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

From: From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi

Day Session Description
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