Syndromic management of STDs in pharmacies : evaluation and randomised intervention trial

摘要: Background Improved clinic based syndromic management of sexually transmitted diseases (STDs) in Tanzania reduced HIV transmission. However, many developing countries, people seek STD treatment pharmacies. This study used standardised simulated patients (SSP) to assess pharmacies and evaluate the impact an educational intervention. Methods SSP presented syndromes urethral discharge, genital ulcer, vaginal pelvic inflammatory disease (PID) at 180 randomly selected Lima, Peru. These were then randomised receive or not education on recognition, management, prevention counselling, again visited by SSP. Results At 360 pharmacy visits before intervention, most often recognised as related ulcer (81%) discharge (73%) men, followed (43%) PID (6%) women. Treatments offered 82.5% rarely conformed international national guidelines (for 1.5%; 1%; 4%; PID, none). Only 20.5% referred a physician 30% received any counselling. The intervention reached 55% pharmacies, produced small but significant increase counselling; "intent intervene" analysis, provided post-counselling more than did controls (40% v 27%, p = 0.01). Conclusion Pharmacies usually failed recognise women, treatment, with ineffective regimens. Educational interventions improved More effective are needed improve referral practices.