Signs and Symptoms of Gonorrhoea

Sourced by: Choma Magazine ( – HIVSA Project

Gonorrhoea (pronounced goh-nuh-REE-uh) or ‘The Clap’ is a sexually transmitted illness (STI) and is caused by bacteria called Neisseria gonorrhoea. Gonorrhoea is passed on from one person to another through oral, vaginal or anal sex. It can also be transmitted from a pregnant mother to her infant child at birth. If you’re infected with gonorrhoea, symptoms of the infection will show up in your mouth, throat, anus, cervix fallopian tubes and uterus.

Ejaculation does not need to happen for gonorrhoea to spread. If infected fluids touch from either your partner’s vagina or penis, and then that is followed by touching your anus, mouth or even your eyes, then that can cause you to be infected.

The STI doesn’t only spread between a man and a woman, it can also spread between females who have sex with females and males who have sex with males.

Many people with gonorrhoea may not always show any symptoms (meaning they are asymptomatic) and can live up to many years without knowing they are infected, spreading the unknowingly. Having unsafe sex increases your chances of being infected by gonorrhoea. There are symptoms that you can look out for. These symptoms are sometimes confused for a urinal tract infection, so make sure you understand the difference between the two. Also speak to a nurse or doctor about your symptoms so that you don’t incorrectly diagnose yourself.

Signs and symptoms

The signs or symptoms of gonorrhoea will depend on where, on your body, you are first infected by the STI.

Signs and symptoms in the genital area can include:
  • Pain or burning when urinating
  • More vaginal discharge than usual
  • Vaginal discharge that looks different than usual
  • Bleeding between periods or spotting
  • Pain in the pelvis or abdomen
Signs and symptoms in the rectum/anus include:
  • Painful bowel movements
  • Itching in the anal area
  • Pus-like discharge
  • Bright red blood on toilet paper
Signs and symptoms in the eyes:
  • Itching
  • Sensitivity to light
  • Pain
  • Abnormal, pus-like discharge
Signs and symptoms in the throat:
  • Swollen glands in the neck
  • Sore throat
What happens if I don’t treat gonorrhoea?

Gonorrhoea can cause serious health problems to a person infected even if they do not have or show any signs or symptoms. This STI can cause skin rashes or spread to the joints, which can cause swelling or pain while moving. You could also struggle to get pregnant later in your life.

Getting Tested and Treatment

You need to visit your local doctor or clinic to get tested for gonorrhoea. You will also need to get tested for other STIs such as chlamydia because that is also an STI which doesn’t always show any symptoms. Gonorrhoea can be treated by antibiotics but if left untreated, as explained earlier, this STI can leave serious health problems. Although the antibiotics can help cure you of gonorrhoea, they can’t fix any permanent injury/damage done to your body. This is why it’s important to get tested as soon as you suspect you or your partner may be infected with the STI.

In order for the treatment to work and be cured, you need to finish the treatment even if you notice the symptoms going away. You can get be re-infected with gonorrhoea, so always practise safe sex and tell your partner to also get tested for gonorrhoea.

Chomas, if you notice any of these symptoms or if your partner shows symptoms of gonorrhoea, like an unusual sore, a smelly discharge, burning when urinating, or spotting, then visit your local clinic as soon as possible. If you have a burning question to ask me about gonorrhoea, or want to share your story then you are more than welcome to.

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What Exactly are ARVs?

Sourced by: Choma Magazine ( – HIVSA Project

By Dr Sindi

Antiretroviral treatment (ART) – what is it and how does it work?

ARV = antiretroviral. An antiretroviral is a drug that works to deal with infections caused by a retrovirus. In our setting the main retrovirus we deal with is HIV

ART = antiretroviral treatment. A combination of 3 or more ARVs taken daily to suppress HIV’s ability to replicate

Antiretroviral treatment ART is taken to slow down the life cycle of HIV.

HIV multiplies by infecting CD4 cells, and using these cells to make millions of copies of itself. These copies are what we call the “viral load”. This process destroys the CD4 cell because the cell has been hijacked and is being used for something it is not meant for.

The CD4 cells are a very important part of your immune system. They are the “soldiers” of the immune system and their job is to identify whatever is making you sick, and get the body to fight the infection.

The lower the CD4 count drops, the higher the viral load goes, the weaker your immune system becomes. You then become vulnerable to what we call opportunistic infections and if you get too ill you could die. Taking ART reverses this process and ensures that your CD4 count can go up again and that the viral load comes down.

At the onset of the HIV pandemic, people had to take many tablets twice a day to stay healthy but we have advanced to the stage where some people are taking one-pill once-a-day. This is an important advance because people are not discouraged to take medication any longer. The one-pill once- a-day is a Fixed Dose Combination (FDC) of three different tablets that have been combined into one tablet.

The FDC we are all familiar with is part of our first line treatment. The originator FDC is Atripla but because of its cost, it was not accessible to everyone. Generics then came onto the market and this is how South Africa has managed to give FDC at its public sector clinics.

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Common Mental Illnesses and Their Treatment

Sourced by: Choma Magazine ( – HIVSA Project

It’s been said that one in three South Africans experience mental illness, yet there are many people who suffer in silence. Because there is a stigma around mental illness, some people are afraid to talk about it and so they never get the help they need. Do you know anyone who has a mental illness choma? Or do you think you might have one yourself?

Mental illness isn’t necessarily something that you can see and so not many people recognize how important it is to treat. However, just like physical illness, mental illness requires treatment. Having a mental illness is not wrong or shameful so no one should be afraid to talk about it. Getting the help you need will help you to live the life you deserve.

To help you understand mental illnesses choma, here are the most common mental illnesses in South Africa.

Major depressive disorder 

Major depressive disorder (MDD) – also known as major depression, clinical depression or unipolar depression – is a disorder where the person feels low all the time.

People who suffer from MDD usually struggle with concentration, anxiety, experience feelings of worthlessness (sometimes having suicidal thoughts), sleep too much or have trouble sleeping.

Treatment: Once a healthcare professional has diagnosed you with MDD, they would recommend treatment such as an antidepressant. They would also suggest psychotherapy, behavioral or cognitive therapy, or talk therapy, to help you deal with your emotional state.


Claustrophobia is the fear of small spaces. While it is normal to feel scared when you’re trapped or if you’re in a small space and there is danger, if you’re claustrophobic you would feel fear even if there is no real danger.

When you’re claustrophobic you go out of your way to avoid small spaces like lifts, public toilets, shop changing rooms and tunnels. People who are claustrophobic also often experience panic attacks when they are in situations where they feel trapped.

Symptoms of a panic attack include dizziness, shortness of breath and chest pains.

Treatment: Some people who are claustrophobic simply try to avoid places that might bring on panic attacks. If you’re claustrophobic or if you’re suffering with panic attacks, speak to your doctor who could help you with medication and/or recommend a mental health professional who could help you recover.

Bipolar Disorder 

Bipolar disorder, also known as manic-depressive illness, is a disorder where your moods are severely affected. People with bipolar disorder often experience extreme highs (full of energy, overjoyed, feelings of being invincible), known as manic episodes and extreme lows (feeling sad, depressed, hopeless), known as depressive episodes.

Treatment: People with Bipolar disorder are usually treated with mood-stabilising drugs and/or antipsychotic drugs – which are drugs meant to control the symptoms of Bipolar Disorder.


Schizophrenia is a mental disorder that causes symptoms such as delusions and hallucinations.

Treatment: Antipsychotic medication is usually prescribed for someone with Schizophrenia. This medication is used to help control the symptoms of Schizophrenia.

Eating disorders 

Eating disorders relate to extreme disturbances in eating behaviour, and include anorexia (where someone stops eating entirely because of body dysmorphic behaviour; they have an unhealthy body image), bulimia (a person with bulimia also has an unhealthy body image and a desire to lose weight. Overeating through binge eating is usually followed by self-induced vomiting or not eating at all) and binge-eating disorder (where someone eats an unusually large amount of food and can’t stop eating).

Treatment: Depending on your type of disorder, treatment could include a combination of psychological counseling, nutrition education, medical monitoring and sometimes medication.

Mental Illness, in whatever form, should be taken seriously. If you or someone you know might be struggling with a mental illness, visit SADAG (The South African Depression Group).

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Health Risks of Smoking Cigarettes

Sourced by: Choma Magazine ( – HIVSA Project

Unlike food and water, the body doesn’t need tobacco in the system. So, why then do we start smoking chomas? Is it because we think it looks cool? Do we do it to fit in with the popular crowd or do we do it because one of our relatives smokes? Some people smoke their first cigarette never thinking that they may end up as regular smokers. But, are we aware of the dangers of smoking cigarettes? Continuous tobacco smoking may result in health problems and in serious cases, may be fatal. I’ve slightly touched on the dangers of cigarette smoking and how bad it can be for your health, but not in detail. Here are the health risks of cigarette smoking chomas.

Health effects of smoking tobacco

1. Change in appearance on the face

Smoking negatively affects the appearance of your face causing you to age quicker and get deeper wrinkles. Smoking damages your skin which could be due to the heat from the cigarette directly burning the skin. It also yellows your teeth which is caused by tar and nicotine. Nicotine is a colourless chemical which turns yellow when mixed with oxygen. When the tobacco is placed in your mouth or inhaled, the nicotine and tar will settle in the front of your mouth and these substances will then try and get into your teeth causing your teeth to turn yellow.

Your skin will also start sagging and have more wrinkles which may be caused by the chemicals found in tobacco. The chemicals damage collagen and elastin which are fibres that give your skin its elasticity and strength.

2. Lung damage

If you remember smoking your first cigarette, you may have felt a pain or burning in your lungs and throat right? Others may have felt sick or even threw up the first few times of smoking a cigarette. This is your body defending itself against poisons from entering.

The chemicals in tobacco interfere with your body’s method of cleaning out air and your lungs. When the smoke gets into your lungs, it can lead to your body overproducing mucus – that’s why some smokers cough a lot to clear their throat.

The walls of your lungs have many sacs that hold the air. The smoke then damages these sacs and will end up in less oxygen getting into your blood.
That’s why smokers have a shortness of breath. This will eventually end up as lung disease if the smoking continues. In most cases, lung cancer is caused by cigarette smoking. And if you have asthma, the tobacco smoke can trigger an attack or make the attack worse.

3. Heart and blood vessels

The chemicals found in tobacco may harm your heart and blood vessels in many ways, namely:

  1. Increase the blood pressure (which leads to a stroke) and heart rate (which makes your heart work harder than normal).
  2. Damage the blood vessel walls, making them stiff and less elastic. Smokers are at a higher risk for clogged arteries in the legs because there’s not enough blood flow going to the leg muscles. This may cause pain in the legs when walking, for example, and if it’s not treated the lack in blood flow can lead to the legs being amputated/removed.
  3. Increase your chances of getting cardiovascular diseases such as heart disease (which may lead to a heart attack) or a stroke (when the part of the brain doesn’t get enough blood due to a clot or a burst blood vessel).

Tobacco found in cigarettes is dangerous chomas, and sometimes deadly. It is addictive, so it makes it harder to quit. Do you have any other risks you think I might have left out? Share in the comments below.

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Warning Signs of Bipolar disorder

Understanding Bipolar1

Bipolar Disorder: What Is It?

Bipolar disorder, sometimes called manic depression, is a disorienting condition that causes extreme shifts in mood. Like riding a slow-motion roller coaster, patients may spend weeks feeling like they’re on top of the world before plunging into a relentless depression. The length of each high and low varies greatly from person to person. In any given year, bipolar disorder affects more than 2% of American adults.

Depressive Phase Symptoms

Without treatment, a person with bipolar disorder may experience intense episodes of depression. Symptoms include sadness, anxiety, loss of energy, hopelessness, and difficulty concentrating. Patients may lose interest in activities that were once pleasurable. They may gain or lose weight, sleep too much or too little, and contemplate suicide.

Manic Phase Symptoms

During a manic phase, patients tend to feel euphoric and may believe they can accomplish anything. This can result in inflated self-esteem, agitation, reduced need for sleep, being more talkative, being easily distracted, and a sense of racing thoughts. Reckless behaviors, including spending sprees, sexual indiscretions, fast driving, and substance abuse, are common. Having three or more of these symptoms nearly every day for a week may indicate a manic episode.

Bipolar I vs. Bipolar II

People with bipolar I disorder have manic episodes or mixed episodes and often have one or more depressive episodes. People with bipolar II have major depressive episodes with less severe mania; they experience hypomania, a condition that is less intense than mania or lasting less than a week. Patients may seem like the “life of the party” — full of charm and humor. They may feel and function fine, even if family and friends can see the mood swing. However, hypomania can lead to mania or depression.

Mixed Episode

People with mixed episode experience depression and mania at the same time. This leads to unpredictable behavior, such as sadness while doing a favorite activity or feeling very energetic. It’s more common in people who develop bipolar disorder at a young age, particularly during adolescence. But some estimates suggest up to 70% of bipolar patients experience mixed episodes.

Causes of Bipolar Disorder

Doctors aren’t exactly sure what causes bipolar disorder. A leading theory is that brain chemicals fluctuate abnormally. When levels of certain chemicals become too high, the patient develops mania. When levels drop too low, depression may result.

Bipolar Disorder: Who’s At Risk?

Bipolar disorder affects males and females equally. In most cases, the onset of symptoms is between 15 and 30 years old. People are at higher risk if a family member has been diagnosed, especially if it’s a first degree relative, but doctors don’t think the disorder kicks in based on genetics alone. A stressful event, drug abuse, or other unknown factor may trigger the cycle of ups and downs.

Bipolar Disorder and Daily Life

Bipolar disorder can disrupt your goals at work and at home. In one survey, 88% of patients said the illness took a toll on their careers. The unpredictable mood swings can drive a wedge between patients and their co-workers or loved ones. In particular, the manic phase may scare off friends and family. People with bipolar disorder also have a higher risk of developing anxiety disorders.

Bipolar Disorder and Substance Abuse

About 60% of people with bipolar disorder have trouble with drugs or alcohol. Patients may drink or abuse drugs to relieve the uncomfortable symptoms of their mood swings. This is especially common during the reckless manic phase.

Bipolar Disorder and Suicide

People with bipolar disorder are 10 to 20 times more likely to commit suicide than people without the illness. Warning signs include talking about suicide, putting affairs in order, and inviting death with risky behavior. Anyone who appears suicidal should be taken very seriously. Do not hesitate to call one of the Suicide Helpline (0800 567 567) and the Destiny Helpline: (0800 41 42 43). If you have a plan to commit suicide, go to the emergency room for immediate treatment.

Diagnosing Bipolar Disorder

A crucial step in diagnosing bipolar disorder is to rule out other possible causes of extreme mood swings. These may include brain infection or other neurological disorders, substance abuse, thyroid problem, HIV, ADHD, side effects of certain medications, or other psychiatric disorders. There is no lab test for bipolar disorder. A psychiatrist usually makes the diagnosis based on a careful history and evaluation of the patient’s mood and other symptoms.

Medications for Bipolar Disorder

Medications are key in helping people with bipolar disorder live stable, productive lives. Mood stabilizers can smooth out the cycle of ups and downs. Patients may also be prescribed antipsychotic drugs and anticonvulsant drugs. Between acute states of mania or depression, patients typically stay on maintenance medication to avoid a relapse.

Talk Therapy for Bipolar Disorder

Talk therapy can help patients stay on medication and cope with their disorder’s impact on work and family life. Cognitive behavioral therapy focuses on changing thoughts and behaviors that accompany mood swings. Interpersonal therapy aims to ease the strain bipolar disorder may place on personal relationships. Social rhythm therapy helps patients develop and maintain daily routines.

Lifestyle Tips for Bipolar Disorder

Establishing firm routines can help manage bipolar disorder. Routines should include sufficient sleep, regular meals, and exercise. Because alcohol and recreational drugs can worsen the symptoms, these should be avoided. Patients should also learn to identify their personal early warning signs of mania and depression. This will allow them to get help before an episode spins out of control.

Electroconvulsive Therapy (ECT)

Electroconvulsive therapy can help some people with bipolar disorder. ECT uses an electric current to cause a seizure in the brain. It is one of the fastest ways to ease severe symptoms. ECT is usually a last resort when a patient does not improve with medication or psychotherapy.

Educating Friends and Family

Friends and family may not understand bipolar disorder at first. They may become frustrated with the depressive episodes and frightened by the manic states. If patients make the effort to explain the illness and how it affects them, loved ones may become more compassionate. Having a solid support system can help people with bipolar disorder feel less isolated and more motivated to manage their condition.

When Someone Needs Help

Many people with bipolar disorder don’t realize they have a problem or avoid getting help. If you’re concerned about a friend or family member, here are a few tips for broaching the subject. Point out that millions of Americans have bipolar disorder, and that it is a treatable illness — not a personality flaw. There is a medical explanation for the extreme mood swings, and effective treatments are available.

If you would like to speak to a Counselor for free telephonic counselling call the Substance Abuse Helpline 0800 21 22 23/Destiny Helpline 0800 41 42 43, or SMS 31393. SADAG is open 7 days a week, every day of the year from 8am-8pm. SADAG provides FREE telephonic counselling, referrals to Support Groups, Psychologists, Psychiatrists, Clinics, etc. We also have brochures, self-help tips & online resources at

Typhoid Fever Advisory

What is typhoid fever?

Rounded Rectangle:
  • Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi.
  • It is spread through water and food sources that have been contaminated with faecal material containing Salmonella Typhi bacteria.
  • Symptoms include high grade fever of 39 to 40 degrees Celsius, stomach pains, weakness, headache, loss of appetite and a rash of flat rose coloured spots on the chest in severe cases. Symptoms usually develop 1 – 3 weeks after exposure.
  • It is diagnosed after a stool sample or blood is tested for the presence of Salmonella Typhi. It is treatable in mild cases but can be life-threatening in severe cases.
  • If one suffers from typhoid fever and recovers, he or she may still continue to carry the bacteria even after the symptoms have disappeared (carrier).

How can one prevent typhoid fever?

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  • Drinking safe water:
    Contaminated drinking water is a particular problem in areas where typhoid fever is endemic. For that reason, drink only bottled water or water that has been transported and /or stored in clean containers and properly treated by boiling or chemical disinfection.
  • Eating foods that are thoroughly cooked and still hot and steaming
    : Avoid food that’s stored or served at room temperature. Hot, steaming food is best.
  • Avoiding eating raw fruits and vegetables if they cannot be well washed, peeled or cooked
    : This is because raw produce may have been washed in unsafe water, avoid fruits and vegetables that you can’t peel and/or cook (Cook it, Peel it or Leave it!).
  • Avoiding foods and beverages from street vendors
    : Food and juices from street vendors are more likely to be contaminated.
  • Practice regular hand washing
    : Wash hands with soap and water before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water is not available
  • Proper disposal of feces
    using latrines/toilets.
  • Vaccination:
    Protective for 3 years. The typhoid vaccine is not 100% effective (limited protection) and is therefore not a substitute for proper hygiene and sanitation practices.


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If you’re recovering from typhoid fever, these measures can help keep others safe:

  • Take your antibiotics.
    Follow your health worker’s instructions for taking your antibiotics, and be sure to finish the entire prescription.
  • Wash your hands often.
    This is the single most important thing you can do to keep from spreading the infection to others. Wash hands thoroughly with soap and water for at least 30 seconds, especially before eating and after using the toilet.
  • Avoid handling food.
    Avoid preparing food for others until your health worker says you are no longer contagious.


Rounded Rectangle:
  • Antibiotic therapy
    : is the only effective treatment for typhoid fever.
  • Drinking fluids
    : This helps prevent the dehydration that results from prolonged fever. If you’re severely dehydrated, you may need to receive fluids intravenously.
  • Surgery:
    If there is intestinal perforation, surgery is needed to repair the perforation (hole).

Malnutrition in Africa and the link to under-development

Malnutrition is known to be a direct or indirect cause of illness and death. It directly causes death especially if severe forms go untreated or indirectly by rendering those affected especially children under 5 years vulnerable to preventable infections. Globally malnutrition accounts for up to 35% deaths among children under five years old. Three forms of malnutrition, which are wasting, stunting and intrauterine growth retardation are the major contributors to child mortality, accounting for 2 million deaths annually. Despite concerted efforts by both global and local players to remedy the situation, malnutrition still abounds globally. As a result, between 2000 and 2015, there was slow progress towards the realization of the health-related Millennium Development Goals (MDGs) especially those that targeted maternal and child health. In September 2015, the United Nations adopted the Sustainable Development Goals where Goal 2.2 targets “by 2030 end all forms of malnutrition, including achieving by 2025 the internationally agreed targets on stunting and wasting in children under five years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons”.

Africa, especially the sub-Saharan region represents one of the regions where under-nutrition is most prevalent. More specifically, a recent WHO (2013) report revealed that an estimated 160 million children under 5 years are stunted of whom 36% are in Africa alone. In addition, micronutrient malnutrition, or “hidden hunger” particularly deficiencies in Vitamin A, Iron and Iodine remain a pervasive problem in this region.

In the Africa region, underlying factors include traditional practices that may adversely affect maternal and child feeding and health & reproductive care. In addition, poor access to diversified foods, low use of fortified foods, seasonal fluctuation in food supply and diet quality limit achievement of optimal nutrition. Low agricultural productivity is mostly due to poor access to land, information and inputs to improve farm production. High daily workload for women, teenage pregnancy, too frequent births and lack of knowledge of good child care practices have also been listed as underlying factors.


A vicious cycle exists between malnutrition and diarrhoea among children; malnourished children being more susceptible to severe episodes of diarrhoea and diarrhoea in turn affecting a child’s nutrient intake and ability to absorb nutrients. Children stunted by malnutrition are not only short for their ages but their bodies and brains can incur lasting damage. Research shows that stunted children are more susceptible to disease, tend to do poorly in school, and earn less as adults than their well-nourished peers. The World Bank also estimates that malnourished children are at risk of losing more than 10% of their lifetime earning potential. Costs of Hunger in Africa studies have revealed that countries in Africa are likely losing up to 2 – 17% of their GDPs due to child undernutrition. According to the Lancet (2013) deficiencies in essential vitamins and minerals have important adverse effects on child survival and development. For example, iron deficiency anemia not only impairs cognitive performance in children but also, increases the risk of death due to illness and is associated with a higher risk of mortality during pregnancy and delivery.

There is therefore likely to be slow progress towards the realization of the health, nutrition, education and economic development related Sustainable Development Goals in Africa unless the poor nutrition status of women and children is addressed.

The SUN framework

A global push for action and investment to improve maternal and child nutrition: the Scaling Up Nutrition (SUN) movement has emerged to address this critical issue. The SUN Framework calls for the implementation and scaling up of two complementary approaches;

The first one is direct effective nutrition-specific interventions, focusing on pregnant women and children under two with direct interventions such as the promotion of good nutritional practices, micronutrients, and complementary feeding. This approach is premised on the critical window of opportunity or the 1000-day period between conception to age 24 months due to the potential for nutrition interventions in this period to have a high impact. Evidence shows that proper nutrition during the 1000 days between a woman’s pregnancy and her child’s second birthday gives children a healthy start in life. Poor nutrition during this period leads to irreversible consequences such as stunted growth and impaired cognitive

The second is a broad multi-sectoral nutrition-sensitive approach that tackles the determinants of undernutrition by promoting agriculture and food security, access to and consumption of nutritious foods, social protection, care practices and access to health care. This is because tackling undernutrition is not a health sector issue per se but depends on complex linkages between the health, agriculture, welfare, education and economic development sectors.


  1. UNICEF, 2015 UNICEF Data: Monitoring the situation of children and women.

  2. World Bank, 2013

  3. African Union, NEPAD, WFP and ECA. 2013. Cost of Hunger in Africa: Social and Economic Impact of Child Undernutrition in Egypt, Ethiopia, Swaziland and Uganda.

  4. African Union, NEPAD, WFP and ECA. 2015. Cost of Hunger in Africa: Social and Economic Impact of child Undernutrition in Burkina Faso, Ghana, Malawi and Rwanda.