malawi_hiv_program_reports 1.0.1 → 1.0.2

data/app/services/malawi_hiv_program_reports/pepfar/tb_prev3.rb

@@ -0,0 +1,421 @@
+# frozen_string_literal: true
+
+module MalawiHivProgramReports
+  module Pepfar
+    ##
+    # Patients who started TPT just before the start of the current
+    # and have finished within the current reporting period.
+    class TbPrev3
+
+      attr_reader :start_date, :end_date, :check_date, :cut_off_point, :occupation, :location
+      
+      include MalawiHivProgramReports::Adapters::Moh::Custom
+      include Utils
+      include MalawiHivProgramReports::Utils::CommonSqlQueryUtils
+
+      def initialize(start_date:, end_date:, **kwargs)
+        @start_date = ActiveRecord::Base.connection.quote(start_date)
+        @check_date = start_date.to_date - 6.months
+        @cut_off_point = start_date.to_date
+        @end_date = ActiveRecord::Base.connection.quote(end_date)
+        @occupation = kwargs[:occupation]
+        @location = kwargs[:location]
+      end
+
+      def find_report
+        report = init_report
+        patients = group_patients_by_tpt_course(patients_on_tpt)
+
+        load_patients_into_report(report, patients.six_h, '6H') do |patient|
+          # 6H has a constant dosage of 1 pill per day
+          patient_completed_tpt?(patient, '6H')
+        end
+
+        load_patients_into_report(report, patients.three_hp, '3HP') do |patient|
+          # 3HP daily dosages vary by patient weight can't use easily use pills
+          # to determine course completion
+          patient_completed_tpt?(patient, '3HP')
+        end
+
+        report
+      end
+
+      def fetch_individual_report(patient_id)
+        individual_tpt_report(patient_id)
+      end
+
+      private
+
+      def init_report
+        pepfar_age_groups.each_with_object({}) do |age_group, report|
+          report[age_group] = %w[M F Unknown].each_with_object({}) do |gender, gender_sub_report|
+            gender_sub_report[gender] = %w[6H 3HP].each_with_object({}) do |tpt, tpt_sub_report|
+              tpt_sub_report[tpt] = {
+                started_new_on_art: [],
+                started_previously_on_art: [],
+                completed_new_on_art: [],
+                completed_previously_on_art: []
+              }
+            end
+          end
+        end
+      end
+
+      def load_patients_into_report(report, patients, tpt, &patient_has_completed_tpt)
+        patients.each do |patient|
+          next if patient['transfer_in'] == 1 && !patient_has_completed_tpt[patient]
+
+          age_group = patient['age_group']
+          gender = patient['gender']&.first&.upcase || 'Unknown'
+          tpt_states = find_patient_tpt_state(patient, &patient_has_completed_tpt)
+
+          tpt_states.each do |tpt_state|
+            report[age_group][gender][tpt][tpt_state] << patient
+          end
+        end
+      end
+
+      def find_patient_tpt_state(patient, &patient_has_completed_tpt)
+        if patient_has_completed_tpt[patient]
+          return %i[completed_new_on_art] if patient_new_on_art?(patient) && patient['transfer_in'] == 1
+
+          return %i[started_new_on_art completed_new_on_art] if patient_new_on_art?(patient)
+
+          return %i[completed_previously_on_art] if patient['transfer_in'] == 1
+
+          return %i[started_previously_on_art completed_previously_on_art]
+        end
+
+        return %i[started_new_on_art] if patient_new_on_art?(patient)
+
+        %i[started_previously_on_art]
+      end
+
+      def patient_new_on_art?(patient)
+        tpt_initiation_date = patient['tpt_initiation_date'].to_date
+        art_start_date = patient['art_start_date'].to_date
+
+        (tpt_initiation_date >= art_start_date) && (tpt_initiation_date < art_start_date + 180.days)
+      end
+
+      def patients_on_tpt
+        clients = fetch_patients_on_tpt.to_a
+        results = []
+        clients.each do |client|
+          next if client['tpt_initiation_date'].to_date > cut_off_point
+
+          result = individual_tpt_report(client['patient_id'])
+          next if result.blank?
+          next if result['tpt_initiation_date'].to_date < check_date
+
+          client['tpt_initiation_date'] = result['tpt_initiation_date']
+          client['total_pills_taken'] = result['total_pills_taken']
+          client['months_on_tpt'] = result['months_on_tpt']
+          client['total_days_on_medication'] = result['total_days_on_medication']
+          client['drug_concepts'] = result['drug_concepts']
+          client['transfer_in'] = result['transfer_in']
+          results << client
+        end
+        results
+      end
+
+      def fetch_patients_on_tpt
+        ActiveRecord::Base.connection.select_all <<~SQL
+          SELECT person.person_id AS patient_id,
+                 patient_identifier.identifier AS arv_number,
+                 DATE(MIN(orders.start_date)) AS tpt_initiation_date,
+                 #{function_manager(function: 'date_antiretrovirals_started', location: @location, args: "person.person_id::int, MIN(denominator_patient.start_date)::date, #{@location}::int")} AS art_start_date,
+                 #{function_manager(function: 'patient_outcome', location: @location, args: "person.person_id::int, #{@end_date}::date, #{@location}::int")} AS outcome,
+                 person.gender,
+                 person.birthdate,
+                 #{function_manager(function: 'disaggregated_age_group', location: @location, args: "person.birthdate::date, #{@end_date}::date")} AS age_group
+          FROM person
+          LEFT JOIN patient_identifier
+            ON patient_identifier.patient_id = person.person_id
+            AND patient_identifier.voided = 0
+            AND #{in_manager(column: 'patient_identifier.identifier_type', values: "(SELECT patient_identifier_type_id FROM patient_identifier_type WHERE name = 'ARV Number')")}
+            #{site_manager(operator: 'AND', column: 'patient_identifier.site_id', location: @location)}
+          LEFT JOIN (#{current_occupation_query}) AS current_occupation ON current_occupation.person_id = person.person_id
+          #{site_manager(operator: 'AND', column: 'current_occupation.site_id', location: @location)}
+          INNER JOIN(
+              SELECT denominator_encounter.patient_id AS patient_id, patient_state.start_date AS start_date
+              FROM person
+              INNER JOIN patient_program
+                ON patient_program.patient_id = person.person_id
+                AND #{in_manager(column: 'patient_program.program_id', values: "(SELECT program_id FROM program WHERE name = 'HIV PROGRAM')")}
+                AND patient_program.voided = 0
+              INNER JOIN patient_state
+                ON patient_state.patient_program_id = patient_program.patient_program_id
+                AND patient_state.state = 7 /* State: 7 == On antiretrovirals */
+                AND patient_state.start_date < DATE(#{start_date})
+                AND patient_state.voided = 0
+              INNER JOIN encounter AS denominator_encounter
+                ON denominator_encounter.patient_id = patient_program.patient_id
+                AND #{in_manager(column: 'denominator_encounter.program_id', values: "(SELECT program_id FROM program WHERE name = 'HIV PROGRAM')")}
+                AND #{in_manager(column: 'denominator_encounter.encounter_type', values: "(SELECT encounter_type_id FROM encounter_type WHERE name = 'Treatment')")}
+                AND denominator_encounter.encounter_datetime >= #{interval_manager(date: start_date, value: 6, interval: 'MONTH', operator: '-')}
+                AND denominator_encounter.encounter_datetime <= DATE(#{start_date})
+                AND denominator_encounter.voided = 0
+                 #{site_manager(operator: 'AND', column: 'patient_program.site_id', location: @location)}
+              GROUP BY denominator_encounter.patient_id, patient_state.start_date
+          ) AS denominator_patient ON denominator_patient.patient_id = person.person_id
+          INNER JOIN encounter AS prescription_encounter
+            ON prescription_encounter.patient_id = denominator_patient.patient_id
+            AND prescription_encounter.program_id = 1
+            AND #{in_manager(column: 'prescription_encounter.encounter_type', values: "(SELECT encounter_type_id FROM encounter_type WHERE name = 'Treatment')")}
+            AND prescription_encounter.encounter_datetime >= #{interval_manager(date: start_date, value: 6, interval: 'MONTH', operator: '-')}
+            AND prescription_encounter.encounter_datetime <= DATE(#{end_date})
+            AND prescription_encounter.voided = 0
+          INNER JOIN orders
+            ON orders.encounter_id = prescription_encounter.encounter_id
+            AND #{in_manager(column: 'orders.order_type_id', values: "(SELECT order_type_id FROM order_type WHERE name = 'Drug order')")}
+            AND orders.start_date >= #{interval_manager(date: start_date, value: 6, interval: 'MONTH', operator: '-')}
+            AND orders.start_date <= CAST(#{end_date} as DATE)
+            AND orders.voided = 0
+          INNER JOIN concept_name
+            ON concept_name.concept_id = orders.concept_id
+            AND #{in_manager(column: 'concept_name.name', values: "'Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine'" )}
+          INNER JOIN drug_order
+            ON drug_order.order_id = orders.order_id
+            AND drug_order.quantity > 0
+          WHERE person.voided = 0 #{%w[Military Civilian].include?(@occupation) ? 'AND' : ''} #{occupation_filter(occupation: @occupation, field_name: 'value', table_name: 'current_occupation', include_clause: false)}
+           #{site_manager(operator: 'AND', column: 'person.site_id', location: @location)}
+            AND person.person_id NOT IN (
+            /* External consultations */
+            SELECT DISTINCT registration_encounter.patient_id
+            FROM patient_program pp
+            INNER JOIN program p ON p.program_id = pp.program_id AND p.name = 'HIV PROGRAM' AND p.retired = 0
+            INNER JOIN encounter AS registration_encounter
+              ON registration_encounter.patient_id = pp.patient_id
+              AND registration_encounter.program_id = pp.program_id
+              AND registration_encounter.encounter_datetime < #{interval_manager(date: end_date, value: 1, interval: 'MONTH', operator: '+')}
+              AND registration_encounter.voided = 0
+            INNER JOIN (
+              SELECT MAX(encounter.encounter_datetime) AS encounter_datetime, encounter.patient_id
+              FROM encounter
+              INNER JOIN encounter_type
+                ON encounter_type.encounter_type_id = encounter.encounter_type
+                AND encounter_type.name = 'Registration'
+              INNER JOIN program
+                ON program.program_id = encounter.program_id
+                AND program.name = 'HIV PROGRAM'
+              WHERE encounter.encounter_datetime < CAST(#{end_date} AS DATE) AND encounter.voided = 0
+              GROUP BY encounter.patient_id
+            ) AS max_registration_encounter
+              ON max_registration_encounter.patient_id = registration_encounter.patient_id
+              AND max_registration_encounter.encounter_datetime = registration_encounter.encounter_datetime
+            INNER JOIN obs AS patient_type_obs
+              ON patient_type_obs.encounter_id = registration_encounter.encounter_id
+              AND #{in_manager(column: 'patient_type_obs.concept_id', values: "(SELECT concept_id FROM concept_name WHERE name = 'Type of patient' AND voided = 0)")}
+              AND #{in_manager(column: 'patient_type_obs.value_coded', values: "(SELECT concept_id FROM concept_name WHERE name IN ('Drug refill', 'External consultation') AND voided = 0)")}
+              AND patient_type_obs.voided = 0
+            WHERE pp.voided = 0
+          )
+          GROUP BY person.person_id #{group_by_columns('patient_identifier.identifier, person.gender, person.birthdate, denominator_patient.start_date')}
+        SQL
+      end
+
+      def individual_tpt_report(patient_id)
+        result = process_current_tpt_course_date(patient_id)
+        c_start_date = ActiveRecord::Base.connection.quote(result[:start_date])
+        c_end_date = ActiveRecord::Base.connection.quote(client_tpt_end_date(patient_id, c_start_date))
+        ActiveRecord::Base.connection.select_one <<-SQL
+            SELECT
+                CASE
+                  WHEN tpt_transfer_in_obs.value_datetime IS NULL THEN DATE(MIN(o.start_date))
+                  WHEN tpt_transfer_in_obs.value_datetime > MIN(o.start_date) THEN DATE(MIN(o.start_date))
+                  ELSE DATE(tpt_transfer_in_obs.value_datetime)
+                END AS tpt_initiation_date,
+                COUNT(DISTINCT(DATE(o.start_date))) AS months_on_tpt,
+                SUM(dor.quantity) + SUM(CASE WHEN tpt_transfer_in_obs.value_numeric IS NOT NULL THEN tpt_transfer_in_obs.value_numeric ELSE 0 END) AS total_pills_taken,
+                SUM(DATEDIFF(o.auto_expire_date, o.start_date)) + SUM(CASE WHEN tpt_transfer_in_obs.value_datetime IS NOT NULL THEN DATEDIFF(tpt_transfer_in_obs.obs_datetime, tpt_transfer_in_obs.value_datetime) ElSE 0 END) AS total_days_on_medication,
+                GROUP_CONCAT(DISTINCT o.concept_id SEPARATOR ',') AS drug_concepts,
+                CASE
+                  WHEN tpt_transfer_in_obs.value_numeric IS NOT NULL THEN 1
+                  ELSE 0
+                END AS transfer_in,
+                MAX(o.start_date) AS last_dispensed_date,
+                MAX(o.auto_expire_date) AS auto_expire_date
+            FROM orders o
+            INNER JOIN concept_name cn
+              ON cn.concept_id = o.concept_id
+              AND cn.name IN ('Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine')
+              #{site_manager(operator: 'AND', column: 'o.site_id', location: @location)}
+            LEFT JOIN obs tpt_transfer_in_obs
+              ON tpt_transfer_in_obs.person_id = o.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
+              #{site_manager(operator: 'AND', column: 'tpt_transfer_in_obs.site_id', location: @location)}
+              AND tpt_transfer_in_obs.value_drug IN (SELECT drug_id FROM drug WHERE concept_id IN (SELECT concept_id FROM concept_name WHERE name IN ('Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine')))
+            INNER JOIN drug_order dor
+              ON dor.order_id = o.order_id
+              AND dor.quantity > 0
+            WHERE DATE(o.start_date) BETWEEN DATE(#{c_start_date}) AND DATE(#{c_end_date})
+            AND o.order_type_id IN (SELECT order_type_id FROM order_type WHERE name = 'Drug order')
+            AND o.voided = 0
+            AND o.patient_id = #{patient_id}
+            GROUP BY o.patient_id
+        SQL
+      end
+
+      def process_current_tpt_course_date(patient_id)
+        result = client_tpt_dates(patient_id)
+        return { start_date: '1900-01-01', end_date: } if result.blank?
+
+        sorted_result = result.sort { |a, b| a['start_date'].to_date <=> b['start_date'].to_date }.reverse
+        return_date = { start_date: sorted_result.last['start_date'], end_date: }
+
+        course_interruption = result.first['course'] == '3HP' ? 1 : 2
+        # loop through the result array and find the first gap in the dates that equals the course interruption
+        sorted_result.each_with_index do |row, index|
+          next if index.zero?
+
+          diff = ActiveRecord::Base.connection.select_one("SELECT TIMESTAMPDIFF(MONTH,DATE('#{row['end_date']}'), DATE('#{sorted_result[index - 1]['start_date']}')) as months")['months']
+
+          if diff.to_i >= course_interruption
+            return_date = { start_date: sorted_result[index - 1]['start_date'], end_date: }
+            break
+          end
+        end
+        return_date
+      end
+
+      def client_tpt_dates(patient_id)
+        ActiveRecord::Base.connection.select_all <<~SQL
+          (
+            SELECT
+              DATE(o.value_datetime) AS start_date,
+              DATE(o.obs_datetime) AS end_date,
+              CASE
+                WHEN count(distinct(o.value_drug)) > 1 THEN '3HP'
+                WHEN o.value_drug = #{isoniazid_rifapentine_drug.drug_id} THEN '3HP'
+                ELSE '6H'
+              END AS course
+            FROM obs o
+            WHERE o.concept_id = #{::ConceptName.find_by_name('TPT Drugs Received').concept_id}
+            AND o.voided = 0
+            #{site_manager(operator: 'AND', column: 'o.site_id', location: @location)}
+            AND o.value_drug IN (SELECT drug_id FROM drug WHERE concept_id IN (SELECT concept_id FROM concept_name WHERE name IN ('Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine')))
+            AND o.person_id = #{patient_id}
+            AND o.value_numeric IS NOT NULL
+            AND DATE(o.obs_datetime) <= DATE(#{start_date})
+            GROUP BY DATE(o.obs_datetime)
+            ORDER BY DATE(o.obs_datetime) DESC
+          )
+          UNION
+          (
+            SELECT
+              DATE(o.start_date) AS start_date,
+              DATE(o.auto_expire_date) AS end_date,
+              CASE
+                WHEN count(distinct(o.concept_id)) > 1 THEN '3HP'
+                WHEN o.concept_id = #{isoniazid_rifapentine_concept.concept_id} THEN '3HP'
+                ELSE '6H'
+              END AS course
+            FROM orders o
+            INNER JOIN encounter e ON e.encounter_id = o.encounter_id AND e.voided = 0 AND e.program_id = 1 /* HIV PROGRAM */
+            INNER JOIN drug_order dor ON dor.order_id = o.order_id AND dor.quantity > 0
+            WHERE o.order_type_id IN (SELECT order_type_id FROM order_type WHERE name = 'Drug order')
+            AND o.voided = 0
+            #{site_manager(operator: 'AND', column: 'o.site_id', location: @location)}
+            AND o.concept_id IN (#{::ConceptName.where(name: ['Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine']).select(:concept_id).to_sql})
+            AND o.patient_id = #{patient_id}
+            AND o.auto_expire_date IS NOT NULL
+            AND DATE(o.start_date) <= DATE(#{start_date})
+            GROUP BY DATE(o.start_date)
+            ORDER BY DATE(o.start_date) DESC
+          )
+        SQL
+      end
+
+      def client_tpt_end_date(patient_id, start_date)
+        # Get patient tpt dispensations dates after the start date and before the end date
+        result = ActiveRecord::Base.connection.select_all <<~SQL
+          (
+            SELECT
+              DATE(o.value_datetime) AS start_date,
+              DATE(MAX(o.obs_datetime)) AS end_date,
+              CASE
+                WHEN count(distinct(o.value_drug)) > 1 THEN '3HP'
+                WHEN o.value_drug = #{isoniazid_rifapentine_drug.drug_id} THEN '3HP'
+                ELSE '6H'
+              END AS course
+            FROM obs o
+            WHERE o.concept_id = #{::ConceptName.find_by_name('TPT Drugs Received').concept_id}
+            AND o.voided = 0
+            #{site_manager(operator: 'AND', column: 'o.site_id', location: @location)}
+            AND o.value_drug IN (SELECT drug_id FROM drug WHERE concept_id IN (SELECT concept_id FROM concept_name WHERE name IN ('Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine')))
+            AND o.person_id = #{patient_id}
+            AND o.value_numeric IS NOT NULL
+            AND DATE(o.obs_datetime) BETWEEN DATE(#{start_date}) AND DATE(#{end_date})
+            GROUP BY DATE(o.obs_datetime)
+            ORDER BY DATE(o.obs_datetime) DESC
+          )
+          UNION
+          (
+            SELECT
+              DATE(o.start_date) AS start_date,
+              DATE(MAX(o.auto_expire_date)) AS end_date,
+              CASE
+                WHEN count(distinct(o.concept_id)) > 1 THEN '3HP'
+                WHEN o.concept_id = #{isoniazid_rifapentine_concept.concept_id} THEN '3HP'
+                ELSE '6H'
+              END AS course
+            FROM orders o
+            INNER JOIN encounter e ON e.encounter_id = o.encounter_id AND e.voided = 0 AND e.program_id = 1 /* HIV PROGRAM */
+            INNER JOIN drug_order dor ON dor.order_id = o.order_id AND dor.quantity > 0
+            WHERE o.order_type_id IN (SELECT order_type_id FROM order_type WHERE name = 'Drug order')
+            AND o.voided = 0
+            #{site_manager(operator: 'AND', column: 'o.site_id', location: @location)}
+            AND o.concept_id IN (#{::ConceptName.where(name: ['Rifapentine', 'Isoniazid', 'Isoniazid/Rifapentine']).select(:concept_id).to_sql})
+            AND o.patient_id = #{patient_id}
+            AND o.auto_expire_date IS NOT NULL
+            AND DATE(o.start_date) BETWEEN DATE(#{start_date}) AND DATE(#{end_date})
+            GROUP BY DATE(o.start_date)
+            ORDER BY DATE(o.start_date) DESC
+          )
+        SQL
+
+        return end_date if result.blank?
+
+        sorted_result = result.sort { |a, b| a['start_date'].to_date <=> b['start_date'].to_date }
+        return_date = sorted_result.last['end_date']
+        course_interruption = result.first['course'] == '3HP' ? 1 : 2
+        # use a for loop to check if there is a course interruption
+        sorted_result.each_with_index do |row, i|
+          next if i.zero?
+
+          if row['course'] != sorted_result[i - 1]['course']
+            return_date = sorted_result[i - 1]['end_date']
+            break
+          end
+          diff = ActiveRecord::Base.connection.select_one("SELECT TIMESTAMPDIFF(MONTH,DATE('#{sorted_result[i - 1]['end_date']}'),DATE('#{row['start_date']}')) as months")['months']
+          if diff.to_i >= course_interruption
+            return_date = sorted_result[i - 1]['end_date']
+            break
+          end
+        end
+        return_date
+      end
+
+      ##
+      # Groups patients into their TPT categories (ie 6H and 3HP) based on their drugs
+      #
+      # Returns an object with a three_hp and six_h methods, each of which
+      # is an array of patients for that category.
+      def group_patients_by_tpt_course(patients)
+        patients.each_with_object(OpenStruct.new(six_h: [], three_hp: [])) do |patient, categories|
+          if patient_on_3hp?(patient)
+            categories.three_hp << patient
+          else
+            categories.six_h << patient
+          end
+        end
+      end
+
+      def isoniazid_rifapentine_drug
+        @isoniazid_rifapentine_drug ||= ::Drug.find_by!(concept_id: isoniazid_rifapentine_concept.concept_id)
+      end
+    end
+  end
+end

data/app/services/malawi_hiv_program_reports/pepfar/tpt_status.rb

@@ -0,0 +1,181 @@
+# frozen_string_literal: true
+
+module MalawiHivProgramReports
+  module Pepfar
+    # This class is used to generate the TPT Status report for an ART patient
+    class TptStatus
+      attr_reader :start_date, :end_date, :patient_id
+
+      include Utils
+
+      def initialize(start_date:, end_date:, **kwargs)
+        @start_date = start_date
+        @end_date = end_date
+        @patient_id = kwargs[:patient_id]
+        @tpt_status = {}
+      end
+
+      def find_report
+        patient_tpt_status
+      rescue StandardError => e
+        Rails.logger.error("Error generating TPT Status report for patient #{patient_id}: #{e.message}")
+        Rails.logger.error(e.backtrace.join("\n"))
+        raise e
+      end
+
+      private
+
+      def patient_tpt_status
+        return tb_treatment_status if patient_on_tb_treatment?(patient_id)
+        return completed_tpt_status if patient_history_on_completed_tpt
+
+        patient = TbPrev3.new(start_date:, end_date:).fetch_individual_report(patient_id)
+        return default_status if patient.blank?
+
+        tpt_status_based_on_patient(patient)
+      end
+
+      def tb_treatment_status
+        {
+          tpt: nil,
+          completed: false,
+          tb_treatment: true,
+          tpt_init_date: nil,
+          tpt_complete_date: nil,
+          eligible: {
+            '3HP': false,
+            '6H': false
+          }
+        }
+      end
+
+      def completed_tpt_status
+        tpt = patient_history_on_completed_tpt.include?('IPT') ? '6H' : '3HP'
+        { tpt:, completed: true, tb_treatment: false, tpt_init_date: nil, tpt_complete_date: nil, tpt_end_date: nil,
+          eligible: {
+            '3HP': false,
+            '6H': false
+          } }
+      end
+
+      def default_status
+        patient = ::Patient.find(patient_id)
+        art_start_date = patient.art_start_date
+        { tpt: nil, completed: false, tb_treatment: false, tpt_init_date: nil, tpt_complete_date: nil, tpt_end_date: nil,
+          eligible: {
+            '3HP': art_start_date ? difference_in_months(end_date.to_date, art_start_date.to_date) < 3 : true,
+            '6H': art_start_date ? difference_in_months(end_date.to_date, art_start_date.to_date) < 3 : true
+          } }
+      end
+
+      def tpt_status_based_on_patient(patient)
+        tpt = determine_tpt(patient)
+        completed = patient_has_totally_completed_tpt?(patient, tpt)
+        tpt_init_date = patient['tpt_initiation_date']
+        tpt_current_expiry_date = patient['auto_expire_date']&.to_date
+        diff_in_months = difference_in_months(end_date.to_date, tpt_current_expiry_date)
+        art_start_date = ::Patient.find(patient_id).art_start_date
+        tpt_complete_date = completed ? patient['auto_expire_date']&.to_date : nil
+        tpt_end_date = calculate_tpt_end_date(tpt, tpt_init_date)
+        tpt_name = determine_tpt_name(tpt, patient)
+        arv_drug_runout_date = patient_arv_drug_runout_date
+
+        @tpt_status.merge!({ tpt: tpt_name, completed:, tb_treatment: false,
+                             tpt_init_date:, tpt_complete_date:,
+                             tpt_end_date:, art_start_date:,
+                             art_drug_auto_expire_date: arv_drug_runout_date })
+        determine_eligibility(tpt, diff_in_months, art_start_date, arv_drug_runout_date)
+      end
+
+      def determine_tpt(patient)
+        patient_on_3hp?(patient) ? '3HP' : '6H'
+      end
+
+      def determine_tpt_name(tpt, patient)
+        if tpt == '6H'
+          'IPT'
+        else
+          (patient['drug_concepts'].split(',').length > 1 ? '3HP (RFP + INH)' : 'INH 300 / RFP 300 (3HP)')
+        end
+      end
+
+      def calculate_tpt_end_date(tpt, tpt_init_date)
+        tpt == '6H' ? tpt_init_date + 6.months : tpt_init_date + 3.months
+      end
+
+      def determine_eligibility(tpt, diff_in_months, art_start_date, arv_drug_runout_date)
+        three_hp_eligible = false
+        six_h_eligible = false
+        tpt_init_date = @tpt_status[:tpt_init_date]
+        tpt_end_date = @tpt_status[:tpt_end_date]
+        case tpt
+        when '3HP'
+          # 3HP is taken 1 dose per week
+          # if client misses dose for less than a month, they are eligible
+          # if client misses more than a month:
+          # check if they have been on ART for less than 3 months, they are eligible
+          # if they have been on ART continuosly for more than 3 months, they are not eligible
+          three_hp_eligible = true if diff_in_months <= 1
+          if diff_in_months > 1 && (arv_drug_runout_date && difference_in_months(arv_drug_runout_date.to_date,
+                                                                                 art_start_date.to_date) < 3)
+            #  Patient defaulted for ART and TPT and was on ART for less than 3 months: patient TPT status is reset
+            three_hp_eligible = true
+            six_h_eligible = true
+            tpt_end_date = nil
+            tpt_init_date = nil
+            @tpt_status[:tpt] = nil
+          end
+        when '6H'
+          # 6H is taken 1 dose per day
+          # if client misses dose for less than 2 months, they are eligible
+          # if client misses more than a month:
+          # check if they have been on ART for less than 3 months, they are eligible
+          # if they have been on ART continuosly for more than 3 months, they are not eligible
+          six_h_eligible = true if diff_in_months <= 2
+          if diff_in_months > 2 && (arv_drug_runout_date && difference_in_months(arv_drug_runout_date.to_date,
+                                                                                 art_start_date.to_date) < 3)
+            #  Patient defaulted for ART and TPT and was on ART for less than 3 months: patient TPT status is reset
+            three_hp_eligible = true
+            six_h_eligible = true
+            tpt_end_date = nil
+            tpt_init_date = nil
+            @tpt_status[:tpt] = nil
+          end
+        end
+        @tpt_status.merge!({
+                             tpt_init_date:,
+                             tpt_end_date:,
+                             eligible: {
+                               '3HP': three_hp_eligible,
+                               '6H': six_h_eligible
+                             }
+                           })
+      end
+
+      def patient_has_totally_completed_tpt?(patient, tpt)
+        if tpt == '3HP'
+          init_date = patient['tpt_initiation_date'].to_date
+          end_date = patient['auto_expire_date'].to_date
+          days_on_medication = (end_date - init_date).to_i
+          days_on_medication >= 80
+        else
+          patient['total_days_on_medication'].to_i >= 176
+        end
+      end
+
+      def patient_arv_drug_runout_date
+        ::Patient.find(patient_id).last_arv_drug_expire_date
+      end
+
+      def patient_history_on_completed_tpt
+        @patient_history_on_completed_tpt ||= ::Observation.where(person_id: patient_id,
+                                                                  concept_id: ::ConceptName.find_by_name('Previous TB treatment history').concept_id)
+                                                           .where("value_text LIKE '%complete%' AND obs_datetime < DATE('#{end_date}') + INTERVAL 1 DAY")&.first&.value_text
+      end
+
+      def difference_in_months(date1, date2)
+        ((date1.year * 12) + date1.month) - ((date2.year * 12) + date2.month)
+      end
+    end
+  end
+end