Table 1

SP case scenarios for both adults and children, with expected management

Description of the case scenarioSymptomsOpening statement by the SP on entering the pharmacyExpected management
Upper respiratory tract infection (URI), likely of viral aetiologyIndividual with a 2-day history of acute-onset low-grade fever, with runny nose and non-productive cough; does not look sick. Family members have similar symptoms.Child with URI: ‘Sir/Ma’am, my niece at home has fever and cough. Can you give me some medicine for her?’Acceptable: Not dispensing antibiotics, with or without referral to a doctor; dispensing symptomatic treatments according to current guidelines.
Unacceptable: Dispensing antibiotics and/or steroids.
Adult with URI: ‘Since two days I have cough and fever. Can you help me?’
Uncomplicated, acute diarrhoeaIndividual with 1-day history of acute onset, watery diarrhoea; no blood in the stool. No fever. Appears well hydrated.Child with diarrhoea: ‘Sir/Ma’am, my niece at home has diarrhoea. Can you give me some medicine for her?’Acceptable: Dispensing oral rehydration salts (ORS), not dispensing antibiotics, with or without referral to a doctor. For paediatric SPs, zinc should be given with ORS.
Unacceptable: Dispensing antibiotics and restricted antimotility drugs such as loperamide.
Adult with diarrhoea: ‘I have diarrhoea. Can you help me?’
Acute febrile illness suggestive of malariaIndividual with a 4-day history of high fever with shivering/chills, every other day; no cough or any other symptoms. No headache, fits or altered consciousness.Child with fever: ‘Sir/Ma’am, since four days my niece has fever and chills. Can you give me some medicine for him?’Acceptable: Referral for malaria blood test without dispensing antimalarials or antibiotics.
Dispensing antimalarials, other antibiotics or steroids.
Adult with fever: ‘I have fever since a few days that is not going away. I also get chills.’
  • SP, standardised patient.