Epidemiology of gonorrhoea: a global perspective

Abstract

Although understanding the local epidemiology of gonorrhoea is critical for local efforts, understanding the multinational epidemiology may support development of national and international prevention and control policies and strategies. In this paper, current epidemiology of gonorrhoea is reviewed through an international lens and with a focus on selected populations. The World Health Organization (WHO) estimates that ~87 million new gonococcal infections occurred among people aged 15–49 years in 2016. Gonorrhoea rates are rising in many countries. Gay, bisexual and other men who have sex with men, racial or ethnic minorities, Indigenous populations and sex workers appear to bear disproportionate burdens of gonorrhoea. International travel can facilitate spread of gonorrhoea, including resistant strains, across international borders. Critical gaps in epidemiological knowledge are highlighted, including data on gonorrhoea among transgender persons and the burden of extragenital gonorrhoea. Even as further data are gathered, action — informed by currently available data — is needed now to confront this growing international threat.

Developing target product profiles for Neisseria gonorrhoeae diagnostics in the context of antimicrobial resistance: An expert consensus

“…Gay, bisexual and other men who have sex with men (MSM), racial or ethnic minorities, indigenous populations and sex workers appear to bear disproportionate burdens of NG. Asymptomatic, particularly extra-genital, gonorrhoea is significantly common in men who have sex with men (MSM) which remains undiagnosed and untreated and may lead to a reservoir which can result in widespread transmission among multiple partners [18,19].…”

Gonorrhoea: tackling the global epidemic in the era of rising antimicrobial resistance

“…Kirkcaldy et al provide a global epidemiologic overview of the growing international threat of gonorrhoea, emphasising the disproportionate burden among MSM, transgender individuals, racial or ethnic minorities and Indigenous populations, sex workers and international travellers. 7 There is a need to improve STI surveillance including collecting more data among key populations, especially from transgender and adolescents, as well as the burden of extragenital gonorrhoea. Unemo et al describe the critical work of the WHO Gonococcal Antimicrobial Surveillance Program, a network of reference laboratories, established in 1990.…”

Targeted surveillance strategies for efficient detection of novel antibiotic resistance variants

“…There are numerous hypotheses for how to focus sampling and most quickly identify these variants. Novel variants may be more likely to emerge or spread in certain anatomical niches, demographics, or geographic regions ( Lewis, 2013 ; Collignon et al, 2018 ; Frost et al, 2019 ; Hernando Rovirola et al, 2020 ), some of which may be systematically under-sampled ( Kirkcaldy et al, 2019 ) and thus may provide a basis for sampling priority. Data on such characteristics may be obtained from metadata recorded during clinical encounters.…”