Syndromic management of urethral discharge in Ghanaian pharmacies

Objectives: To evaluate the training of pharmacists in Accra, Ghana, in the syndromic management of STIs. Methods: We randomly selected 50 pharmacy outlets that had received the training (intervention) and 50 outlets that had not received thr training (no intervention). Simulated clients described the symptoms of urethral discharge to the first pharmacy staff encountered and completed a standardised questionnaire after each encounter. Results: Correct drug provision for urethral discharge improved with the educational intervention but remained relatively low (no intervention 18%; intervention 39%; p <0.05). More encouraging, treatment for gonorrhoea was usually correct without the intervention (64%) and improved further in the intervention outlets (76%). The treatment for chlamydia was less often appropriate but also improved (31% and 31%). Condom promotion was poor, with almost no outlets offering condoms. Conclusions: The current training led to improvements in the treatment of urethral discharge. Future training needs to be improved, especially with regard to condom promotion. Moreover, since less than one third of simulated clients were seen by pharmacists, the training should be expanded to other pharmacy staff. With enhanced training of all pharmacy staff, the role of pharmacy outlets in STI management and prevention in Ghana and elsewhere can be optimised.