Diagnosis and treatment of presumed STIs at Mexican pharmacies: Survey results from a random sample of Mexico City pharmacy attendants
Turner,Abigail Norris; Ellertson,Charlotte; Thomas,Sarah L.; Garcia,Sandra G.
Sexually Transmitted Infections 79(3): 224-228
Publication date: 2003
People in developing countries often seek medicaladvice for common ailments from pharmacies. As one example,pharmacists routinely diagnose and treat symptomatic sexuallytransmitted infections (STIs). We aimed to assess the qualityof advice provided in Mexico City pharmacies by presenting hypotheticalSTI related syndromes and recording pharmacy attendants'suggested diagnoses and treatments.
We interviewed the first available attendant in eachof a 5% random sample of Mexico City's pharmacies. Weinquired about the training, age, and experience of the attendantand about the typical number of clients coming for treatmentof suspected STIs. After considering three hypothetical casestudies, attendants recommended diagnoses, treatments, and,sometimes, physician follow up.
Most Mexico City "pharmacists" are actually clerks,with trained pharmacists rarely available on the premises. Theaverage pharmacy attendant was 32 years old, with a median of5 years' experience at that pharmacy, but very limited(if any) training. 62% reported seeing 10 or more clients withgenital or vaginal infections per month. Depending on the casestudy, attendants provided appropriate diagnoses in 0-12%of cases, recommended appropriate treatments in 12-16%of cases, and suggested physician follow up for 26-67%of cases.
In general, surveyed pharmacy personnel were unableto diagnose accurately or offer appropriate treatment advicewhen presented with classic, common STI symptoms. Given thevolume of clients seeking advice from this source, trainingpharmacy attendants could significantly help to reduce the burdenof disease associated with STIs in Mexico City.