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Thailand Medical News  Jan 30, 2019  5 years, 2 months, 2 weeks, 5 days, 1 hour, 41 minutes ago

Oral Gonorrhea : A Growing Challenge For Healthcare In Thailand And Globally

Oral Gonorrhea : A Growing Challenge For Healthcare In Thailand And Globally
Thailand Medical News  Jan 30, 2019  5 years, 2 months, 2 weeks, 5 days, 1 hour, 41 minutes ago
An often-overlooked type of STD, oral gonorrhea presents a challenge for healthcare in Thailand and globally. The threat this bacterial infection poses is not limited to the disease itself – there are large-scale public health issues related both to long-term inflammation by an infection in the throat or mouth left untreated and to the wrongful prescription of certain antibiotics that give rise to so-called “super-strains” of bacteria that cannot be combated with conventional antibiotics. Awareness campaigns, proper diagnosis by healthcare providers, and appropriate treatment can help combat this illness.

A Growing Challenge For Healthcare In Thailand

Oral gonorrhea is a particular concern for Thailand because of the high numbers of M2M (male-to-male) sexual encounters relative to neighboring countries. Many members of this community, more so than in the Thai population at large, mistakenly believe engaging in oral sex poses little or no risk to participants – or, that if there are risks, they are negligible and easily detected. This is not the case with oral gonorrhea. The higher rates of promiscuity among the M2M populations compound dangers of the widely held myth in the safety of oral sex, rendering this group at a much higher risk of infection.

However, Oral Gonorrhea is not just restricted to the M2M community, a growing number of cases are also found in heterosexual female and male youths (15 to 21 years of age)  especialy in countries like Britain, US, Australia and even China.

Indeed, the National Institutes of Health, in a 2017 study, found that oral gonorrhea in particular disproportionately affects the M2M community because of the types of sexual activities this group engages in:

“The rate of gonorrhea is much higher in men who have sex with men than in heterosexuals. Because of unique behavioral characteristics, asymptomatic sites of infection, mainly the pharynx, are principal drivers of gonorrhea prevalence in men who have sex with men.


The Importance of Identifying and Diagnosing Oral Gonorrhea

While gonorrhea infections located on or around the genitals or anus often come with tell-tale symptoms like itching, burning, and painful urination, infections of the mouth and throat are almost never accompanied by symptoms.

Due to the nearly complete lack of symptoms in most cases, the biggest obstacle to diagnosing oral gonorrhea is the first step of ordering the test. Especially in public clinics where resources are scarce, doctors will typically only perform diagnostic tests for STD infections when there is a compelling reason to do so – i.e., symptoms that might raise a red flag.  

For this reason, health advocacy groups like US Centers for Disease Control and the World Health Organization recommend regular gonorrhea testing of all sexually active individuals regardless of the presence of symptoms. A thorough screening of as many members of a given population as possible can help greatly reduce STD transmission rates.

Testing for oral gonorrhea, relative to other diagnostic procedures, is relatively inexpensive. A swab test will indi cate the presence of any infection.

If there is a positive result, the healthcare provider will then move on to treatment. Previously, treatment of gonorrhea (oral and other varieties) was the straightforward administration of an antibiotic cocktail, typically including Azithromycin and Ceftriaxone. However, as explored below, recent studies have discovered a waning effectiveness of these drugs for the treatment of gonorrhea as well as wider public health implications.

Misdiagnosis of Oral Gonorrhea: Complications

Oral gonorrhea is often misdiagnosed in Thailand and abro