Table 1

Overview of SP scenarios

Scenario descriptionPresenting historyExpected outcome
1. Presumptive TB: 2–3 weeks of cough with intermittent fever, along with loss of appetite and weight loss;
seeking medical advice for the first time.
‘I have a cough and fever for the last 2–3 weeks that is not getting better. I have lost my appetite and feel I am losing weight. I have taken cough medicine but there is no improvement. Can I get some medicines?’Verbal or written referral to a doctor in a TB centre, hospital or a healthcare provider without dispensing any antibiotics.
2. Presumptive MDR- TB: 4 weeks of cough with history of incomplete TB treatment, seeking medical advice for the first time.‘I have been suffering from a bad cough for about 4 weeks. I took some traditional medicines for cough relief, but they are not working. It seems to be similar to the cough I had 2 years ago when I got TB. But I remember that I was already treated for TB for 3 months and the tests were fine. Is it related to my previous condition? What do you suggest?’
The SPs would admit to a loss of appetite, to his clothes becoming a bit loose, fever and feeling fatigued if prompted by the pharmacy staff. If the staff asked about history of TB treatment, the SPs would say ‘I did it for about 3 months, later, when the doctor found my sputum test was fine, I thought it was cured and after 3 months of treatment, I stopped taking the medication’.
Verbal or written referral to a doctor in a TB centre, hospital or a healthcare provider without dispensing any antibiotics.
  • MDR-TB, multidrug-resistant tuberculosis; SP, standardised patient; TB, tuberculosis.