International statistics have shown that an estimated 200 million new cases of gonorrhoea are recorded annually, with the majority of these affecting the developing countries. Without a doubt, gonorrhoea is a leading sexually transmitted infection (STI) that tends to affect both males and females alike, although women may not manifest overt symptoms of the infection in some cases. Typically, however, a person is likely to start experiencing symptoms about 4 to 6 days following infection. Furthermore, if a man has a single sexual intercourse with an infected woman, he stands a 20% chance of becoming infected. However, the risk is much higher (about 50-70%) for a woman who has unprotected sex with an infected man.

This article intends to highlight a few salient facts you should be familiar with as far as gonorrhoea is concerned.

What is the cause of gonorrhoea?

Gonorrhoea is usually caused by a bacterium known as Neiserria gonorrhoea, a gram-negative diplococcus often transmitted from person to person through vaginal, oral or anal sexual intercourse. Unfortunately, an infected pregnant woman may also transmit the infection to her newborn in the course of childbirth which leads to ophthalmia neonatorum. If left untreated, the newborn may suffer blindness of both eyes. Identified risk factors for gonorrhoea include unprotected sex with an infected partner, multiple sex partners, homosexuality especially among men, drug abuse and early age of onset of sexual activity among others.
Note that gonorrhoea is not spread by sharing toilets or bathrooms.

What are the symptoms of gonorrhoea?

About 50% of women with gonorrhoea will not show any symptoms whereas the others may experience vaginal discharge often described as purulent with a mild odour, painful urination (dysuria), pain during sex (dyspareunia) as well as mild lower abdominal pain. Infected males often experience a burning sensation during urination (dysuria) often accompanied by a purulent discharge from the penis. A newborn who acquired gonococcal infection from the infected mother typically presents with pain, redness and discharge of pus from both eyes.

How is gonorrhoea diagnosed?

Gonorrhoea is traditionally diagnosed by collecting a swab from the site of infection and sending the sample to the lab for microscopic examination, culture and antibiotic sensitivity especially in those who do not respond to initial empiric treatment. In recent times, modern polymerase chain reaction (PCR) - based testing methods have also emerged for faster diagnosis. Moreover, it is advised to also screen all gonorrhoea-positive patients for other sexually transmitted diseases such as syphilis, chlamydia and HIV.

How can one prevent gonorrhoea?

The acronym ABC for general prevention of sexually transmitted diseases (STDs) also applies to gonorrhoea. A stands for Abstinence, B is for Being faithful to one partner while C stands for Correct and consistent use of condoms. As simple as these measures may seem to be, they have been shown over time to be highly effective in stemming the tides of sexually transmitted infections and their feared complications. The risky behaviours earlier mentioned such as indiscriminate sex, male homosexuality and hard drug abuse should also be avoided. Furthermore, in an effort to reduce vertical transmission of gonorrhoea from infected mothers to their babies, routine screening for the infection in pregnant women is also advised.

What is the treatment for gonorrhoea?

Despite increasing rates of antibiotic resistance, injectable ceftriaxone administered in conjuction with azithromycin or doxycycline remains the first line of treatment for gonorrhoea. However, where empiric therapy is not effective, swabs should be taken for culture and sensitivity to determine the most appropriate antibiotics to which the organism is susceptible.
In conclusion, it is worthy of note that to avoid re-infection, treatment is not complete without contact tracing and treatment of identified sexual partner(s) of the infected person.