Table 3 PALM PLUS Training the Trainer to Train (TtTtT) case scenario training plan

Sun

Travel to venue

1

Introduction to TtTtT PALM PLUS

Mon

1, 2

Straightforward symptom scenarios:

• Cough and difficulty breathing -severe pneumonia

• Runny/blocked nose - URTI

• Blood in urine - Bilharzia

• Confused patient - delirium

• Fever - Malaria

3,4

HIV testing

• Headache - sinusitis

• Approach to STI

• Lymphadenopathy - Bubo

• Vaginal discharge/sexually abused

Tues

1

Managing HIV - routine care & ART

• Weight loss & sore mouth - focus on routine care

• Asymptomatic - oral thrush - focus on starting ARVs

• Diarrhoea - focus on ART follow-up

2

TB - diagnosing, treatment & follow-up

• Cough - HIV negative, sputum positive - focus on TB follow up

• Fever - HIV unknown, 1 smear positive - educate about Malaria

3

TB and HIV - diagnosing and treating both TB & HIV

• Discharging ear - HIV positive, 1 smear positive - TB care

• Cough - HIV positive, smear negative - Health worker with TB & HIV

4

ART and/or TB drug side effects

• Burning feet - peripheral neuropathy TB med related

• Abdominal pain - drug related - drug related hepatitis - NVP or TB treatment

• Vomiting - lactic acidosis - ARV side effect - ARV care

• Skin rash - ARV side effect

Weds

1

Pregnancy: Unwell and tired - HIV pregnancy/PMTCT

2

Chronic respiratory disease: Cough, difficult breathing with wheeze - acute asthma

--

Free time

Thurs

--

Full day training experience - consolidation of content knowledge and training skills

Fri

1

Making PALM PLUS your own - a creative exercise

2

Evaluation & Closure