STI management in Tanzanian private drugstores: practices and roles of drug sellers.

OBJECTIVES: To describe the role and possible contribution of private drugstores in sexually transmitted infection (STI) management in rural Tanzania. METHODS: A cross-sectional study that included drug sellers in private drugstores in eight districts of Tanzania. Data collected through interviews with drug sellers and the simulated client method presenting a male and female STI case. "QATI" scores (Questions, Advice, Treatment and drug Information) were developed to describe overall STI management. RESULTS: Although 74% of drug sellers stated that there were no STI-related drugs in the store, medications were dispensed in 78% of male and 63% of female simulated client visits. The clients were dispensed drugs recommended in the Tanzanian guidelines for syndromic management of urethral or vaginal discharge in 80% of male and 90% of female cases. Drug sellers dispensed antibiotics during 76% of male and 35% of female simulated client visits. Dosage regimens were often incorrect and complete syndromic management rarely provided. Most drug sellers agreed that it is within their professional role to give information on STI treatment (89%) and prevention (95%). Drug-use information was almost always provided. Advice was however seldom given and questions occasionally asked. Overall STI management was better for men than for women. CONCLUSIONS: The drug sellers, although aware of the prescription-only status of antibiotics, saw themselves as having a role in STI management and were ready to provide drugs. In this resource-limited setting, drug sellers could provide effective and safe STI management especially to male patients if given appropriate tools to improve practice. The consequences of this for official policy need to be discussed.

Consumer survey of malaria fact card: an educational and communication tool in Tanzania.

OBJECTIVE: To determine the usefulness of the malaria fact card as a health educational and communication tool in Dar Es Salaam. METHODS: A prospective consumer survey pilot study on the malaria fact card, a health educational and communication tool was carried out between January and February 2004 in Dar Es Salaam, Tanzania. Parameters studied include consumers' understanding of the malaria fact card, consumer behavioural responses and awareness of malaria prevention and treatment. A total of 131 respondents from 10 randomly selected community pharmacies in which malaria fact cards were distributed since 2003 participated in the study. Data were collected using structured and semi structured questionnaires. RESULTS: It was found that 95% of respondents reported that the fact card was easy to read and understand. The study revealed that 64.6% (n = 127) responses acknowledged getting new information on correct treatment of malaria using Sulphadoxine-Pyrimethamine (SP), while 8.6% acquired new information about prevention strategies. Only 33% of the consumers surveyed indicated to visit the pharmacies on regular basis. Further, results indicated that 84% of respondents asked the pharmacists for health information and/or advice when purchasing antimalarial medicines. Of all responses 38% (n = 179) related to prevention strategies and 26.8% related to correct use of SP medications. CONCLUSION: We conclude that the malaria fact card is useful as a health educational and communication tool . It is recommended that pharmacists should provide quality and educative information through use of communication tools such as updated malaria fact cards.

Colonic drug targeting.

Specific targeting of drugs to the colon is recognized to have several therapeutic advantages. Drugs which are destroyed by the stomach acid and/or metabolized by pancreatic enzymes are slightly affected in the colon, and sustained colonic release of drugs can be useful in the treatment of nocturnal asthma, angina and arthritis. Treatment of colonic diseases such as ulcerative colitis, colorectal cancer and Crohn's disease is more effective with direct delivery of drugs to the affected area. Likewise, colonic delivery of vermicides and colonic diagnostic agents require smaller doses. This article is aimed at providing insight into the design considerations and evaluation of colonic drug delivery systems. For this purpose, the anatomy and physiology of the lower gastrointestinal tract are surveyed. Furthermore, the biopharmaceutical aspects are considered in relation to drug absorption in the colon and hence various approaches to colon-specific drug delivery are discussed.