CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

The quality of service delivery all around the world is continuously improved by the usage of

computer-based applications. These applications are mostly built based on artificial intelligence

which is the area of computer science that focuses on the creation of machines that can perform

functions considered as intelligent by humans. These functions performed by the machines are

highly sensitive and require knowledge in the domain where these machines are designed to act

as if originally, they are in control of situations. The ability to create such machine has intrigued

humans since the advent of technology, and today, with the introduction of computers and great

research of ages into the field of Artificial Intelligence programming techniques, the production

and design of smart machines is becoming a reality as researchers can now build a system which

can mimic human thought and understand human behavior via expert system technology.

An expert system is a computer application that performs a task that would otherwise be

performed by a human expert; such tasks include but are not limited to making financial forecast,

scheduling routes for delivery vehicles, diagnosing human illnesses, and several others. Most

expert systems are designed to take human place while others are designed to aid humans. To

design an expert system, the domain of the knowledge field is required, so an individual needs to

be able to study how the human expert makes decisions and translate the rules used into terms

that the computer would understand. Expert system is an example of a symbolic paradigm being

one of the two major paradigms for developing intelligent systems in the field of artificial

intelligence.

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1.2 STATEMENT OF THE PROBLEM

The continuous increase in population without a corresponding increase in medical

infrastructure, biased, , inconsistency, retirement or death of human experts, has brought about

drastic limitations in health care sector this has made it necessary to think of designing an expert

system that can assist the health sector in the diagnosis of HIV/AIDS.

1.3 SIGNIFICANCE OF THE STUDY

The relevance of this study cannot be overemphasized as the numerous challenges faced in the

medical area of HIV/AIDS are so obvious that most health practitioners tend to shy away from

providing services, this has put much work load on the few agencies offering such services,

which are mostly non-governmental organizations. An expert system for diagnosing HIV/AIDS

is therefore a system with enormous level of significance that cannot be undermined; this system

will be of great benefit to not just man but also government and health sectors. The obvious

challenges faced by the government, health sector and individual are enough to suggest that the

relevance of the system are not limited to but include the following;

Professionalism: This system shall contain valid and well researched algorithm that shall aid in

decision making, this decision support system shall be written on the basis of the manually

collected data and enhanced through well designed syntax to take decisions that are seen to be

from facts already programmed, by this the system tends to be very professional and reliable.

The system is also not prone to mistakes and can be easily updated.

Reduced time consumption:One of the major advantages of an expert system is speed, the

system to be designed will reduce the time consumption of record handling and enhance

efficiency as the workload will be reduced to the minimum level.

Proper data collection: The expert system will use a secured database management system to

safely store information that can be collected and made reference to when required.
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 Confidentiality: The system will handle the issue of the fear of result and status exposure,

people believe that with the already existing manual system, their results pass through hands that

they should not, with the computerized system, anonymity and patient’s confidentiality will be

maintained.

Ease in learning: The time used in learning the procedure of proper diagnosis will be reduced as

knowledge of experts using the system will be documented for further reference by those who

will be coming in newly from time to time. this will improve learning in the domain

1.4 OBJECTIVE OF THE STUDY

The general aim of this study is to design a knowledge based expert system with a medical

encapsulation for the diagnosis of HIV/AIDS, and the specified objectives are: grant access to

registered client, provide links for client to explore information on HIV/AIDS, perform client’s

risk factor analysis through logical test, determine results and display client’s computer-based

laboratory test. the system will handle facts about the domain of study and tend to use this known

facts with the information provided by the users to check how corresponding it is for an effective

decision making.

1.5 SCOPE OF THE STUDY

The study covers the design of a knowledge based system in the medical domain of HIV/AIDS

diagnosis, the knowledge based system handles symptomatic fields of relatedness to the one

understudy where patients are checked through stepwise procedure using the following;

a) Voluntary pre-test counseling: This link will handle risk assessment where the person

under diagnosis will be briefly introduced to factors that transmit HIV virus and other related

ailments, they will also be taught on risk reduction methods where general advice will be

given on how to live a medically healthy life.

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 b) Voluntary HIV/AIDS testing: This is done using approved HIV testing protocol which

uses three different HIV/AIDS test kits for HIV/AIDS confirmatory test before result is given

out.

c) Voluntary post counseling: This link handles emotional support and referral, in this aspect,

individuals whose test results are made available are advised, and this advice is of two

distinct levels;

i If diagnosis reads negative, the individual is advised on how to remain negative

and healthy, this is done based on what to do and not to do so as to avoid contacting the

virus.

ii If diagnosis reads positive, emotional talks are delivered to show the patients that

positive test result does not mean the end as people living with the HIV/AIDS virus can

still live a normal and healthy life like everyone else, further tests are then carried on for

drug placement and dispensing.

1.6 DEFINITIONS OF TERMS

Artificial Intelligence (Artificial Intelligence): The phrase “Artificial Intelligence” can be

defined as the simulation of human intelligence on a machine, so as to make the machine

efficient to identify and use the right piece of “Knowledge” at a given step of solving a problem.

[ CITATION Kon00 \l 1033 ]

Expert Systems (ES): This is a type of computer application that makes decision or solves

problems in a particular field such as finance and medicine by using knowledge and analytical

rules defined by domain experts [ CITATION Ovi00 \l 1033 ].

Decision Support System (DSS): This refers to an interactive computerized system that gathers

and presents data from a wide range of sources, they are systems and sub-systems that assist

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people in decision making based on data collected from a wide range of sources [ CITATION Mar02

\l 1033 ].

Intelligence: This is a term for referring to general mental capability to reason, solve problems,

think abstractly, learn and understand to make decisions (Microsoft Encarta, 2009).

Fact: This is a concept in philosophy that treats both the meaning of the word true and the

criteria by which we judge the truth or falsity in spoken and written statements (Microsoft

Encarta, 2009)

Domain: The term, domain, refers to a particular area of study, it is also used to describe the

scope of a subject and an area of activity over which somebody has influence [ CITATION Ovi00 \l

1033 ].

Knowledge: This is a theoretical or practical understanding of a subject or domain, those who

posses knowledge are called experts, a domain expert is one who has deep knowledge of both

facts and rules and strong practical experience in a particular domain [ CITATION Ovi00 \l 1033 ].

Domain Knowledge: This is that knowledge which is specific to a study area and not general or

common sense knowledge [ CITATION Ovi00 \l 1033 ].

Heuristic Knowledge: These are judgmental knowledge that underlines expertise; they are

usually implicit and are not necessarily being explicit even to the expert.

Knowledge Base: This is the part of a program in which rules and other methods of

representations are used to store domain knowledge [ CITATION Ovi00 \l 1033 ].

Inference Mechanism: This provides the reasoning ability that enables the expert system to

form conclusions [ CITATION Ovi00 \l 1033 ].

HIV: This is an Acronym for Human Immunodeficiency Virus, infectious agent that causes

acquired immunodeficiency syndrome (AIDS), a disease that leaves a person vulnerable to life-

threatening infections (Microsoft Encarta, 2009).

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Counseling: Advice or guidance, especially as provided by a professional in a given field

(Microsoft Encarta, 2009).

Pre test counseling: This provides an opportunity for clients to explore their risk of HIV, to

learn about the strategies for avoiding HIV, and help clients decide whether to take the HIV test

(www.patient.co.uk/health/hiv-and-aids).

Counselors: They are persons who have received special training in client centered HIV

counseling. They do not only provide information, they also help the client make an informed

choice about HIV testing, adoption of safe behavioral practices in order to reduce and minimize

HIV transmission and facilitate coping with the psychosocial impact of a positive HIV test result

(www.patient.co.uk/health/hiv-and-aids).

Voluntary: It is a self decision that is not based on force from any one, the decision to pursue

HIV testing must be made by the client after counseling (Microsoft Encarta, 2009).

Window period: The window period is described as the time it takes for a person who has been

infected to test positive for HIV antibodies (www.patient.co.uk/health/hiv-and-aids).

Adherence: Taking medications exactly as prescribed. Poor adherence to HIV treatment

increases risk for developing drug resistant (www.patient.co.uk/health/hiv-and-aids).

CD4 T-cells: CD4 T-cells also known as helper T-cells acts as a co-coordinator of the immune

response, they are unfortunately the main targets of the HIV. HIV destroys infected CD4 T-cells

leading to an overall weakening of the immune system (www.who.int/).

Cluster of Differentiation (CD4) Count: This is also known as CD4 cell count or CD4

Lymphocyte count. It is a laboratory test that measures the number of CD4 cells in a sample of

blood (www.who.int/)

Testing: This is a laboratory procedure for detecting ailments, in HIV/AIDS diagnosis, it is a

way of detecting antibodies in the serum or plasma, and they include tests like the Elisa test and

the rapid HIV tests. (Microsoft Encarta, 2009)

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Baseline test: Base line testing includes CD4 count, viral load and resistant testing, the results

are used to guide HIV treatment choices and monitor effectiveness of Anti-Retroviral Therapy

(ART). Baseline is an initial measurement used as the basis for future comparison

(www.who.int/).

Confirmatory test: A specific test designed to confirm the result of an earlier test, it is an

important test for eliminating false positive result where a negative sample will tend to read

positive (www.who.int/).

Risk reduction: The goal of HIV counseling is to eliminate risk, it is discovered that this can be

best achieved through small steps for incremental behavioral changes that bring a reduction in

risk of infection (www.who.int/).

Referral: The act or process of directing somebody or something to somebody else, especially

of sending a patient to consult a medical specialist (Microsoft Encarta, 2009).

Condom: A close-fitting rubber covering worn by a man over the penis during sexual

intercourse to prevent pregnancy or the spread of sexually transmitted diseases (Microsoft

Encarta, 2009).

Opportunistic infections: They are infections that take advantage of a weakened immune

system; they include bacterial infections, fungal infections, pneumonia e.t.c (Cichocki, 2009).

World Health Organization (WHO): Agency of the United Nations that organizes and

funds health-care programs in nearly every country in the world. established in 1948 (Microsoft

Encarta, 2009).

UNAIDS: UNAIDS, is the Joint United Nations Program on HIV/AIDS, it is an initiative

partnership that leads and inspires the world in achieving universal access to HIV prevention,

treatment, care and support (www.unaids.org/).

Antiretroviral Therapy (ART): This is treatment of people infected with Human

Immunodeficiency Virus (HIV) using anti-HIV drugs. The standard treatment consists of a
7
combination of at least three drugs (often called Highly Active Antiretroviral Therapy (HAART)

that suppresses HIV replication. ART has the potential both to reduce mortality and morbidity

rates among HIV-infected people, and to improve their quality of life.

HADS: HIV AND AIDS DIAGNOSIS SYSTEM.

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 CHAPTER TWO

LITERATURE REVIEW

2.0 HISTORY OF ARTIFICIAL INTELLIGENCE

To however get a detailed understanding about expert systems, a brief history of Artificial

Intelligence is unavoidably necessary. The quest for Artificial Intelligence is as modern as the

frontiers of computer science and as old as antiquity. The concept of thinking machine began as

early as 2500BC, when the Egyptians looked to talking statues for mystical advice (Haack,

2004). Artificial Intelligence as both a term and a science was coined 120 years later, after the

operational digital computer had made debut. In 1956, Allen Newell, J.C Shaw and Herbert

Simon introduced the first Artificial Intelligent program, the Logic Theorist to find the basic

equations of logic as defined in principia mathematica by Bertrand Russell and Alfred North

Whitehead. For one of the equations, the Logic Theorist surpassed its inventor’s expectations by

finding a new and better proof. Suddenly a true thinking machine that knew more than its

programmers evolved and lead to the development of another system called the General Problem

Solver (G.P.S). They were developed to imitate human problem solving protocols regardless of

the information contained in the domain, however, as time progressed they were said to be weak

a method as they covered weak information about their domain of study which led to weak

performance in problem solving involving complex domains (Nilsson, 2009).

The foundation of Artificial Intelligence covers several disciplines including but not restricted to

philosophy, mathematics, psychology, computer engineering and linguistics. The connectionist

paradigm evolved from a model proposed on artificial neurons that mimics the structure of

human brain, the model was proposed in 1943 by McColloch and pitts. The rise of Artificial

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Intelligence continued as Feigenbaum and others at Stanford began the heuristic programming

project (HPP) to investigate other problem domains that could benefit from the expert system

technology. By this the next major effort was in the area of medical diagnosis, MYCIN was

developed by Bruce Buchanan and Dr Edward Shortliffe to diagnose bacterial infection in the

blood using about 450 rules. MYCIN is the most widely known expert system in the era of the

growth of Artificial Intelligence because of the two reasons below as coined from (Feigenbaum

and Buchanan, 1993)

a. ts design was based on interviews with several doctors that specialized in particular

domains, hence, it contains a number of heuristic rules used in identifying certain

infections by physicians.

b. It lead to the later development of EMYCIN (Empty MYCIN) which was the first

expert/knowledge-based system shell, the development time of EMYCIN was

considerably reduced as compared to MYCIN, the researchers developed EMYCIN by

taking all the rules out of the system and leaving just an empty shell in which other

developers in other domains can just plug in their knowledge base.

From the dark ages also known as the birth of Artificial Intelligence to the era of great

expectations also known as the rise of Artificial Intelligence, expert systems have been providing

pre-selected rules for decision making within specialized domains of knowledge but are limited

by the fixed choice and by the date of the expert opinion embodied in the decision rules. Expert

systems have been found to have profound impacts which include reducing time of task from

days to hours, minutes to seconds. The benefits of expert system since this time include but are

however not limited to improved customer satisfaction, improved quality of products and

services, accurate and consistent decision making. They operate in hazardous environments

where humans could be exposed to various risks; expert systems have featured and make things
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 easier in various fields such as agriculture, education, manufacturing industries, banking,

medicine, and so on. In medicine, diagnosis of patients’ complicated conditions, clinical

laboratory identification of bacterial infectious diseases and recommendation of treatments,

surgery, emergencies, drugs and toxicology and dentistry are some of the domains for expert

system development. Expert systems emulate the decision making ability of human experts, they

are designed to solve complex problems by reasoning about knowledge like an expert, and not by

following the procedure of a developer as in the case in conventional programming (Meech,

2006).

2.1 INTELLIGENT SYSTEM EVOLUTION

As the attributes of personal computing hardware (speed, memory, storage capacity, and

resolution) have doubled since the 1980s, our society has reached a point where no serious

performance limitations exist for "intelligent methods" and the computational complexities are

now embedded within or subsumed beneath the Human-Machine Interface. As a result, these

approaches can be applied to study and solve extremely complex and intricate problems beyond

the ability of the human mind to handle in a time frame appropriate for process control. Process

control has traditionally tried to maintain a system at a set-point for as much time as possible in

response to upsets or disturbances in load variables. Nowadays, the set-points themselves have

become disturbances with updates occurring at increasing frequencies as communication and

measurement cycles have sped up to bandwidths previously unimaginable (Meech, 2006).

The definition of intelligent systems is a difficult problem and is subject to a great deal of debate.

From the perspective of computation, the intelligence of a system can be characterized by its

flexibility, adaptability, memory, learning, temporal dynamics, reasoning, and the ability to

manage uncertain and imprecise information

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Expert systems technology was originally invented in the Artificial Intelligence laboratories in an

attempt to apply the state-space search, knowledge representation, and inference techniques

developed in early research to some "real-world problems." The hope of the inventors was to

demonstrate, especially to those always-fickle funding agencies, that Artificial Intelligence was

possible and practical and that thinking about thinking machines was scientifically sound. They

succeeded beyond their wildest dreams. Expert systems have evolved as a highly marketable

offshoot of research in the subfield of computer science called artificial intelligence (Artificial

Intelligence). Since its unofficial inception at the Dartmouth Summer Research Project on

Artificial Intelligence in 1956 (attended by well known personalities such as Marvin Minsky,

Allen Newell, Herbert Simon, Claude Shannon and John McCarthy), Artificial Intelligence has

had as one of its primary goals the creation of ‘thinking machines.’ While this ambitious goal has

not yet been attained to anyone’s acknowledgment, there have been substantial advances in what

we now know about human thinking and learning. Along the way, research in Artificial

Intelligence from the late 1950s to the 1970s at Stanford, MIT and Carnegie-Mellon Universities

provided some very powerful techniques for codifying human experience and knowledge so that

computers can store it and apply it to solve practical problems. The mid-1970s saw the

emergence of the first expert systems for applications (Avron and Feigenbaum, 1981).

According to Barr and Feigenbaum (1981), the mid-1970s saw the emergence of the first expert

systems for applications such as medical diagnosis (Mycin, by Shortliffe), chemical data analysis

(Dendral, by Lindsay and others), and mineral exploration (Prospector, by Duda and others).

Furthermore, Turing is seen to have made a significant and characteristic provocative debate in

artificial intelligence. Turing (1950) in his Turing test defined intelligent behavior as the ability

of human level performance in all cognitive tasks. The issue of acting humans springs up when

intelligent systems interact with people. For example, an expert system explaining how it came
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 to a diagnosis or a natural language processing system has a dialogue with a user. He later

concluded that, for any complex decision to be made, or problem to be solved, experts in specific

areas have particular knowledge, specific alternatives, the chances of success, and also the

benefits or costs that may be inquired. Based on these earlier concepts, intelligent systems were

developed and have since been very useful to supervisors and managers with situational

assessment and long time planning.

2.2 EXPERT SYSTEM

Expert systems are computer programs that can perform some tasks which typically require the

capabilities of a skilled human. These tasks are usually of a decision-making nature rather than

physical actions. Examples of such tasks are managing water levels in a wetland, forecasting

weather conditions, assessing environmental impacts, and selecting mitigation measures for

environmental hazards. As computer programs that contain human expertise, they are referred to

variously by the labels expert systems, knowledge-based systems, inference systems or rule-

based systems [ CITATION Aji05 \l 1033 ].

In the late 1960's to early 1970's, expert systems began to emerge as a branch of Artificial

Intelligence. The intellectual roots of expert systems can be found in the ambitions of Artificial

Intelligence to develop “thinking computers”. Domain specific knowledge was used as a basis

for the development of the first intelligent systems in various domains. Feigenbaum (1981)

published the best single reference for all the early systems. In the 1980's, expert systems

emerged from the laboratories and developed commercial applications due to the powerful new

software for expert systems development as well as the new possibilities of hardware.

Feigenbaum (1982) defined an expert system as "an intelligent computer program that uses

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knowledge and inference procedures to solve problems that are difficult enough to require

significant human expertise for their solution". Differences from conventional programs include

facts such as: An expert system simulates human reasoning about a problem domain as the main

focus is the expert's problem solving abilities and how to perform relevant tasks, as the expert

does. An expert system performs reasoning over representations of human knowledge in addition

to doing numerical calculations or data retrieval using the knowledge base and the inference

engine separately. An expert system solves problems using heuristic knowledge rather than

precisely formulated relationships in forms that reflect more accurately the nature of most human

knowledge dealing with symbolic values and procedures.

Shu-Hsien (2004) said that Expert system (ES) is a branch of applied artificial intelligence

community in the mid 1960’s. The basic idea behind expert system is simply that expertise,

which is the vast body of task-specific knowledge, is transferred from a human to a computer.

This knowledge is then stored in the computer and users call upon the computer for specific

advice as needed. The computer can make inferences and arrive at a specific conclusion. Then

like a human consultant, it gives advice and explains, if necessary, the logic behind the advice.

Turban and Aronson (2001) provided powerful and flexible means for obtaining solutions to a

variety of problems that often cannot be dealt with by other more traditional and orthodox

methods. Thus, their use is proliferating too many sectors of our social and technological life,

however, their applications categories are; rule-based systems, knowledge-based systems, neural

networks, fuzzy expert system, object oriented methodology, case-based reasoning (CBR),

system architecture development, intelligent agent (Artificial Intelligence) systems, modeling,

ontology, and database methodology together with their applications for different research and

problem domains. The goal of expert systems research is to program into a computer the

knowledge and experience of an expert. Expert systems are used in medicine, business
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management, mining natural resources and much more. An alternative way to present them is

functionally, i.e., according to the types of problems that they address. The non-exclusive

categories that seem to capture most applications are classification, prediction, interpretation,

planning, monitoring and control, and analysis. The categorical approach is advantageous

because the user then acquires an appreciation of the broad applicability of expert system

methodology without becoming distracted by details that are specific to particular applications

(Davis and Clark, 1989; The surveys in Hushon, 1987, Moninger and Dyer, 1988).

The areas explained below are some of the fields where expert systems are used, according to

Alexander and Fairbridge( 1999). These fields of applying expert system technologies are

however not limited to just the underlisted fields as the growth in technology advances day-by-

day.

Classification problems are the most common type of application. This is due to the impact of

our inherent human need to classify objects and events as being members of particular

groupings. A salient characteristic of classification problems is that there is a finite (usually

small) and enumerable list of possible groups; this make these problems relatively easy to solve.

Hence, all problems that fall into a particular solution group are treated similarly with respect to

action. Diagnosis is a very common application problem, where systems are diagnosed in terms

of the causes of malfunction. These include biological systems (e.g., trees, crops or fish

populations), hydrological and chemical systems (e.g., lakes and streams), mechanical systems

(e.g., waste treatment) or physical systems (e.g., hailstorm severity). The cause may be a

pathogen, a malfunctioning pump, a parasite, a climate change, and so on. Other non-diagnostic

classification systems only seek to place an object or event into a particular category without

15
labeling that category as malfunctional; for example, identification of type of atmospheric

inversion, classification of soils, selection of options in insecticides, or identification of species.

Another large class of expert systems applications includes those that deal with prediction, these

estimate some important future characteristic of an environmental system based on current

details about it. Some examples of prediction problems are forecasting for weather and other

environmental phenomena, qualitative modeling of biological or physical systems (e.g.,

vegetation change, crop production and wildlife populations), and damage estimation (e.g.,

following toxic contamination, for insect epidemics or for flooding). When these expert systems

select their predictions from a small set of possible future conditions, they can also be

categorized as classification expert systems. It should be apparent that there is some overlap

between classification and prediction problems. In fact, all these categories are non-exclusive,

and hence overlaps exist between most of them. In fact, many systems can be categorized in

multiple ways.

Interpretation problems are similar to prediction problems except that the characteristic to be

estimated is a current one, rather than a future one. Because this characteristic condenses and

summarizes the information about an environmental system, it usually carries with it some

important management implications. Ways in which expert systems have been applied include

hazard and risk ratings (e.g., fire danger rating, and contamination or toxicity potential

estimation), environmental assessment (e.g., impacts of human intervention, cost estimation, and

report evaluation or generation), data interpretation (e.g., model interpretation, site selection or

ranking, species selection and equipment selection), and management actions (e.g., fire

suppression, and crop production and treatment prescriptions).

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 Solutions to the above three categories of problems most often consist of a single action or

parameter estimate. Planning type problems, on the other hand, are resolved by specifying an

ordered set of actions to be performed. Because a large number of possible action sequences are

possible, planning problems tend to be much more difficult to solve and are more

computationally costly. Examples of reported applications in this area are catastrophe mitigation

(e.g., hazardous site cleanup, and fire suppression), forest and agriculture production (planting,

treatment and harvest), construction (e.g., roads or airport runways), and scheduling and resource

planning (e.g., for regional water quality, landscape and land use). Expert systems provide a

viable approach to solving planning problems because these problems usually have a fairly well

defined goal that is constrained by certain of their attributes. Moreover, they are non-quantitative

in nature and require a systematic search through a large number of possible solutions.

In contrast to the off-line decision making that is inherent in the problems described above; there

are situations in which decisions are made as part of real-time operations, Monitoring and

control problems are of this type. In many of these instances monitoring and control activities are

intertwined in the sense that a process is monitored by an expert system that also takes action

when some condition signals its attention. At other times, an expert system only performs

monitoring, and a human being performs the control action. Examples of monitoring and control

applications are very few in the environmental sciences, and this category is only mentioned here

for the sake of completeness.

2.3 EXPERT SYSTEM COMPONENTS

Most expert systems consist of several distinct components. These are knowledge base, working

memory, reasoning engine, explanation subsystem and a user interface. The knowledge base

contains the scientific knowledge and experience for the particular area of expertise. Imagine that

we are designing an expert system to diagnose automobile engine malfunctions. We might want
17
to include knowledge about spark plugs, fuel pump, battery, starter, fuel injectors, etc., and also

how these engine components affect engine operation. A competent mechanic can usually

pinpoint engine problems fairly quickly with only a small amount of information about the

functioning of the various parts. Often a specialist, such as a mechanic, possesses intuition that

he or she has acquired through years of experience. This intuition is often ratified in rules-of-

thumb (or good guesses) that allow the specialist to solve problems quickly and effectively. For

this type of expert knowledge to be used by a computer it must be represented in some way that

the computer can easily manipulate. There are numerous techniques for knowledge

representation, but traditionally the most common one is the use of condition-action rules, the

expert system operates either in consultation mode or knowledge acquisition mode. The various

system components enable it to solve problems for which it has knowledge in the knowledge

base, to interact with users, and to explain the rationale for the solutions it reaches. This is further

explained in figure 2.1 by Luger and Stubblefield (1989), as a comprehensive review of the

techniques of the functions of expert system components (Alexander and Fairbridge, 1999).

Condition–action rules are IF-THEN statements where the consequent action(s) are performed if

the premise conditions are true. For example, IF battery charged AND battery-cables = clean

AND engine-starting = not cranking THEN check starter. This method of knowledge

representation is popular because each rule is modular and contains a ‘chunk of domain

knowledge, expert system programmers find rules easy to program, and experts are often able to

express their heuristic knowledge in the IF-THEN format. Working memory is like the short-term

memory of the expert system. It contains assertions about the problem currently under

investigation. These assertions may be obtained from the user (via queries), from external

programs, from a real time process, or from external data files. Assertions may be facts gathered

from the above sources, or they may be hypotheses which have been inferred from other facts

that are already known. Because the ultimate goal of knowledge system consultation is to infer
18
problem solutions, some of these intermediate hypotheses will eventually be solutions. All facts

and hypotheses in the working memory together describe the current context, or the current state,

of a consultation session. Usually a closed world assumption is assumed, i.e., only those

assertions that are present in the working memory are true and all other possible assertions about

the state of the world are assumed false. While the knowledge base and working memory are

passive entities, the reasoning engine navigates through the knowledge base and registers

established assertions in the working memory. A reasoning engine operating on a knowledge

base and working memory is how an expert system solves problems. Navigation is performed by

the particular control strategy that the reasoning engine employs. A control strategy determines

the order in which knowledge base elements (such as rules) are examined in order to arrive at the

solution to a problem. Assertions are established as true by the particular inference mechanism

used. In a rule-based knowledge representation, the inference method is usually used and rules

are selected for evaluation either by the content of their premise conditions (data-driven control)

or by their consequent actions (goal-driven control). Details of how the reasoning engine

operates are determined by the knowledge representation method used, what types of assertions

must be made, and the overall problem-solving methods that are applied. The purpose of an

explanation subsystem is to enable the expert system to display to users an understandable

account of the motivation for all of its actions and conclusions. Explanation is part of the larger

issue of human factors engineering, which also includes the user interface – i.e., the how’s and

why’s of a computer system’s interaction with users. Explanation systems are not involved with

the correct execution of an expert system. Instead, their purpose is to convince the user that the

system’s conclusions are reasonable, to explain how it reached those conclusions, and to aid

system developers in debugging the knowledge base and the reasoning methods (Alexander and

Fairbridge, 1999).

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The term user interface refers to the physical and sensory interaction between computer and user.

Functionally, this means how the user inputs information to the system and how information is

returned to the user. The more natural (i.e., intuitive and understandable) this interface is, the

more effective the human computer interaction will be. Traditionally, this interaction has been

serial and text based using the conventional, interactive terminal format. Recent advances in

computer interfaces enable expert systems to utilize display graphics, hot graphics (graphical

objects that perform some action when activated), point-and-click operations, video, sound and

animation. For most software users, the interface is the application, and hence expert systems

may fall into disuse if they lack good user–interface capabilities, figure 2.1 shows the basic

components of an expert system.

Fig 2.1:Basic components of an expert system Source: Kock, E. D. (2003)

The major components of expert systems that have to be understood are;

Knowledge engineer: This refers to the engineer who encodes the expertise in a declarative

format of the knowledge base.

Domain expert: This refers to the individual or set of individuals who are currently experts,

solving the problems in a more manual way which the system is designed to solve.
20
System user: These are individuals who will be consulting with the system to get advice which

have already been encoded by the experts.

System engineer: The individual who builds the user interface, designs the declarative formats

of the knowledge base and implements the inference engine

Depending on the size of the system to be designed, the knowledge engineer and the system

engineer might be the same person. For a custom built system, the design of the format of the

knowledge base and the coding of the domain knowledge are closely related. The format has a

significant effect on the coding of the knowledge. The development of expert systems may

enable a major acceleration in several areas of human endeavors, for instance computer programs

have important advantages over books as medium for the recording of knowledge, in that they

can be updated rapidly and are necessarily more precise and unambiguous. The availability of

the expertise of a leading practitioner in a field in a fully precise and directly testable form may

well enable others to find improved ways of teaching the underlying skills. A refined form of the

knowledge might again be stored in the form of an expert system, a valuable benefit of designing

an expert system, which has been little exploited so far, is the possibility that it may be directly

used as an aid for training or educating or other services. Although the pace of development in

the expert system field in recent years is extremely impressive, it is hard to escape the feeling

that we are still only scratching the surface of a major new technology with potentials which are

yet barely appreciated.

Figure 2.2 shows by Unified Modeling Language (UML), how an expert system interacts with its

component

21
 User

Domain

Expert

User Interface
Expertise System

Engineer

Inference

Knowledge Engine

Engineer

Knowledge Working
Encoded
Base Storage
Expertise

Fig 2.2: expert system components and human interface (Source:

www.myreaders.info/html/artificial_intelligence.html)

For a perfect expert system design, all users are put into consideration and their major functions

and activities are linked to them, also, those having relatedness are also linked perfectly to each

other as demonstrated in the diagram above.

22
2.4 EXPERT SYSTEM IN MEDICAL DIAGNOSIS

Expert systems for medical diagnoses are interactive computer programs, designed to assist

health professionals with decision making tasks. The clinicians interact with the system using

both the clinician knowledge and the system to make a better analysis of the patient’s data than

either humans or software could make on their own. Intelligent systems, particularly

expert systems for diagnosis and treatment, have been developed for use in a range of medical

contexts:

MYCIN: It was the first well known medical expert system developed by Shortliffe at Stanford

University (Buchanan and Shortliffe, 1984) used for diagnosis and remedy of bacterial infections.

It uses backward chaining inference procedure. It helps doctors, not expert in antimicrobial drugs

to prescribe such drugs for blood infections. The limitation of MYCIN is that its knowledge base is

incomplete since, it does not cover anything like the full spectrum of infectious diseases. Running

it would have required more computing power than most hospitals could afford at that time (1976).

Doctors do not relish typing at the terminal and require a much better user interface than that

provided.

PERFEX: It is a medical expert system that supports solving problems clinicians currently have in

evaluating perfusion studies (Ezquerra et al., 1992). The heart of the PERFEX system is the

knowledge base, containing over 250 rules. They were formulated using the expertise of clinicians

and researchers at Emory University Hospital. PERFEX limitation resides in its output. It is mostly

numerical.

INTERNIST-I: It is a rule-based expert system designed at the University of Pittsburgh in 1974

(Kumar et al., 2009) for the diagnosis of complex problems in general internal medicine.

ONCOCIN: It is a rule-based medical expert system for oncology protocol management

(Wiederhold et al., 2001) developed at Stanford University. ONCOCIN was designed to assist

physicians with the treatment of cancer patients receiving chemotherapy.

23
 Dxplain: It is a decision support system which uses a set of clinical findings (signs, symptoms,

laboratory data) to produce a ranked list of diagnoses which might explain (or be associated with)

the clinical manifestations (Elhanan et al., 1996). The Dxplain provides justification for why each

of these diseases might be considered, suggests what further clinical information would be useful

to collect for each disease and lists what clinical manifestations, if any, would be unusual or

typical for each of the specific diseases.

PUFF: It is an expert system for the interpretation of pulmonary function tests for patients with

lung disease (Shortliffe et al., 1984). PUFF was probably the first Artificial Intelligence system to

have been used in clinical practice.

2.5 MEDICAL DIAGNOSIS SYSTEM

Medical diagnosis, simply termed often as diagnosis refers both to the process of attempting to

determine or identify a possible disorder or disease. The history of medical diagnosis began in

earnest from ancient Egypt and the day of Hippocrates (The father of medicine) in ancient

Greece. In Traditional Chinese Medicine, there are four diagnostic methods namely inspection,

auscultation-olfaction (to study sounds arising within organs such as the heart, lung, and stomach

prior to treatment), interrogation and palpation (a method of clinical examination using gentle

pressure of the fingers to detect growths, changes in the size of underlying organs, and unusual

tissue reaction to pressure) (Berger, 1999)

Esagil-kin-apli (1069-1046 BC) introduced the use of empiricism, logic and rationality in the

diagnosis of an illness or disease, the book made use of logical rules in combining observed

symptoms on the body of a patient with its diagnosis and prognosis. There are a number of

methods and techniques that can be used in diagnostic procedure including differential diagnosis

or following medical algorithms (Berger, 1999).

Differential Diagnosis: The method of differential diagnosis is based on finding as many

candidate diseases or conditions as possible that can possibly cause the signs and symptoms,
24
 followed by a process of elimination or at least rendering the entries more or less probable by

further medical test.

Pattern recognition: In a pattern recognition method the provider uses experience to recognize

a pattern of clinical characteristics. It is mainly based on certain symptoms or signs associated

with certain diseases or conditions, not necessarily involving the more cognitive processing

involved in a differential diagnosis

DIAGNOSTIC CRITERIA

The term diagnostic criteria designate the specific combinations of signs, symptoms and test

results that the clinician uses to attempt to determine the correct diagnosis

(www.patient.co.uk/health/diagnostic_criteria).

2.6 HIV/AIDS

HIV stands for Human Immunodeficiency Virus. This is the virus in the group of viruses called

retrovirus. HIV destroys cells in the body called CD4 T cells. CD4 T cells are a type of

lymphocyte (A white blood cell). These are important cells involved in protecting the body

against various bacteria, viruses and other germs. HIV actually multiplies within CD4 cells, it

cannot be destroyed by white blood cells as it keeps changing its outer coat so as to protect itself

(www.patient.co.uk/health/hiv-and-aids).

AIDS stands for Acquired Immunodeficiency Syndrome. This is the term which covers the range

of infections and illness which can result from a weakened immune system caused by HIV.

Because ART has altered the way we think about the condition, the term late stage HIV is being

used instead of AIDS (www.patient.co.uk/health/hiv-and-aids).

25
From the above, it can be noted that, HIV and AIDS are not the same thing and persons with

HIV infections do not automatically develop AIDS. AIDS is even unlikely to develop in people

who have been treated in the early stage of HIV infection. Even in people who do not receive

treatment, the time lag is usually several years between first being infected with the virus and

then developing infection and other AIDS problems, this is because it usually takes several years

for the number of CD4 T cells to reduce to a level where our immune system is weakened

(www.patient.co.uk/health/hiv-and-aids).

CONTACTING HIV According to www.patient.co.uk/health/hiv-and-aids, the

commonest ways of being infected with HIV include but are however not limited to the

following

- Sexual transmission: This is the most common way to pass the virus on. In 2010, it accounted

for about 19 in 20 new confirmed cases in the United Kingdom. Semen, vaginal secretion

and blood from an infected person contain HIV; the virus can enter the body through the

lining of the vagina, vulva, penis, rectum or mouth during sex. Having vaginal or anal sex

with an infected person is the most common route. Oral sex carries a much lower risk, but

this increases if you have a condition which affects the defense barriers of the mouth like

ulcer, bleeding/damaged gums or sore throat. One cannot be infected with HIV by coming

into contact with the saliva of an infected persons, HIV is also not passed on by coughing and

sneezing.

- Needle sharing: HIV (and other viruses such as hepatitis B and hepatitis C) can be passed

on by people who are dependent on inject-able drugs and share needles, syringes and other

injecting equipment which are contaminated with infected blood. However, needle-exchange

26
 services run by hospitals, clinics and drug dependency units and the more ready availability

of medicines taken by mouth has drastically reduced needle sharing as a source of infection.

- Infected blood: In the past, quite a number of cases occurred from infected blood

transfusions. This is now rare as since 1985, all blood products are checked for HIV before

being used. However, in developing countries, it is still a significant problem.

- From Mother to Child: HIV can be passed to an unborn child from a HIV infected mother.

However, with appropriate treatment, the vast majority of babies born to HIV-positive

mothers will not have HIV. Achieving this depends on detecting HIV before pregnancy, or,

in early pregnancy, when anti retroviral medicines can be taken by the mother. Having a

caesarean section to deliver the baby reduces the risk even further. HIV can occasionally be

passed to babies through breast milk during breast feeding. If formula milk is available,

mothers with HIV are encouraged not to breast feed.

2.7 DIAGNOSING HIV/AIDS

HIV tests are used to detect the presence of the human immunodeficiency virus (HIV), the virus

that causes acquired immunodeficiency syndrome (AIDS), in serum, saliva, or urine. Such tests

may detect antibodies, antigens, or RNA.

HIV has been found in saliva, tears, nervous system tissue and spinal fluid, blood, semen

(including pre-seminal fluid, which is the liquid that comes out before ejaculation), vaginal fluid

and breast milk. However, only blood, semen, vaginal secretions and breast milk generally

transmits infection to others (www.about.com/Diagnosis of AIDS_HIV.htm). Mandel, Bennet

and Dolin (2007) however, stated that AIDS begins with HIV infection. People infected with

HIV may have no symptoms for 10 years or longer, but they can still transmit the infection to

27
others during this symptom-free period. If the infection is not detected and treated, the immune

system gradually weakens and AIDS develop. The symptoms of AIDS are primarily the result of

infection that does not normally develop in individuals with healthy immune system. These are

called opportunistic infections. People with AIDS have had their immune system damaged by

HIV and are very susceptible to these opportunistic infections. Common symptoms are chills,

fever, sweating (particularly at night), swollen lymph glands, weakness, weight loss and others.

The first stage of contracting HIV is known as the primary infection. About 8 in 10 persons

develop symptoms at this time. The three most common symptoms (sometimes known as the

classic triad) are sore throat, fever and a blotchy red rash. Other symptoms can include feeling

sick, diarrhea, swollen glands, headache, tiredness and general aches and pains. The symptoms

can last up to three weeks and are often thought of as flu or mild viral illness. After any primary

infection settles, the individual can remain without any symptoms for several years hence even

without treatment, there are often no symptoms for a long time (often up to 10 years) so as many

do not even realize they are infected, however, the virus continues to multiply, the number of

CD4 T cells tends to gradually fall and the virus can be passed on to others. During this time,

some persons develop persistent swollen lymph glands or night sweats and with time, experience

problems such as recurring mouth ulcers, recurring herpes or shingles infections, old

Tuberculosis (TB) infections may reactivate in some cases even before AIDS develops,

especially in people in the developing world, other symptoms of HIV that may be experienced

before AIDS include diarrhea, skin rashes, tiredness and loss of weight

(www.patient.co.uk/health/hiv-and-aids.)

The term AIDS is used to describe the advanced stage of HIV infection, people who have an

early HIV diagnosis and treatment do not develop this stage. AIDS is a general term which

28
includes various diseases which can result to a weakened immune system. Typically, a person

with AIDS has:

- A very low CD4 T cells (around 200 cells per cubic millimeter of blood or below), and/or

- One or more opportunistic infection such as pneumonia, severe thrush in the vagina or

mouth, fungal infections, Tuberculosis, etc. these infections can cause a range of symptoms

such as sweats, fever, cough, diarrhea, weight loss and generally feeling unwell.

In addition, people with AIDS often have increased risk of developing other conditions as;

a. Certain cancers: Kaposi’s sarcoma is a cancer which is actually only seen in people with

AIDS. There is also an increased risk of developing cancer of the cervix and lymphoma.

b. An AIDS-related brain illness such as encephalopathy (AIDS dementia).

c. A severe body wasting syndrome.

The laboratory diagnosis of HIV infection is usually made on the basis of the detection of

antibodies to HIV. Serological tests for detecting antibodies to HIV are generally classified as

screening assays (sometimes referred to as first-line assays) or supplemental assays (sometimes

referred to as confirmatory assays). First-line assays can provide the presumptive identification

of antibody-positive specimens, and supplemental assays are used to confirm whether specimens

found reactive with a particular screening assay contain antibodies specific to HIV and/or HIV

antigen. The most widely used screening assays are enzyme immunoassays (often referred to as

EIAs or ELISAs) as they are the most appropriate for screening large numbers of specimens on a

daily basis, e.g. blood donations. The earliest assays used purified HIV lysates (1st generation),

and often lacked sensitivity and specificity. Improved assays based on recombinant proteins

and/or synthetic peptides, which also enabled the production of combined HIV-1/HIV-2 assays,

became rapidly available (2nd generation). The so-called 3rd generation or sandwich EIAs,

which use labeled antigen as conjugate, are extremely sensitive and have reduced the window

period considerably. Enhanced EIAs have been developed that detect both HIV antibody and
29
antigen (4th generation assays) leading to earlier detection of HIV infection and further reducing

the window period (Duong et al, 2007).

A variety of simple, instrument-free assays are now available, including agglutination,

immunofiltration (flow-through tests), immunochromatographic (lateral-flow tests) and dipstick

tests. Specimens and reagents are often added to the test device by means of a dropper. A

positive result is indicated by the appearance of a colored dot or line, or by an agglutination

pattern. Most of these assays can be performed in less than 20 minutes and are therefore called

rapid assays. Other simple assays are less rapid and their procedures require 30 minutes to 2

hours. The results are read visually. In general, these assays are most suitable for use in testing

and counseling centers and laboratories that have limited facilities and process low numbers of

specimens daily. When a single screening assay is used for testing in a population with a very

low prevalence of HIV infection, the probability that a person is infected when a positive test

result is obtained (i.e., the positive predictive value) is very low, since the majority of people

with positive results are not infected. This problem occurs even when an assay with high

specificity is used. Accuracy can be improved if a second supplemental assay is used to retest all

those specimens found reactive by the first assay. The negative predictive value will generally

always approach near to 100%, irrespective of prevalence. A third assay may also be required to

elucidate the correct status (www.who.int/diagnostics_laboratory/en/).

ASSAYS FOR LABORATORY DIAGNOSIS OF HIV

An assay is a quantitative or qualitative test of a substance to determine its components;

frequently used to test for the presence or concentration of infectious agents or antibodies e.t.c

(Advanced English Dictionary)

30
According to Jeffery et al (2006), the commonly used assays for HIV rapid tests in laboratories

today are;

Determine HIV Rapid Test

The test kit which can appear in any of the form shown in figure 2.3 is used to detect HIV

antibodies in serum or plasma. It is termed as first line test, it is the first kit used on the patient, if

patient is found reactive, the second line is introduced for conclusion, else the test result is given

as negative.

Fig 2.3: HIV positive, negative and invalid test result with Determine Rapid test kit
Source: Jeffery et al (2006)

Uni-Gold Recombigen HIV-1 Test

The Uni-Gold assay which can appear in any of the form shown in figure 2.4 is a lateral flow

immunochromatographic procedure for the qualitative determination of HIV-1 antibodies in

finger-stick or venipuncture whole blood, serum, and plasma. It is termed the second line test kit

as it is used when the first line (Determine) test result is reactive, it is a confirmatory test kit and

when its result comes out positive, the client is positive, and else the third line is introduced.

31
 Fig 2.4: HIV positive, negative and invalid test result with HIV uni-gold test kit

Source: Jeffery et al (2006)

HIV 1/2 Stat-Pak

A qualitative immunochromatographic assay which can appear in any of the form shown in

figure 2.5 is used for the detection of antibodies to human immunodeficiency virus types 1 and 2

(HIV-1 and HIV-2) in human serum, plasma and whole blood. It is termed as the third line test

also known as chain breaker, when used, the result is always final. If the patient test positive to

the first two lines and negative to the third, the patient is advised to come back in three months

time for testing again

Fig 2.5: HIV positive and HIV negative test result with HIV 1/2 Stat-Pak

Source: Jeffery et al (2006)

32
2.8 VOLUNTARY COUNSELLING AND TESTING

According to Saeed (2001), ever since the beginning of AIDS epidemic in 1981, the number of

people infected and affected by HIV/AIDS is on the rise. During the course of infection, a broad

range of physical, social and psychological needs and problems is experienced. Changing nature

of the illness imposes a variety of psychological and emotional strains on individuals and those

closest to them. Taking into account the dilemmas associated with it, the effects of HIV epidemic

are enormous. AIDS, in fact, is seen more as a psychosocial phenomenon than a disease.

HIV/AIDS counseling assists people to make informed decisions, cope better with their

condition, live more positive lives, and prevent HIV transmission. HIV/AIDS counseling is

important because infection with HIV is forever. Role of counseling in HIV/AIDS is perhaps

more important than in any other disease.

HIV COUNSELLING

HIV counseling is a confidential dialogue between a client and counselor aimed at enabling the

client to cope with stress and take personal decisions related to HIV/AIDS. The counseling

process includes evaluating the personal risk of HIV transmission and discussing how to prevent

infection. It concentrates specifically on emotional and social issues related to possible and

actual infection with HIV and AIDS. HIV counseling has as its objectives both prevention and

care. It is important for counselors to have a basic understanding of the HIV antibody tests that

may be performed, as well as the necessity of confirmatory HIV antibody testing (Nigerian

Federal Ministry of Health, 2011).

Pre-test Counseling

Pre test counseling should focus on two main topics: (a) the person's personal history of risk

behaviors or having been exposed to HIV, and (b) assessment of the person's understanding of
33
HIV/AIDS (including modes of transmission), and the person's previous experiences in crisis

situations. The aim of pre-test counseling is to provide information about the technical aspects of

testing and the possible personal, medical, social, psychological and legal implications of being

diagnosed as either HIV positive or negative. Information should be up to date and given in a

manner that is easy to understand. Testing of blood donors is different from testing of those

suspected of having HIV/AIDS, however, both require enquiring about risk behaviors. Testing

should be discussed as a positive act that is linked to changes in risk behavior, coping and

increasing the quality of life (Nigerian Federal Ministry of Health, 2013).

Post-test Counseling

The counseling session should begin by trying to put the person at ease. If possible, the room

should be quiet, without the fear of being disturbed. Arrange the chairs so that bright light will

not shine in anyone's eyes. The counselor should then tell the person the test result in a clear and

direct manner. The result (either positive or negative) should then be discussed, including how

the person feels about the result. Providing further information might be necessary although the

person may be shocked (no matter what the result), and may not fully take in all the information.

However, in some circumstances, this might be the only chance to counsel this person and so

asking them to repeat the information, or have some basic facts written down will be helpful. It is

important for the person to have time to reflect on the result and understand the next course of

action. Ideally, couple and/or family counseling should be started and further counseling follow-

up arranged (Nigerian Federal Ministry of Health, 2013).

HIV - negative Test Result Counseling

If the HIV test is negative, then counseling about risk behaviors and methods of prevention are

vitally important. Also, the counselor must explain about the "window period" (between 3-6
34
months) when a negative result may be a false negative, if there is concern about the HIV status

of the person, counsel him to return for a repeat test in 3-6 months. Ensure protection in the

meanwhile, explaining that the client could become infected at any time. This is an ideal time to

discuss sexual practices and preferences and potential drug abuse (particularly intravenous drug

use) and other risk behaviors. The person will probably be more open to learning about safe sex

practices and modifying risk behaviors and be willing to consider necessary behavior changes.

Free condoms can be given out during this session together with advice on how to use them and

where to get more when needed (Nigerian Federal Ministry of Health, 2013).

HIV-positive Test Result Counseling

(The positive test result will only be given after the second HIV test confirms a positive result.)

The counselor should tell the person as gently as possible, providing emotional support and

discussing how best to cope with the result. This is not the time for speculation, but time to give

clear, factual explanations of what the news means. Assess the emotional impact of the news and

validate the person's reactions as normal. Fear of dying, job loss, family acceptance, concern

about the quality of life, the effects of treatment and response by society might be explored. If

there is a concern that the person might not return for follow up counseling, then information

about relevant related services might be included, such medical treatment for opportunistic

infections, social services for financial and ongoing psychosocial support etc. However, if follow

up counseling is an option, then it would be advisable to leave this information to a later date

when the person is more able to absorb the details and explore some options. Assess the person's

understanding and ability to use preventive methods. Free condoms can be given out during this

session together with advice on how to use them and where to get more (Nigerian Federal

Ministry of Health, 2013).

35
HIV TESTING

According to the National guidelines for HIV Counseling and testing by the Nigerian Federal

Ministry of Health in November 2011, HIV testing is mainly carried out using anti-body

detecting techniques, which include enzyme-linked Immunosorbent Assay (ELISA), simple and

rapid tests. Testing is carried out in public and private health facilities including Non-

Governmental Organizations (NGOs) and Faith Based Organizations (FBOs) at the following

tiers of care:

a. Tertiary health facilities like Teaching hospitals, Federal medical centers

and Research institutes.

b. Secondary health facilities like General hospitals and state specialist

hospitals.

c. Primary health clinics, community health centers, NGO’s and alone HCT

centers, health posts and mobile clinics.

The indications for HIV testing include:

a. Need to know one’s health Status

b. Screening of donated Blood for organ transplant and transfusion.

c. HIV prevalence surveillance in a given population

d. Diagnosis of HIV infection in individuals

e. Treatment Monitoring

f. Research.

LABORATORY HIV TESTING

Persons who become infected with HIV produce antibodies over a period of three(3) months

according to the Nigerian Federal Ministry of Health Guidelines for HIV counseling and Testing

presentation in November 2011. Different types of tests are available for the detection of these

antibodies in adults and children over 18 months of age.

36
TYPES OF HIV TESTS

o Rapid Test: Rapid tests are recommended for HCT services because they are

fast, simple and accurate. It takes about 15 – 30 Minutes to perform; it can be

performed even in clinics without laboratories or specialized laboratory equipment

and are accurate when the instructions are strictly followed.

The test is performed using a small sample of blood (taken from the clients finger tip), serum or

plasma and the result is ready within 15 Minutes (Nigerian Federal Ministry of Health, 2011).

Enzymes Linked ImmunoSorbent Serologic Assays (ELISA): ELISA test results usually

take longer to obtain, and was originally developed for donor blood screening and therefore is

more suitable for batch testing in settings where large number of clients are seen daily. Only

trained medical laboratory scientist are to perform this test (Nigerian Federal Ministry of Health,

2011).

Virology Test: Virology testing detects the presence of the viral particles and gives the most

accurate results; examples include Deoxyribonucleic acid (DNA) and Ribonucleic acid (RNA)

by Polymerase Chain Reactions (PCR) tests, P24 antigen tests and viral culture. These tests are

not used in HIV counseling and testing services because they are expensive and require high

level of skills (Guidelines for HIV Counselling and Testing, November 2011). The test is

however recommended for Early Infant Diagnosis (EID) in children less than 18 months of age

(Nigerian Federal Ministry of Health, 2011).

RECOMMENDED HIV TEST KITS

An essential requirement of all HIV testing is accuracy of the test result. The rapid test kits used

are those approved by health agencies as part of the algorithm by HIV/AIDSDivision of federal

ministry of health (Nigerian Federal Ministry of Health)

TESTING ALGORITHMS

37
Testing algorithms show the strategies to be used for HIV testing, there are three strategies

defined by World Health Organization (WHO), based on different principles or methods known

as testing algorithm (Nigerian Federal Ministry of Health, 2013).

Serial Testing: With serial testing, an innitial blood sample is taken and tested using the more

sensitive kit. If the result is negative, the result is given to the client as HIV negative. If the result

is positive, the blood sample is tested using a second HIV rapid test kit, if the second test is also

positive, the result is given to the client as HIV positive. However, if the second test is negative,

a tie Breaker is used as the third test kit and the result of the tie breaker becomes final (Nigerian

Federal Ministry of Health, 2013). The serial testing algorithm flow is shown in the figure 2.6

below.

Test Specimen with Screening Test

Test Result Test Result

Negative Positive

Report as Negative Test Specimen using a second rapid test with a different
antigenic specification

Test Result Test Result

Negative Positive

Test Specimen using Tie breaker Report as Positive

38
Test Result Test Result
Positive Negative
 Re-test client in 3 months Report as Negative

Fig 2.6: Serial Algorithm for HIV testing.

Source: Health, F. M. (November 2011). National Guideline for HIV Counselling and Testing.

Parallel Testing: Parallel testing strategy involves use of blood samples (plasma, Serum or

whole blood) with two HIV test kits based on different test principles simultaneously (in parallel)

and the result issued if both test gives the same result (concordant result), however, if one result

is positive and the other is negative (discordant result), the tests are repeated using the same test

kits. If the result is still discordant, a recommended tie breaker is used and the result from the tie

breaker is given to the client. In cases where the tie breaker is not available, the client is referred

to a reference laboratory (Nigerian Federal Ministry of Health, 2011). Parallel algorithm is

further explained by the figure 2.7 below.

Test specimen with two rapid test kits of different

antigenic specifity at the same time

Both Test Kits give same result?

Test Specimen on a
No different Third Test
39 Kit (Tie-Breaker)

Yes
 Report Test Result as seen
Report Test Result as seen

Fig 2.7: Parallel Algorithm for HIV testing. Source: Health, F. M. (November 2011). National

Guideline for HIV Counselling and Testing

2.9 DRUG PRESCRIPTION AND DISPENSAL

In the early 1980s, when the HIV/AIDS epidemic began, patients rarely lived longer than a few

years. But today, there are many effective medicines to fight the infection, and people with HIV

have longer, healthier lives. Although there is still no cure for HIV, treatment is now effective at

allowing people with HIV to live their lives as normally as possible. Since the introduction of

medicines to treat HIV, the death rate of AIDS has reduced dramatically. With effective

treatment, very few people go on to develop AIDS.

HIV is now a treatable medical condition and most people with the virus remain fit and well on

treatment. Since the 1990’s, a number of medicines have been developed called antiretroviral

medicines. Antiretroviral medicines work against HIV infection by slowing down the replication

of the virus in the body, newer medicines are more effective than medicines in the past. There

are several classes of these medicines which include Neucleuside Reverse Transcriptase

Inhibitors (NRTIs), Neucleutide Reverse Transcriptase Inhibitors (NtRTIs), Protase Inhibitors

(PIs) and Non- Neucleuside Reverse Transcriptase Inhibitors (NNRTIs). Newer classes of

medicines have recently been introduced which are Integrase Inhibitors, Fusion Inhibitors and

CCR5 antagonists. The medicine in each class works in different ways but all work to stop the

HIV from replicating itself. This method of treatment is called Anti-Retroviral Therapy (ART), it

is still occasionally referred to as Highly Active Antiretroviral Therapy (www.MedlinePlus.htm).

40
 As a general rule, drug dispenser is normally started when

- CD4 T cells has fallen below a certain level (around 350 cells per cubic millimeter of blood or

less) even without symptoms, the exact level when drug is dispensed depends on various factors

which doctors do discuss with the infected persons during post counseling. These include any

symptom present and the rate of decline of the CD4 T cells.

- Opportunistic infections or other AIDS-related problems develop. Opportunistic infections are

usually treated with anti-biotics, anti-fungals or anti-TB medicines obviously depending on

which infection develops, even if infections have not developed, once the CD4 T-cells fall to a

low level, regular doses of one or more antibiotics is being advised or other medicines to prevent

certain infections from developing (www.MedlinePlus.html)

CHAPTER THREE

DESIGN METHODOLOGY

3.0 INTRODUCTION

Research Methodology refers to the means necessary to systematically proffer step-by-step

description of how solution to actualize stated Objectives of the research work will be carried

out. It outlines the various steps that are adopted.

3.1 SYSTEM DESIGN

A. Carry out an evaluation of pattern classification algorithms on appropriate datasets using

Expert System builder version 3.0. The process of evaluation will involve the following

steps;

i. Acquisition of relevant HIV/AIDS patient’s symptoms datasets from The General

Hospital Aguda Surulere Lagos State.

ii. Preparation of the acquired data set to a format supported by the expert system

software.
41
 iii. Verify the best method to ensure the accuracy of each of the algorithms used in the

experiments.

B. The Hiv/Aids Diagnosis system’s Decision Support System (DSS) has a user interface that

will be used to feed patient data into the system, the system also has a knowledge base the

houses the following modules;

i. The diagnostic Module

ii. The Medical expert knowledge Logic.

The web-based User interface will be developed using;

i. Windows 8 operating system, Apache web server, MYSQL database

ii. PHPMYADMIN

iii. Cascading style sheet (CSS)

iv. Hyper text markup Language (HTML)

v. Javascript frameworks

3.1.1 DESIGN TOOLS

WAMP PACKAGE

WAMP is the abbreviation of the package; Windows, Apache, MYSQL and PHP.

Apache HTTP server is web server software. PHP stands for hyper text pre-processor,

it is a kind of HTML embedded language which executed on the server. MYSQL

server is small relation database Management system.

Combination of these packages formed a powerful web application platform.

PHP (PHP HYPERTEXT PRE-PROCESSOR): This served as the server side scripting

language and was used to connect to the database along side with HTML code.

HTML (HYPERTEXT MARK-UP LANGUAUGE): This is a mark-up language

42
 that was used to create or design a website of the system.

JAVASCRIPT: This served as the client side scripting Language.

APACHE: This was the server used to execute the web code created with PHP and

HTML.

PHPMYADMIN: This was used to create my database and tables needed in the web

application

LOCAL HOST: This is the host/address of the Local machine used or in use, The IP

address is 127.0.0.1.

MYSQL: This was the type of database used in the course of design.

3.2 SOFTWARE DEVELOPMENT LIFE CYCLE

The software development life cycle (SDLC), also referred to as the application

development life-cycle, is a term used in systems engineering, information system

and software engineering to describe a process for planning, creating, testing and

deploying an information system. It is composed of a number of clearly defined and

distinct work phases which are used by system engineers and system developer to

plan for, design, build, test, and deliver information system. SDLC provides a series

of step to be followed to design and develop a software product efficiently. There are

different types of software development life cycle which are:

1. Waterfall model

2. Iterative model

3. Spiral model

4. Agile model

5. Prototype model

6. RAD model (Rapid application development)

43
 7. V- model

8. Fish model

In developing the decision support system, the software design methodology used was the waterfall

model development process.

3.2.1 WATER FALL MODEL

The waterfall model is a sequential design process, used in software development processes, in

which progress is seen as flowing steadily downwards through the phases of conception,

initiation, analysis, design, construction, testing, production/implementation and maintenance.

In Royce's original waterfall model (2007 Software Engineering Project Management 2nd

edition With R. Thayer & Ed Yourdon), the following phases are followed in order: System and

software requirements: captured in a product requirements document Analysis: resulting in

models, schema, and business rules Design: resulting in the software architecture Coding: the

development, proving, and integration of software Testing: the systematic discovery and

debugging of defects Operations: the installation, migration, support, and maintenance of

complete systems.

Thus the waterfall model maintains that one should move to a phase only when it’s proceeding

phase is reviewed and verified.

Various modified waterfall model including Royce's final model, which include slight or major

variations on this process. These variations included returning to the previous cycle after flaws

were found downstream or returning all the way to the design phase if downstream phases deemed

insufficient.

44
 REQUIREMENT Product requirement document

Software architecture
DESIGN

Software
IMPLEMENTATION

VERIFICATIO

MAINTENC

Fig 3.1: Hierarchy of Expert System development process

(Source: https://en.wikipedia.org/wiki/Winston_W._Royce)

The research methodology and System Design actually follow the hierarchy represented in the

figure above. The background, concepts and problem selection are discussed under the same

heading as the system study and investigation, where a procedure is undertaken in learning about

HIV/AIDS and its various symptoms and available treatment before looking for a way of designing

a system that will be able to use these selected problems to diagnose the ailment. By this, it was
45
 learnt that, to be diagnosed, the patient has to go through a process known as Voluntary Testing

and Counseling (VCT). The process therefore consists of the basic steps used in the design of the

proposed system as it basically involves pre–test counseling, actual testing and post test

counseling, by this, the HIV/AIDS Diagnostic System (HADS) is divided into modules to handle

the above tasks.

3.3 HIV/AIDS DIAGNOSIS EXPERT SYSTEM MODULES

3.3.1 USER INTERFACE

The user interface serves as the medium through which patient data can be fed into the system

for processing. It is also through the user interface that the diagnostic results, reminders, alerts

and recommendations are displayed to the user.

The User interface was designed by using:

i. Windows 8 operating system, Apache web server, MYSQL database and PHPmyAdmin

ii. Google Chrome web browser

iii. Cascading style sheet (CSS)

iv. Adobe Dreamweaver CS6

v. JavaScript frameworks

3.3.2 MEDICAL KNOWLEDGE BASE

The medical knowledge base consists of the following:

46
 1. The diagnostic module that contains symptoms, diagnostic results and prescribed

recommendation. This module stores relevant information required for diagnosis of

HIV/AIDS status and as well as stores the results obtained after diagnosis.

2. The medical expert knowledge module that house the knowledge of the medical expert as

regards HIV/AIDS. The knowledge acquired from the medical expert is coded into the Expert

system by the knowledge engineer. The knowledge from the expert is coded following

standard Clinical practice Guidelines (CPGs) for HIV/AIDS.

3. The electronic medical record (EMR) that contains the details of all persons that the system

has been used to diagnose as regards their HIV/AIDS status. The EMR contains information

about a patient’s healthcare that are essential for his or her present and future care (WHO,

2001) and are covered by section 3 of the Health Records Act, 2001 (AustLII, 2012)

3.3.3 INFERENCE ENGINE

The Inference engine serves as the processing component within the system that co-ordinates the

activities within the system in such a way as to be able to execute according to the knowledge

base with reference to patient’s input data. It therefore generates the appropriate results.

3.4 DATABASE DESIGN

This is the design of the SQL database which consist of the specification of the various relations,

fields that the table contains and their corresponding data type as well as the field length

specification. In the MYSQL environment, the term database referred to a collection of tables

(relations) and other database objects such as indexes.

47
 Fig 3.2: System database, Source:127.0.0.1/phpmyadmin

3.4.1 TABLES

One of the most critical components of the database is its table that’s because SQL server uses

table to store data. You create a table to contain a set of related information. When you create a

table, you define its column; column refers to the individual pieces of information (fields) you

want to track for a specific table. You can control how information is stored in a particular

column by configuring the properties

PROPERTIES OF A TABLE

DATA TYPE CONSTRAINTS DEFAULT RULE

48
 Fig 3.3: database source table Source: http://downloads.mysql.com/mysql-tutorials

3.5 DEVELOPMENT OF A PROTOTYPE SYSTEM USING EXPERT SYSTEM

BUILDER VERSION 3.0

Introduction

In the following sections, a brief introduction is given about the designing of the prototype and

the expert system shells. The steps involved in the development of the prototype are discussed.

Finally the results and observations are tabulated from (Shodhganga ,2013)

Designing a Expert system prototype

Expert systems require special approaches to systems analysis, especially to the collection of the

data (or rather knowledge) on which the system is based. The process of gathering the

knowledge to stock the expert system's knowledge-base & knowledge acquisition has proved to

be the most difficult component of the knowledge engineering process. It's known as the

'Knowledge Acquisition Bottleneck', and expert system projects are more likely to fail at this

stage than any other. Knowledge acquisition almost always involves extracting knowledge from

someone expert in the specific field. This process of knowledge elicitation involves a variety of

interview and non-interview techniques.

The development of Expert systems requires special approach to software management. The

methodologies used to build expert systems have been shaped by the problems with knowledge

acquisition, described earlier. For a long time, the favourite development methodology was rapid

49
prototyping. (Cyclical development means more or less the same thing). In the mid-1980s, this

approach came under criticism, because it appeared to have all the shortcomings of the

unstructured approaches which had been used, with very poor results, in the early days of

mainstream software. But the structured systems analysis & design methodologies did not seem

to be appropriate, because of the differences between knowledge and data. As a result, special-

purpose development methodologies for knowledge engineering were developed. The most well

known is KADS, (KADS is a development methodology for knowledge-based systems) which

was developed at the University of Amsterdam, as part of the ESPRIT programme, in co-

operation with several European partners. The phase of prototyping can have the following steps.

i. Build a small prototype

ii. Test, improve and expand it

iii. Demonstrate and analyse feasibility

iv. Complete the design

Prototyping systems development focuses on the iterative creation of a new expert system.

Rather than going through the whole SDLC process for everything that could be potentially

envisioned with the system, a portion of the system is chosen to use to create a prototype. The

prototype does not go through extensive requirements analysis and instead focuses on getting

something created quickly for immediate use by end-users in order to gather feedback to either

modify the prototype or begin the process again with another component. While the prototyping

development method gets users involved in the system's development and typically brings about

real results quickly, it can be difficult to manage prototyping-based projects due to its differences

with SDLC. The primary level analysis and design is illustrated in figure 3.4

50
 NEGATIVE RESULT

POSITIVE RESULT

Figure 3.4: Primary level of analysis and design, Source: Shodhganga.iniflibnet.ac.in

The process of building an expert system is commonly known as knowledge- engineering. This

implies knowledge acquisition from a human or other source and coding it into the knowledge

base of the expert system. The main phases in the knowledge engineering process are the dialog

process as represented in Fig. 3.5. This is similar to the task of a system designer discussing the

requirements of the program with the client, in conventional programming. After acquiring

knowledge from the human expert, the knowledge engineer has to explicitly code it into the

expert system knowledge-base. After the coding stage, the human expert evaluates the expert

system and gives feedback/critique to the knowledge engineer. The knowledge engineer alters

the knowledge base in order to reflect the human expert's comments

51
Fig 3.5 ES-builder Source: Shodhganga.iniflibnet.ac.in
This process will iterate until the human expert finds the expert system satisfactory for the

envisaged purpose. Some rule-based systems may display the capability to learn rules by

example (rule induction), creating rules from tables of data. Learning is a complex process,

hindered by ambiguities, duplications and inconsistencies in the human expert knowledge.

Expert System Shell Used

Expert system shells provide methods of building expert systems without extensive knowledge

of programming through mechanisms that

(i) Input the decisions, questions and rules that are followed (ii) Construct a knowledge database

that can be manipulated by subsequent parts of the system

(iii) verifies possible violations of surface validity and (iv) operates the "inference engine" that

operates on the rules, poses the questions to the users, and determines whether a particular

52
decision is valid. Most expert systems also allow the user to halt the processing at any time to

query the system why a question was asked, or how a decision was reached. Most expert system

shells can now run easily on most current micro-computers and are able to handle the

manipulation of a relatively large number of rules and associated questions. Expert system shells

are expert system development tools consisting essentially of the expert system without the

knowledge base, embodying the inference engine, working memory, and the user interface . An

example of the inference engine part of an expert system that deduces new conclusions from

known facts is illustrated below:

IF test results =known

AND Opportunity infection rate=known

AND Opportunity infection = dominant

THEN Client= Suspected HIV/AIDS Positive

Expert systems give advice or solve problems by drawing upon this knowledge stored in the

IF/THEN rules. A survey of different expert system shells was conducted. After careful study of

the shell for the development of prototype ES-Builder V3.0 is selected

ES-Builder Ver. 3.0 Expert System Shell

ES-Builder Ver. 3 is simple software to build a expert system prototype. It does away with the

separate programs model of the previous version and combines everything into one simple

interface. The user can create a web site in the ES-Builder Ver. 3.0 Expert System Shell. A full

expert systems project can be created in HTML format for electronic publishing. Built-in

exporting functions include the flexibility to create a web page for:

i.Searching the expert system

ii.Displaying the Knowledge Base

iii. Displaying the Decision Tree

53
 iv. Displaying the full Decision Table

v. Listing the Attributes and Values

vi. Specifying the ES Documentation

Some of the important features of the ES-Builder are as follows:

The ES-Builder Expert System Shell is a set of purpose built tools for use in the teaching of

the basic concepts of expert systems.

ES-Builder is compatible with all versions of Microsoft Windows from 98 to XP and above. It

has a simple familiar Windows interface which allows the easy entry of expert system data once

the research for the expert system has been completed.

ES-Builder allows the user to easily build decision trees of basically unlimited size and

complexity. Once conclusions, attributes and values are defined using the decision tree, data

entry is simple and intuitive.

ES-Builder uses the Windows tree view component which allows the easy creation of expert

system decision trees by point and click addition of attributes, values, and conclusions. Many

possible errors in tree construction are precluded by the program which only allows valid

branches to be added to any node. The decision tree can be tested easily at every stage of data

entry for validity by a simple button click that will report errors and move to the erroneous node.

ES-Builder allows the user to add detailed notes about each attribute, value and conclusion

along with a picture or diagram to illustrate each one. This additional data becomes art of the

Expert System web site.

Once the Decision Tree is completed using ES-Builder, the user can print the decision tree to a

selected printer or choose to export paste the tree in rich text form into another document, e.g.

the word processor they are using to write up their assignment.

The detail procedural analysis was carried out. After going through the analysis the procedure

which was adopted to develop a prototype is mentioned below.

54
i. Study of ES-Builder Ver. 3.0

ii. Discussions/interviews with the Medical experts in field and academicians in Medicine

iii. The framing of rules using the Medical knowledge and incorporation into Expert system

Builder

iv. Testing and Implementation

A series of discussion and the interviews were held with the practicing doctors who are experts

in the field of study. The discussions consisted of understanding the concept of subject matters

and the intricacies involved in them. The broad outlines of the rules which need to be framed

were noted. The discussions and the interviews with the academicians in medicine were

conducted. The interviews were of great help in framing of the rules

Decision Tree Generated:

HIV/AIDS DIAGNOSIS
+---A – Enter User ID

|
|---V - Confirmed
||
| |+---A - Pre-Test Counselling
||
| |---V - Yes
|||
| | +---A – Correctly Counselled?
|||

55
 | | |---V - Yes
||||
| | | +---A – Save Result
||||
| | | |---V - Yes
|||||
| | | | |+---A – If negative Result
|||||
| | | | |---V - Yes
|||||
| | | | | | +---C – Print Result
||||||
||||||
| | | | | | | | +---V - No
||||||||
| | | | | | | +---C - Suspected Positive Result, Lab Test Required
Figure 3.6: A Decision tree developed. Source: ES Builder 3.0 season workshop (2016)

CHAPTER FOUR

SYSTEM SPECIFICATION AND IMPLEMENTATION

4.0 REQUIREMENT SPECIFICATIONS

Requirements are the description of the functionality of services to be provided by a system and

its operational constraints that reflect the need to solve specific problems.

The requirements have been broken down into system and user requirement.

4.1.1 SYSTEM SOFTWARE REQUIREMENT

 Operating System…………………………..Windows XP professional or Above

 Relational Database System…………………MYSQL

 Programming language………………………PHP, HTML, JavaScript, CSS

56
  Development Environment………………….Expert system Builder, Notepad++

 Web Server………………………………….Apache HTTP Server

 Modeling tool……………………………….Microsoft office suite

 Server Software…………………………….. Windows 2007 server

4.1.2 THE USER HARDWARE REQUIREMENT

Since this is a web based system, it requires less hardware configuration

i. Memory (RAM)……………………..256MB upward

ii. Hard drive size…………………………20GB upward

4.2 SYSTEM TESTING AND FLOW CHARTS

System testing is a crucial aspect of implementation activity. It requires careful planning on the

part of the designer. System testing involves running of the program with data representation of

all the anticipated processing conditions that will be encountered so as to detect possible errors

and fix them in the course of the system design. Before a system is put to use, this procedure is

very important as it is indeed a programming practice to extensively test a program before

compiling it. In the course of this design, a prototype of the HIV/AIDS diagnostic system was

first designed and tested before the complete system design was carried out, this procedure was

of great help as it reduced the errors during system testing of the complete design to the barest

minimum and only few corrections where made during this stage.

4.2.1 COMPONENT TESTING

Each component of the web application were tested to be sure that they are functioning perfectly

with little or no error.

57
4.2.2 DATABASE TESTING

The knowledge in the database was coded using MYSQL and they followed the if-then rules

generated by the expert coded in the knowledge base of my framework which was coded in PHP

programming language

4.2.3 INTEGRATION TESTING

Here the whole web application was tested by connecting it with the web server to validate that

all the modules are working together and tested to look for any possible error.

SYSTEM FLOW DIAGRAMS

START

NO
REGISTERED?
REGISTER

YES
LOGIN

NO
LOGGED IN INFO
CORRECT?

YES

DASH BOARD

58
 HDS PATIENT
DIAGNOSIS

VIEW RESULT LOGOUT

Fig. 4.1 Process Flow Chart

STOP
Source: xpertrule.com/expert-systems

Start

Enter User ID

No Confirmed

ok?
Yes

Client Page

Diagnostic Test
Procedure

No
Pre-Test Counselling

Correctly Counselled?
59
 No
Yes

Save Record

Suspected Positive
No If Negative
Yes
Result, Lab Test
Result? Print Result
Required (Official Stop
page)

Fig. 4.2 System Flow Chart, Source: xpertrule.com/expert-systems

LABORATORY TESTING

KIT A

Case 1 Case 3
Case 2

Invalid KIT B
RESULT Negative HIV
antibodies result
Positive HIV
antibodies result

Negative Post-
Test Counseling Case 1 Case 2

STOP Negative HIV antibodies result

KIT C
60

Case 1 Case 2
 Negative HIV Positive HIV Positive HIV
antibodies result antibodies result antibodies
result

STOP
Test for Opportunistic
infections
2

Test for Opportunistic infections

CD4 <200 & viral CD4 >=200 || <=500 CD4 >500 & viral Reoccurring
load <55000 viral load <55000 load <55000 infections

Immediate Keep monthly check Keep monthly check Immediate

treatment required and daily treatment and daily treatment treatment required

STOP

Fig.4.3 Procedural flow of the system

Source: xpertrule.com/expert-systems
61
4.3 MAINTENANCE

The system will however be continually improved upon, more user interaction will continually

be done to improve more at the design phase and also kept current primarily by updating its

knowledge base since in healthcare, identification of knowledge quickly becomes a very difficult

challenge due to the sheer amount of ever expanding knowledge corpus (BMO 2011)

4.4 SYSTEM IMPLEMENTATION

The system implementation phase describes the completed system based on its mode of

operation, at this stage, the system definition is checked practically as end users are trained, and

an operational team is built as a productive environment is set for required performance.

The designed system helps clients detect with great reliability and assurance of security their

HIV status in testing centers by entering test results based on test and control lines on test kits

into the system. The system is built with analytical operational analogies conforming to that of

the national interim algorithm for HIV serology as defined by the Nigerian Federal Ministry of

Health, by their definition, The designed system contains Developed system modules for

effective implementation such as;

Home Page:

The index page or home page of the system contains some introductory messages that explain

the system, it also contains only one login information for both newly created client and old

client, at the creation of client by the system administrator, the client is created with some default

details, hence the login for new client is a link, that takes them to the welcome page that

validates their login with their own userID, by the change of their default details, they are then

62
granted access to the client area of the system by proper login from the index page which

contains fields for User’s Login details required.

The Screenshot can be found in appendix

Client Page:

On successful login, the client is taken to his/her respective page to perform their functions, the

available client pages on the system are the counselors’ page where counseling and testing are

carried out, the laboratory page where laboratory test results are recorded. The activities

performed by the counseling and testing client involve risk assessment of clients so as to know

how to perform counseling properly.

During the above analysis, client risk and opportunistic infection analysis are performed by

counting from his/her response during analysis; the result aids the client on counseling. The

Screenshot can be found in appendix

Testing page:

The test page is of three sectors, the determine page is the first test page, its contains three test

result using determine as line one (1) test procedure, the results are the positive result, negative

result and the invalid result. The uni-gold test page is also similar to the determine and so also is

the stat-pak test page as they all have test results of type positive, negative and invalid. The

images of the three test pages which are the determine test page, uni-gold test page and stat-pak

test page.

The Screenshot can be found in appendix

Result page:

The test result page declares the status of the client, during testing, there are two possible test

results to be expected, a Positive test result as seen in figure 4.8 indicates that the antibody

responsible for HIV infection is found present in the client while a negative result as shown in

figure 4.9 shows that the client is free of such antibody.

63
 The Screenshot can be found in appendix

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

5.1 SUMMARY

The HIV/AIDS diagnostic system (HADS) is a medical expert system that aids in the diagnosis

of HIV antibodies and in detecting the extent of the infection so as to recommend treatment

options in infected persons, it contains answers to some frequently asked questions about the

disease, it has a help module that assists the users, it has its operational terms and condition

module, the system also contains many secured modules that are used for its actual design

purposes. These modules are made secured so as to ensure that usage is only by authorized

personnel and restriction to diagnostic procedures is guaranteed. The system is to be however

used following recommendations of its designer which revolve around the presence of a human

expert in any medical establishment using the system.

5.2 CONCLUSION

Medical expert systems have by all means proven effective in medical establishments, by these,

the use of medical diagnostic system has become very popular in medical establishments of

recent. The system can help establishments that use it in effective and confidential counseling

and testing. The system gives with great amount of accuracy the possibility of being infected
64
 with the virus before displaying the result. Though the surest way is by Lab testing, the

effectiveness of its risk analysis cannot be undermined as during its testing phase a count on

those infected due to high risk analysis and opportunistic infection analysis shows that person

with high possibility end up having the virus when an actual laboratory test is performed.

5.3 RECOMMENDATIONS

There should be a human expert who is knowledgeable in the manual operation of the previous

system, the human expert will monitor the expert system and certify it after a period of time.

Back-up files should be archived in a safe location away from areas prone to accident so that a

recovery can be done in case of accidents.

The system should be installed and properly monitored in establishments of needs so that

accurate data capturing can be guaranteed, by these, data analysis will become easier when it

comes to medical research involving HIV/AIDS.

The system design had a lot of challenges which created some limitations to the system, if proper

studies are done, the system can be upgraded to cover more areas and by the coverage further

studies can be carried so that medical diagnosis of HIV/AIDS through blood implantation can be

made possible.

65
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APPENDIX A
Index (home) page

68
Registration page

69
Welcome Page

Analysis page

70
Suspected Positive test result page

Determine test
71
Uni-gold test

Stat-pak test

72
 Positive test result page

Negative test result page

APPENDIX B
SOURCE CODES
INDEX PAGE (CLIENT LOGIN)
<html>
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body>
<body bgcolor="#6699FF">
<tablewidth="1300"border="0"align="center"><tr>
<tdcolspan="7"><divalign="center"><imgsrc="file:///C:/Users/Technical%20Service/Desktop/HDS

73
%20FILES/includes/images/header.JPG.JPG" width="1200" height="160" /></div></td> </tr><tr
bgcolor="#FFFFFF">
<?php require_once("includes/session.php");?> <?php require_once("includes/connection.php")?> <p>
<?php include("includes/header.php") ?>
<?php if(isset($_POST['submit'])){ $userid=$_POST['userid']; $password=$_POST['password'];
$hash_password=sha1($password); $query="SELECT userid,password FROM staffs WHERE
userid='{$userid}' AND password='{$hash_password}'"; $result=mysql_query($query,$connection);
if(!$result){ die("Database Query Failed Due to: ".mysql_error());}if(mysql_num_rows($result)==1)
{ if($found_user=mysql_fetch_array($result)){$_SESSION['password']=$found_user['password'];

$_SESSION['username']=$found_user['userid'];if($_SESSION['password']= $password)
{header("Location:staffpage.php?userid={$_SESSION['username']}&&status={$field}");}
}else {header("Location:errorpage.php?userid={$_SESSION['username']}");} }else
{header("Location:errorpage.php");}} ?> <form name="form1" method="post"
action="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/basis/welcome%20page.html">
<table width="1200" border="0" align="center"> <tr> <td width="338"><font
color="#CC0000"><em><strong>NEW CLIENT SHOULD <a href="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/Start%20here.html">CLICK HERE</a></strong><a
="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/hds.html"></a></em></font></td>
<td width="575" rowspan="3" background="includes/images/bgimage.jpg"><p
align="center"><strong><font color="#000066">CLIENT LOGIN</font></strong></p> <p
align="center"><font color="#000000">USERNAME</font><strong> <input name="userid"
type="text" id="userid" size="25"> </strong></p> <div align="center"> <p> <input type="submit"
name="submit" id="submit" value="ENTER"></p> <p>&nbsp;</p></div> </form> <p
align="center">&nbsp; </p></td> <td width="338">&nbsp;</td> </tr> <tr> <td height="164"
width="150"><p align="left"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/Start%20here.html"></a><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/basis/Vision.html"></a><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/basis/Mission.html"></a><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/basis/Help.html"></a></p>
<p><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/side.JPG.JPG" width="310" height="213" /></p></td>

74
 <td><div align="justify"><font color="#000000">HIV/AIDS has been an epidemic not only in
Nigeria but the world in general, many people have died due to this epidemic, the death rate is very high
due to many reasons including lack of awareness, this system tend to provide this awareness to
individuals and groups for proper handling of people living with the virus and also educates people on
how to stay free from it.............</font></div></td>
</tr> <tr> <td height="143"><p><font color="#000000">The HIV/AIDS diagnostic system is a
medical diagnostic system used in medical establishments trained by the system designers to cover
HIV/AIDS related conditions, it helps in diagnosing clients, it is easy to use and reliable for medical
establishments...</font></p></td>
<td><div align="right"><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/index13.jpg.jpg" width="330" height="209" /></div></td> </tr> </body>
<script type="text/javascript">
var y=prompt("PLEASE ENTER YOUR NAME")
alert("WELCOME "+ y)
</script><script> alert (y +" HOW ARE YOU FEELING TODAY? PLEASE TYPE IN YOUR
USERNAME IN ALPHANUMERIC ORDER, e.g ugo123,ada332 or Emeka222 AND CLICK ENTER
LET'S GET STARTED");
document.getElementById("user id").style.left = "0px"; </script>
</html>
WELCOME PAGE
<html>
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tr>
</div></td></tr> <table width="1200"border="1" align="center"> <tr bgcolor="#FF0000"> <td
bgcolor="#66FF00"><div align="right" <?php //Date echo "Today is ".date("l F d, Y");?> </div>
<div align="right"></div></td> </tr> <tr bgcolor="#FF0000"> <td height="48"><p
align="center"><strong><font color="#000000">WELCOME TO HIV/AIDS DIAGNOSTIC
SYSTEM</font></strong></p></td> </tr> <tr> <td height="44" bgcolor="#66FF00"><div
align="center" class="white"> <form id="form1" name="form1" method="post" action=""> </form>
75
<strong> </div></td> </tr> <tr> <td bgcolor="#66FF00"><div align="center"><img
src="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/includes/images/header.JPG.JPG"
width="1200" height="160" align="middle" /></div> <div align="center"></div></td> </tr>
<tr> <td colspan="4" bgcolor="#FF0000"><div align="right" class="H"><em><strong> <div
align="left"> <div align="right">DESIGNED BY NWIGWE UGOCHUKWU GODWILL
Copyright &copy;2015 </tr></table><tr> <td width="338"><font
color="#CC0000"><em><strong>NEW CLIENT SHOULD <a href="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/Start%20here.html">CLICK HERE</a></strong><a
="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/hds.html"></a></em></font></td><tr> <td height="164" width="150"><p
align="left"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/Start
%20here.html">Home</a>|| ||<a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/basis/Vision.html">Vision</a>|| ||<a href="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/basis/Mission.html">Mission</a>|| ||<a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/basis/Help.html">Help</a></p>
</body>
</html>
<td><divalign="right"><imgsrc="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/SNAG-15101823330500.png" width="330" height="155" /></div></td>
</tr><div align="right"<tdbgcolor="#FF0000"><ahref="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/basis/risk%20and%20opportunistic%20analysis
%20page.html"><font color="#FF0000">NEXT</a> <tr> <td height="25"
colspan="2"><divalign="center"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/basis/Contact%20Me.html"> <fontcolor="#000000">ContactMe</a>||||
<ahref="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/basis/Help.html">Help</a>|| ||
<a href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/basis/Terms%20and
%20conditions.html">Terms&Conditions</a>||<a href="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/basis/About.html">About</a>||<a
href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/basis/FAQS.html">FAQS</a></div></td> </tr>

RISK AND OPPORTUNISTIC ANALYSIS PAGE

<html>
76
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tr>
<td colspan="7"><div align="center"><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/header.JPG.JPG" width="1200" height="160" /></div></td> </tr><tr
bgcolor="#FFFFFF">
<?php require_once("includes/session.php");?> <?php require_once("includes/connection.php")?> <p>
<?php include("includes/header.php") ?>
</tr></table></body></html>
<?phprequire_once("../includes/session.php");?><?phprequire_once("../includes/connection.php")?
><p><?php include("../includes/header.php") ?><?php //Date $date= date("l F d, Y");?> <?php $rand =
rand(000,900);?><?php $rand = "HOSP"."/".$rand."/"."HS"?><?php $query4 = "SELECT * ";
$query4 .= "FROM count "; $query4 .= "WHERE sno = '0' ";$result4 = mysql_query($query4,
$connection); $found_count = mysql_fetch_array($result4); $mtotal = $found_count['mtotal']; $mtotal =
$mtotal + 1; $query5 = "UPDATE count SET mtotal ='{$mtotal}' WHERE sno='0'"; $result5 =
mysql_query($query5, $connection);?> <?php $query4 = "SELECT * "; $query4 .= "FROM count ";
$query4 .= "WHERE sno = '0' "; $result4 = mysql_query($query4, $connection); $found_count =
mysql_fetch_array($result4); $mtotal = $found_count['mtotal']; $ftotal = $found_count['ftotal']; $total =
$found_count['total']; $total = $mtotal + $ftotal; $query6 = "UPDATE count SET total ='{$total}'
WHERE sno='0'"; $result6 = mysql_query($query6, $connection); ?><?php if (isset($_GET['id'])) {$id
= $_GET['id']; $id = @$_GET["id"]; $query1 = "SELECT * "; $query1 .= "FROM client "; $query1 .=
"WHERE id = '{$id}' "; $result1 = mysql_query($query1, $connection); $found_client =
mysql_fetch_array($result1); $_SESSION['id']=$found_client['id']; }?> <?php $yes_status =
'unchecked'; $no_status = 'unchecked'; $selected_radio = @$_POST['select']; if ($selected_radio==8)
{ $yes_status = 'checked'; }else if ($selected_radio == 0){$no_status = 'checked';}$selected_radio1 =
@$_POST['select2']; if ($selected_radio1==8) {$yes_status = 'checked'; }else if ($selected_radio1 ==
0) {$no_status = 'checked';} $selected_radio2 = @$_POST['select3'];if ($selected_radio2==8)
{$yes_status = 'checked'; }else if ($selected_radio2 == 0){ $no_status = 'checked';} $selected_radio3 =
@$_POST['select4'];if ($selected_radio3==8){$yes_status = 'checked';}else if ($selected_radio3 == 0)
{$no_status = 'checked';}$selected_radio4 = @$_POST['select5']; if ($selected_radio4==10)
77
{$yes_status = 'checked'; }else if ($selected_radio4 == 0){$no_status = 'checked';}$selected_radio5 =
@$_POST['select6'];if ($selected_radio5==8){$yes_status = 'checked'; }else if ($selected_radio5 == 0)
{$no_status = 'checked';} $selected_radio6 = @$_POST['select7']; if ($selected_radio6==8)
{$yes_status = 'checked';}else if ($selected_radio6 == 0){$no_status = 'checked'; }$selected_radio7 =
@$_POST['select8'];if ($selected_radio7==8){$yes_status = 'checked';}else if ($selected_radio7 == 0)
{$no_status = 'checked';} $selected_radio8 = @$_POST['select9']; if ($selected_radio8==8)
{$yes_status = 'checked'; }else if ($selected_radio8 == 0){ $no_status = 'checked';} $selected_radio9 =
@$_POST['select10'];
if ($selected_radio9==8){$yes_status = 'checked'; }else if ($selected_radio9 == 0){ $no_status =
'checked';}$selected_radio10 = @$_POST['select11'];if ($selected_radio10==8){$yes_status =
'checked';}else if ($selected_radio10 == 0){$no_status = 'checked';} $selected_radio11 =
@$_POST['select12']; if ($selected_radio11==10){$yes_status = 'checked';
}else if ($selected_radio11 == 0){$no_status = 'checked';} $selected_radio12 = @$_POST['select13'];
if ($selected_radio12==10){$yes_status = 'checked';
}else if ($selected_radio12 == 0){$no_status = 'checked';}
$selected_radio13 = @$_POST['select14']; if ($selected_radio13==10){ $yes_status = 'checked'; }else if
($selected_radio13 == 0){ $no_status = 'checked';} $selected_radio14 = @$_POST['select15']; if
($selected_radio14==10){ $yes_status = 'checked'; }else if ($selected_radio14 == 0){ $no_status =
'checked';} $selected_radio15 = @$_POST['select16'];
if ($selected_radio15==10){ $yes_status = 'checked'; }else if ($selected_radio15 == 0){ $no_status =
'checked';} $selected_radio16 = @$_POST['select17']; if ($selected_radio16==10){ $yes_status =
'checked'; }else if ($selected_radio16 == 0){ $no_status = 'checked';} $selected_radio17 =
@$_POST['select18']; if ($selected_radio17==0){
$yes_status = 'checked'; }else if ($selected_radio17 == 10){ $no_status = 'checked';} $selected_radio18
= @$_POST['select19']; if ($selected_radio18==10){ $yes_status = 'checked';}else if
($selected_radio18 == 0){ $no_status = 'checked';} $selected_radio19 = @$_POST['select20']; if
($selected_radio19==10){ $yes_status = 'checked'; }else if ($selected_radio19 == 0){ $no_status =
'checked';} $selected_radio20 = @$_POST['select21']; if ($selected_radio20==10){ $yes_status =
'checked'; }else if ($selected_radio20 == 0){ $no_status = 'checked';} $selected_radio21 =
@$_POST['select22']; if ($selected_radio21==10){ $yes_status = 'checked'; }else if ($selected_radio21
== 0){ $no_status = 'checked'; }

78
$opt_analysis = @$selected_radio7 + @$selected_radio8 + @$selected_radio9 +@$selected_radio10 +
@$selected_radio11 + @$selected_radio19 + @$selected_radio20 + @$selected_radio21; $opt_analysis
=$opt_analysis."%";
$risk_analysis = @$selected_radio + @$selected_radio1 + @$selected_radio2 + @$selected_radio3 +
@$selected_radio12 + @$selected_radio13 + @$selected_radio14 + @$selected_radio15 +
@$selected_radio16 + @$selected_radio17; $risk_analysis = $risk_analysis."%"; ?>
<?php
if ( isset($_POST['submit'])){ $query = "UPDATE client SET opt_analysis='{$opt_analysis}',
risk_analysis ='{$risk_analysis}' WHERE id='{$_SESSION['id']}'"; $result=mysql_query($query,
$connection); if ($result)
header("Location:labTest.php?
id={$_SESSION['id']}&opt_analysis={$opt_analysis}&risk_analysis={$risk_analysis}");
if(!$result){ die("Database query failed as: ".mysql_error());}} ?> <form
action="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/basis/Suspected%20Positive
%20test%20result%20page.html" method="post"> <table align="center"> <td width="361"><table
width="1200" border="1" align="left"> <tr> <td colspan="3" bgcolor="#FF0000"><div align="center"
class="RED"> <div align="center"><font color="#0000FF" size="+1"><strong>*****DIAGNOSTIC
PROCEDURE*****</strong></font></div></div></td></tr><tr><tdcolspan="3"bgcolor="#FFFFFF">
<div align="center"><font color="#0000FF"><strong>HIV COUNSELLING AND TESTING:
CLIENT INTAKE FORM</strong></font></div></td></tr><tr><td colspan="3"
bgcolor="#FF0000"><div align="right"> <?php
//Date
echo "Today is ".date("l F d, Y");?></div></td> </tr> <tr><td colspan="3" bgcolor="#FF0000"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/basis/welcome
%20page.html"><font color="#FFFFFF">BACK</a></td> </tr> <tr> <td height="120" colspan="3"
bgcolor="#66FF33"><p align="center">CLIENT'S NAME: <input name="name" type="text"
id="name" value=""name"]?> AGE: <input name="age" type="text" id="age" value=""age"]?> DATE
OF VISIT: <input name="dov" type="text" id="dov" value=""dov"]?>
STATE OF RESIDENCE: <input name="state" type="text" id="state" value=""state"]?> </p> <p
align="center">L.G.A OF RESIDENCE: <inputname="lga" type="text" id="lga" value="<?php echo
$found_client["lga"]?> <input name="status" type="text" id="status" value=""status"]?> Martial Status:
<input name="status" type="text" id="status" value=""status"]?> Sex: <input name="sex" type="text"

79
id="sex" value=" "sex"]?> Contact Number: <input name="number" type="text" id="number"
value=""number"]?> </p> </td> </table> <table width="1200" border="0">
<tr> <td colspan="4" bgcolor="#66FF00"><div align="center">CLIENT IDENTIFICATION
NUMBER : <input type="text" name="id" id="id" value=""id"]?> </div></td> </tr> <tr> <td
colspan="2" bgcolor="#66FF00"><div align="center"><strong><font color="#FF0000"
size="+2">Knowledge Assessment</font></strong></div></td><td colspan="2"
bgcolor="#66FF00"><div align="center"><font color="#FF0000" size="+2">HIV Risk
Analysis</font></div></td> </tr>
<tr> <td width="375" bgcolor="#66FF00">Previously Tested Negative to HIV?</font></td>
<td width="186" bgcolor="#66FF00">YES <input type="radio" name="select" value="8" />
NO <input type="radio" name="select" value="0" /></td><td width="413" bgcolor="#66FF00">Ever
Had Sexual intercourse?</font></td><td width="198" bgcolor="#66FF00">YES <input type="radio"
name="select13" value="10" />NO <input type="radio" name="select13" value="0" /></td> </tr>
<tr> <td bgcolor="#66FF00">Client informed about HIV transmission routes?</font></td> <td
bgcolor="#66FF00">YES <input type="radio" name="select2" value="8" />NO <input type="radio"
name="select2" id="radio4" value="0" /></td> <td bgcolor="#66FF00">Did you had any blood
transfusion 3 Month ago?</font></td> <td bgcolor="#66FF00">YES <input type="radio"
name="select14" value="10" />NO <input type="radio" name="select14" value="0" /></td> </tr>
<tr> <td bgcolor="#66FF00">Client Informed about Risk Factors for HIV Transmission?</font></td>
<td bgcolor="#66FF00">YES <input type="radio" name="select3" value="8" />NO <input
type="radio" name="select3" id="radio" value="0" /></td> <td bgcolor="#66FF00">Have more than
one sex partner?</font></td><td bgcolor="#66FF00">YES <input type="radio" name="select15"
value="10" /> NO <input type="radio" name="select15" value="0" /></td> </tr> <tr> <td
bgcolor="#66FF00">Client Informed on methods of prevention?</font></td> <td
bgcolor="#66FF00">YES <input type="radio" name="select4" value="8" /> NO
<input type="radio" name="select4" value="0" /></td> <td bgcolor="#66FF00">Unprotected sex with
casual partner in the last 3 months</font></td> <td bgcolor="#66FF00">YES <input type="radio"
name="select16" value="10" />NO <input type="radio" name="select16" value="0" /></td> </tr>
<tr> <td bgcolor="#66FF00">Client informed about possible test result?</font></td> <td
bgcolor="#66FF00">YES <input type="radio" name="select5" value="10" />NO <input
type="radio" name="select5" value="0" /></td> <td bgcolor="#66FF00">Unprotected sex with
regular partner in last 3 months?</td> <td bgcolor="#66FF00">YES <input type="radio"
name="select17" value="0" /> NO <input type="radio" name="select17" value="10" /></td> </tr>
80
<tr> <td bgcolor="#66FF00">Client consent given for HIV testing?</font></td> <td
bgcolor="#66FF00">YES <input type="radio" name="select6" value="8" />NO<input type="radio"
name="select6" value="0" /></td> <td bgcolor="#66FF00">Have you ever been infected with any
S.T.I's?</font></td> <td bgcolor="#66FF00">YES <input type="radio" name="select18"
value="10" />NO<input type="radio" name="select18" value="0" /></td> </tr> <tr> <td
colspan="2"bgcolor="#66FF00"><divalign="center"><strong><fontcolor="#FF0000"
size="+2">ClinicalTBScreening</font></strong></div></td><tdcolspan="2" bgcolor="#66FF00"><div
align="center"><strong><fontcolor="#FF0000"size="+2">SyndromicSTIScreening</font></strong></d
iv></td> </tr> <tr> <td bgcolor="#66FF00">Coughing for more than two weeks?</font></td>
<td bgcolor="#66FF00">YES <input type="radio" name="select8" value="8" />NO<input
type="radio" name="select8" value="0" /></td> <td bgcolor="#66FF00">Notice of urethral
discharge/burning when urinating?</font></td> <td bgcolor="#66FF00">YES <input type="radio"
name="select20" value="10" />NO<input type="radio" name="select20" value="0" /></td> </tr> <tr>
<td bgcolor="#66FF00">Weight loss in last 4 weeks?</font></td> <td bgcolor="#66FF00">YES
<input type="radio" name="select9" value="8" />NO<input type="radio" name="select9" value="0"
/></td> <td bgcolor="#66FF00">Notice of scrotal sweeling and pain?</font></td> <td
bgcolor="#66FF00">YES <input type="radio" name="select21" value="10" /> NO <input
type="radio" name="select21" value="0" /></td> </tr> <tr> <td bgcolor="#66FF00">Constant
headache for more than 2 weeks?</font></td> <td bgcolor="#66FF00">YES <input type="radio"
name="select10" value="8" /> NO <input type="radio" name="select10" value="0" /></td> <td
bgcolor="#66FF00">Complain of genital sores with or without pain?</font></td> <td
bgcolor="#66FF00">YES <input type="radio" name="select22" value="10" />NO <input
type="radio" name="select22" value="0" /></td> </tr> <tr> <td bgcolor="#66FF00">Fever for
more than two weeks?</font></td> <td bgcolor="#66FF00">YES <input type="radio"
name="select11" value="8" />
NO<input type="radio" name="select11" value="0" /></td> <td bgcolor="#66FF00">&nbsp;</td>
<td bgcolor="#66FF00">&nbsp;</td> </tr> <tr> <td bgcolor="#66FF00">Night sweats for more
than 2 weeks?</font></td> <td bgcolor="#66FF00">YES <input type="radio" name="select12"
value="10" />NO <input type="radio" name="select12" value="0" /></td> <td
bgcolor="#66FF00">&nbsp;</td> <td bgcolor="#66FF00">&nbsp;</td> </tr> <tr> <td
colspan="4" bgcolor="#66FF00"><div align="right"> <input name="submit" type="submit"
id="submit" value="NEXT" /> </div></td> </tr> </table> <p> <td colspan="3"
bgcolor="#FF0000"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
81
%20FILES/basis/Negative%20test%20result%20page.html"><font color="#FFFFFF">CLICK HERE IF
YOU ONLY SELECTED "YES" IN KNOWLEDEGE ASSESSMENT </a></td> </p>
<p align="center">
<?php if(!empty($message)){echo "<font color=\"#330033\" </font>
</p> <?php include("../includes/footer.php") ?>
<script> alert ("WELCOME TO THE RISK AND OPPORTUNISTIC ANALYSIS PAGE, PLEASE
CAREFULLY FILL IN THE FORM, ANSWER THE QUESTIONNAIRE WITH UTMOST
HONESTY AND PRINT THIS PAGE. BE REST ASSURED THAT YOUR PRIVACY IS INTACT.
GOOD LUCK");
document.getElementById("user id").style.left = "0px"; </script>
<script type="text/javascript">
var x=Math.floor((Math.random() *10000) +1);
alert("NOTE : YOUR IDENTIFICATION NUMBER IS HED" +x)
</script>
SUSPECTED POSITIVE TEST RESULT PAGE
<html>
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tr>
<tdcolspan="7"><divalign="center"><imgsrc="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/header.JPG.JPG" width="1200" height="160" /></div></td> </tr><tr
bgcolor="#FFFFFF">
<?php require_once("includes/session.php");?> <?php require_once("includes/connection.php")?><?php
include("includes/header.php") ?><?php
$id = @$_GET["id"]; $query1 = "SELECT * "; $query1 .= "FROM client "; $query1 .= "WHERE id =
'{$id}' "; $result1 = mysql_query($query1, $connection); $found_client = mysql_fetch_array($result1);?
><table width="1200" border="0" align="center"> <tr> <td width="262" bgcolor="#66FF00"><div
align="right"></div></td> <td width="619" bgcolor="#66FF00"><div align="center"> <p><font
color="#FF0000" size="+1"><strong><font color="#FF0000">*****LABORATORY
PROCEDURE*****</strong></font> </p> </div></td> <td width="305"
82
bgcolor="#66FF00">&nbsp;</td> </tr> <tr> <td height="34" colspan="3" bgcolor="#66FF00"><p
align="center"><font color="#FFFFFF"><strong>THANKS FOR GIVING US YOUR
TIME</strong></font> <p align="center"> <strong><font color="#FFFFFF">YOUR RESULT
DETAILS ARE AS SHOWN BELOW</font></strong> <p align="center"><strong><font
color="#FFFFFF">IDNUMBER:<inputname="id"type="text"id="id"value=""> </font></strong><font
color="#FFFFFF"> HIV STATUS: </font> <input name="lab_test" type="text" id="lab_test"
value="LAB TEST REQUIRED"readonly=""> <p align="center"> <font color="#FFFFFF"> YOUR
OPPORTUNISTIC INFECTION AND RISK ANALYSIS PRESENTS A POSSIBILITY!!!
HOWEVER, THE SURE WAY OF CONFIRMING YOUR STATUS IS BY LABORATORY
TESTING AND CONFIRMATION.</font> <p align="center"><font color="#FF0000">AIDS IS
REAL!!! HELP SPREAD THE NEWS </font> <div align="center"> <p><br/> </p> </div>
</tr> <tr> <td colspan="4" bgcolor="#66FF00"><div align="center"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/Start%20here.html">GO
HOME</a></div> </form> </tr>
<?php include("includes/footer.php") ?

LAB TEST
<html>
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tr>
<tdcolspan="7"><divalign="center"><imgsrc="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/header.JPG.JPG" width="1200" height="160" /></div></td> </tr><tr
bgcolor="#FFFFFF">
<?php require_once("includes/session.php");?> <?php require_once("includes/connection.php")?> <p>
<tr> <td bgcolor="#66FF33"><div align="center">
<?php require_once("includes/session.php");?>
<?php require_once("includes/connection.php")?><?php include("includes/header.php") ?>

83
<?php $positive_status = 'unchecked'; $negative_status = 'unchecked'; $invalid_status = 'unchecked';
$selected_radio=""; $status ="";

if (isset($_POST['submit'])){$selected_radio = $_POST['selection']; if ($selected_radio=='positive'){

$positive_status = 'checked'; }else if ($selected_radio == 'negative'){ $negative_status =
'checked'; }else if ($selected_radio == 'invalid'){ $invalid_status = 'checked';} $lab_test =
$selected_radio; $id = $_SESSION['id'];
$query = "UPDATE client SET lab_test ='{$lab_test}' WHERE id='{$_SESSION['id']}'";
$result=mysql_query($query,$connection); if($result){ if($positive_status == 'checked')
{header("Location:uni.php?id={$_SESSION['id']}");} else if($negative_status == 'checked')
{header("Location:finishn.php?id={$_SESSION['id']}");}
else if($invalid_status == 'checked') {header("Location:det1.php?id={$id}");} } else {$message="The
result could not be recorded".mysql_error()."<br/> <form name="form1" method="post"
action="det.php"> <table width="1200" border="0" align="center"> <tr> <td width="250"
bgcolor="#66FF00">&nbsp;</td> <td width="462" rowspan="2" bgcolor="#66FF00"><div
align="center"> <p><font color="#FF0000" size="+1"><strong>*****LABORATORY PROCEDURE
DETERMINE TEST KIT*****</strong></font></p> <p>
<input type="text" name="id" id="id" value= " " align="middle" </p> </div></td> <td
width="268" bgcolor="#66FF00">&nbsp;</td> </tr> </div></td> <td bgcolor="#66FF00"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/Start%20here.html">CLIENT
AREA</a> </td> </tr> <tr> <td height="34" colspan="3" bgcolor="#66FF00"><p align="center">
<p align="center"><font color="#FFFFFF"><strong>CHOOSE FROM THE UNDERLISTED TEST
KITS, THE EXACT ONE THAT LOOKS LIKE THE RESULT FROM YOUR DIAGNOSTIC AND
CLICK BELOW. FROM LEFT TO RIGHT IS A,B,C.</strong></font></p> <div align="center">
<p><br/> </p> </div> </tr> <tr> <td bgcolor="#66FF00"><div align="center"><img
src="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/includes/images/determine
%20p.JPG.JPG" width="110" height="200"></div> <td bgcolor="#66FF00"><div
align="center"><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/determine%20n.JPG.JPG" width="110" height="200"></div> <td
bgcolor="#66FF00"><div align="center"><img src="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/includes/images/determine%20i.JPG.JPG" width="110"
height="200"></div> <tr> <td> <div align="center"> <input type="radio"
name="selection" value="positive"> </div> <td> <div align="center"> <input type="radio"
84
name="selection" value="negative"> </div> <td> <div align="center"> <input
type="radio"name="selection"value="invalid"></div></tr><li><td colspan="3" bgcolor="#FF0000"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS%20Official%20use%20only
%20(LAB%20TEST)/basic/Positive%20test%20result%20page.html"><font color="#FFFFFF">A </li>
<licolspan="3"bgcolor="#FF0000"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/Negative%20test%20result
%20page.html"><font color="#FFFFFF">B
</li><licolspan="3"bgcolor="#FF0000"><ahref="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/Invalid%20test%20result
%20page.html"><font color="#FFFFFF">C </li></a></td> </div> </form> <td width="2"></td>
</tr>
<?php include("includes/footer.php")
<?php require_once("includes/session.php"); ?><?php require_once("includes/connection.php")?><?php
include("includes/header.php") ?> <?php
$positive_status = 'unchecked'; $negative_status = 'unchecked'; $invalid_status = 'unchecked';
$selected_radio=""; $status =""; if (isset($_POST['submit'])){ $selected_radio =
$_POST['selection']; if ($selected_radio=='positive'){$positive_status = 'checked';
}else if ($selected_radio == 'negative'){ $negative_status = 'checked'; }else if ($selected_radio ==
'invalid'){ $invalid_status = 'checked';}$lab_test = $selected_radio; $id = $_SESSION['id']; $query =
"UPDATE client SET lab_test ='{$lab_test}' WHERE id='{$_SESSION['id']}'";
$result=mysql_query($query,$connection); if($result){ if($positive_status == 'checked')
{header("Location:finishp.php?id={$_SESSION['id']}");} else if($negative_status == 'checked')
{header("Location:stat.php?id={$_SESSION['id']}");} else if($invalid_status == 'checked')
{ header("Location:uni1.php?id={$_SESSION['id']}");}} } ?>
<form name="form1" method="post" action="uni.php"> <table width="1200" border="0"
align="center"> <tr> <td width="250" bgcolor="#66FF00">&nbsp;</td> <td width="462"
rowspan="2" bgcolor="#66FF00"><div align="center"> <p><font color="#FF0000"
size="+1"><strong>*****LABORATORY PROCEDURE UNI-GOLD
TEST*****</strong></font></p> <p> <input type="text" name="id" id="id" value=" "
align="middle" </p> </div></td> <td width="268" bgcolor="#66FF00">&nbsp;</td> </tr> <td
bgcolor="#66FF00"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/Start
%20here.html">CLIENT AREA</a> </td> </tr> <tr> <td height="34" colspan="3"
bgcolor="#66FF00"><p align="center"> <p align="center"><font
85
color="#FFFFFF"><strong>CHOOSE FROM THE UNDERLISTED TEST KITS, THE EXACT ONE
THAT LOOKS LIKE THE RESULT FROM YOUR DIAGNOSTIC AND CLICK BELOW. FROM
LEFT TO RIGHT IS A,B,C. </strong></font> <strong><font color="#FFFFFF">BASELINE
TEST </font></strong></p> <div align="center"> <p><br/> </p> </div></tr> <tr> <td
bgcolor="#66FF00"><div align="center"><img src="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/includes/images/uni%20P.JPG.JPG" width="200"
height="143"></div> <td bgcolor="#66FF00"><div align="center"><img
src="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/includes/images/uni
%20N.JPG.JPG" width="200" height="143"></div> <td bgcolor="#66FF00"><div
align="center"><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/uni%20I.JPG.JPG" width="200" height="143"></div> <tr> <td> <div
align="center"> <input type="radio" name="selection" value="positive"> </div> <td> <div
align="center"> <input type="radio" name="selection" value="negative" </div> <td> <div
align="center"> <input type="radio" name="selection" value="invalid" </div> </tr> <li> <td
colspan="3" bgcolor="#FF0000"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/Positive%20test%20result
%20page.html"><font color="#FFFFFF">A </li> <licolspan="3"bgcolor="#FF0000"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS%20Official%20use%20only
%20(LAB%20TEST)/basic/Negative%20test%20result%20page.html"><font color="#FFFFFF">B
</li><licolspan="3"bgcolor="#FF0000"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/Invalid%20test%20result
%20page.html"><font color="#FFFFFF">C </li></a> </div> </form> <td width="2"></td> </tr>
<?php include("includes/footer.php") ?>
<?php require_once("includes/session.php");?>
<?php require_once("includes/connection.php")?> <?php include("includes/header.php") ?>
<?php $positive_status = 'unchecked'; $negative_status = 'unchecked'; $invalid_status = 'unchecked';
$selected_radio=""; $status =""; if (isset($_POST['submit'])){ $selected_radio =
$_POST['selection']; if ($selected_radio=='positive'){ $positive_status = 'checked';
}else if ($selected_radio == 'negative'){ $negative_status = 'checked'; }else if ($selected_radio ==
'invalid'){ $invalid_status = 'checked';} $lab_test = $selected_radio; $id = $_SESSION['id'];
$query = "UPDATE client SET lab_test ='{$lab_test}' WHERE id='{$_SESSION['id']}'";
$result=mysql_query($query,$connection); if($result){ if($positive_status == 'checked')

86
{header("Location:finishp.php?id={$_SESSION['id']}"); } else if($negative_status == 'checked')
{header("Location:finishn.php?id={$_SESSION['id']}");} else if($invalid_status == 'checked')
{header("Location:stat1.php?id={$_SESSION['id']}"); }}}
?> <form name="form1" method="post" action="stat.php"><tr> </div> </form> <td
width="2"></td> </tr> <table width="1200" border="0" align="center"> <tr> <td width="250"
bgcolor="#66FF00">&nbsp;</td> <td width="462" rowspan="2" bgcolor="#66FF00"><div
align="center"> <p><font color="#FF0000" size="+1"><strong>*****LABORATORY
PROCEDURE STAT-PACK TEST*****</strong></font></p> <p> <input type="text" name="id"
id="id" value=" " align="middle" </p> </div></td> <td width="268"
bgcolor="#66FF00">&nbsp;</td> </tr> </div></td><td bgcolor="#66FF00"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/Start%20here.html">CLIENT
AREA</a> </td> </tr> <tr> <td height="34" colspan="3" bgcolor="#66FF00"><p align="center">
<p align="center"><font color="#FFFFFF"><strong>CHOOSE FROM THE UNDERLISTED TEST
KITS, THE EXACT ONE THAT LOOKS LIKE THE RESULT FROM YOUR DIAGNOSTIC AND
CLICK BELOW. FROM LEFT TO RIGHT IS A,B,C. </strong></font> <strong><font
color="#FFFFFF">BASELINE TEST </font></strong></p> <div align="center"> <p><br/>
</p> </div> </tr> <tr> <td bgcolor="#66FF00"><div align="center"><img
src="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/includes/images/stat
%20P.JPG.JPG" width="127" height="160"></div> <td bgcolor="#66FF00"><div
align="center"><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/stat%20N.JPG.JPG" width="127" height="160"></div> <td
bgcolor="#66FF00"><div align="center"><img src="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/includes/images/stat%20I.JPG.JPG" width="127"
height="160"></div> <tr> <td> <div align="center"> <input type="radio" name="selection"
value="positive"> </div> <td> <div align="center"> <input type="radio" name="selection"
value="negative"> </div> <td> <div align="center"> <input type="radio" name="selection"
value="invalid"> </div> </tr> <li> <td colspan="3" bgcolor="#FF0000"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS%20Official%20use%20only
%20(LAB%20TEST)/basic/Positive%20test%20result%20page.html"><font color="#FFFFFF">A </li>
<li colspan="3" bgcolor="#FF0000"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/Negative%20test%20result
%20page.html"><font color="#FFFFFF">B </li> <li colspan="3" bgcolor="#FF0000"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS%20Official%20use%20only
87
%20(LAB%20TEST)/basic/Invalid%20test%20result%20page.html"><font color="#FFFFFF">C
</li></a> </div> </form> <td width="2"></td> </tr>

NEGATIVE RESULT
<!--savedfrom url=(0141)file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS
%20Official%20use%20only%20(LAB%20TEST)/basic/Invalid%20test%20result%20page.html -->
<html><head><meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS%20Official%20use
%20only%20(LAB%20TEST)/basic/stylesheets/default.css" rel="stylesheet" media="all"
type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tbody><tr>
<td colspan="7"><div align="center"><img src="./Negative test result page_files/header.JPG.JPG"
width="1200" height="160"></div></td> </tr><tr bgcolor="#FFFFFF">
<!--?php require_once("includes/session.php");?--> <!--?php
require_once("includes/connection.php")?--><!--?php include("includes/header.php") ?--><!--?php
$id = @$_GET["id"]; $query1 = "SELECT * "; $query1 .= "FROM client "; $query1 .= "WHERE id =
'{$id}' "; $result1 = mysql_query($query1, $connection); $found_client =
mysql_fetch_array($result1);?--></tr></tbody></table><table width="1200" border="0"
align="center"> <tbody><tr> <td width="262" bgcolor="#66FF00"><div align="right"></div></td>
<td width="619" bgcolor="#66FF00"><div align="center"> <p><font color="#FF0000"
size="+1"><strong><font color="#FF0000">*****LABORATORY
PROCEDURE*****</font></strong> </font></p><font color="#FF0000" size="+1">
</font></div></td> <td width="305" bgcolor="#66FF00">&nbsp;</td> </tr> <tr> <td height="34"
colspan="3" bgcolor="#66FF00"><p align="center"><font color="#FFFFFF"><strong>THANKS FOR
GIVING US YOUR TIME</strong></font> </p><p align="center"> <strong><font
color="#FFFFFF">YOUR RESULT DETAILS ARE AS SHOWN BELOW</font></strong> </p><p
align="center"><strong><font color="#FFFFFF">ID NUMBER: <input name="id" type="text" id="id"
value=""> </font></strong><font color="#FFFFFF"> HIV STATUS: </font> <input
88
name="lab_test" type="text" id="lab_test" value="NEGATIVE" readonly=""> </p><p align="center">
<font color="#FFFFFF">WE CONGRATULATE YOU AND ADVICE YOU TO PROTECT YOUR
SELF AD STAY NEGATIVE.</font> </p><p align="center"><font color="#FF0000">AIDS IS
REAL!!! HELP SPREAD THE NEWS </font> </p><div align="center"> <p><br> </p>
</div> </td></tr> <tr> <td colspan="4" bgcolor="#66FF00"><div align="center"><a
href="file:///C:/Users/Technical%20Service/Desktop/HDS%20FILES/HDS%20Official%20use%20only
%20(LAB%20TEST)/basic/lab%20test%20page.html">GO HOME</a></div> </td></tr>
<!--?php include("includes/footer.php") ?

--></tbody></table></body></html>

POSITIVE RESULT
<html>
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tr>
<tdcolspan="7"><divalign="center"><imgsrc="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/header.JPG.JPG" width="1200" height="160" /></div></td> </tr><tr
bgcolor="#FFFFFF">
<?php require_once("includes/session.php");?> <?php require_once("includes/connection.php")?><?php
include("includes/header.php") ?><?php
$id = @$_GET["id"]; $query1 = "SELECT * "; $query1 .= "FROM client "; $query1 .= "WHERE id =
'{$id}' "; $result1 = mysql_query($query1, $connection); $found_client = mysql_fetch_array($result1);?
><table width="1200" border="0" align="center"> <tr> <td width="262" bgcolor="#66FF00"><div
align="right"></div></td> <td width="619" bgcolor="#66FF00"><div align="center"> <p><font
color="#FF0000" size="+1"><strong><font color="#FF0000">*****LABORATORY
PROCEDURE*****</strong></font> </p> </div></td> <td width="305"
bgcolor="#66FF00">&nbsp;</td> </tr> <tr> <td height="34" colspan="3" bgcolor="#66FF00"><p
align="center"><font color="#FFFFFF"><strong>THANKS FOR GIVING US YOUR
TIME</strong></font> <p align="center"> <strong><font color="#FFFFFF">YOUR RESULT
89
DETAILS ARE AS SHOWN BELOW</font></strong> <p align="center"><strong><font
color="#FFFFFF">ID NUMBER: <input name="id" type="text" id="id" value="">
</font></strong><font color="#FFFFFF"> HIV STATUS: </font> <input name="lab_test"
type="text" id="lab_test" value="POSITIVE" readonly/> <p align="center"> <font
color="#FFFFFF">YOUR TEST RESULT SHOWS THAT YOU ARE POSITIVE TO HIV
ANTIBODY AND SHOULD BE EROLLED FOR PROPER MEDICATION.</font> <p
align="center"><font color="#FF0000">AIDS IS REAL!!! HELP SPREAD THE NEWS </font>
<div align="center"> <p><br/> </p> </div> </tr> <tr> <td colspan="4"
bgcolor="#66FF00"><div>align="center"><a href="file:///C:/Users/Technical
%20Service/Desktop/HDS%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/lab
%20test%20page.html">GO HOME</a></div> </form> </tr>
<?php include("includes/footer.php") ?

INVALID RESULT
<html>
<head>
<title>HIV/AIDS DIAGNOSTIC SYSTEM</title>
<link href="stylesheets/default.css" rel="stylesheet" media="all" type="text/css">
</head>
<body bgcolor="#6699FF">
<table width="1300" border="0" align="center"> <tr>
<td colspan="7"><div align="center"><img src="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/includes/images/header.JPG.JPG" width="1200" height="160" /></div></td> </tr><tr
bgcolor="#FFFFFF">
<?php require_once("includes/session.php");?> <?php require_once("includes/connection.php")?><?php
include("includes/header.php") ?><?php
$id = @$_GET["id"]; $query1 = "SELECT * "; $query1 .= "FROM client "; $query1 .= "WHERE id =
'{$id}' "; $result1 = mysql_query($query1, $connection); $found_client = mysql_fetch_array($result1);?
><table width="1200" border="0" align="center"> <tr> <td width="262" bgcolor="#66FF00"><div
align="right"></div></td> <td width="619" bgcolor="#66FF00"><div align="center"> <p><font
color="#FF0000" size="+1"><strong><font color="#FF0000">*****LABORATORY
PROCEDURE*****</strong></font> </p> </div></td> <td width="305"
bgcolor="#66FF00">&nbsp;</td> </tr> <tr> <td height="34" colspan="3" bgcolor="#66FF00"><p
90
align="center"><font color="#FFFFFF"><strong>THANKS FOR GIVING US YOUR
TIME</strong></font> <p align="center"> <strong><font color="#FFFFFF">YOUR RESULT
DETAILS ARE AS SHOWN BELOW</font></strong> <p align="center"><strong><font
color="#FFFFFF">ID NUMBER: <input name="id" type="text" id="id" value="">
</font></strong><font color="#FFFFFF"> HIV STATUS: </font> <input name="lab_test"
type="text" id="lab_test" value="INVALID"readonly/> <p align="center"> <font
color="#FFFFFF">YOUR TEST RESULT IS INVALID, PLEASE TRY AGAIN.</font> <p
align="center"><font color="#FF0000">AIDS IS REAL!!! HELP SPREAD THE NEWS </font>
<div align="center"> <p><br/> </p> </div> </tr> <tr> <td colspan="4"
bgcolor="#66FF00"><div align="center"><a href="file:///C:/Users/Technical%20Service/Desktop/HDS
%20FILES/HDS%20Official%20use%20only%20(LAB%20TEST)/basic/lab%20test
%20page.html">GO HOME</a></div> </form> </tr>
<?php include("includes/footer.php")

91