Table 1

Standardised patient case details and expected management

Case detailsExpected management
Case descriptionDetails of scenarioHistoryTreatmentAdvice
Acute watery diarrhoea in a child“I need to buy something for my niece who has diarrhoea. She is 2 years old?”
Further questioning would reveal:

  • Four episodes during the last day;

  • More thirsty than usual;

  • May have had a slight fever;

  • No blood in the stool, abdominal pain or vomiting;

  • No medication had been taken.

Pharmacy server to ask:

  • Blood in stool?

  • Duration of diarrhoea?

  • Number of stools per day?

  • Number of episodes of vomiting?

  • Presence of fever?

  • Preillness feeding practices?

  • Type of fluids and foods during illness?

  • Child passing urine?

  • Tried any medication?

  • Oral rehydration therapy using ORS solution;

  • Zinc supplementation;

  •  No sale of antidiarrhoeals, antibiotics or antispasmodics.

  • Explain how to use ORS;

  • Importance of more fluids;

  • Usual diet should be continued (including milk);

  • Take to health worker if signs of dehydration or other problems, for example, blood in stool.

Suspected pulmonary tuberculosis in an adultOn completion of diarrhoea advice: “Also for myself… I have had cough and some fever for 3–4 weeks. We have had a relative staying with us who has TB. Can you suggest something?”
Further questioning would reveal:

  • Sputum in the cough;

  • Sweating at night;

  • Loss of appetite;

  • No medication had been taken.

Pharmacy server to ask:

  • Consulted doctor?

  • Chest pain?

  • Sputum or blood in cough?

  • Weakness or fatigue?

  • Weight loss?

  • Loss of appetite?

  • Chills?

  • Night sweats?

  • Any other symptoms?

  • Tried any medication?

  • Referral to TB clinic or other healthcare provider for sputum examination;

  • No sale of antibiotics (including anti-TB medication) or steroids.

  • Advise that treatment is available free of charge from government hospitals.

  • ORS, oral rehydration salts; TB, tuberculosis.