GONORRHEA AND ITS  WOES

SAVIOUR THADDEUS AND SUNDAY OLAJIDE AWOFISAYO

  1. Bioscientifics Research and Development (Ltd/Gte), ikot ekpene, Nigeria
  2. Clinical Pharmacy and Biopharmacy, Faculty of Pharmcy, University of Uyo, Nigeria

 Correspondence:

Saviour Thompson:

ABSTRACT

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhea. Following transmission N. gonorrhea infects mucosa of exposed anatomic sites, such as the urogenital tracts, rectum, pharynx and conjunctivae.  N. gonorrhea is fairly and easily transmitted; the estimated probability of penile – to - vagina transmission is appropriately 50% per sex act. In this write up, we review current epidemiology of gonorrhea through an international and local lens. The review examines the causes, symptoms, complications, testing, treatment, mode of action and side effect of commonly used drugs in the chemoprophylaxis of gonorrhea.

INTRODUCTION

Gonorrhea is a curable sexually transmitted disease or infection (STD or STI). It is the second most commonly reported bacterial STI in the world follow by Chlamydia.

World health organization (WHO) estimates that about 57million new gonococci infections occurred among 15 – 49 year old in 2016. Similarly, center for disease control and prevention (CDC), 2019 reported that about 3billion cases of gonorrhea were recorded globally. When examining age, race and gender, the highest rate of gonorrhea were found in African considering 15 – 24 years of age and women included.

Apparently, according to epidemiologic and biologic studies the evidence that gonococci infections facilitate the transmission of HIV infection is being discussed. Gonorrhea can spread into the uterus and fallopian tubes, resulting in pelvic inflammatory disease (PID). Pelvic inflammatory disease affects more than 1million women globally every year and can lead to tubal (ectopic) pregnancy. Neisseria gonorrhea also infects mucosa of exposed anatomic sites, such as the urogenital tracts, rectum, pharynx and conjunctivae.  It is often transmitted from penis to vagina from having sex with someone who is infected with it).

More so, people with numerous sexual partners or those who do not use a condom are at greater risk of infection. The best protection against infections is abstinence, monogamy (sex with only one partner) and proper condom usage. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection and these include alcohol and illegal drug abuse; particularly intravenous drug abuse.

CAUSES

Gonorrhea is caused by bacteria called Neisseria Gonorrhea. These bacteria can infect the genital tract, mouth and rectum of both men and women. In women, the opening of the uterus (cervix) is the first phase of infection.

SYMPTOMS

Gonorrhea symptoms usually occur within 2 – 14 days after exposure to the bacteria. Gonorrhea symptoms in men usually include the following burning sensation when urinating, painful and swollen testicle, white, yellow or green discharge from penis and sore throat.

GENDER MANIFESTATIONS

Most women do not have symptoms but if they do, they are often mild. Gonorrhea might be taken for other pathologies such as pains or burning sensation while urinating, bleeding discharge and itching in the vaginal, heavier period or spotting,  and sore throat.

GONORRHEA COMPLICATIONS

Women are at greater risk of long term complications from untreated infections. Untreated infection with gonorrhea in women may ascend up the female reproductive tract and infect the uterus, fallopian tubes, and ovaries. This condition is known as pelvic inflammatory disease (PID) and cause severe and chronic pains and damage to the female reproductive organ. Pelvic inflammatory disease can be caused by other sexually transmitted diseases as well. Women may also develop blocking or scarring of the fallopian tubes, which can prevent future pregnancy or cause ectopic pregnancy.

An ectopic pregnancy is when a fertilized egg implements outside the uterus. Gonorrhea infection may pass to a new born infant during delivery. Men may experience swelling of urethra or a painful abscess in the interior of the penis. The infection can cause reduced fertility or sterility. When gonorrhea infection spreads to the blood stream, both men and women can experience arthritis, heart valve damage or inflammation of the lining of the brain or spinal cord. These are rare but serious conditions.

GONORRHEA QUICK GUIDE AND TESTING

After diagnoses, a sample from the symptomatic area with a swab (penis, vaginal, rectum or throat) is taken and placed on a glass slide. A second method involves taking the same type of sample and placing it on a special dish. This will be incubated under ideal growth condition for several days. A colony of gonorrhea bacteria will grow if gonorrhea is present.

TREATMENT OF GONORRHEA

Antibiotics can cure most gonorrhea infections. Gonorrhea is usually treated with an antibiotics such as ceftriaxone, azithromycin by mouth. Once an antibiotics, is taken relief should come within days. Sometimes intensive treatment with seven days course of an oral antibiotics or dual therapy with two different antibiotics, usually for a total of seven days of therapy may be required. However, scientists are working to develop vaccines to prevent Gonorrhea infection.

It is pertinent to follow up with tests to ensure that the infection has cleared.

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