malawi_hiv_program_reports 1.0.1 → 1.0.2

data/app/services/malawi_hiv_program_reports/moh/cohort_struct.rb

@@ -0,0 +1,219 @@
+# frozen_string_literal: true
+
+require 'ostruct'
+
+module MalawiHivProgramReports
+  module Moh
+    # This class is used to add additional cohort disaggregated data
+    # rubocop:disable Metrics/ClassLength
+    class CohortStruct
+      FIELD_DESCRIPTIONS = {
+        # Table contains various fields of the Cohort report and their descriptions.
+        # A fields description is simply "Indicator: Human Readable Name",
+        # or "Human Readable Name". The former is for fields with an indicator
+        # label and the latter is for fields without.
+        # Examples:
+        #   ...,
+        #   six_a: "KS: Kaposis Sarcoma",
+        #   regimen_2p: "Regimen 2P",
+        #   ...
+        total_other_patients: 'All others (not circled)',
+        patients_with_7_plus_doses_missed_at_their_last_visit: 'Adherence: 4+ Doses',
+        unknown_age: 'Unknown age',
+        cum_unknown_age: 'Unknown Age (Cumulative)',
+        quarterly_unknown_age: 'Unknown Age (Quarterly)',
+        died_total: 'Died: Died Total',
+        died_within_the_1st_month_of_art_initiation: 'M1: Died within the 1st month after ART initiation',
+        died_within_the_2nd_month_of_art_initiation: 'M2: Died within the 2nd month of art initiation',
+        died_within_the_3rd_month_of_art_initiation: 'M3: Died within the 3rd month after ART initiation',
+        died_after_the_3rd_month_of_art_initiation: 'M4+: Died within the 3rd month after ART initiation',
+        no_tb: 'Nev/>2 Years: Never TB or TB over 2 years ago',
+        cum_no_tb: 'Nev/>2 Years: Never TB or TB over 2 years ago (Cumulative)',
+        quarterly_no_tb: 'Nev/>2 Years: Never TB or TB over 2 years ago (Quarterly)',
+        who_stage_two: 'CD4: CD4 below threshold',
+        cum_who_stage_two: 'CD4: CD4 below threshold (Cumulative)',
+        quarterly_who_stage_two: 'CD4: CD4 below threshold (Quarterly)',
+        asymptomatic: 'Asy: Asymptomatic / mild',
+        cum_asymptomatic: 'Asy: Asymptomatic / mild (Cumulative)',
+        quarterly_asymptomatic: 'Asy: Asymptomatic / mild (Quarterly)',
+        pregnant_women: 'Preg: Pregnant women',
+        cum_pregnant_women: 'Preg: Pregnant Women (Cumulative)',
+        quarterly_pregnant_women: 'Preg: Pregnant Women (Quarterly)',
+        defaulted: 'Def: Defaulted (more than 2 months overdue after expected to have run out of ARVs',
+        tb_within_the_last_two_years: 'Last 2 Years: TB within the last 2 years',
+        cum_tb_within_the_last_two_years: 'Last 2 Years: TB within the last 2 years (Cumulative)',
+        quarterly_tb_within_the_last_two_years: 'Last 2 Years: TB within the last 2 years (Quarterly)',
+        total_patients_without_side_effects: 'Side Effects (as of the last visit before end of quarter)',
+        current_episode_of_tb: 'Curr: Current episode of TB',
+        cum_current_episode_of_tb: 'Curr: Current episode of TB (Cumulative)',
+        quarterly_current_episode_of_tb: 'Curr: Current episode of TB (Quarterly)',
+        re_initiated_on_art: 'Re: Patients re-initiated on ART',
+        cum_re_initiated_on_art: 'Re: Patients re-initiated on ART (Cumulative)',
+        quarterly_re_initiated_on_art: 'Re: Patients re-initiated on ART (Quarterly)',
+        zero_p: 'Regimen 0P',
+        zero_a: 'Regimen 0 A',
+        two_p: 'Regimen 2P',
+        two_a: 'Regimen 2 A',
+        four_pp: ' Regimen 4PP',
+        four_pa: ' Regimen 4PA',
+        four_a: 'Regimen 4 A',
+        five_a: 'Regimen 5 A',
+        six_a: 'Regimen 6 A',
+        seven_a: 'Regimen 7 A',
+        eight_a: 'Regimen 8 A',
+        nine_pp: 'Regimen 9PP',
+        nine_pa: 'Regimen 9PA',
+        nine_a: 'Regimen 9 A',
+        ten_a: 'Regimen 10 A',
+        eleven_pp: 'Regimen 11PP',
+        eleven_pa: 'Regimen 11PA',
+        eleven_a: 'Regimen 11 A',
+        twelve_pp: 'Regimen 12PP',
+        twelve_pa: 'Regimen 12PA',
+        twelve_a: 'Regimen 12 A',
+        thirteen_a: 'Regimen 13 A',
+        fourteen_pp: 'Regimen 14PP',
+        fourteen_pa: 'Regimen 14PA',
+        fourteen_a: 'Regimen 14 A',
+        fifteen_pp: 'Regimen 15PP',
+        fifteen_pa: 'Regimen 15PA',
+        fifteen_a: 'Regimen 15 A',
+        sixteen_p: 'Regimen 16P',
+        sixteen_a: 'Regimen 16 A',
+        seventeen_pa: 'Regimen 17PA',
+        seventeen_pp: 'Regimen 17PP',
+        seventeen_a: 'Regimen 17 A',
+        total_patients_with_side_effects: 'Any side effects',
+        total_patients_on_family_planning: 'PIFP: Apprx. % of women who received Depo at ART in the last quarter',
+        total_pregnant_women: 'Pregnant/BreastFeeding as of the last visit before end of quarter',
+        transfered_out: 'TO: Transferred Out',
+        children_12_59_months: 'U5: Children 12 - 59 months',
+        cum_children_12_59_months: 'U5: Children 12 - 59 months (Cumulative)',
+        quarterly_children_12_59_months: 'U5: Children 12 - 59 months (Quarterly)',
+        tb_not_suspected: 'Current TB status any form of TB',
+        tb_confirmed_on_tb_treatment: 'TB confirmed, on TB Treatment',
+        tb_confirmed_currently_not_yet_on_tb_treatment: 'TB confirmed, not on TB Treatment',
+        breastfeeding_mothers: 'BF: Breastfeeding mothers',
+        cum_breastfeeding_mothers: 'BF: Breastfeeding mothers (Cumulative)',
+        quarterly_breastfeeding_mothers: 'BF: Breastfeeding mothers (Quarterly)',
+        patients_with_0_6_doses_missed_at_their_last_visit: 'Adnerence: as of the last visit before end of quarter',
+        total_patients_on_arvs_and_ipt: 'IPT: Apprx. % of patients retained in <b>ART</b> who are currently on IPT',
+        total_breastfeeding_women: 'Total Breastfeeding Women',
+        total_alive_and_on_art: ' Total alive and on ART',
+        kaposis_sarcoma: "KS: Kaposi's Sarcoma",
+        cum_kaposis_sarcoma: "KS: Kaposi's Sarcoma (Cumulative)",
+        quarterly_kaposis_sarcoma: "KS: Kaposi's Sarcoma (Quarterly)",
+        unknown_outcome: 'Patient status is unknown',
+        unknown_regimen: "Specify above regimens counted as 'Other' Other (paed. / adult)",
+        total_patients_with_screened_bp: 'BP screen: Apprx. % of adult ART patients with BP recorded at least once this year',
+        cum_total_registered: 'Total Registered (Cummulative)',
+        quarterly_total_registered: 'Total Registered (Quarterly)',
+        transfer_in: 'TI: Patients transferred in on ART',
+        cum_transfer_in: 'TI: Patients transferred in on ART (Cumulative)',
+        quarterly_transfer_in: 'TI: Patients transferred in on ART (Quarterly)',
+        confirmed_hiv_infection_in_infants_pcr: 'PCR: Infants < 12 months PCR+',
+        cum_confirmed_hiv_infection_in_infants_pcr: 'PCR: Infants < 12 months PCR+ (Cumulative)',
+        quarterly_confirmed_hiv_infection_in_infants_pcr: 'PCR: Infants < 12 months PCR+ (Quarterly)',
+        who_stage_four: '4: WHO stage 4',
+        cum_who_stage_four: '4: WHO stage 4 (Cumulative)',
+        quarterly_who_stage_four: '4: WHO stage 4 (Quarterly)',
+        non_pregnant_females: 'FNP: Non-pregnant females all ages',
+        cum_non_pregnant_females: 'FNP: Non-pregnant females all ages (Cumulative)',
+        quarterly_non_pregnant_females: 'FNP: Non-pregnant females all ages (Quarterly)',
+        unknown_tb_status: 'Unknown (not circled)',
+        total_patients_on_arvs_and_cpt: 'CPT: Apprx. % of patients retained in <b>ART</b> who are currently on CPT',
+        tb_suspected: 'TB Suspected',
+        unknown_side_effects: 'Unkown (not circled)',
+        total_registered: 'Total Registered',
+        pregnant_females_all_ages: 'Female pregnant_females all ages',
+        cum_pregnant_females_all_ages: 'Female pregnant patients all ages (Cumulative)',
+        quarterly_pregnant_females_all_ages: 'Cumulative female pregnant patients (Quarterly)',
+        patients_with_unknown_adhrence: 'Unknown (not circled)',
+        who_stage_three: '3: WHO stage 3',
+        cum_who_stage_three: '3: WHO stage 3 (Cumulative)',
+        quarterly_who_stage_three: '3: WHO stage 3 (Quarterly)',
+        unknown_other_reason_outside_guidelines: 'Unk: Unknown / reason outside guidelines',
+        cum_unknown_other_reason_outside_guidelines: 'Unk: Unknown / reason outside guidelines (Cumulative)',
+        quarterly_unknown_other_reason_outside_guidelines: 'Unk: Unknown / reason outside guidelines (Quarterly)',
+        initiated_on_art_first_time: 'FT: Patients initiated on ART first time',
+        cum_initiated_on_art_first_time: 'FT: Patients initiated on ART first time (Cummulative)',
+        quarterly_initiated_on_art_first_time: 'FT: Patients initiated on ART first time (Quarterly)',
+        presumed_severe_hiv_disease_in_infants: 'PSHD: Pres. Sev. HIV disease age < 12 months',
+        cum_presumed_severe_hiv_disease_in_infants: 'PSHD: Pres. Sev. HIV disease age < 12 months (Cumulative)',
+        quarterly_presumed_severe_hiv_disease_in_infants: 'PSHD: Pres. Sev. HIV disease age < 12 months (Quarterly)',
+        all_males: 'M: Males all ages',
+        cum_all_males: 'M: Males all ages (Cumulative)',
+        quarterly_all_males: 'M: Males all ages (Quarterly)',
+        stopped_art: 'Stop: Stopped taking ARVs (clinician or patient own decision, last known alive)',
+        children_below_24_months_at_art_initiation: 'A: Children below 24 months at ART initiation',
+        cum_children_below_24_months_at_art_initiation: 'A: Children below 24 months at ART initiation (Cumulative)',
+        quarterly_children_below_24_months_at_art_initiation: 'A: Children below 24 m at ART initiation (Quarterly)',
+        children_24_months_14_years_at_art_initiation: 'B: Children 24 months - 14 years at ART initiation',
+        cum_children_24_months_14_years_at_art_initiation: 'B: Children 24 months - 14 years at ART initiation (Cumulative)',
+        quarterly_children_24_months_14_years_at_art_initiation: 'B: Children 24 months - 14 years at ART initiation (Quarterly)',
+        adults_at_art_initiation: 'C: Adults 15 years or older at ART initiation',
+        cum_adults_at_art_initiation: 'C: Adults 15 years or older at ART initiation (Cumulative)',
+        quarterly_adults_at_art_initiation: 'C: Adults 15 years or older at ART initiation (Quarterly)',
+        males_initiated_on_art_first_time: 'Newly initiated male patients',
+        cum_males_initiated_on_art_first_time: 'Newly initiated male patients (Cummulative)',
+        initial_pregnant_females_all_ages: 'Newly initiated pregnant females',
+        cum_initial_pregnant_females_all_ages: 'Newly initiated pregnant females (Cummulative)',
+        initial_non_pregnant_females_all_ages: 'Newly initiated non-pregnant females',
+        cum_initial_non_pregnant_females_all_ages: 'Newly initiated non-pregnant females (Cummulative)',
+        unknown_gender: 'All clients registered but has not gender specified',
+        cum_unknown_gender: 'All clients registered but has not gender specified (Cummulative)',
+        newly_initiated_on_3hp: 'All patients who started 3HP in current reporting period',
+        newly_initiated_on_ipt: 'All patients who started IPT in current reporting period'
+      }.freeze
+
+      def initialize
+        @values = ActiveSupport::HashWithIndifferentAccess.new
+      end
+
+      def method_missing(name, *args, &)
+        name_prefix, name_suffix = split_missing_method_name(name)
+
+        return super(name, *args, &) unless FIELD_DESCRIPTIONS.include?(name_prefix)
+
+        field = value(name_prefix)
+        field.contents = args[0] if name_suffix == '='
+        field.contents
+
+        field.contents
+      end
+
+      def respond_to_missing?(name)
+        field_name, = split_missing_method_name(name)
+        FIELD_DESCRIPTIONS.include?(field_name)
+      end
+
+      def values
+        @values.values
+      end
+
+      private
+
+      # Returns a ReportValue object for the given name
+      def value(name)
+        description = FIELD_DESCRIPTIONS[name]
+        iname_parts = description.split(':', 2)
+        iname_parts.insert(0, nil) unless iname_parts.size == 2
+        short_iname, long_iname = iname_parts
+
+        @values[name] ||= OpenStruct.new(
+          name:,
+          indicator_name: long_iname.strip,
+          indicator_short_name: short_iname ? short_iname.strip : short_iname,
+          description:,
+          contents: nil
+        )
+      end
+
+      def split_missing_method_name(name)
+        match = name.to_s.match(/^([_A-Z0-9]+)(=)?$/i)
+        [match[1].to_sym, match[2]]
+      end
+    end
+    # rubocop:enable Metrics/ClassLength
+  end
+end

data/app/services/malawi_hiv_program_reports/moh/cohort_survival_analysis.rb

@@ -0,0 +1,203 @@
+# frozen_string_literal: true
+
+module MalawiHivProgramReports
+  module Moh
+    # This class is used to add additional cohort disaggregated data
+    # rubocop:disable Metrics/ClassLength
+    class CohortSurvivalAnalysis
+      def initialize(name:, type:, start_date:, end_date:, regenerate:, occupation:)
+        @name = name
+        @type = type
+        @start_date = start_date
+        @end_date = end_date
+        @regenerate = regenerate
+        @occupation = occupation
+      end
+
+      def survival_analysis(quarter, age_group)
+        art_service = CohortDisaggregated.new(name: 'survival_analysis',
+                                              type: 'survival_analysis', start_date: Date.today,
+                                              end_date: Date.today, rebuild: @regenerate)
+
+        start_date, end_date = art_service.generate_start_date_and_end_date(quarter)
+        CohortBuilder.new.init_temporary_tables(start_date, @end_date, @occupation) if @regenerate
+        art_service = CohortDisaggregated.new(name: 'survival_analysis',
+                                              type: 'survival_analysis', start_date: @start_date.to_date,
+                                              end_date: @end_date.to_date, rebuild: @regenerate)
+
+        qtr = quarter.split[0]
+        results = {}
+        years = 1
+
+        years_to_backto = ActiveRecord::Base.connection.select_one <<~SQL
+          SELECT
+           TIMESTAMPDIFF(YEAR, DATE(MIN(encounter_datetime)), DATE('#{end_date}')) years
+          FROM encounter e WHERE program_id = 1 AND voided = 0;
+        SQL
+
+        clinic_start_years = begin
+          years_to_backto['years'].to_i
+        rescue StandardError
+          nil
+        end
+        clinic_start_years = 10 if clinic_start_years.blank?
+
+        while years < clinic_start_years
+          yr = (quarter.split[1].to_i - years)
+          set_qtr = "#{qtr} #{yr}"
+          qstart_date, qend_date = art_service.generate_start_date_and_end_date(set_qtr)
+          results[set_qtr] = {}
+
+          case age_group
+          when 'General'
+            additional_sql = ' GROUP BY e.patient_id'
+          when 'Children'
+            additional_sql = ' GROUP BY e.patient_id'
+            additional_sql += ' HAVING patient_age < 15'
+          when 'Women'
+            option_Bplus_women_ids = pregnant_and_breastfeeding_women(qstart_date, qend_date)
+
+            option_Bplus_women_ids = [0] if option_Bplus_women_ids.blank?
+
+            additional_sql = " AND e.patient_id IN (#{option_Bplus_women_ids.join(', ')})"
+            additional_sql += ' GROUP BY e.patient_id'
+            additional_sql += ' HAVING patient_age >= 15'
+            additional_sql += ' AND gender = "F"'
+          end
+
+          begin
+            data = ActiveRecord::Base.connection.select_all <<~SQL
+              SELECT
+                cum_outcome, timestampdiff(month, DATE('#{qend_date}'), DATE('#{end_date}')) qinterval,
+                timestampdiff(year, DATE(e.birthdate), DATE('#{end_date}')) AS patient_age,
+                e.gender
+              FROM temp_earliest_start_date e
+              INNER JOIN temp_patient_outcomes o ON o.patient_id = e.patient_id
+              WHERE date_enrolled BETWEEN '#{qstart_date.strftime('%Y-%m-%d')}'
+              AND '#{qend_date.strftime('%Y-%m-%d')}'
+              #{additional_sql};
+            SQL
+          rescue StandardError
+            return results
+          end
+
+          (data || []).each do |r|
+            outcome = r['cum_outcome']
+            outcome = (outcome.blank? ? 'Unknown' : outcome)
+
+            if results[set_qtr][outcome].blank?
+              results[set_qtr][outcome] = {}
+              results[set_qtr][outcome][r['qinterval']] = 0
+            end
+            results[set_qtr][outcome][r['qinterval']] += 1
+          end
+
+          years += 1
+        end
+
+        append_last_six_months(quarter, results, end_date) if age_group == 'Women'
+
+        results
+      end
+
+      def pregnant_and_breastfeeding_women(start_date, end_date)
+        patient_ids = []
+
+        patients = ActiveRecord::Base.connection.select_all <<~SQL
+          SELECT
+            e.*, patient_reason_for_starting_art_text(e.patient_id) reason
+          FROM temp_earliest_start_date e
+          WHERE date_enrolled BETWEEN '#{start_date.to_date}' AND '#{end_date.to_date}'
+          AND gender IN('F','Female') GROUP BY e.patient_id
+          HAVING reason LIKE '%pregnant%' OR reason LIKE '%breast%';
+        SQL
+
+        (patients || []).each do |aRow|
+          patient_ids << aRow['patient_id'].to_i
+        end
+
+        concept_ids = []
+        ::ConceptName.where(name: 'Breastfeeding').select do |c|
+          concept_ids << c.concept_id
+        end
+        concept_ids << ::ConceptName.find_by_name('Patient pregnant').concept_id
+        concept_ids << ::ConceptName.find_by_name('Is patient pregnant?').concept_id
+        concept_ids << ::ConceptName.find_by_name('Is patient breast feeding?').concept_id
+        yes_concept_id = ::ConceptName.find_by_name('Yes').concept_id
+
+        patients = ActiveRecord::Base.connection.select_all <<~SQL
+          SELECT
+            e.*, patient_reason_for_starting_art_text(e.patient_id) reason
+          FROM temp_earliest_start_date e
+          INNER JOIN obs ON obs.person_id = e.patient_id
+          WHERE date_enrolled BETWEEN '#{start_date.to_date}' AND '#{end_date.to_date}'
+          AND gender IN('F','Female') AND obs.voided = 0
+          AND DATE(obs_datetime) = DATE(earliest_start_date)
+          AND obs.concept_id IN(#{concept_ids.join(',')})
+          AND value_coded = #{yes_concept_id} GROUP BY e.patient_id
+          HAVING reason LIKE '%Lymphocyte count below threshold with who stage%'
+          ORDER BY obs_datetime DESC;
+        SQL
+
+        pregnant_and_breastfeeding_clients = []
+
+        (patients || []).each do |aRow|
+          pregnant_and_breastfeeding_clients << aRow['patient_id'].to_i
+        end
+
+        (patient_ids + pregnant_and_breastfeeding_clients).uniq
+      end
+
+      def append_last_six_months(quarter, results, end_date)
+        art_service = CohortDisaggregated.new(name: 'survival_analysis',
+                                              type: 'survival_analysis', start_date: @start_date.to_date,
+                                              end_date: @end_date.to_date, rebuild: @regenerate)
+
+        qstart_date, qend_date = art_service.generate_start_date_and_end_date(quarter)
+        qstart_date -= 6.month
+        qend_date -= 6.month
+        # set_qtr = "Q#{quarter.split(' ')[0][1..1].to_i - 2} #{qend_date.year}"
+        set_qtr = (quarter[1..1].to_i - 2)
+
+        set_qtr = (set_qtr.zero? ? 4 : set_qtr)
+        set_qtr = (set_qtr == -1 ? 3 : set_qtr)
+        set_qtr = (set_qtr == -2 ? 2 : set_qtr)
+        set_qtr = "Q#{set_qtr} #{qend_date.year}"
+
+        option_Bplus_women_ids = pregnant_and_breastfeeding_women(qstart_date, qend_date)
+        option_Bplus_women_ids = [0] if option_Bplus_women_ids.blank?
+
+        data = ActiveRecord::Base.connection.select_all <<~SQL
+          SELECT
+            cum_outcome, timestampdiff(month, DATE('#{qend_date}'), DATE('#{end_date}')) qinterval,
+            timestampdiff(year, DATE(e.birthdate), DATE('#{end_date}')) AS patient_age,
+            e.gender
+          FROM temp_earliest_start_date e
+          INNER JOIN temp_patient_outcomes o ON o.patient_id = e.patient_id
+          WHERE date_enrolled BETWEEN '#{qstart_date.strftime('%Y-%m-%d')}'
+          AND '#{qend_date.strftime('%Y-%m-%d')}' AND gender = 'F' AND e.patient_id IN (#{option_Bplus_women_ids.join(', ')});
+        SQL
+
+        (data || []).each do |r|
+          outcome = r['cum_outcome']
+          outcome = (outcome.blank? ? 'Unknown' : outcome)
+
+          if results[set_qtr].blank?
+            results[set_qtr] = {}
+            results[set_qtr][outcome] = {}
+            results[set_qtr][outcome][r['qinterval']] = 0
+          elsif results[set_qtr][outcome].blank?
+            results[set_qtr][outcome] = {}
+            results[set_qtr][outcome][r['qinterval']] = 0
+          end
+
+          puts "######### #{r['qinterval']}"
+          results[set_qtr][outcome][r['qinterval']] += 1
+        end
+
+        results
+      end
+    end
+    # rubocop:enable Metrics/ClassLength
+  end
+end

data/app/services/malawi_hiv_program_reports/moh/moh_tpt.rb

@@ -0,0 +1,223 @@
+# frozen_string_literal: true
+
+module MalawiHivProgramReports
+  module Moh
+    # This class generates the MOH TPT report
+    # rubocop:disable Metrics/ClassLength
+    class MohTpt
+      include MalawiHivProgramReports::Utils::CommonSqlQueryUtils
+      attr_reader :start_date, :end_date, :start_of_month, :end_of_month, :raw_end_date, :raw_start_date
+
+      def initialize(start_date:, end_date:, **kwargs)
+        @raw_end_date = end_date.to_date
+        @raw_start_date = start_date.to_date
+        @start_date = start_date - 9.months
+        @end_date = @start_date + 3.months
+        @start_of_month = @start_date.beginning_of_month
+        @end_of_month = @end_date.end_of_month
+        @occupation = kwargs[:occupation]
+      end
+
+      def data
+        report = init_report
+        drop_tables
+        initiated_on_art
+        initiated_on_tpt
+        create_indexes
+        process_initiated_on_art report, fetch_initiated_on_art
+        process_initiated_tpt report, fetch_initiated_on_tpt
+        response = []
+        report.each do |key, value|
+          response << { age_group: key, gender: 'F', **value['F'] }
+          response << { age_group: key, gender: 'M', **value['M'] }
+        end
+        response
+      end
+
+      private
+
+      GENDERS = %w[F M].freeze
+      AGE_GROUPS = ['<1 year', '1-4 years', '5-9 years', '10-14 years', '15-19 years',
+                    '20-24 years', '25-29 years', '30-34 years', '35-39 years', '40-44 years',
+                    '45-49 years', '50-54 years', '55-59 years', '60-64 years', '65-69 years',
+                    '70-74 years', '75-79 years', '80-84 years', '85-89 years',
+                    '90 plus years'].freeze
+
+      def init_report
+        AGE_GROUPS.each_with_object({}) do |age_group, report|
+          report[age_group] = GENDERS.each_with_object({}) do |gender, tpt_report|
+            tpt_report[gender] = {
+              initiated_art: [], started_tpt: [], not_completed_tpt: [],
+              completed_tpt: [], died: [], pregnant: [],
+              defaulted: [], stopped: [],
+              transfer_out: [], confirmed_tb: [],
+              breast_feeding: [], skin_rash: [],
+              nausea: [], peripheral_neuropathy: [],
+              dizziness: [], yellow_eyes: []
+            }
+          end
+        end
+      end
+
+      def process_initiated_on_art(report, patients)
+        patients.each do |patient|
+          report[patient['age_group']][patient['gender']][:initiated_art] << patient['patient_id']
+        end
+      end
+
+      def process_initiated_tpt(report, patients)
+        TptOutcome.new(start_date:, end_date: raw_end_date)
+                  .moh_report(report, patients, start_date, end_date)
+      end
+
+      def fetch_initiated_on_art
+        ActiveRecord::Base.connection.select_all <<~SQL
+          SELECT patient_id, age_group, gender FROM temp_initiated_on_art
+          WHERE art_start_date >= DATE('#{start_of_month}')
+        SQL
+      end
+
+      def fetch_initiated_on_tpt
+        result = ActiveRecord::Base.connection.select_all <<~SQL
+          SELECT * FROM temp_initiated_on_tpt
+          WHERE start_date >= DATE('#{start_of_month}')
+        SQL
+        # convert to array of hashes
+        result.to_a
+      end
+
+      def initiated_on_art
+        ActiveRecord::Base.connection.execute <<~SQL
+          CREATE TABLE temp_initiated_on_art
+          SELECT pp.patient_id, coalesce(o.value_datetime, min(art_order.start_date)) art_start_date, p.gender, disaggregated_age_group(p.birthdate, DATE('#{raw_end_date}')) age_group
+          FROM patient_program pp
+          INNER JOIN person p ON p.person_id = pp.patient_id AND p.voided = 0
+          INNER JOIN patient_state ps ON ps.patient_program_id = pp.patient_program_id AND ps.voided = 0 AND ps.state = 7 -- ON ART
+          INNER JOIN orders art_order ON art_order.patient_id = pp.patient_id
+            AND art_order.start_date >= DATE('#{start_of_month}')
+            AND art_order.start_date < DATE('#{end_of_month}') + INTERVAL 1 DAY
+            AND art_order.voided = 0
+            AND art_order.order_type_id = 1 -- Drug order
+            AND art_order.concept_id IN (#{arv_concepts})
+          INNER JOIN drug_order do ON do.order_id = art_order.order_id AND do.quantity > 0
+          LEFT JOIN encounter e ON e.patient_id = pp.patient_id
+            AND e.encounter_type = 9 -- HIV CLINIC REGISTRATION
+            AND e.voided = 0
+            AND e.encounter_datetime < DATE('#{end_of_month}') + INTERVAL 1 DAY
+            AND e.program_id = 1 -- HIV PROGRAM
+          LEFT JOIN obs o ON o.person_id = pp.patient_id
+            AND o.concept_id = 2516 -- ART start date
+            AND o.encounter_id = e.encounter_id
+            AND o.voided = 0
+          LEFT JOIN (#{current_occupation_query}) a ON a.person_id = pp.patient_id
+          WHERE pp.patient_id NOT IN (
+            SELECT o.patient_id
+            FROM orders o
+            INNER JOIN drug_order do ON do.order_id = o.order_id AND do.quantity > 0
+            WHERE o.order_type_id = 1 -- Drug order
+              AND o.voided  = 0
+              AND o.concept_id IN (#{arv_concepts})
+              AND o.start_date < DATE('#{start_of_month}')
+            GROUP BY o.patient_id
+          )
+          AND pp.program_id = 1 #{%w[Military Civilian].include?(@occupation) ? 'AND' : ''} #{occupation_filter(occupation: @occupation, field_name: 'value', table_name: 'a', include_clause: false)}
+          GROUP BY pp.patient_id
+        SQL
+      end
+
+      def initiated_on_tpt
+        ActiveRecord::Base.connection.execute <<~SQL
+          CREATE TABLE temp_initiated_on_tpt
+          SELECT
+            pp.patient_id,
+            coalesce(tpt_transfer_in_obs.value_datetime, min(tpt_order.start_date)) start_date,
+            p.gender, disaggregated_age_group(p.birthdate, DATE('#{raw_end_date}')) age_group,
+            patient_outcome(p.person_id, DATE('#{@raw_end_date}')) AS outcome,
+            DATE(COALESCE(art_start_date_obs.value_datetime, MIN(art_order.start_date))) AS earliest_start_date,
+            GROUP_CONCAT(DISTINCT tpt_order.concept_id SEPARATOR ',') AS drug_concepts,
+            CASE
+              WHEN count(DISTINCT tpt_order.concept_id) >  1 THEN '3HP'
+              WHEN tpt_order.concept_id = 10565 THEN '3HP'
+              ELSE '6H'
+            END AS tpt_type
+          FROM patient_program pp
+          INNER JOIN person p ON p.person_id = pp.patient_id AND p.voided = 0
+          INNER JOIN patient_state ps ON ps.patient_program_id = pp.patient_program_id AND ps.voided = 0 AND ps.state = 7 -- ON ART
+          INNER JOIN orders tpt_order ON tpt_order.patient_id = pp.patient_id
+            AND tpt_order.start_date >= DATE('#{start_of_month}')
+            AND tpt_order.start_date < DATE('#{end_of_month}') + INTERVAL 1 DAY
+            AND tpt_order.voided = 0
+            AND tpt_order.order_type_id = 1 -- Drug order
+            AND tpt_order.concept_id IN (#{tpt_concepts})
+          INNER JOIN drug_order do ON do.order_id = tpt_order.order_id AND do.quantity > 0
+          LEFT JOIN encounter AS clinic_registration_encounter
+            ON clinic_registration_encounter.encounter_type = (
+              SELECT encounter_type_id FROM encounter_type WHERE name = 'HIV CLINIC REGISTRATION' LIMIT 1
+            )
+            AND clinic_registration_encounter.patient_id = pp.patient_id
+            AND clinic_registration_encounter.program_id = pp.program_id
+            AND clinic_registration_encounter.encounter_datetime < DATE('#{@end_date}') + INTERVAL 1 DAY
+            AND clinic_registration_encounter.voided = 0
+          INNER JOIN orders AS art_order
+            ON art_order.patient_id = pp.patient_id
+            /* AND art_order.encounter_id = prescription_encounter.encounter_id */
+            AND art_order.concept_id IN (SELECT concept_id FROM concept_set WHERE concept_set = 1085)
+            AND art_order.start_date < DATE('#{@end_of_month}') + INTERVAL 1 DAY
+            AND art_order.order_type_id IN (SELECT order_type_id FROM order_type WHERE name = 'Drug order')
+            AND art_order.start_date >= DATE('1901-01-01')
+            AND art_order.voided = 0
+          LEFT JOIN obs AS art_start_date_obs
+            ON art_start_date_obs.concept_id = 2516
+            AND art_start_date_obs.person_id = pp.patient_id
+            AND art_start_date_obs.voided = 0
+            AND art_start_date_obs.obs_datetime < (DATE('#{@end_of_month}') + INTERVAL 1 DAY)
+            AND art_start_date_obs.encounter_id = clinic_registration_encounter.encounter_id
+          LEFT JOIN obs tpt_transfer_in_obs ON tpt_transfer_in_obs.person_id = pp.patient_id
+            AND tpt_transfer_in_obs.concept_id = #{::ConceptName.find_by_name('TPT Drugs Received').concept_id}
+            AND tpt_transfer_in_obs.voided = 0
+            AND tpt_transfer_in_obs.value_drug IN (#{tpt_concepts})
+            AND tpt_transfer_in_obs.obs_datetime < DATE('#{end_of_month}') + INTERVAL 1 DAY
+          LEFT JOIN (#{current_occupation_query}) a ON a.person_id = pp.patient_id
+          WHERE pp.patient_id NOT IN (
+            SELECT o.patient_id
+            FROM orders o
+            INNER JOIN drug_order do ON do.order_id = o.order_id AND do.quantity > 0
+            WHERE o.order_type_id = 1 -- Drug order
+              AND o.voided  = 0
+              AND o.concept_id IN (#{tpt_concepts})
+              AND o.start_date < DATE('#{start_of_month}')
+            GROUP BY o.patient_id
+          )
+          AND pp.program_id = 1 #{%w[Military Civilian].include?(@occupation) ? 'AND' : ''} #{occupation_filter(occupation: @occupation, field_name: 'value', table_name: 'a', include_clause: false)}
+          GROUP BY pp.patient_id
+        SQL
+      end
+
+      def drop_tables
+        execute_query 'DROP TABLE IF EXISTS temp_initiated_on_art'
+        execute_query 'DROP TABLE IF EXISTS temp_initiated_on_tpt'
+      end
+
+      def create_indexes
+        execute_query 'CREATE INDEX idx_temp_initiated_on_art ON temp_initiated_on_art(patient_id)'
+        execute_query 'CREATE INDEX idx_temp_initiated_on_tpt ON temp_initiated_on_tpt(patient_id)'
+      end
+
+      def execute_query(query)
+        ActiveRecord::Base.connection.execute(query)
+      end
+
+      def arv_concepts
+        @arv_concepts ||= ::ConceptSet.where(concept_set: ::ConceptName.where(name: 'Antiretroviral drugs')
+                                                                   .select(:concept_id))
+                                      .collect(&:concept_id).join(',')
+      end
+
+      def tpt_concepts
+        @tpt_concepts ||= ::ConceptName.where(name: ['Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine'])
+                                       .collect(&:concept_id).join(',')
+      end
+    end
+    # rubocop:enable Metrics/ClassLength
+  end
+end