar?1. Menos de un día2. Un día o más8.36 ¿Durante la enfermedad que lo llevó a la muerte _________________ tuvo espasmos oconvulsiones?1. Sí2. No3. No sabe8.37 ¿Durante la enfermedad que lo llevó a la muerte, el/ella estuvo inconsciente/ no respondía aestímulos?1. Sí2. No3. No sabe8.38 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo la fontanela abombada?1. Sí279

2. No3. No sabe8.39 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo “tétanos” (utilizar palabra local)?1. Sí2. No3. No sabe8.40 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo los ojos amarillos?1. Sí2. No3. No sabe8.41 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo el ombligo enrojecido o le salía pus?1. Sí2. No3. No sabe8.42 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo áreas de la piel que estaban rojas ycalientes?1. Sí2. No3. No sabe8.43 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo salpullido en al piel con ampollas quecontenían pus?1. Sí2. No3. No sabe8.44 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo fiebre?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 8.24)8.44.1 (Si tuvo fiebre pregunte): ¿Cuántos días le duró la fiebre? __________________ días8.25. ¿Durante la enfermedad que lo llevó a la muerte, el/ella hizo frecuentemente deposiciones aguadaso líquidas?1. Sí2. No3. No sabe280

8.25 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo asientos (diarrea*)?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, en ambas preguntas 8.24 y 8.25 vaya a la pregunta8.26)*Nota: Incluya acá los términos locales para diarrea.8.25.1 (Si presentó deposiciones aguadas o liquidas o tuvo asiento/diarrea, pregunte):¿Cuántos días paso el/ella con asientos? __________ Días8.26.2 ¿Siente usted que esto representó mas deposiciones aguadas o líquidas de lo que usualmentehacia el niño?1. Sí2. No3. No sabe8.26.3 ¿Había sangre, a simple vista, en las deposiciones aguadas o líquidas?1. Sí2. No3. No sabe8.26.4 Durante el tiempo que hizo deposiciones aguadas o líquidas, ¿Tomó el niño sales de rehidrataciónoral o sueros caseros (agua de plátano o naranja con azúcar y sal)?1. Sí2. No3. No sabe8.27 ¿Durante la enfermedad que lo llevó a la muerte, ___________ tuvo tos?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 8.27)8.33.1 (Si “sí” pregunte): ¿Cuántos días le duró la tos? ____________ días8.34 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo dificultad para respirar?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 8.28)8.27.1 (Si “sí” pregunte): ¿Cuántos días paso con dificultad para respirar? ________ Días8.35 ¿Durante la enfermedad que lo llevó a la muerte, el niño tuvo respiración rápida?281

1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 8.29)8.35.1 (Si “sí” pregunte): ¿Cuántos días pasó con respiración rápida? ________ días8.36 ¿Durante la enfermedad que lo llevó a la muerte, ___________ alguna vez dejó de respirar porlargo tiempo y volvió a respirar después?1. Sí2. No3. No sabe8.37 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo retracción de la pared torácica?1. Sí2. No3. No sabe8.38 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo respiración ruidosa? (Demuestre cadasonido)8.31.1 Estridor 1. Sí2. No3. No sabe8.31.2 Ronquido 1. Sí2. No3. No sabe8.31.3 Sibilancia 1. Sí(Silbido en el pescuezo) 2. No3. No sabe8.39 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo aleteo nasal al respirar?1. Sí2. No3. No sabe8.40 ¿Durante la enfermedad que lo llevó a la muerte, _________________ tuvo neumonía (usartérminos locales)?1. Sí2. No3. No sabe282

Nota: Cuando prepare el cuestionario específico para el país, incluya el término local paraneumonía.PASAR A LA SECCION 10Sección 9: Muertes Post-neonatales9.1 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo fiebre?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.2)9.2.1 (Si tuvo fiebre pregunte): ¿Cuántos días le duró la fiebre? __________________ días9.3 ¿Durante la enfermedad que lo llevó a la muerte, ________, tuvo frecuentemente deposicionesaguadas o líquidas?1. Sí2. No3. No sabe9.3 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo asientos/ diarrea?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, en ambas preguntas 9.2 y 9.3 vaya a la pregunta 9.4)9.3.1 Si presentó deposiciones aguadas o líquidas o tuvo asientos/diarrea, pregunte):¿Cuántos días paso el/ella pasó con asientos?________ díasNota: Incluya acá los términos locales para diarrea.9.3.2 ¿Había sangre, a simple vista, en las deposiciones aguadas o líquidas?1. Sí2. No3. No sabe9.3.3 Durante el tiempo que hizo las deposiciones aguadas o líquidas, ¿Tomó el niño sales derehidratación oral o sueros caseros (agua de plátano o jugo de naranja con azúcar y sal)?1. Sí2. No3. No sabe9.4 ¿Durante la enfermedad que lo llevó a la muerte, ___________ tuvo tos?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.5)283

9.4.1 (Si “sí” pregunte): ¿Cuántos días le duró la tos? ____________ Días9.4.3 ¿La tos fue muy severa?1. Sí2. No3. No sabe9.5 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo dificultad para respirar?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.6)9.5.1 (Si “sí” pregunte): ¿Cuántos días pasó con dificultad para respirar?________ días9.6 ¿Durante la enfermedad que lo llevó a la muerte, el niño tuvo respiración rápida?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.7)9.6.1 (Si “sí” pregunte): ¿Cuántos días pasó con respiración rápida? ________ Días9.7 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo retracción de la pared torácica?1. Sí2. No3. No sabe9.8 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo respiración ruidosa? (Demuestre cadasonido)9.8.1 Estridor 1. Sí2. No3. No sabe9.8.2 Ronquido 1. Sí2. No3. No sabe9.8.3 Sibilancia 1. Sí2. No3. No sabe9.9 ¿Durante la enfermedad que lo llevó a la muerte, el/ella tuvo aleteo nasal al respirar?284

1. Sí2. No3. No sabe9.10 ¿Durante la enfermedad que lo llevó a la muerte, _________________ tuvo neumonía (usartérminos locales)?1. Sí2. No3. No sabeNota: Cuando prepare el cuestionario específico para el país, incluya el término local paraneumonía.9.11 __________ experimentó alguna convulsión generalizada/ataque durante la enfermedad que lollevó a la muerte?1. Sí2. No3. No sabe9.12 ______________ estuvo inconsciente durante la enfermedad que lo llevó a la muerte?1. Sí2. No3. No sabe9.13 En algún momento durante la enfermedad que llevó a la muerte a ______________ perdió sucapacidad de agarre?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.14)9.13.1 (Si “sí” pregunte): ¿Cuánto tiempo antes de que el/ella muriera perdió su capacidad de agarre?1. menos de 12 horas2. 12 horas o más9.14 ¿En algún momento durante la enfermedad que llevó a la muerte a ______________ dejo de sercapaz de responder al hablarle?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.15)9.14.1 (Si “sí” pregunte): ¿Cuánto tiempo antes de que el/ella muriera dejó de ser capaz de responder alhablarle?1. menos de 12 horas2. 12 horas o más285

9.15 ¿En algún momento durante la enfermedad que llevó a la muerte, el niño dejó de ser capaz de seguirmovimientos con sus ojos?1. Sí 2. No 3. No sabeSi “no” o “No sabe”, vaya a la pregunta 9.15)9.15.1 (Si “si” pregunte): ¿Cuánto tiempo antes de que el/ella muriera dejó de ser capaz de seguirmovimientos con sus ojos?1. menos de 12 horas2. 12 horas o más9.16 ¿ ________________ tuvo rigidez de cuello durante la enfermedad que lo llevó a la muerte? (Demostrar)1. Sí2. No3. No sabe9.17 ¿_____________ tuvo la fontanela abombada durante la enfermedad que lo llevó a la muerte?1. Sí2. No3. No sabe9.18 ¿Durante el mes anterior a su muerte ___________ tuvo salpullido en la piel?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.19)9.18.1 (Si “sí” pregunte) El salpullido lo tuvo _____________en todo su cuerpo?1. Sí2. No3. No sabe9.18.2 ¿El salpullido lo tuvo __________________también en la cara?9.18.3 ¿Cuántos días le duró el salpullido? ________________ días286

9.18.4 ¿El salpullido se presentó con ampollas las cuales tenían agua adentro?1. Sí2. No3. No sabe9.18.5 ¿La piel se agrieto /partió o peló después de que apareciera el salpullido?1. Sí2. No3. No sabe9.18.6 ¿Esta enfermedad era “sarampión”?1. Sí2. No3. No sabe9.19 ¿Durante la enfermedad que lo llevó a la muerte, _________________ se puso muy delgadito?1. Sí2. No3. No sabe9.20 ¿Durante la enfermedad que lo llevó a la muerte, _________________ se le hincharon las piernas olos pies?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 9.21)9.20.1 (Si “sí” pregunte): ¿Cuánto duró la hinchazón? Número de semanas ______9.21 ¿Durante la enfermedad que lo llevó a la muerte, la piel de _________________se peló en parches?1. Sí2. No3. No sabe9.22 ¿El pelo de ____________________ cambió de color a rojizo (o amarillento)?1. Sí2. No3. No sabe287

9.23 ¿ ___________________ tuvo “kwashiorkor” durante el mes antes de su muerte?1. Sí2. No3. No sabe9.24 ¿__________________ tuvo “marasmo” durante el mes antes de su muerte?1. Sí2. No3. No sabe9.25 ¿Durante la enfermedad que lo llevó a la muerte, _____________ sufrió de “falta de sangre (anemia)”o “palidez”?1. Sí2. No3. No sabe9.26 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo palidez palmar? (Muestreuna foto de ser posible)1. Sí2. No3. No sabe9.27 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo las uñas blancas? (Muestreuna foto de ser posible)1. Sí2. No3. No sabe9.31 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo bolas o hinchazón en susaxilas?1. Sí2. No3. No sabe9.32 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo bolas o hinchazón en laparte de la entrepierna (ingle)?1. Sí2. No3. No sabe9.33 ¿Durante la enfermedad que lo llevó a la muerte, _____________ tuvo una erupción blanquecinadentro de la boca o en la lengua?1. Sí2. No3. No sabe288

Sección 10: Tratamiento y RegistrosMe gustaría hacerle unas preguntas acerca de cualquier medicamento que _______________ haya podidohaber recibido durante la enfermedad que lo llevó a la muerte.10.4 ¿ _________________ recibió alguno de los siguientes medicamentos?10.1.1 Antibióticos 1. Sí2. No3. No sabe10.1.2 Cloroquina 1. Sí2. No3. No sabe10.1.3 Aspirina 1. Sí2. No3. No sabe10.5 ¿Tiene usted registros médicos (tarjeta de salud) que pertenezcan a ______________?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 10.5)10.2.1 (Si “sí” pregunte): ¿Podría ver esos registros médicos?1. Sí 2. No 3. No sabe(Si “no” o “no sabe”, vaya a la pregunta 10.5)Si el entrevistado le permite a usted ver los registros médicos, copie todo lo relacionado a los 12 mesesprevios a la muerte del niño.10.6 Pesos (los dos más recientes)10.3.1Registre las fechas en las que se tomaron los pesos más recientes del niño1. _____/___/___ (dd/mm/aa)2. ____/___/____ (dd/mm/aa)10.3.3 Registre los dos pesos más recientes3. kg ___._4. kg ___._10.4 Notas Médicas10.4.3 Registre la fecha de la última nota médica ___/___/___ (dd/mm/aa)10.4.4 Transcriba la nota médica289

10.5 ¿Se hizo certificado de defunción?1. Sí 2. No 3. No sabe(Si “no” o “No sabe”, vaya a la pregunta 10.7)INSTRUCTIONES PARA EL ENTREVISTADOR – Pregunte si puede ver el certificado de defunción yregistre si usted pudo verlo.10.5.2 ¿Pudo ver el certificado de defunción?1. Sí 2. No(Si “No”, vaya a la pregunta 10.7)10.6 Registre la causa inmediata de defunción reportada en el certificado__________________________10.6.5 Registre la primera causa de muerte reportada en el certificado10.6.6 Registre la segunda causa de muerte reportada en el certificado10.6.7 Registre la tercera causa de muerte reportada en el certificado10.6.8 Registre las causas que contribuyeron a la muerte reportadas en el certificadoFIN DE LA ENBTREVISTAAGRADEZCA AL ENTREVISTADO (S) POR SU COOPERACION290

Appendix LXI: ARI Child Death Report Form (English only)Patient ID:Date of this reportPatient BackgroundDate of Birth: Date of death: Sex:EventMedical NotesDate of the last noteTranscription of the note:1.Death certificate issued: YesNoRecord of the immediate cause of death from the certificate:Record the first underlying cause of death from the certificate: __________________________Record the contributing cause (s) of death from the certificate: __________________________If there is not a death certificate then write:Possible cause of death reported by the mother or the caretaker:Place where the child died:HospitalOther health facilityOn route to the hospital or health facilityHome291

Appendix LXII: Form for Households that Drop Out of Study (English)Form for Households that Drop Out of StudyParticulate Air Pollution Exposure and Childhood Acute Respiratory Infections in GuatemalanChildren: A Randomized Intervention TrialMunicipality_____ _____Community (###)____ ____ ____Household (###)____ ____ ____Date of Interview (dd/mm/yy):_____/______/______Date left study (dd/mm/yy):_____/______/______1. REASONS WHY THE HOUSEHOLD CHOSE TO STOP PARTICIPATING IN THE STUDY: (Check allboxes that apply):1 Too invasive2 Time consuming3 Don’t see any benefit4 Don’t want to wait for plancha stove5 Dislike study methods6 Dislike study personnel7 Plan to migrate (permanent)8 Other (specify) ___________________________________________2. INTERVIEWER COMMENTS:_________________________________________________________________________________292

Appendix LXIII: Form for Households that Drop Out of Study (Spanish)Formulario ParaCasas que se retiran del estudioExposición a Partículas Contaminantes en el Aire e Infecciones RespiratoriasAgudas en Niños en Guatemala: Un estudio de intervención aleatorio.Municipio (##)_____ _____Comunidad (###)____ ____ ____Vivienda (###)____ ____ ____Fecha de entrevista (dd/mm/aa):_____/______/______Fecha que salió del estudio (dd/mm/aa):_____/______/______1. RAZONES POR LAS QUE DEJA DE PARTICIPAR EN EL ESTUDIO: (Cheque tantascasillas como apliquen):1 Muy invasivo2 Consume mucho tiempo3 No ve el beneficio4 No desea esperar por la plancha5 No le gusta la metodología6 No le agrada el personal7 Planea mudarse permanentemente a otro lugar8 Otro (especifique) ___________________________________________2. COMENTARIOS DEL ENTREVISTADOR:____________________________________________________________________________293

Appendix LXIV: Heart Rate Variability Study: Baseline Questionnaire(English)INDOOR AIR POLLUTION FROM COOKING FIRES AND CARDIOVASCULAR HEALTH INGUATEMALABASELINE HEALTH STATUS QUESTIONNAIRENOTE TO HSPH IRB: This questionnaire will be administered orally by trained field staff only.A. INTRODUCTION AND CONSENT:B.Question Answer CodeA1 Group GROUP AGROUP BA2 ID (home)A3A4ID (participant)ID InterviewerA5 Date dd /mm /yyA6 Consent No = 0Yes = 1A7 ASK: When were you born? dd / mm / yyCHRONIC RESPIRATORY SYMPTOMSB. COUGH:Question Answer CodeB1 Do you cough or have you coughed a lot?If “NO”, go to section C (Phlegm)No = 1Yes = 2B2Do you cough or have you coughed when getting up in themorning?No = 1Yes = 2B3IF, Yes: Since how long ago have you been coughingwhen getting in the morning?B8 Do you cough or have you coughed during the night? No = 1Yes = 2B9 If, Yes: Since how long ago have you been coughingduring the night?Less than 3 months =1Around 3 months = 2More than threemonths = 3Less than 3 months =1Around 3 months = 2More than threemonths = 3294

C. PHLEGM:Question Answer CodeC1 Do you produce or have you produced a lot of phlegm? No = 1Yes = 2→ If “NO” go to section D (Periods of Cough withPhlegm)C2 Do you produce or have you produced phlegm whengetting up in the morning?No = 1Yes = 2C3C8If, Yes: Since how long ago have you been producingphlegm when getting up in the morning?Do you produce or have you produced phlegm during thenight?Less than 3 months =1Around 3 months = 2More than threemonths = 3No = 1Yes = 2C9If, Yes: Since how long ago have you been producingphlegm during the night?Less than 3 months =1Around 3 months = 2More than threemonths = 3E. CARDIOVASCULAR HEALTH:Question Answer CodeE1 1. Do you get shortness of breath when walking quicklyor up a hill?No = 1Yes = 2F. SMOKING:Question Answer CodeF1 Have you ever smoked cigarettes? No = 1 (GO TO F6)Yes = 2F2 How old were you when you started smoking? # yearsF3 Do you smoke cigarettes now? No = 1Yes = 2 (GO TOF5)F4 How many years ago did you stop smoking? # yearsF5 How many cigarettes per day do/did you usually smoke? # cigs / dayF6How many cigarettes per day are usually smoked in yourhome by others?# cigs / dayG. TYPICAL EXPOSURES:Question Answer CodeG1 How many times per month do you usuallyenter the “temascal” (steam sauna) after a firehas been lit inside?# times / month295

G2 Where do you usually sleep? Kitchen = 1Bedroom connected to kitchen=2Bedroom separate fromkitchen = 3Other = 4G3G4G5How many meals per day do you usuallycook?How often do you burn a kerosene candlenear you at night?Where are you usually found when thecooking fire is lit in your kitchen?Less than once per day = 1One meal per day = 2Two meals per day = 3Three or more meals per day= 4Never = 1Less than once per week = 2One to two times per week = 3Three to four times per week =4Five or more times per week =5In the kitchen, cooking = 1In the kitchen, not cooking = 2In a room connected to thekitchen = 3In a room not connected tokitchen = 4Outside near home = 5Outside away from home = 6OBSERVATIONS:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________THANK PARTICIPANT FOR INFORMATION – END OF INTERVIEWForm RevisionSignature Supervisor:_____________________Date: _________________Data EntrySignature Data Enterer # 1: ________________ Signature Data Enterer # 2: ________________Revision of Data EntrySupervisor Signature: _____________________ Date: __________________296

Appendix LXV: Heart Rate Variability Study: Baseline Questionnaire(Spanish)CONTAMINACION DEL AIRE EN COCINAS Y SALUD CARDIOVASCULAR EN GUATEMALALINEA BASAL DEL ESTADO DE SALUD Y EXPOSICIONNOTE TO HSPH IRB: This questionnaire will be administered orally by trained field staff only.A. INTRODUCCION Y CONSENTIMIENTO:Pregunta Opciones AnswerA1 Grupo GRUPO AGRUPO BA2 ID (casa)A3A4ID (participante)ID de EntrevistadorA5 Fecha dd /mm / aaA6 Consentimiento No = 0Sí = 1A7 PREGUNTE: ¿Cuándo nació? dd / mm / aaSINTOMAS CRONICAS RESPIRATORIASB. TOS: (SJO’L)Pregunta Opciones AnswerB1 ¿Ud. Tose o ha tosido mucho?No = 1Sí = 2Si “NO”, pase a la sección C (Flema)B2 ¿Ud. Tose o ha tosido al levantarse por las mañanas? No = 1B3Si, SI: ¿Desde hace cuánto tiempo ha estado tosiendo allevantarse por las mañanas?B8 ¿Ud. Tose o ha tosido durante la noche? No = 1Sí = 2Sí = 2Menos de 3 meses = 1Alrededor de 3 meses= 2Más de 3 meses = 3B9Si, SI: ¿Desde hace cuánto tiempo ha estado tosiendodurante la noche?Menos de 3 meses = 1Alrededor de 3 meses= 2Más de 3 meses = 3297

C. FLEMA:Pregunta Opciones AnswerC1 ¿Ud. saca flema o ha sacado flemas mucho?No = 1Sí = 2→ Si “NO” pasar a la sección D (Periodos de Tos conFlema)C2 ¿Ud. saca o ha sacado flemas al levantarse por lasmañanas?No = 1Sí = 2C3Si, SI: ¿Desde hace cuánto tiempo lleva sacando flemasal levantarse por las mañanas?C8 ¿Ud. saca o ha sacado flemas durante la noche? No = 1Sí = 2C9 Si, SI: ¿Desde hace cuánto tiempo lleva sacando flemasdurante la noche?Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3Menos de 3 meses =1Alrededor de 3meses = 2Más de 3 meses = 3E. SALUD CARDIOVASCULAR:Pregunta Opciones AnswerE1 1. ¿Tiene dificultad para respirar cuando caminandorapido o subiendo una cuesta?No = 1Sí = 2F. SMOKING:Pregunta Opciones AnswerF1 ¿Has fumado cigarillos? No = 1 (PASE A F6)Sí = 2F2 ¿Cuántos años tenía cuando empezó a fumar cigarillos? # añosF3 ¿Ud. fuma cigarillos ahora? No = 1Sí = 2 (PASE A F5)F4 ¿Desde hace cuántos años dejó de fumar? # añosF5 ¿Cuántos cigarillos por día fuma/fumó normalmente? # cigs / díaF6¿Cuántos cigarillos por día normalmente se fuman en sucasa por otras personas?# cigs / díaG. EXPOSICIONES TIPICOS:Pregunta Opciones AnswerG1 ¿Normalmente, cuántas veces al mes Ud.entra en el temascal duespués de haberencendido un fuego adentro?# veces al mes298

G2 ¿Dónde duerme normalmente? Cocina = 1Cuarto conectado a la cocina=2Cuarto aparte de la cocina = 3Otro = 4G3G4G5¿Cuátas comidas al día normalmenete cocinaUd.?¿Qué tan frecuente se enciende un candíl degas cerca de tí en la noche?¿Dónde se encuentra Ud. nomalmentecuándo el fuego está encendido en sucocina?Menos de una comida al día =1Una comida al día = 2Dos comidas al día = 3Tres o más comidas al día = 4Nunca = 1Menos de una vez a lasemana = 21 - 2 veces a la semana = 33 – 4 veces a la semana = 45+ veces a la semana = 5En la cocina, cocinando = 1En la cocina, no cocinando = 2En un cuarto conectado a lacocina = 3En un cuarto no conectado ala cocina = 4Afuera cerca a la casa = 5Afuera lejos de la casa = 6OBSERVATIONS:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________AGRAECER AL PARTICIPANTE POR LA INFORMACION - FIN DE LA ENTREVISTARevisión del FormularioFirma Supervisor:______________________Ingreso de datosFirma Digitador # 1: _________________Fecha: __________________Firma Digitador # 2: _________________Revisión del ingreso de datosFirma del supervisor:_____________________ Fecha de la revisión: _________________299

Appendix LXVI: Heart Rate Variability Study: Follow-up Questionnaire(English)INDOOR AIR POLLUTION FROM COOKING FIRES ANDCARDIOVASCULAR HEALTH IN GUATEMALAHEALTH MEASURES AND RECENT EXPOSURES QUESTIONNAIRENOTE TO HSPH IRB: This questionnaire will be administered orally by trained field staff only. Allof the questions that will be asked to the participants are preceded by the word, “ASK.”QUESTIONS AND OBSERVATIONS DURING EQUIPMENT SETUP (DAY 1)A. INTRODUCTION:A1 Group GROUP AGROUP BA2 ID (home)A3A4ID (participant)ID InterviewerA5 Date dd /mm /yyA6 Time field worker arrived at home hh : mmB. BREATH CARBON MONOXIDE (CO)B1.1B1.2ASK: Do you cook daily?ASK: When did you last finish cooking?No = 1 (GO TO B2)Yes = 2Date (dd/mm/yy)Time (hh:mm)B2.1B2.2ASK: Do you smoke?ASK: When did you last smoke?No = 1 (GO TO QUESTION B3)Yes = 2Date (dd/mm/yy)Time (hh:mm)B3. Breath CO Monitor ID (# # #)B4. Time of Start of Measurements (hh : mm)B5.1 Measure 1 (ppm) (# # #)B5.2 Measure 2 (ppm) (# # #)B5.3 Measure 3 (ppm) (# # #)300

C1. SPIROMETRY:C1.1 Operator IDC1.2 Spirometer IDC1.4 Height of participant cmC1.5 Weight of participant kgC1.7 Time spirometry performedhh : mmC1.8 Supervisor present No = 1Yes = 2C2. RECENT COLD WITH COUGH:C2.1 ASK: Have you had a cold with cough in recentdays?No = 1Yes, during the past two weeks = 2Yes, for more than two weeks = 3C3. SPIROMETRY RESULTS:(With a maximum of 8 blows)Blow #1Good blow = 1Slow start = 2Little force = 3Abrupt ending = 4Cough = 5Bad technique = 6Short blow = 7Operator MicroloopAparatusFEV1Result Best = 12 nd best = 2FVCResult Best = 12 nd best = 22345678Calculate ONLY using the valuesof he good blows the differencebetween the first and secondbest LITERS LITERS301

C4. SPIROMETRY QUALITY CONTROL:C4.1 At least three good blows No = 1Yes = 2C4.2 FEV1: Is the difference between the best and second bestless than 0.20 liters?No = 1Yes = 2C4.3 FVC: Is the difference between the best and second bestless than 0.20 liters?No = 1Yes = 2C4.4 If it is not possible to achieve a good blow describe the reason?D. HEART RATE VARIABILITY MONITORING:D1 Holter IDD2 Start time of Holter recording hh : mmD3 Time of first positional checks hh : mmD4 Start time of first rest period hh : mmE. PULSE OXIMETRY AND BLOOD PRESSURE (After 20 minutes of rest):E1 Time hh : mmE2 Pulse Oximeter IDE3 % O 2 Saturation %E4 Pulse Rate # BPME5 Blood Pressure Monitor IDE6 Systolic Blood Pressure mm HgE7 Diastolic Blood Pressure mm HgOBSERVATIONS (Include initial and date):___________________________________________________________________________________________________________________________________________________________302

QUESTIONS AND OBSERVATIONS WHILE COLLECTING EQUIPMENT (DAY 2)G. INTRODUCTION:G1 Group GROUP AGROUP BG2 ID (home)G3ID (participant)G1.4 ID InterviewerG1.5 Date dd /mm /yyG1.6 Time field worker arrived at home hh : mmH. AIR POLLUTION MONITORS:H7. OBSERVE: Where any of the monitorsmoved from the location they wereoriginally placed?H8. OBSERVE: Do the monitors seem to befunctioning correctly?H9. ASK: Were the tubes, Hobo CO ormini-pumps on the participanttaken off since they were placedyesterday?No = 1Yes = 2 (NOTE IN OBSERVATIONS)No = 1 (NOTE IN OBSERVATIONS)Yes = 2No = 1 (GO TO QUESTION E)Yes = 2 (FILL TABLE BELOW)MONITORS THAT THE PARTICIPANTS REMOVED:H9.1 Monitor ID F9.2 ASK: Why? F9.3 ASK:Where did they leave it?Kitchen = 1Main house = 2Outside = 3Other = 4 (specify)H9.4 ASK:Which day?(dd/mm/yy)H9.5 ASK:What time?(hh:mm)H9.1.1 H9.2.1 H9.3.1 H9.4.1 H9.5.1 H9.6.1H9.6 ASK:¿How long?(hours)H9.1.2 H9.2.2 H9.3.2 H9.4.2 H9.5.2 H9.6.2H9.1.3 H9.2.3 H9.3.3 H9.4.3 H9.5.3 H9.6.3H9.1.4 H9.2.4 H9.3.4 H9.4.4 H9.5.4 H9.6.4I. BREATH CARBON MONOXIDE.I1.2 If answered “Yes” to B1.1ASK: When did you last finish cooking?Date (dd/mm/yy)303

Time (hh:mm)I2.1 If answered “Yes” to B2,ASK: When did you last smoke?Date (dd/mm/yy)Time (hh:mm)I3. Breath CO Monitor ID (# # #)I4. Time of Start of Measurements (hh : mm)I5.1 Measure 1 (ppm) (# # #)I5.2 Measure 2 (ppm) (# # #)I5.3 Measure 3 (ppm) (# # #)J. QUESTIONS J1 TO J6 REFER TO THE TIME SINCE THE MONITORS WERE PLACED YESTERDAY.J1.J1.2.1ASK: Since the monitors were placed yesterday,was the temascal used?ASK: When was the temascal used?No = 1 (GO TO QUESTION I2)Yes = 2Date (dd/mm/yy)Time (hh:mm)J2. ASK: Since the monitors were placed yesterday,was trash burned near (

J4.3.1 ASK: How long? #. # (hours)J4.1.2J4.3.2If more than one location reported, ASK:Where?If more than one location reported, ASK:How long?Kitchen = 1Bedroom = 2Outside = 3Other = 4 (Specify)#. # (hours)J5. ASK: Since the monitors were placed yesterday,were you near a fire in another house?No = 1 (GO TO QUESTION I6)Yes = 2J5.2 ASK: How long? #. # (hours)J5.3 ASK: What type of stove does the otherhouse have?J6. ASK: Since the monitors were placed yesterday,have there been any special activities in thehouse (parties, meals that were not cookedbecause the family went away, etc)?J6.1ASK: When?Open fire = 1Plancha = 2Other = 3 (Specify___________)No = 1 (END OF INTERVIEW)Yes = 2Date (dd/mm/yy)Time (hh:mm)J6.2 Describe activity:L. HEART RATE VARIABILITY MONITORING:L1 Holter IDL2 Start time of second rest period hh : mmL3 End time of Holter recording hh : mmM. PULSE OXIMETRY AND BLOOD PRESSURE (After 20 minutes of rest):M1 Time hh : mmM2 Pulse Oximeter IDM3 % O 2 Saturation %M4 Pulse Rate # BPMM5 Blood Pressure Monitor IDM6 Systolic Blood Pressure mm Hg305

M. PULSE OXIMETRY AND BLOOD PRESSURE (After 20 minutes of rest):M7 Diastolic Blood Pressure Mm HgOBSERVATIONS (Include initials and date): _____________________________________________________________________________________________________________________________________________________________________________________________________________________THANK PARTICIPANT FOR INFORMATION – END OF INTERVIEWForm RevisionSignature Supervisor:_____________________Date: _________________Data EntrySignature Data Enterer # 1: ________________ Signature Data Enterer # 2: ________________Revision of Data EntrySupervisor Signature:_____________________ Date: _________________306

Appendix LXVII: Heart Rate Variability Study: Follow-up Questionnaire(Spanish)CONTAMINACION DEL AIRE EN COCINAS Y SALUD CARDIOVASCULAR ENGUATEMALAMEDICIONES DE LA SALUD Y EXPOSICION RECIENTENOTE TO HSPH IRB: This questionnaire will be administered orally by trained field staff only. Allof the questions that will be asked to the participants are preceded by the word, “PREGUNTE” andhave been translated to Spanish.QUESTIONS AND OBSERVATIONS DURING EQUIPMENT SETUP (DAY 1)A. INTRODUCTION:A1 Group GROUP A (00-12)GROUP B (00-18)A2 ID (home)A3A4ID (participant)ID InterviewerA5 Date dd /mm /yyA6 Time field worker arrived at home hh : mmB. BREATH CARBON MONOXIDE (CO)B1.1 PREGUNTE: ¿Ud. cocina diariamente? No = 1 (GO TO B2)B1.2 PREGUNTE:¿Hace cuánto tiempo terminó de cocinarla última vez?Sí = 2Fecha (dd/mm/aa)Hora (hh:mm)B2.1B2.2PREGUNTE: ¿Ud, fuma?PREGUNTE: ¿Cuándo fumó la ultima vez?No = 1(GO TO QUESTION B3)Sí = 2Fecha (dd/mm/aa)Hora (hh:mm)B3. Breath CO Monitor ID (# # #)B4. Time of Start of Measurements (hh : mm)B5.1 Measure 1 (ppm) (# # #)B5.2 Measure 2 (ppm) (# # #)B5.3 Measure 3 (ppm) (# # #)307

C1. SPIROMETRY:C1.1 Operator IDC1.2 Spirometer IDC1.4 Height of participant cmC1.5 Weight of participant kgC1.7 Time spirometry performedhh mmC1.8 Supervisor present No = 1Sí = 2C2. RECENT COLD WITH COUGH:C2.1 PREGUNTE: ¿En los últimos días ha tenidocatarro con tos?No = 1Sí, durante las ultimas dossemanas = 2Sí, por más dos semanas = 3C3. SPIROMETRY RESULTS:(With a maximum of 8 blows)Blow #1Good blow = 1Slow start = 2Little force = 3Abrupt ending = 4Cough = 5Bad technique = 6Short blow = 7Operator MicroloopAparatusFEV1Result Best = 12 nd best = 2FVCResult Best = 12 nd best = 22345678Calculate ONLY using the valuesof he good blows the differencebetween the first and secondbest LITERS LITERS308

C4. SPIROMETRY QUALITY CONTROL:C4.1 At least three good blows No = 1Yes = 2C4.2 FEV1: Is the difference between the best and second bestless than 0.20 liters?No = 1Yes = 2C4.3 FVC: Is the difference between the best and second bestless than 0.20 liters?No = 1Yes = 2C4.4 If it is not possible to achieve a good blow describe the reason?D. HEART RATE VARIABILITY MONITORING:D1 Holter IDD2 Start time of Holter recording hh : mmD3 Time of first positional checks hh : mmD4 Start time of first rest period hh : mmE. PULSE OXIMETRY AND BLOOD PRESSURE (After 20 minutes of rest):E1 Time hh : mmE2 Pulse Oximeter IDE3 % O 2 Saturation %E4 Pulse Rate # BPME5 Blood Pressure Monitor IDE6 Systolic Blood Pressure mm HgE7 Diastolic Blood Pressure mm HgOBSERVATIONS (Include initial and date):___________________________________________________________________________________________________________________________________________________________309

QUESTIONS AND OBSERVATIONS WHILE COLLECTING EQUIPMENT (DAY 2)G. INTRODUCTION:G1 Group GROUP AGROUP BG2 ID (home)G3ID (participant)G1.4 ID InterviewerG1.5 Date dd /mm /yyG1.6 Time field worker arrived at home hh : mmH. AIR POLLUTION MONITORS:H7. ¿Algún equipo fue cambiado del lugardonde se puso originalmente?H8. ¿Cree usted que está funcionado elequipo?H9. PREGUNTE: ¿Se quitaron los tubos,el Hobo o la Mini-Bomba del bebé ola madre durante el tiempo desde quese colocaron los equipos el día deayer?No = 1Sí = 2 (ANOTAR EN OBSERVACIONES)No = 1 (ANOTAR EN OBSERVACIONES)Sí = 2No = 1 (PASE A LA PREGUNTA E)Sí = 2 (LLENE EL CUADRO ABAJO)EQUIPOS QUE LAS PERSONAS QUITARON:H9.1 ID del Equipo H9.2 PREGUNTE:¿Por cuál razón?H9.3 PREGUNTE:¿Dónde lo dejaron?Cocina = 1Casa principal = 2Afuera = 3Otro = 4 (especificar)H9.4PREGUNTE:¿Qué día?(dd/mm/aa)H9.5PREGUNTE:¿A qué hora?(hh:mm)H9.1.1 H9.2.1 H9.3.1 H9.4.1 H9.5.1 H9.6.1H9.6PREGUNTE:¿Cuánto tiempo?H9.1.2 H9.2.2 H9.3.2 H9.4.2 H9.5.2 H9.6.2H9.1.3 H9.2.3 H9.3.3 H9.4.3 H9.5.3 H9.6.3H9.1.4 H9.2.4 H9.3.4 H9.4.4 H9.5.4 H9.6.4310

I. MONOXIDO DE CARBONO EN EL ALIENTO.I1. Si contestó “Sí” al B1.1,PREGUNTE:¿Hace cuánto tiempo terminó de cocinarla última vez?Fecha(dd/mm/aa)Hora (hh:mm)I2.1 Si contestó “Sí” a B2,PREGUNTE:¿Hace cuánto tiempo terminó de fumarFecha(dd/mm/aa)Hora (hh:mm)por última vez?I3. ID del monitor del CO en el aliento (# # #)I4. 1 Hora de Empezar Medidas (hh : mm)I5.1 Medida 1 (ppm) (# # #)I5.2 Medida 2 (ppm) (# # #)I5.3 Medida 3 (ppm) (# # #)J. LAS PREGUNTAS J1 HASTA J6 SE REFIEREN AL TIEMPO DESDE QUE SE COLOCARON LOSEQUIPOS EL DIA DE AYER,J1. PREGUNTE:¿Desde que se colocaron losequipos el día de ayer, usó el temascal?J1.2.1PREGUNTE:¿Cuándo usó el temascal?No = 1(PASE A LA PREGUNTA I2)Sí = 2Fecha (dd/mm/aa)Hora (hh:mm)J2.J3.J3.2.1J3.4.1J3.2.2J3.4.2PREGUNTE:¿Desde que se colocaron los equipos el díadeayer, se quemó basura cerca (

J4.J4.1.1J4.3.1J4.1.2J4.3.2PREGUNTE:¿ Desde que se colocaron los equipos el díade ayer, usó el candil (lámpara dekerosina con mecha) cerca de Usted?PREGUNTE:¿Dónde?PREGUNTE:¿Cuánto tiempo?Si se reporta más de un lugar, PREGUNTE:¿Dónde?Si se reporta más de un lugar, PREGUNTE:¿Cuánto tiempo?No = 1 (PASE A LA PREGUNTA I5)Sí = 2 (LLENAR CUADRO ABAJO)Cocina = 1Cuarto = 2Afuera = 3Otro = 4 (Especificar)#. # (horas)Cocina = 1Cuarto = 2Afuera = 3Otro = 4 (Especificar)#. # (horas)PREGUNTE:J5. ¿ Desde que se colocaron los equiposel día de ayer, estuvo Ud.cerca a un fuego en otra casa?J5.2 PREGUNTE:¿Por cuánto tiempo?J5.3 PREGUNTE:¿Qué tipo de estufa tiene la otra casa?J6. PREGUNTE:¿Desde que se colocaron los equipos el díade ayer, ha habido actividades especiales enla casa (fiestas, tiempos de comida en los queno se cocinó porque la familia salió, etc.)?J6.1 PREGUNTE:¿Cuándo?No = 1 (PASE A LA PREGUNTA I6)Sí = 2#. # (horas)Fuego Abierto = 1Plancha = 2Otro = 3 (Especifique ____________)No = 1 (FINALICE LA ENCUESTA)Sí = 2Fecha (dd/mm/aa)Hora (hh:mm)J6.2 Describir la actividad:L. HEART RATE VARIABILITY MONITORING:L1 Holter IDL2 Start time of second rest period hh : mmL3 End time of Holter recording hh : mm312

M. PULSE OXIMETRY AND BLOOD PRESSURE (After 20 minutes of rest):M1 Time hh : mmM2 Pulse Oximeter IDM3 % O 2 Saturation %M4 Pulse Rate # BPMM5 Blood Pressure Monitor IDM6 Systolic Blood Pressure mm HgM7 Diastolic Blood Pressure mm HgOBSERVATIONS (Include initials and date): _____________________________________________________________________________________________________________________________________________________________________________________________________________________THANK PARTICIPANT FOR INFORMATION – END OF INTERVIEWForm RevisionSignature Supervisor:_____________________Date: _________________Data EntrySignature Data Enterer # 1: ________________ Signature Data Enterer # 2: ________________Revision of Data EntrySupervisor Signature:_____________________ Date: _________________313

Appendix LXVIII: Health Surveillance Flow ChartASSESSMENT ACTION FOR CHILD OUTCOMEMEASUREWEEKLY HOME VISIT BYTRAINED FIELD WORKERApply IMCI algorithm and classify child:OUTCOMEASSESSMENT #11. Well2. Minor or mild illness, treat at home3. Illness meeting criteria for referralfor medical opinion, treatment(includes): ALRI (fast breathing, chestindrawing, etc Diarrhoea with dehydration Severe infection Danger signs Severe burns, scalds Other requiring referralChild well, no otheractionMinor illness, treatat home: AURI Minor burns,scalds Mild diarrhoea notdehydrated Other minorFieldworkerclassification by IMCIcriteriaASSESSMENT IN HOME BY STUDYDOCTOR1. Apply IMCI algorithm and classify Treat at home Refer to hospital2. Additional medical assessment(auscultation, auroscopy, etc) Wheezing Pneumonia Otitis media Other3. RSV assay if meet criteria for ALRI oraudible wheeze4. Child deathTreatment at home: Antibiotics Fluids OtherTRANSFER TO HOSPITALFull clinical assessment and treatment: Chest Xray Pulse oxymetry IV fluids and antibiotics

Appendix LXIX: VALIDATION OF MAM TERMINOLOGYSandra Saenz de TejadaAnthropologistSeptember, 2002Lay semantics and popular health culture regarding diarrheal and respiratory illnesseswere collected in San Juan Ostuncalco, Quetzaltenango, in 1998 as part of preliminaryresearch in the area. As the study site has been moved to Comitancillo, San Marcos, itwas necessary to assess if the lay terms used in San Juan for a series of health conditionswere the same as those used in Comitancillo. As the research team is planning on usingboth a Spanish and Mam version of the baseline and weekly surveys, it was necessary tovalidate the terms in Spanish as well.ObjectivesThis brief study had two main objectives: to validate medical terms and to glean generalinformation of interest. The specific objectives were the following 1 :1. Validate, with representative groups of caretakers, key medical terms in bothSpanish and Mam in four villages in the study area;OUTCOME2. To assess, with representative groups of caretakersASSESSMENT #2a. The ability of the study population to understand Spanish.b. Perceptions about cooking with a plancha stove;Doctor classificationby IMCI criteriac. General sources of income in each of the four villages:d. How women reckon time;OUTCOMEASSESSMENT #3Additional medicale. Sensibility at smoking questions;assessment of ALRI,wheeze, Otitis media.f. Knowledge of birth weights; andRSV assay resultg. General awareness of the estimated birth date and prematurity.OUTCOMEMethods VERBAL AUTOPSYASSESSMENT #4With Initiate the and aid carry of the out research team, four representatives communities of the study areawere verbal selected, autopsy (atHospital investigationone Ladino (Spanish-speaking) and three Mam: Santa Teresa (Ladino),suitable interval)and diagnosisIxmoco, Tuichilupe, and El Pedregal Candelaria (see Map 1). Santa Teresa is aProtocol to becommunity finalised after of local around 450 households (average household size in the area is around 5.8),enquiry into cultural,OUTCOME1 etc., issues relating toASSESSMENT #5The original terms of references did not include specific objective 2b – 2g. These were notchild deaths.Verbal autopsy resultasked in the first group session in Santa Teresa, as the list developed by Morten and Nigel wasreceived by the end of the first day in the field.

7 km NE of San Lorenzo. Ixmoco is a village located around 18 km N of San Lorenzo; ithas approximately 250 households. Tuichilupe is located 5 km N of San Lorenzo, on theroad to Comitancillo (the county seat or cabecera municipal); it has 400 households. ElPorvenir Candelaria is located 6 km NE of San Lorenzo (on the same road as SantaTeresa) and has around 250 households.Most information for this brief study was gathered through group discussions, one pervillage. Team members knowledgeable of the communities (usually residents of thesecommunities) asked around 10 women to attend these sessions; both young and olderwomen were included. Group discussions were held in the local language. In SantaTeresa it was conducted by the anthropologist; in the Mam villages it was conducted byJobita Martínez, an elementary school teacher from Santa Rosa (outskirts of SanLorenzo) and member of the research team. In addition, two women with COPD-likesymptoms were briefly interviewed. Fieldwork took place during the first week ofSeptember 2002.Main Results1. Ability to speak SpanishIn the Mam villages, women usually learn Spanish at school as a second language. In themore isolated villages, Spanish is spoken only rarely and by the time women are in theirearly 30s they have forgotten most of it. This is clearly the case in El PorvenirCandelaria and Ixmoco, but not in Tuichilipe, which is closer to Comitancillo. Inaddition, girls in Tuichilupe can attend the local high school (in the other three villagesthere is only an elementary school 2 ; the school in Ixmoco had merely the first threegrades and only in the last three years the other three grades were opened). It was quitesurprising to find women who had finished grade school, but still had troubleunderstanding Spanish. Younger women (early 20s), however, could still understandSpanish.Women over 40 rarely speak any Spanish, as they hardly ever attended school (womenrepeatedly said that their own parents prevented them from going to school as they didnot see any use of it). They few that speak some Spanish usually learned it as migrantworkers in coffee plantations.2. Perceptions of the plancha stoveIn all four villagers, all participants cooked with firewood. Most household gatherbiomass, usually in small quantities and few can rely on this strategy alone. The majorityof households buy a tarea of firewood, which lasts from two to four weeks, depending onhousehold size. A tarea costs between Q120 and Q150, a significant amount for theimpoverished villagers.2 In Guatemala elementary school comprises six years. In some Maya areas the first three yearsare taught in both the Maya language and Spanish; the other three years are taught entirely inSpanish.

Most participants in the group discussions cooked in an open fire (fuego natural), a fewcooked in poyos (raised, open fires), none had a gas stove and only had a plancha stove.In all groups it was said that if they had the means they would buy a plancha stove andthat only the better off in their village could afford one.When asked about the differences between cooking in an open fire or in a stove, womenin Santa Teresa and in Tuichilupe (plancha stoves are barely known in Ixmoco and ElPorvenir Candelaria) mentioned a reduced exposure to smoke, a more efficient use of fueland that with plancha stoves it was possible to cook several dishes simultaneously. Theythought this would reduce total cooking time and thus the time spent in the kitchen.3. Sources of incomeThe four are mostly agricultural villages but, apparently, with different access to land.While most households 3 in Ixmoco and El Porvenir used to migrate to coffee plantationseach September, only around 50% of the population in Tuichilupe used to migrate. Mosthouseholds with access to land grow maize, faba beans, black beans, oats, wheat; manyhave a few apple and peach trees. Most of these crops are for self-consumption or areused as fodder for the few cows and sheep that most families have. Usually, the onlycash crops are wheat and fruits.A few men in each village are self-employed masons. Young people are beginning tomigrate to the city, and a few others have migrated to the USA, but this varies by village:while around 35 persons from Ixmoco (both genders) are said to have migrated, only oneman has done it in Tuichilupe.Women raise income when they migrate to the coffee farms. Locally, they raise smalllivestock (pigs, poultry, sheep), which they sell in Comitancillo. Apparently, they do notcontrol the fruits of their labor, as their husbands control this income.4. Reckoning of timeUsually it is only men who own watches, and few women have either clocks or watchesat home. Women know the time of day through the radio: most stations broadcast thetime of day every 15 minutes. In addition to the radio, women in Tuichilupe reckon timeby the buses coming back from San Marcos. These buses blow their horns and mark,throughout the village, every hour, starting at 11 am and ending by 8 pm. Older womensaid they could tell time by the shadows of the trees around their homes; if they needed toknow the hour they would either turn the radio on or ask any of the children to look at theclock and tell them the time of day.To have a better idea of how women reckon the duration of daily chores, they were askedhow long it took them to cook beans, nixtamal (maize), beans, to reheat tortillas ortamalitos, doing the dishes or the laundry. For the chores that take more time, like thelaundry or cooking beans, women told the time they would start the chore and the time3 Apparently, the whole household, adults and children, migrate to the coffee plantations.

they would finish it (e.i. “I place the pot of beans in the fire at 8 am and by 12 they aredone”). For other chores, they would estimate the hour or fraction of the hour (e.i“cooking tamalitos takes around one hour, but if the firewood is not dry it takes one andhalf hours”). For shorter chores, like reheating tortillas, women would said it took themaround one minute to reheat each tortilla, and about 10 to 20 minutes to reheat them all.It should be noted that younger women seemed more skilled at measuring time than olderones.5. SmokingWomen said that most men smoke, though only occasionally, as tobacco is consideredquite expensive. There is no shame associated to male smoking, and both men andwomen would feel comfortable answering questions about this topic.Smoking among women seems more complicated, as this could be a sensitive topic. InIxmoco (the most isolated village of the four) it was said that women smoking in publicwere not well seen and that they had never seen a woman smoking. They thought thatwomen who smoke would be sensitive at being questioned and that they would deny it.In all villages older women used to smoke hand-made cigars rolled in maize husks(cigarros de tusa), but apparently this has fallen in disuse. In Tuichilupe and El PorvenirCandelaria women insisted they had never seen women smoking in public and that theypersonally did not smoke because they didn’t like the taste and smell of tobacco, and notbecause of social pressure. While most women from these two villages thought smokinghas no negative connotations, other women thought otherwise:.As a woman I cannot smoke, because my husband doesn’t smoke. I would beashamed to be seen smoking or going to the store to buy cigarettes. Sometimes, when my baby has a tummy ache or might have ojo, I am in the need tobuy cigarettes to cure him. But I am careful to explain to the clerk that I ambuying cigarettes only for medicinal purposes. (Young woman from El PorvenirCandelaria)6. Birth weight and awareness of estimated date of birthWomen give birth at home, attended by a TBA. TBAs do not weigh children; none of thewomen present in the discussions had any of their children weighted. Two TBAs presentin the discussions said they had seen many newborns and could estimate their weight, tothe whole pound. Women customarily rest at home and do not venture out until the babyis 40 days old. Then they take the babies to the clinic. Apparently, this is the first timethe baby’s weight is taken.Some TBAs give an estimated date of birth, others do not and only warn women whenthey are close to give birth. Some women said they keep track of their pregnancy, byestimating the date of their last period. Women seemed to have an embodied knowledgeof their pregnancies: they know that when their womb “falls down” (les baja la panza)the child is about to be born and they think of this as their due time. When a child is bornbefore her due time women said they would start labor with the womb still high (no habajado la panza). Preterm children are called elsen, a term that means stillbirth,

premature, miscarriage, and abortion. Several women in the groups had had an elsen, andall infants, except one, had died. Overall, women tend to have a general idea of theirtime of delivery and intuitively know when the child is preterm. A premature child isconsidered an abortion (women themselves translated the word as aborto) as it is verylikely to die, as the local conditions are abysmal.7. Medical termsThe medical terms collected in San Juan Ostuncalco proved useless in Comitancillo, asthe Mam spoken in the two municipios varies greatly. Most terms had to be translatedfrom Spanish. In a few cases the translations are problematic and the meanings of the layterms are not well understood. It is quite probable, however, that the general lay healthculture in the two municipios is very similar.Table 1. List of validated termsEnglish Mam Santa Teresa’s SpanishDiarrhea E’elen Diarrea [educated term]Asientos*Diarrhea with blood Ch’koj [literally, blood] Diarrea con sangreStool deposition Cha’l Hacer popéVomit Xa’b VémitosThirst Ku’aj SedNormal breastfeeding Tbanel mixin Mamar bienMamar igualMamar como de costumbreAppetiteWater or sore eyesTbanel wan [eats well]Wayaj [hunger, appetite]Talen twutz [has tears in eyes]Nchi’ ok’ twutz [irritated andwatery eyes]Comer bienComer igualComer como de costumbreOjos llorososHeadache Nchon twi Dolor de cabezaBurn from fire Ma txe’y tun k’aq’ Quemadura por fuegoScaldMa txe’y tun k’ka’ [burn fromhot water]Quemadura por liquido*Convulsions Ma tzaj k’imin tij [is half Ataque(children)dead]*Lethargic/Ma ku’ numtzaj [fainted] Privadounconscious (children) Ma tzel tsendid [lwithout hersenses]Ma ku’ kim [almost dead]Cough Sjol TosDry cough Sjol tkij Tos secaAttack of cough Mañor tk’ul [a lot of throat] Mucha tos

Nja jik’ibe tun sjol [chokingfrom cough][ataque is mostly associated toconvulsions]Mucus Tcha’n MocosBlocked nose Ma jtzet tcha’n [tight nose] Nariz tapadaSore throat Nchon toj k’ul Dolor de gargantaEar pain Nchon xqin Dolor de oídoEar discharge Poj Not askedFever Kyaq’ Calentura [low fever]Fiebre [high fever]Phlegm Xloq’ FlemasBring up phlegm Ma jatz xloq’ Sacar flemas*Noisy breathingSirrin tzi tquj [noise in thechest; “boiling in the chest” orrattle]Sirrin [children]Tzolen [elderly - rattle]Ntzizen [snore, purr]No term was registered;women tended to associatenoisy breathing to constipado[a lay illness similar to theflue] and a buen resfrio [agood cold]*Wheeze Sirrin SilbidoTightness in the chest Unknown concept Unknown conceptDifficult breathing Mi nwe’ txew [no alcanzarespirar]Mi njatz txeu [breathingdoesn’t go out]Txew penex [barely breathing]Nxpet txew [blockedbreathing]Le cuesta respirar* Terms not well understoodMost of the terms are probably unproblematic. There are, however, two sets of termsthat might need more precision. Neither the Mam nor the Ladino differentiate lethargicfrom unconscious: in Spanish, a single lay term is used: privado. In Mam a series ofexpressions are used. Ma ku’ numtzaj [fainted], ma tzel tsendid [lwithout her senses] andeven desmay’ [from the Spanish desmayo, to faint] all refer to the same condition; ma ku’kim [almost dead] is the most severe of all.In the Spanish group discussion a single mother seemed to know about wheeze. She usedthe word silbido [whistle] to refer to it. The rest of participants were not familiar with thesymptom.In Mam the word sirrin is a multivocal terms that includes several types of noise: thevoice of a person with a sore throat, the voice when the throat is dry, the voice when aperson is panting, the rattle of phlegm described as the purr of a cat, and wheeze. A morespecific word for wheeze was sought: women were asked about xub’en [whistle of bothhumans and birds] but it did not make sense for them to talk about breathing or cough interms of xub’en. They consistently said it was incorrect to use the word this way.

DiscussionThe information was gleaned very rapidly and must be taken as preliminary.In the two villages where plancha stoves are more familiar, women thought that one ofthe main advantages of this type of stove is that it allows cooking several dishes at thesame time, which, according to their view, reduced the time spent cooking and the timespent at the kitchen. This could have great implications to the study, given that exposureto smoke and time spent in the kitchen are of key importance. In the other two villages,women were not familiar with this type of stoves and could not tell how it would affecttheir cooking.Most of the terms for symptoms are probably unproblematic. If the study requires adistinction between a lethargic and an unconscious child, further study will be needed.The current lay terms, both in Spanish and Mam, collapse both conditions.The lay term for wheeze remains problematic. Silbido is not well known in the Ladinovillage, but probably will be understood by the population. It is unclear if mothersrecognize wheeze or if silbido is not well known because it is a rare condition.In Mam, many mothers seemed to recognize a sound similar to wheeze (to what extent itactually is wheeze is another question), but the word that they use to describe itencompasses a series of sounds, one of which is wheeze. Fabricating a word for wheezeproved problematic. The word used in San Juan Ostuncalco and fabricated by Dr.Sánchez, sqirjen, means sneeze in Comitancillo and would be useless in this region.The most appropriate word to refer to wheeze is probably sirrin. If the term is to be usedin a questionnaire it would require a second question, asking mothers what kind of sirrinit was, whether wheeze or something else (the most common meaning if sirrin isprobably a light rattling sound, usually compared to that of a purring cat). The use of theword sirrin would also require a fairly good training of fieldworks that would enablethem to differentiate that sirrin referring to wheeze.In addition to these terms, the term ch’koj might also be problematic. Ch’koj meansblood, but also diarrhea with blood. There are some cases of “diarrhea from cold” thatmight include some specks of blood, but given that ch’koj is mostly considered “hot”, theterm would not include those cases of diarrhea from cold, regardless of the presence ofblood in the stool.Conclusions and recommendationsFour group discussions were held in four communities in Comitancillo, one of themLadino (Spanish-speaking), the other three Mam. General characteristics of the villagewere discussed, and a list of medical terms was validated. Data collection took only afew days and the information presented in this report should be considered preliminary.

1. The ability to speak Spanish seems to be related to schooling and age, where olderwomen speak almost no Spanish and women in their early 20s speak some. Buteven some of these women can be mostly monolingual. It is best to assume thatSpanish will not be understood and conduct the survey in Mam.2. Currently, most women cook on an open fire and need to buy fuel at aconsiderable expense. For those who knew how plancha stoves work, their mainadvantages vis-à-vis the open fire is a reduction in smoke, greater fuel efficiencyand the possibility of cooking several dishes simultaneously.a. This probably implies a modification of time-activity patterns, mostcertainly a reduction of the time spent in the kitchen. As there are severalvillages in the study area where planchas are widely used (Santa Teresaamong them), it is highly recommended to conduct some observation trialsand/or individual interviews with women that have begun cooking withplanchas in the last six to 12 (or perhaps even 24) months. This could bedone in a small number of households for one or two weeks. It isrecommended not to postpone this study, and to conduct a field trialwithin the next few months.b. If direct observations are to be conducted, observer reactivity will bemostly felt in terms of a reduction of rest periods and social interactionwith family and friends, as Maya women are often urged to keep alwaysbusy. Modification of cooking patterns and time spent in the kitchen willprobably be minor, mostly due to the fact that households are too poor tosignificantly alter their eating patterns. Time spent cleaning the kitchencould be altered for the sake of the observer, but previous long-termobservations (from breakfast to dinner) elsewhere in the country(Sacatepequez) involving child-eating patterns, did not result in sparklingkitchens. On the contrary, it is unlikely that any additional cleaning wascarried out.c. One concern, however, would be that the presence of the observer wouldprobably force families to share their meager food supplies. Mayahospitality and reciprocity norms dictate that such food should be offeredand received. If this were the case, households would need to besomehow compensated (sugar, rice or coffee are good choices).Alternatively, it could be assumed that the use of the plancha stove wouldnot alter the time spent eating the meals, and thus the observer could leavethe home before the meal was consumed.3. The main source of income was probably agricultural wage labor, as in somevillages most households used to migrate to the coffee plantations for severalmonths each year. Given the current crisis in coffee production and the shortageof agricultural wage labor, villagers will probably rely on their own production tomeet consumption needs and supplement their income through a variety of oddjobs, both locally and off-farm. Women raise income mostly by raising smalllivestock (poultry, sheep, and pigs)

4. Few women own clocks or watches, but most are well aware of the time of day.Women tell time mostly by the radio, as most stations broadcast the time of dayevery 15 minutes or so. The ability to measure the duration of domestic choresseems to vary by age, younger women being more skilled than older ones. Theaccuracy of their time measurements would need to be validated through directobservations.5. There is no sensibility regarding smoking among men. Smoking among womencould be underreported, as it has a negative connotation among some villagers.The number of female smokers, however, is probably very low.6. Most women deliver at home with the aid of a TBA and infants are not regularlyweighted. The first time infants are weighted, if at all, is when first taken to thehealth post, usually after the 40-day post-partum rest period.7. Some TBAs give women an estimated date of birth at the beginning of theirpregnancy; others tell them the probable date only during the last month. Somewomen keep track of their pregnancy, based on their last period; others do not.Women, however, seem to have a general awareness of a full-term infant, as theyknow that their expected time of delivery is when their womb “falls down”. Ifthey give birth when the womb is still “high”, they call that elsen, which meansstillborn, abortion, miscarriage or premature. Most premature infants die.8. Twenty-eight terms for health conditions were validated. Most are probablyunproblematic, but some deserve further attention.a. Neither the Mam nor the Ladino differentiates lethargic from unconscious.If the distinction is needed for research purposes, further fieldwork isnecessary.b. Wheeze is also a problematic term. The Mam use the word sirrin to referto different kinds of noisy breathing and even to changes in the voice dueto a sore throat or to panting after strenuous exercise. A more specificterm was sought but not found. The word for whistle was suggested, butwomen claimed it did not make sense to talk about breathing or cough interms of xub’en: the term proved to be more confusing than enlightening.With the available information, probably the best way to ask about wheezewould be to ask about sirrin and then assess what kind of noise it was.This approach requires appropriate training for fieldworkers.c. In Spanish, a single mother used the word silbido to describe wheeze, butfew mothers seem to recognize the symptom.d. Women in the group discussions could not describe difficult breathing.Women with COPD-like symptoms were more specific. They describedtheir condition mostly in terms of blocked breathing, nxpet txew, or barelybreathing, txew penex.9. Most Mam do not learn to read and write their own language and some difficultyin reading Mam was observed. Sufficient time should be allowed forfieldworkers to become familiar with the Mam instruments; they probably will

need more time getting acquainted with the Mam version than with the Spanishone. In addition, there are slight differences in pronunciation between thedifferent villages. In this report, an attempt was made to use “standard villageMam”, but it might well be inaccurate.

APPENDIX 1: GROUP DISCUSSION GUIDEGuía de discusión en grupoSaludo, bienvenida, agradecimiento. Explicación de la actividad. Presentación del equipo y delas demás participantes.1. Uso de planchas.a) ¿Dónde cocinan Uds?b) ¿Compran la leña o la recolectan? ¿Cuánto cuesta la tarea?c) ¿Habrá familias en la comunidad que usen estufas de plancha para cocinar?d) ¿Creen Uds que se cocina mas rápido al usar una plancha?e) En general, si uno tuviera una estufa de plancha, ¿pasaría mas, menos o igual de tiempococinando?2. Uso del tiempoa) ¿Cómo miden el tiempo?b) ¿Quiénes usan reloj?c) PEDIR QUE CALCULEN TIEMPO PARA TAREAS DOMESTICAS COMUNES: cocinartamalitos, nixtamal, frijoles, recalentar tortillas/tamalitos [ANOTAR FORMA DEEXPRESION]3. Conocimiento del idioma española) ¿Quiénes son las señoras que hablan español en la comunidad?b) ¿De qué edad?c) ¿Dónde lo han aprendido?d) ¿Hasta qué grado han estudiado?4. Sensibilidad/molestia por preguntas por fumara) fumar entre los hombresb) fumar entre las mujeres5. Fecha aproximada de parto, prematurez, peso al nacera) ¿Dónde dan a luz?b) ¿Pesa la comadrona los ninos al nacer?c) ¿Da la comadrona la fecha del parto desde el principio del embarazo?d) Si la comadrona no da fecha de parto, ¿cómo saben cuando va a nacer el niño?e) ¿Cómo se le dice al niño que nace antes de su tiempo?f) Y los que nacen después?6. ¿En qué trabajan la aquí?a) los hombresb) las mujeres7. Estamos trabajando con el Centro de Salud y vamos a estar vieniendo a sus casas a ver como está lasalud de Uds y de sus hijos. Necesitamos poder hacerle unas preguntas a modo que todo mundo entiendamuy bien. Queremos revisar con Uds algunos términos para enfermedades y que nos ayuden a escoger losmejores.

Appendix LXX. HOBO CO CalibrationAppendix Standard Operating Procedure for calibration checks of HOBO COmonitors (UCB-HCOCAL-1)1.0 Statement of PurposeThis protocol describes the procedure for performing calibration checks of the HOBOCO monitors using Scotty CO calibration gases (24.9 ppm).1.1 Equipment requirementsScotty CO gas canister (24.9 ppm)RegulatorTygon tubing attached to rubber cup5cm wide clear package sealing tapeHOBO CO monitorCABLE-PC-3.5 Logger to PC COM port cableComputer loaded with Boxcar pro software2.0 Preparation of monitorsNOTE: calibration checks should only be performed after the data from the lastsampling site has been downloaded and savedNOTE: Sampling intervals and sampling setup must be programmed into thelogger prior to taping of the monitor to seal openings2.1 connect serial cable to COM port2.2 open boxcar pro software2.3 connect serial cable to CO logger2.4 select launch from logger menu2.5 check battery status2.6 check channel 1 is selected next to ‘enable/disable channels’. If not select‘enable/disable channels’ and check box next to channel 1 (0-125 ppm) andSelect apply.2.7 select 1 second from the ‘interval duration’2.8 type in label for calibration check and date (HOBO CO ID#_calibration_date)2.9 select box with delayed start. In the boxes on the right insert date of calibrationand sufficient time to program all monitors being checked for simultaneouslaunch (usually 20 minutes or so) *note: As convention these should be with 00seconds2.10 select ‘start’2.11 select ‘continue’ from screen with enable channel reminder2.12 click ‘ok’ for old data to be erased from logger2.13 detach cable from logger then press ‘OK’… note the logger is now logging COlevels.

2.14 Check that logger is switched on by looking at LED face on for several seconds.When the logger is switched on it should flash faintly every two seconds. Whenoff the logger LED should not flash2.15 program other loggers to be calibrated3.0 taping of monitors3.1 three pieces of tape will be cut and placed on the HOBO CO monitor so that thebottom and the vertical sides in the longer dimension are sealed. There should bea slight overlap on the tape across the bottom. The tape should cover the black gasentry ports and the cable programming port3.2 a smaller piece of tape will be cut to cover the entry port on the shorter dimensionof the HOBO CO monitor4.0 calibration procedure4.1 when the monitors are scheduled to start pull the tape down off the port on theshorter dimension. With this port facing you pull the tape down off the top rightport so that air can pass into the monitors.4.2 wait 5 minutes4.3 attach regulator to gas cylinder.4.4 attach free end of Tygon tubing with rubber cup to the regulator.4.5 turn on gas. Gas flow should be 300ml per minute. Gas can be audibly heardexiting rubber cup if close to ear4.5 note the exact minute and press open end of rubber cup over the black port on theshorter dimension.4.5 maintain rubber cup sealed over this port for 3 minutes.4.6 remove rubber cup. Immediately re-seal the two open ports with the tape that ishanging down. Record exact minute cup is removed and monitor resealed.4.7 wait for at least 5 minutes4.8 place regulator on zero air tank. Attach Tygon tubing with rubber cup. Turn gason at 300 ml per minute. Un-tape HOBO CO monitor and press rubber cup toblack port on shorter dimension. Record time flushing starts4.9 flush for 3 minutes. Record stop time5.0 downloading calibration data5.1 open boxcar pro software5.2 plug CABLE-PC-3.5 ‘stereo’ plug into logger5.3 select ‘Logger’ from the top menu of the boxcar software. When the drop downmenu appears select ‘readout’5.4 A window should appear with ‘connecting’ and then ‘HOBO found’. Anotherwindow will then appear saying offload. Wait for data to download to desktop.5.5 unplug logger at prompt and select ‘OK’.5.6 A window will appear with ‘save as’. At the top select the data directory ‘HOBOCO CALIBRATION’. Check the filename reads ‘HOBO CO #_calibration_Date’.Select ‘save’. The boxcar pro will then display a graph of the data downloaded.CHECK: there is an elevated region where the gas was entered. This does notshow large spikes or rapid decreases in the two minutes following the entry of thegas

5.7 select ‘file export’ from ‘file’ menu. Select ‘excel’ in window that opens5.8 select boxes for ‘include serial number’ and ‘all series’. Select ‘export’5.9 select data directory ‘HOBO CO CALIBRATION’ to save file. Select save.6.0 calculation of calibration check-point6.1 open excel6.2 open the text version of the calibration file from the data directory6.3 an import wizard window will open6.4 select delimited and then ‘next’6.5 select tab only as the delimiter. Select ‘next’6.6 select finish6.6 select column A. select ‘format cells’ from top menu. Select ‘time’. Select‘13:30:55’ (format of cells hh:mm:ss)6.7 starting at the first data point select all rows until the recorded time that the rubbercup was removed and monitor resealed after 24.9ppm CO gas had been directedinto the monitor for 3 minutes. After the next 120 data points (2 minutes) deleteremaining datapoints and compute mean and standard deviation6.8 compare value to measured value recorded on calibration graph for each HOBOCO monitor. If value differs by more than 20% repeat calibration. If second valuediffers by more than 20% report to field manager and send monitor back forservice.6.9 record value of calibration check point on chart in air monitoring room.

Appendix LXXI. Fuel Use Survey (English DRAFT)Notes for the Interviewer:1. All instructions for interviewers are shown in bold and in capital letters, or inparenthesis. These instructions must not be read to the person being interviewed.2. Questions based on observations on the part of the interviewer have been written incapital letters and must not be addressed to the participants.3. When a question is not necessary, indications to “GO TO question #….” appear.When this indication does not appear, the interviewer should continue with thefollowing question.4. All questions with multiple selection options must be read to the participant to allowhim to select an option.5. This interview should preferably be conducted with someone familiar with thesource of household fuel and with someone who frequently tends the fire.A: Introduction/Baseline InformationA1: Household ID number: ___________A2: Interviewer initials: ___________A3: Interview date: ___/ ___/ ___mm dd yyA4: Interview start time: ___________A5: Location: ____________ ______________Community MunicipalityA6: Household coordinates: _____N/ _____WA7: OBSERVE if the household has an:1 Open Fire2 PlanchaA8a: OBSERVE if the survey respondent is:1 Male2 FemaleI’d like to begin with one personal question and a few questions about your role in collecting fuelfor your household.A8b: What is your age? RECORD BELOW. (Order of this question?)Age_____

A9: Who is the primary fuel collector in the household?1 Father/ Male head of household2 Mother/ Female head of household3 Child(ren)4 Others: (specify)____________A10: How much time did you spend last week acquiring (collecting or purchasing) fuelwood?1 ? hours2 hours3 hours4 hours (specify)______A11: Who primarily tends the fire in the household?1 Father/ Male head of household2 Mother/ Female head of household3 Child(ren)4 Others: (specify)____________B: Household Fuel CharacteristicsNow, I’m going to ask some questions about the types of fuel you use in your household.B1: What is your primary fuel source in the household? RECORD RESPONSES FORTHE WET AND DRY SEASON.Wet Season DrySeason1Wood GO TO B2a 2Crop residue (including corn cobs) GO TO B3a 3Manure 4Charcoal 5Kerosene 6LPG (gas) 7Other (specify)________ B2a: If primary fuel in B1 is wood, what species do you usually use? RECORDRESPONSES FOR THE WET AND DRY SEASON. CHECK ALL SPECIESTHAT APPLY. If not, GO TO B3.Wet SeasonDry Season1 Hule (rubber tree, rubberwood) 2 Pine 3 Oak 4 Eucalyptus 5 Cyprus 6 Other fir (specify):_____________ 7 Other broadleaf (specify): ____________ 8 Unknown

B2b: Why do you use this species (open response)?B3a: If primary fuel in B1 is crop residue, what type do you usually use? RECORDRESPONSES FOR THE WET AND DRY SEASON. CHECK ALL CROPRESIDUES THAT APPLY. If not, GO TO B4.Wet Season DrySeason1 Corn Cobs or other material from corn plants 2 Broccoli (?) 3 Cauliflower (?) 4 Other (specify):_____________ 5 Unknown B3b: Why do you use this crop residue (open response)?B4: Rank the activities you use fuel for from most fuel consuming to least fuelconsuming:SCALE WILL BE FROM 1 (MOST FUEL USED) to 5 (LEAST FUEL USED) or 6 (if somerespondents specify “other”).Rank1Cooking____2Heating water____3Heating the house____4Preparing animal food____5Chuj/Temescal____6Other (specify) __________ ____Is this question more useful? What will it tell us?B5: I will name a fuel type and follow with questions about how much fuel you use eachweek and month. READ EACH FUEL TYPE. IF THE RESPONDENT USES THEFUEL TYPE, ASK THE QUESTIONS ABOUT FUEL USE. IF NOT, GO TO THENEXT FUEL TYPE.FUEL TYPEWhat season is it?How muchfuel do youuse eachweek duringthewet season?How muchfuel do youuse eachweekduring thedry season?How muchfuel do youuse eachmonthduring thewet season?How muchfuel do youuse eachmonthduring thedry season?1 Wood (log (loads) (loads) (loads) (loads)

that is the size ofyour thigh)2 Wood (loads) (loads) (loads) (loads)(twigs/branches)3 Corn cobs (sacks) (sacks) (sacks) (sacks)4 Crop residue (bunches) (bunches) (bunches) (bunches)(specify):____________5 Charcoal (sacks) (sacks) (sacks) (sacks)6 Kerosene (bottles) (bottles) (bottles) (bottles)7 LPG (bottles) (bottles) (bottles) (bottles)8 Electricity ($Q) ($Q) ($Q) ($Q)9 Other(specify):____________B6: Does fuel availability change by season?1 YES2 NO GO TO C1B7: How does fuel availability change by season?1 More fuel during the dry season2 Less fuel during the dry season3 More fuel during the wet season4 Less fuel during the wet seasonB8: How do you deal with differences in fuel availability?1 Fuel Storage2 Reduce frequency of cooking during the rainy season/crisis period3 Change sources4 Other (specify):___________C. Household Fuel SourcesNow we will ask you a series of questions about where you get your household fuel.C1: In your household, is fuel:1 Collected only2 Purchased only GO TO C123 Collected and purchasedC2: Where do you collect your fuel? Respond to all that apply.1 Milpa (specify location________________)C2a: In your household, who is primarily responsible for collecting in the milpa?1 Adult men

2 Adult women3 Children2 Forest (specify location________________)C2b: In your household, who is primarily responsible for collecting in the forest?1 Adult men2 Adult women3 Children3 Agriculture (specify location________________)C2c: In your household, who is primarily responsible for collecting in the fields?1 Adult men2 Adult women3 Children4 Coast (specify location________________)C2d: In your household, who is primarily responsible for collecting at the coast?1 Adult men2 Adult women3 Children5 Other (specify location________________)C2e: In your household, who is primarily responsible for collecting at thislocation?1 Adult men2 Adult women3 ChildrenC3: Do you collect household fuel primarily on: sensitive – question rephrase or Orderor cut?1 Public Land2 Private Land3 No responseC4: How far do you travel to collect your household’s primary fuel source? (base ontime?)1 Less than 3 km2 More than 3 km3 Other (specify)____C5: Do you cut live trees or dead wood?1 Live trees2 Dead Wood GO TO C73 BothC6: How long do you dry green wood before burning in the plancha?1 Less than 1 month2 1 to 3 months3 3 to 6 months4 6 to 12 months

5 Over 1 yearC7: If you harvest/collect wood, what size wood do you prefer to cut for household fuel?[length is an issue too, since the open fire is more flexible than the plancha]1 Smaller around than arm (3-10cm. diameter)2 As big as leg (10-20cm. diameter)3 Bigger than leg (specify)________C8: How often do you cut your household fuel? [cutting and collecting may not be doneat same time/frequency]1 Less than once a week2 Once a week3 Every 3-5 days4 Every other day5 Every dayC9: How often do you collect your household fuel?1 Less than once a week2 Once a week3 Every 3-5 days4 Every other day5 Every dayC10: How much time, on average, does the fuel collector(s) in your household spendcollecting fuel? RECORD THE NUMBER OF HOURS PER DAY AND THENUMBER OF HOURS PER WEEK BELOW.1 per day: __________ hours2 per week: ___________ hoursC11: Has the time you spend collecting fuel changed since:1 Last year hasn’tchanged Moretime2 Five years ago hasn’t Morechanged time3 Ten years ago hasn’t Morechanged time4 ___ years ago hasn’t More(fill in number of years changed timeago)5 Don’t know Lesstime Lesstime Lesstime LesstimeC12: Where do you purchase your fuel? Respond to all that apply.1 DO NOT PURCHASE GO TO D12 Market3 Shop4 Truck driver

5 Delivery6 On-site7 Property/forest owner8 Agricultural field9 Other (specify) ______________________________C14: How often do you purchase household fuel?1 Less than once a week2 Once a week3 Every 3-5 days4 Every other day5 Every dayC15: Do you purchase fuel individually or as a collective:1 Individually2 CollectivelyC16a: Has the price you pay for fuel changed in the last five years?1 Hasn’t changed2 More expensive GO TO C16b3 Less expensive GO TO C16c4 Don’t knowC16b: How do you deal with higher fuel prices?1 Be more efficient/careful (frugal) with fuel use2 Reduce frequency of cooking3 Change fuel source or sources (specifiy):____________4 Spend less money on other things (specifiy):____________ to free more moneyfor purchasing fuel5 Other (specify):___________C16c: How do you deal with lower fuel prices?1 Be less efficient/careful (frugal) with fuel use2 Increase frequency of cooking3 Change fuel source or sources (specifiy):____________4 Spend more money on other things (specifiy):____________4 Other (specify):___________D. Fuel perceptions and attitudesAdd questions about history of plancha? Or are these questions only for thosehouseholds with the older planchas?You would then have to add a few questions about the age and who built the plancha andif the household paid anything for it and whether the plancha once provided benefits, but

does not do so anymore and why. If it is because the plancha fell into disrepair, weshould ask why they did not repair it. These households are noted in the censusOBSERVE if household has a plancha, if not GO TO D3.D1a: Since the plancha was installed, do you feel the amount of fuel you use for cookinghas:1 Increased2 Decreased3 Stayed the same4 Don’t knowGO TO D2PROCEED TO D1bGO TO D5GO TO D5D1b: What fuel source do you use less of?Wet Season DrySeason1Wood 2Crop residue (specify)_______ 3Charcoal 4Kerosene applicable? 5LPG (gas) D1c: How much less do you use? Can this be better quantified?None Some A Lot1Wood 2Crop residue (specify)_________ 3Charcoal 4Kerosene 5LPG (gas) D2a: What fuel source do you use more of?Wet Season DrySeason1Wood 2Crop residue (specify)_______ 3Charcoal 4Kerosene 5LPG (gas) D2b: How much more do you use?None Some A Lot1Wood 2Crop residue (specify)_________

3Charcoal 4Kerosene 5LPG (gas) D3a: Can you remember a time when the fuel you used was different?1 NO GO TO D52 YESD3b: When was the fuel source different? (open response)D3c: Why was the fuel source different? (open response)D4: Since the installation of the plancha, do you: (present this question in a table?)1 Spend more time in the kitchen2 Spend less time in the kitchen3 Time in the kitchen hasn’t changed4 Have your baby in the kitchen more often5 Have your baby in the kitchen less often6 The time that this baby spends in the kitchen is not different from the time your otherbabies spent in the kitchen7 Cook more animal food in the kitchen8 Cook less animal food in the kitchen9 Animal food cooking practices haven’t changed10 Burn more fuel for space heating in the kitchen11 Burn less fuel for space heating in the kitchen12 Amount of fuel burned for space heating hasn’t changedD5: Please name your most commonly used fuel (RECORD NAME BELOW).Compared to other fuels, your most commonly used fuel is:Name fuel__________________ExpensiveEasy to getMakes a Slow Cooking FireMore Smokeythe samethe samethe samethe sameInexpensiveHard to getMakes a Fast Cooking FireLess Smokey

Doesn’t cause illnessthe sameCauses illnessD6: Please name your least commonly used fuel (RECORD NAME BELOW).Compared to other fuels, your least commonly used fuel is:Name fuel__________________ExpensiveEasy to getMakes a Slow Cooking FireMore SmokeyDoesn’t cause illnessthe samethe samethe samethe samethe sameInexpensiveHard to getMakes a Fast Cooking FireLess SmokeyCauses illnessD7: If you could spend less time collecting and/or purchasing fuel, how would you use it?(open response)D8: If you could spend less money purchasing fuel, how would you use the savings?(open response)D9: Do you have any reasons not to use certain trees? (open response)D10: Do you have any reasons not to cut trees from specific locations? (open response)D11: Do you have any other comments or observations about the fuel use in yourhousehold (or in your neighborhood?)?

Thank you very much for your help and participation!Interview stop time: ________InterviewInterviewer’s initials: _______________Interview ReviewSupervisor’s signature:_________________Interviewer’s signature: ________________Review Date: _________________Data EntryData Entry # 1 Signature: ________________________________Data Entry # 2 Signature:Data Entry ReviewSupervisor’s signature:___________________ Review Date: _________________