Men with urethral discharge

Export Indicator

Number of men reporting urethral discharge in the past 12 months
What it measures

Progress in reducing unprotected sex among men.

Rationale
Urethral discharge among men is a sexually transmitted infection syndrome generally most commonly caused by Neisseria gonorrhoeae or Chlamydia trachomatis. Presentation with an acute sexually transmitted infection syndrome, such as urethral discharge, is a marker of unprotected sexual intercourse, and urethral discharge facilitates HIV transmission and acquisition. Surveillance for urethral discharge therefore contributes to secondgeneration HIV surveillance by providing early warning of the epidemic potential of HIV from sexual transmission and ongoing high-risk sexual activity that may require more aggressive programme interventions to reduce the risk. Untreated urethral discharge can result in infertility, blindness and disseminated disease. Increasing resistance to the recommended treatment options for Neisseria gonorrhoeae may render this infection untreatable.
Numerator

Number of men reported with urethral discharge during the reporting period

Denominator

Number of men 15 years and older

Calculation

Numerator/denominator

Method of measurement

Routine health information systems

Measurement frequency
Data should be recorded daily and reported quarterly to the national or subnational level. They should also be consolidated annually and reported to WHO.
Disaggregation

None

Strengths and weaknesses
Although WHO has provided a global case definition, the actual case definition may vary between and within countries, as may clinical diagnostic capacity. Although this indicator may be underreported, in the absence of changes in case definition or major changes in screening practices, these data can generally be used for following trends over time within a country.
 
Countries reporting on urethral discharge should communicate the extent to which the data are deemed representative of the national population.
 
Following trends in urethral discharge is a feasible means to monitor incident sexually transmitted infection in a population. Data on vaginal discharge among women, although useful for monitoring purposes at the local and national levels, are not requested at the global level because, in many settings, sexually transmitted infections do not cause most vaginal discharge cases.
 
Countries should periodically assess the causes of urethral discharge syndrome to understand the predominant causes of urethral discharge and, therefore, the appropriate therapy.
 
If a country is unable to report on the denominator, WHO will use the denominator from the United Nations Population Division. Examine trends in comparable groups over time.
Further information
Strategies and laboratory methods for strengthening surveillance of sexually transmitted infection 2012. Geneva: World Health Organization; 2012 (http://www.who.int/reproductivehealth/publications/rtis/9789241504478/en).