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For postnatal only show flag if tested postive within 24 months
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@makombe
makombe committed Oct 29, 2024
1 parent 46b697e commit 121f80a
Showing 1 changed file with 57 additions and 4 deletions.
61 changes: 57 additions & 4 deletions ...va/org/openmrs/module/kenyaemr/calculation/library/hiv/NeedsViralLoadTestCalculation.java
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Original file line number Diff line number Diff line change
Expand Up @@ -11,6 +11,8 @@

import org.apache.commons.logging.Log;
import org.apache.commons.logging.LogFactory;
import org.joda.time.DateTime;
import org.joda.time.Days;
import org.openmrs.Concept;
import org.openmrs.Encounter;
import org.openmrs.EncounterType;
Expand Down Expand Up @@ -41,7 +43,13 @@
import org.openmrs.parameter.OrderSearchCriteria;
import org.openmrs.ui.framework.SimpleObject;

import liquibase.pro.packaged.b;
import liquibase.pro.packaged.bo;
import liquibase.pro.packaged.d;
import liquibase.pro.packaged.e;

import java.util.Arrays;
import java.util.Calendar;
import java.util.Collection;
import java.util.Date;
import java.util.List;
Expand Down Expand Up @@ -204,7 +212,10 @@ else if (lastVLResultDate != null && daysSince(lastVLResultDate, context) >= 365
Concept htsPmtctAncEntryPoint = cs.getConcept(HTS_PMTCT_ANC_ENTRY_POINT_CONCEPT_ID);
Concept htsPmtctMatEntryPoint = cs.getConcept(HTS_PMTCT_MAT_ENTRY_POINT_CONCEPT_ID);
Concept htsPmtctPncEntryPoint = cs.getConcept(HTS_PMTCT_PNC_ENTRY_POINT_CONCEPT_ID);
Encounter lastHtsEnc = null;
Concept dateOfDelivery = cs.getConcept(Dictionary.DATE_OF_CONFINEMENT); //Though named date of confinement, same concept used for delivery date
Encounter lastHtsEnc = null;
Date dateOfDeliveryValue = null;
Date dateTestedPositiveAtHts = null;
List<Concept> vlOrderConcepts = Arrays.asList(cs.getConceptByUuid(Dictionary.HIV_VIRAL_LOAD), cs.getConceptByUuid(Dictionary.HIV_VIRAL_LOAD_QUALITATIVE));
OrderSearchCriteria OrderSearchCriteria = new OrderSearchCriteria( patient, null, vlOrderConcepts, null, null, null,
null, null, false, null, null, null, null, true, true, false, false);
Expand All @@ -224,28 +235,70 @@ else if (lastVLResultDate != null && daysSince(lastVLResultDate, context) >= 365
boolean isConfirmedPositiveAtAnc = lastAncEnc != null ? EmrUtils.encounterThatPassCodedAnswer(lastAncEnc, htsFinalTestQuestion, htsPositiveResult) : false;
boolean isConfirmedPositiveAtPostnatal = lastMchPostnatalEnc != null ? EmrUtils.encounterThatPassCodedAnswer(lastMchPostnatalEnc, htsFinalTestQuestion, htsPositiveResult) : false;
boolean isConfirmedPositiveAtDelivery = lastMchDeliveryEnc != null ? EmrUtils.encounterThatPassCodedAnswer(lastMchDeliveryEnc, htsFinalTestQuestion, htsPositiveResult) : false;
boolean testedPositiveWithin24MonthsInPostnatal = false;

if(lastMchPostnatalEnc != null) {

Date dateTestedPositivePnc = null;
for (Obs obs : lastMchPostnatalEnc.getObs()) {
if(obs.getConcept().equals(dateOfDelivery)) {
dateOfDeliveryValue = obs.getValueDate();
} else if(obs.getConcept().equals(htsFinalTestQuestion) && obs.getValueCoded().equals(htsPositiveResult)) {
dateTestedPositivePnc = obs.getObsDatetime();
}
}
if(dateOfDeliveryValue != null && dateTestedPositivePnc != null) {
testedPositiveWithin24MonthsInPostnatal = testedPositiveWithin24MonthsInPnc(dateOfDeliveryValue, dateTestedPositivePnc);
}
}

if ( vlOrders.size() == 0 && artStartDate == null &&
(isConfirmedPositiveAtAnc || isConfirmedPositiveAtPostnatal || isConfirmedPositiveAtDelivery)) {
if ( vlOrders.size() == 0 && artStartDate == null &&
(isConfirmedPositiveAtAnc || (isConfirmedPositiveAtPostnatal && testedPositiveWithin24MonthsInPostnatal) || isConfirmedPositiveAtDelivery)) {
needsViralLoadTest = true;
flagMessage = "Due for Pre-ART Viral Load";
}

if(lastHtsEnc != null) {
boolean isPositiveTestResult = lastHtsEnc != null ? EmrUtils.encounterThatPassCodedAnswer(lastHtsEnc, htsFinalTestQuestion, htsPositiveResult) : false;
if(isPositiveTestResult) {
dateTestedPositiveAtHts = lastHtsEnc.getEncounterDatetime();
}
if(isPositiveTestResult && vlOrders.size() == 0 && artStartDate == null) {
for (Obs obs : lastHtsEnc.getObs()) {
if(obs.getConcept().equals(htsEntryPointQuestion) && (obs.getValueCoded().equals(htsPmtctAncEntryPoint) ||
obs.getValueCoded().equals(htsPmtctMatEntryPoint) || obs.getValueCoded().equals(htsPmtctPncEntryPoint))) {
obs.getValueCoded().equals(htsPmtctMatEntryPoint))) {
needsViralLoadTest = true;
flagMessage = "Due for Pre-ART Viral Load";
}
}
}
}
// check if confirmed positive using hts form and still within 24 months at postnatal
if(dateTestedPositiveAtHts != null && dateOfDeliveryValue != null && dateTestedPositiveAtHts.after(dateOfDeliveryValue) && vlOrders.size() == 0 && artStartDate == null) {
testedPositiveWithin24MonthsInPostnatal = testedPositiveWithin24MonthsInPnc(dateOfDeliveryValue, dateTestedPositiveAtHts);
if(testedPositiveWithin24MonthsInPostnatal) {
needsViralLoadTest = true;
flagMessage = "Due for Pre-ART Viral Load";
}
}

ret.put(ptId, new BooleanResult(needsViralLoadTest, this));
}
}
return ret;
}
private boolean testedPositiveWithin24MonthsInPnc(Date deliveryDate ,Date dateTestedPositive) {
boolean isTestedPositiveWithin24Months = false;
Calendar startCalendar = Calendar.getInstance();
startCalendar.setTime(deliveryDate);
Calendar endCalendar = Calendar.getInstance();
endCalendar.setTime(dateTestedPositive);
int yearDiff = endCalendar.get(Calendar.YEAR) - startCalendar.get(Calendar.YEAR);
int monthDiff = yearDiff * 12 + endCalendar.get(Calendar.MONTH) - startCalendar.get(Calendar.MONTH);

if (monthDiff <= 24) {
isTestedPositiveWithin24Months = true;
}
return isTestedPositiveWithin24Months;
}
}

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