STI Management in Tanzanian Private Drugstores: Practices and Roles of Drug Sellers

To assess the role of private drugstores in the management of sexually transmitted infections (STI) in rural Tanzania, the researchers designed a cross-sectional study that included drug sellers in eight districts of the country. The "simulated client method" was employed, presenting a male and a female STI case; in addition, data were collected through interviews with drug sellers. Overall STI management was described using QATI ("Questions, Advice, Treatment, and drug Information") scores.

While 74 percent of drug sellers said their store stocked no STI-related drugs, medications were dispensed in 78 percent of male and 63 percent of female simulated client visits. In 80 percent of male cases and 90 percent of female cases, the clients received the drugs recommended in Tanzanian guidelines for syndromic management of urethral or vaginal discharge. In 76 percent of male and 35 percent of female simulated client visits, antibiotics were dispensed. However, the researchers found that dosage regimens "were often incorrect," and complete syndromic management was "rarely provided."

Eighty-nine percent of drug sellers agreed it was within their professional role to provide information on STI treatment; 95 percent agreed it was within their professional role to dispense information on prevention. Drug use information was nearly always provided. Advice was seldom given; questions were asked occasionally. In general, the STI management provided was better for men than for women.

"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," the authors concluded. "In this resource-limited setting, drug sellers could provide effective and safe STI management, especially to male patients if given appropriate tools to practice. The consequences of this for official policy need to be discussed."

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