Pharmaceutical Care And Syndromic Management Of Sexually Transmitted Infections (Stis) By Community Pharmacists In Lagos State

ABSTRACT

Sexually Transmitted Infections (STIs) are infections passed from one person to another during sexual contact though some are also passed from mother to child during pregnancy, birth or while breast feeding. STIs constitute an important public health problem. The early detection and treatment of STIs are important aspects of a comprehensive approach to reducing the spread of HIV. Although public-sector services are available even in the most resource-poor countries, they are not acceptable to many clients because they do not have appropriate health personnel or the necessary medicines. Private providers are often preferred because they are perceived to offer better access and confidentiality, and often have the reputation of being less stigmatizing than public sector facilities. However, many of these patients are not managed rationally as their management does not conform to stated guidelines.

The main aim of this work was to determine the knowledge and practice of the community pharmacists on pharmaceutical care and syndromic management of STIs and assess the impact of training. The work also investigated the patronage of STI patients in health facilities, knowledge and practice of the general public as well as the quality of ciprofloxacin tablets in pharmacies in the State.

The research project involved community pharmacists, hospitals, general public and drug quality. It was made up of four (4) studies namely baseline and intervention study on knowledge and practice of community pharmacists; hospital study on patronage and mode of management of STI; general public study on knowledge and practice of different population groups including students and assessment of quality of ciprofloxacin tablets.

The results revealed poor knowledge and practice of community pharmacists about pharmaceutical care, STI and syndromic management of STI. There was statistically significant difference in knowledge and practice post intervention. The results also revealed

poor patronage of hospitals by STI patients and that estimated patronage of community pharmacists is high. The general public survey showed that there was poor knowledge and practice about STIs and its management and that the doctor, pharmacist and parent/guardian were important information sources and confidants about STIs. The quality assessment study revealed that all the products had acceptable physical and physicochemical quality while a quarter of the brands tested did not comply with the chemical (assay) test.

Management of STI patients can improve with the formalized introduction of pharmaceutical care and training and monitoring of community pharmacists on STI syndromic management in the State. Though a few pharmacists are currently engaged in pharmaceutical care, its legal framework and official adoption for community pharmacists has not been done.

The patronage of STI patients in public hospitals needs to be improved in order to serve more people as the current level is low. However, the result is similar to patronage levels in other countries like Ghana and South Africa. In addition, STI knowledge is poor amongst the public which makes their practice for both prevention and treatment inadequate.

It can be concluded that the educational intervention employed improved the knowledge and practice of the community pharmacists about pharmaceutical care, STIs and syndromic management and that the knowledge and practice of the general public about STI and its management is poor. Public enlightenment programmes should be embarked on especially as a control measure against the spread of STIs particularly HIV. The quality of ciprofloxacin tablets found in the pharmacies is largely adequate however manufacturers should be encouraged to improve on good manufacturing practice (GMP). There is a need to empower community pharmacists to enable them appropriately manage STIs in practice.