Gonorrhoea

Gonorrhoea is a sexually transmitted bacterial infection caused by Neisseria gonorrhoeae, affecting the genital tract and, less commonly, the rectum, throat, or eyes. It is frequently managed using a syndromic approach at first-contact health facilities.

• In men: urethral discharge and pain on urination
• In women: may be asymptomatic, or cause vaginal discharge, pelvic pain, or bleeding between periods
• If untreated, can lead to pelvic inflammatory disease and infertility
• Newborns exposed during delivery can develop a severe eye infection (ophthalmia neonatorum)

• Transmitted through unprotected vaginal, anal, or oral sex with an infected partner.
• Transmitted from mother to newborn during childbirth.
• Risk is increased by multiple sexual partners and inconsistent condom use.

• In most health facilities, diagnosis and treatment follow the syndromic management approach, based on presenting symptoms such as urethral or vaginal discharge syndrome.
• Laboratory testing, such as Gram stain or culture, is used where available, particularly for treatment failure or specific presentations.

Uncomplicated gonorrhoea is treated with a single dose of an injectable third-generation cephalosporin such as ceftriaxone.

Treatment for possible chlamydia co-infection (for example, doxycycline) is given alongside, as part of syndromic management, since dual infection is common.

Sexual partners should be treated at the same time to prevent reinfection, and patients are advised to abstain from sex until treatment is completed and symptoms have resolved.

Newborns of mothers with untreated gonorrhoea receive prophylactic eye treatment to prevent ophthalmia neonatorum.

• Consistent and correct condom use.
• Reduce the number of sexual partners.
• Attend regular STI screening if at higher risk.
• Ensure prompt treatment of both partners.
• Antenatal screening and treatment to prevent transmission to the newborn.