Management of simulated patients with sexually transmitted infections by staff of retail pharmacies in Kibera slums of Nairobi
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OBJECTIVE: To evaluate the treatment suggested to sexually transmitted infections (STI) self-medicating patients in retail pharmacies. DESIGN: A descriptive cross-sectional survey. SETTING: Kibera slum, Nairobi City, Kenya. SUBJECTS: Staff of 50 convenient randomly selected retail pharmacies. RESULTS: The majority (97%) of the pharmacy staff who attended to self-medicating patients asked questions. Most of these questions centered around the onset of the stated symptoms, the health of the partner, patient's current health status and previous medications taken. Of the 99 staff evaluated, 60% correctly diagnosed gonorrhoea and 82% correctly diagnosed genital ulcer disease (GUD). Only nine out of fifty (18%) offered the recommended treatment for gonorrhoea and only one individual offered recommended treatment for GUD. The most commonly offered treatment for gonorrhoea and GUD was metronidazole and penicillin, respectively. Overall, only 10% correctly diagnosed both conditions and offered appropriate treatment. The staff also counselled patients on a wide range of issues including condom use, abstinence and being faithful, contact treatment, seeking prompt treatment and completing treatment. CONCLUSION: With only about 10% offering appropriate government recommended treatment for gonorrhoea and GUD, these pharmacy staff working in retail pharmacies in Kibera slum put slum dwellers seeking care at an increased risk of STI related morbidity and transmission due to inappropriate or inadequate treatment. RECOMMENDATION: To improve management of these conditions, in-service training and enforcement of the relevant legislation and policy is needed.