[Show abstract][Hide abstract]ABSTRACT: To evaluate the treatment suggested to sexually transmitted infections (STI) self-medicating patients in retail pharmacies.
A descriptive cross-sectional survey.
Kibera slum, Nairobi City, Kenya.
Staff of 50 convenient randomly selected retail pharmacies.
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.
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.
To improve management of these conditions, in-service training and enforcement of the relevant legislation and policy is needed.
[Show abstract][Hide abstract]ABSTRACT: To evaluate the characteristics of providers in management of STI self-medicating patients in retail pharmacies within the largest informal settlement in Kenya.
We collected sociodemographic, training, and work history attributes among pharmacy staff from a convenience sample of 50 retail pharmacies in Kibera slum using a self-administered questionnaire. We gathered the required data in 8 weeks, collecting completed self-administered questionnaires within 7 to 14 days after distribution. Two data collectors subsequently presented at these pharmacies as mystery patients seeking care for symptoms of genital ulcer disease and gonorrhea and completed a structured observation form within 10 minutes of leaving the pharmacy.
Approximately half the respondents were men aged less than 28 years. Over 90% had 12 years of formal education and an additional 3 years of medical professional training. Two thirds (66%) had been trained in Government institutions. About 65% reported that patients presented without prescriptions, and 45% noted that patients requested specific medicines but were open to advice. One-third (36%) of the patients used the pharmacy as their first point of care. Using mystery patients to evaluate syndromic management of gonorrhea and genital ulcer disease, only 10% offered appropriate treatment per the Kenya Ministry of Health STI syndromic management guidelines.
Although the majority of the pharmacy staff in this informal settlement have some medical training and some experience, a very low proportion offered adequate treatment for 2 common STIs.
[Show abstract][Hide abstract]ABSTRACT: ALTHOUGH THERE IS GREAT regional variation, a significant proportion of those with human immunodeficiency virus (HIV/ AIDS) globally are men who have sex with men (MSM) due to the high efficiency of transmission via anal intercourse.(1) This relatively small number of individuals may be disproportionately at risk of HIV transmission vis-a-vis the wider population, particularly in countries where social or legal retribution accompanies public disclosure. Recent short-term estimates suggest that of the approximately 82,300 new HIV infections in Kenya in 2005, 4.5% were in MSM.(2-3) The incidence among these men may be even higher, as the models assumed that only 1% of the mate population had sex with men and did not account for male sex workers in this population(2).