The researchers undertook the current study to evaluate characteristics of providers in the management of self-medicating sexually transmitted infection (STI) patients shopping in retail pharmacies in Kibera slum, Kenya's largest informal settlement.

A self-administered questionnaire was used to collect socioeconomic, training and work history characteristics of pharmacy staff from a convenience sample of 50 retail pharmacies in Kibera. The completed questionnaires were collected seven to 14 days after being distributed, and the required data were gathered in eight weeks. Subsequently, two data collectors presented at the pharmacies as "mystery patients" seeking care for symptoms of genital ulcer disease (GUD) and gonorrhea, and they completed a structured observation form within 10 minutes of leaving the pharmacy.

Of the respondents, about half were men younger than 28; more than 90 percent had 12 years of formal education and three additional years of professional medical training; and 66 percent had been trained in government institutions. About 65 percent said patients presented without prescriptions; 45 percent said patients requested specific medications but were open to advice. Thirty-six percent of patients used the pharmacy as their first point of care. When "mystery patients" were used to evaluate syndromic management of gonorrhea and GUD, appropriate treatment under the Kenya Ministry of Health STI syndromic management guidelines was offered in only 10 percent of encounters.

"Although the majority of the pharmacy staff in this informal settlement have some medical training and some experience, a very low proportion offered adequate treatment for two common STIs," the authors concluded.

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