NTA Level 4 • Semester 1 • PST04102

Identification of Patients with Gonorrhoea

Disease Control and Prevention • Source Session/Topic 30

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Session 30: Identification of Patients with Gonorrhoea

Total Session Time: 120 minutes + 2 hours Assignment

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• Describe Causes of Gonorrhoea

• Describe Mode of Transmission of Gonorrhoea

• Describe Major Signs and Symptoms of Gonorrhoea

• Explain Treatment of Gonorrhoea

• Explain Prevention and Control of Gonorrhoea

Resources Needed

• Flip charts, marker pens, and masking tape

• Black/white board, chalk and whiteboard markers

• Computer and LCD Projector

SESSION OVERVIEW

SESSION CONTENTS

STEP1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Causes of Gonorrhoea (15 minutes)

|Activity: Brainstorming (5 minutes) |

| |

|ASK students to brainstorm on the following question: |

| |

|What is Gonorrhoea? |

| |

|ALLOW few students to respond |

| |

|WRITE their responses on the flip chart/ board |

| |

|CLARIFY and SUMMARISE by using the content below |

• Gonorrhea is an acute or chronic purulent infection of the urogenital

tract caused by gonococcus is known as Neisseria gonorrhoeae

• Gonorrhea is by far the commonest of so called ‘classical STIs’ known

before the

• emergence of HIV and AIDS all over the world

• Gonorrhea can cause sterility in both males and females and accounts for

a serious

• decline in birth rate in some communities

• The Gonococcus is not able to penetrate intact skin or squamous

epithelium but prefers columnar epithelium such as in the urethra,

endocervix, rectum and conjunctiva

STEP 3: Mode of Transmission of Gonorrhoea (15 minutes)

• Gonorrhoea is mainly transmitted through sexual intercourse,

o However, there are exceptions e.g. gonorrheal ophthalmia neonatorum is

an acute inflammation of the conjunctiva of the new born, contacted

during passage through the birth canal of an infected mother

STEP 4: Signs and Symptoms of Gonorrhoea (30 minutes)

|Activity: Group discussion (15 minutes) |

| |

|DIVIDE students into small manageable groups |

| |

|ASK students to discuss on the following question |

| |

|What are the signs and symptoms of gonorrhoea? |

| |

|ALLOW students to discuss for 10 minutes |

| |

|ALLOW few groups to present and the rest to add points not mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

The signs and symptoms may differ between men to females as follows;

In males

• The earliest symptom is irritation at the urinary meatus

o After an incubation period of 2 – 10 days, symptoms of urethritis

develop in majority of infected men

• A burning sensation when passing urine

• A purulent yellow and profuse discharge soon follow

• Dysuria (difficult in passing urine) may be slight or very severe

• Severe dysuria is often accompanied by urgency and frequency and

occasionally

• Terminal haematuria (blood in urine)

• In untreated cases, the discharge which was purulent and profuse

gradually become

o Scant and less purulent discharges may present only in the mornings

In females

• About 50 -80% of infected women have no symptoms

• Urethritis and discharge often may go unnoticed

• Cervicitis may cause a discharge

• Most of symptoms in females are due to complications of gonorrhoea

• The risk of infection after a single exposure to an infected partner

ranges from 20 to 35% in male and from 60 to 90% in females

STEP 5: Treatment of Gonorrhoea (20 minutes)

• The recommended first line drugs for treatment of Gonorrhoea include the

following:

o Ceftriaxone

o Norfloxacin

o Ciprofloxacin

• The recommended alternative or second line drugs for treatment of

Gonorrhoea include the following:

o Cefixime

o Cefoxitin

o Cefotaxime

o Spectinomycin (Togamycin)

o Azithromycin

o Cotrimoxazole

• Treatment of Ophthalmia neonatorum include:

o Gentamycin and Kanamycin

o Gentamicin can be available in form of eye drops

o Zinnat syrup (oral cephalosporin-cefuroxime)

o The eyes should be washed with saline 2 hourly for the first 12 hours

and subsequently every 4 hours

STEP 6: Prevention and Control of Gonorrhoea (20 minutes)

• Abstinence

• Avoid multiple partners and stick to one uninfected partner

• Proper and consistent use of condom

• Early diagnosis and treatment is important to reduce/prevent

complications and further spread of infection among the community

• Partners must be treated regardless of their symptoms or test results

• Health education on public awareness and specific knowledge of STIs in

the target groups

STEP 7: Key Points (5 minutes)

• Gonorrhoea is a common STI in the community which needs prompt diagnosis

and

treatment

STEP 8: Evaluation (5 minutes)

• What is Gonorrhoea?

• What are signs and symptoms of gonorrhea?

• What is mode of transmission of gonorrhea?

• What is the treatment of gonorrhea?

• How can you prevent Gonorrhoea in the community?

STEP 9: Assignment (5 minutes)

|Activity: Take Home Assignment (5 minutes) |

| |

|ASK the students to work individually on the following Assignment |

|Explain preventive measures that you will take to control Gonorrhoea |

|ALLOCATE time for students to do the assignments and submit |

| |

|REFER students to recommended references |

References

Cook, G. Zumla, A. (2003). Manson’s Tropical Diseases. (21st ed.). London:

Saunders Ltd

Denyer, S. P. Hodges, N. A. &Gorman, S. P (2011) Ed. Hugo & Russell’s

Pharmaceutical

Microbiology (8thed). Oxford: Willey-Blackwell Publishing

Eshuis, J, & Manschot,P (1992).Communicable diseases,(1st ed). Nairobi:

AMREF

GoT (2004): National Infection Prevention and Control (IPC) Guidelines for

Healthcare Workers. Dar es Salaam: MOHSW

GoT (2007) National Guidelines for Management of Sexually Transmitted and

Reproductive Tract Infections (1st ed). Dar es Salaam: MOHSW

GoT (2013) Standard Treatment Guidelines & National Essential Medicines

List (4thed). Dar es Salaam: MOHSW

Nordberg, E., Kingondu, T., & Mugambi, E., et al. (2008) Communicable

Diseases. (4thed.). Nairobi: AMREF

Nordberg, E. (1999): Communicable Diseases, A Manual for Health Workers in

Sub-Saharan Africa, Nairobi: AMREF

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