Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)

  Gonorrhoea is a preventable and curable sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, which is primarily transmitted through vaginal, oral or anal sex. […] In 2020, WHO estimated 82.4 million new infections with N. gonorrhoeae among adults aged 15 to 49 years. Prevalence of gonorrhoea is highest among vulnerable populations such as men who have sex with men, sex workers, transgender women and adolescents and young people in high burden countries. […] WHO has recognized gonorrhoea as a significant public health problem and has set ambitious targets to reduce the global burden through prevention, diagnosis, and treatment strategies. The Global Health Sector Strategies on HIV, viral hepatitis and STIs 20222030 aims to reduce the incidence of N. gonorrhoeae infection by 90% by 2030, compared to 2020 baseline. WHO is working with countries and partners to improve people-centred case management approaches, ensure appropriate treatment recommendations and effective testing and partner services strategies, support the development of new easy to use and affordable diagnostics and treatment, vaccine development and improve surveillance.

• #2 Epidemiology and pathogenesis of Neisseria gonorrhoeae infection – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-neisseria-gonorrhoeae-infection

  Global incidence — The precise global burden of N. gonorrhoeae is difficult to establish because of the lack of diagnostic capability and/or reporting systems in many parts of the world. The World Health Organization (WHO) has estimated the global incidence of several sexually transmitted infections (STIs) among individuals aged 15 to 49 years based on data from regions that have good case-based surveillance systems as well as data from population-based studies. In 2020, the estimate for N. gonorrhoeae was 82.4 million cases, a small decrease from 2016 but higher than the goal needed to achieve a 90 percent reduction in the incidence of gonorrhea by 2030. […] The WHO African Region had the highest incidence rate, followed by the South-East Asia region. In one review of infections during pregnancy in sub-Saharan Africa, the prevalence of sexually transmitted and reproductive tract infections was comparable with that of malaria. The prevalence of N. gonorrhoeae during pregnancy ranged from 1.5 percent in West and Central Africa to 4.9 percent in East and Southern Africa.

• #3 Epidemiology of gonorrhoea – Wikipedia

  https://en.wikipedia.org/wiki/Epidemiology_of_gonorrhoea

  Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. The World Health Organization (WHO) estimated that, in 2016, the global incidence rate was 20 per 1000 women and 26 per 1000 men, totaling 86.9 million new gonococcal infections among people between 15 and 49 years old. […] As of 2018, gonorrhoea was the second most commonly reported STI in Canada. Its incidence rate has been rising since 1997. Incidence rate among men was consistently higher than that among women (70.2 per 100,000 versus 40.6 per 100,000 in 2015). […] In Nordic countries, gonorrhoea affects mainly young people below the age of 30. Infections are more common in men than in women. Nearly half of the reported cases of gonorrhoea are attributed to men who have sex with men (MSM).

• #4 Epidemiology of Gonorrhea: A Global Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7064409/

  Better understanding of the international epidemiology of gonorrhea may inform national and international prevention and control strategies and among whom to focus resources. […] The World Health Organization (WHO) estimated the pooled 2016 global prevalence of urogenital gonorrhea (the proportion of the worlds population with gonorrhea in a given year) to be 0.9% in women and 0.7% in men, corresponding to a total of 30.6 million gonorrhea cases worldwide. […] National case report data complement WHO estimates and allow interpretation of trends. […] In many countries, gonorrhea case rates have increased recently. […] The rate of gonorrhea diagnoses in England rose steadily from 2008 (28.9 per 100,000) to 2018 (101.1 per 100,000), with a momentary decline in 2016. […] The marked inequities by race/ethnicity and among indigenous peoples are not explained by differences in individual behavior.

• #5 Epidemiology and pathogenesis of Neisseria gonorrhoeae infection – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-neisseria-gonorrhoeae-infection

  Global incidence — The precise global burden of N. gonorrhoeae is difficult to establish because of the lack of diagnostic capability and/or reporting systems in many parts of the world. The World Health Organization (WHO) has estimated the global incidence of several sexually transmitted infections (STIs) among individuals aged 15 to 49 years based on data from regions that have good case-based surveillance systems as well as data from population-based studies. In 2020, the estimate for N. gonorrhoeae was 82.4 million cases, a small decrease from 2016 but higher than the goal needed to achieve a 90 percent reduction in the incidence of gonorrhea by 2030. […] The WHO African Region had the highest incidence rate, followed by the South-East Asia region. In one review of infections during pregnancy in sub-Saharan Africa, the prevalence of sexually transmitted and reproductive tract infections was comparable with that of malaria. The prevalence of N. gonorrhoeae during pregnancy ranged from 1.5 percent in West and Central Africa to 4.9 percent in East and Southern Africa.

• #6 Epidemiology of gonorrhoea – Wikipedia

  https://en.wikipedia.org/wiki/Epidemiology_of_gonorrhoea

  In England, there were 82,592 diagnoses of gonorrhoea in 2022, an increase of 50.3% compared to 2021 (54,961). The number of gonorrhoea diagnoses in 2022 was the largest annual number reported since records began. […] In 2020, a total of 677,769 cases of gonorrhea were reported to the CDC, a 45 percent increase from 2016, making it the second most common notifiable sexually transmitted infection in the United States for that year. Rates of reported gonorrhea have increased 111% since the historic low in 2009.

• #7 Gonorrhoea – Annual Epidemiological Report for 2022

  https://www.ecdc.europa.eu/en/publications-data/gonorrhoea-annual-epidemiological-report-2022

  For 2022, 70 881 confirmed cases of gonorrhoea were reported in 28 European Union/European Economic Area (EU/EEA) countries, with a crude notification rate of 17.9 cases per 100 000 population, representing a 48% increase in the crude notification rate compared with 2021 and an 59% increase compared with 2018. […] The gonorrhoea notification rate for the EU/EEA in 2022 is the highest recorded since European surveillance of sexually transmitted infections began in 2009. […] National rates of reported gonorrhoea infection varied considerably across the EU/EEA in 2022, between less than one case to more than 75 cases per 100 000 population. […] Age-specific rates were highest among 20- to 24-year-olds, both for men (99.6 cases per 100 000 population) and women (48.1 cases per 100 000 population). Women aged 20 to 24 years old had the highest increase in notification rate in 2022: 63% compared with 2021. […] Men who have sex with men (MSM) accounted for more than half the reported cases (60%) in 2022.

• #8 Gonorrhea guide: Etiology and epidemiology – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/etiology-epidemiology.html

  Gonorrhea is the second most commonly reported sexually transmitted infection (STI) in Canada, with a gradual and steady increase in reported cases of gonorrhea since 2012. In 2021, 32,192 cases of gonorrhea were reported in Canada for a rate of 84.2 cases per 100,000 people. The reported rate of gonorrhea doubled between 2012 and 2021, with rates higher among males than females. In 2021, gonorrhea rates were highest among females aged 15 to 29 years old and males aged 20 to 39 years old. […] It is important to note that as asymptomatic gonorrhea infections may be undiagnosed and underreported, reported case counts and rates of gonorrhea may underestimate the true prevalence of gonorrhea in Canada. […] Surveillance of AMR in N. gonorrhoeae is crucial to monitor trends and inform efforts to prevent and control its spread. […] Antimicrobial-resistant N. gonorrhoeae is a significant global public health challenge, posing a serious threat to effective treatment of gonococcal infections and raising the possibility of infections becoming untreatable in the future.

• #9 Epidemiology of gonorrhoea – Wikipedia

  https://en.wikipedia.org/wiki/Epidemiology_of_gonorrhoea

  Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. The World Health Organization (WHO) estimated that, in 2016, the global incidence rate was 20 per 1000 women and 26 per 1000 men, totaling 86.9 million new gonococcal infections among people between 15 and 49 years old. […] As of 2018, gonorrhoea was the second most commonly reported STI in Canada. Its incidence rate has been rising since 1997. Incidence rate among men was consistently higher than that among women (70.2 per 100,000 versus 40.6 per 100,000 in 2015). […] In Nordic countries, gonorrhoea affects mainly young people below the age of 30. Infections are more common in men than in women. Nearly half of the reported cases of gonorrhoea are attributed to men who have sex with men (MSM).

• #10 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections

  Gonorrhea is the second most common notifiable sexually transmitted infection (STI) in the United States. This infection is caused by the gram-negative bacterium Neisseria gonorrhoeae and is transmitted through sexual activity or perinatally during vaginal delivery. Reported cases of gonorrhea have remained high in recent years, particularly among sexually active persons who are 20 to 29 years of age. […] In 2023, a total of 601,319 cases of Neisseria gonorrhoeae (gonorrhea) were reported in the United States, making gonorrhea the second-highest reported bacterial STI. […] There are significant differences in the incidence of gonorrhea based on sex, age, race/ethnicity, and region of residence. […] Since 2014, the rates of reported gonorrhea cases among males have been significantly higher than in females. In 2023, the gonorrhea rate (cases per 100,000 population) was 228.3 in males versus 130.7 in females. […] Based on the estimated incident cases among all ages in 2018, the total lifetime direct medical cost of gonorrhea in the United States was estimated at $271 million. […] Gonococcal infections are a significant public health problem in the United States.

• #11 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections

  Gonorrhea is the second most common notifiable sexually transmitted infection (STI) in the United States. This infection is caused by the gram-negative bacterium Neisseria gonorrhoeae and is transmitted through sexual activity or perinatally during vaginal delivery. Reported cases of gonorrhea have remained high in recent years, particularly among sexually active persons who are 20 to 29 years of age. […] In 2023, a total of 601,319 cases of Neisseria gonorrhoeae (gonorrhea) were reported in the United States, making gonorrhea the second-highest reported bacterial STI. […] There are significant differences in the incidence of gonorrhea based on sex, age, race/ethnicity, and region of residence. […] Since 2014, the rates of reported gonorrhea cases among males have been significantly higher than in females. In 2023, the gonorrhea rate (cases per 100,000 population) was 228.3 in males versus 130.7 in females. […] Based on the estimated incident cases among all ages in 2018, the total lifetime direct medical cost of gonorrhea in the United States was estimated at $271 million. […] Gonococcal infections are a significant public health problem in the United States.

• #12 Gonorrhoea – Annual Epidemiological Report for 2022

  https://www.ecdc.europa.eu/en/publications-data/gonorrhoea-annual-epidemiological-report-2022

  For 2022, 70 881 confirmed cases of gonorrhoea were reported in 28 European Union/European Economic Area (EU/EEA) countries, with a crude notification rate of 17.9 cases per 100 000 population, representing a 48% increase in the crude notification rate compared with 2021 and an 59% increase compared with 2018. […] The gonorrhoea notification rate for the EU/EEA in 2022 is the highest recorded since European surveillance of sexually transmitted infections began in 2009. […] National rates of reported gonorrhoea infection varied considerably across the EU/EEA in 2022, between less than one case to more than 75 cases per 100 000 population. […] Age-specific rates were highest among 20- to 24-year-olds, both for men (99.6 cases per 100 000 population) and women (48.1 cases per 100 000 population). Women aged 20 to 24 years old had the highest increase in notification rate in 2022: 63% compared with 2021. […] Men who have sex with men (MSM) accounted for more than half the reported cases (60%) in 2022.

• #13 Gonorrhea guide: Etiology and epidemiology – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/etiology-epidemiology.html

  Gonorrhea is the second most commonly reported sexually transmitted infection (STI) in Canada, with a gradual and steady increase in reported cases of gonorrhea since 2012. In 2021, 32,192 cases of gonorrhea were reported in Canada for a rate of 84.2 cases per 100,000 people. The reported rate of gonorrhea doubled between 2012 and 2021, with rates higher among males than females. In 2021, gonorrhea rates were highest among females aged 15 to 29 years old and males aged 20 to 39 years old. […] It is important to note that as asymptomatic gonorrhea infections may be undiagnosed and underreported, reported case counts and rates of gonorrhea may underestimate the true prevalence of gonorrhea in Canada. […] Surveillance of AMR in N. gonorrhoeae is crucial to monitor trends and inform efforts to prevent and control its spread. […] Antimicrobial-resistant N. gonorrhoeae is a significant global public health challenge, posing a serious threat to effective treatment of gonococcal infections and raising the possibility of infections becoming untreatable in the future.

• #14

  https://ibis.utah.gov/ibisph-view/indicator/important_facts/GonCas.html

  Rate of newly reported cases of gonorrhea by date of diagnosis per 100,000 population. […] Reported gonorrhea rates are calculated by dividing the number of cases within the population of interest by the total number of persons within that population, then multiplying by 100,000. […] Although much less common than chlamydia infections, gonorrhea, caused by the bacterium ”Neisseria gonorrhoeae”, is a priority public health concern in Utah. […] Following a doubling of the Utah gonorrhea rate from 2003 to 2006, when the rate peaked at 35.2 cases per 100,000 persons, the Utah gonorrhea rate decreased annually to the lowest reported rate of 9.8 in 2011. […] From 2011 to 2022, gonorrhea rates increased 830.6% to 91.2 cases per 100,000 persons. […] In 2022, gonorrhea rates in the state were higher in males (118.4 cases per 100,000 persons) than in females (63.1 cases per 100,000 persons).

• #15 Gonorrhea – 2016 STD Surveillance Report

  http://med.iiab.me/modules/en-cdc/www.cdc.gov/std/stats16/Gonorrhea.htm

  The overall rate of reported gonorrhea cases in the 50 most populous metropolitan statistical areas (MSAs) was 162.2 cases per 100,000 population in 2016, representing a 19.6% increase compared with the rate in 2015. […] In 2016, 51.0% of reported gonorrhea cases occurred in just 70 counties or independent cities. […] The rate of reported gonorrhea cases increased the most in the Midwest (26.7% among males and 21.0% among females) and in the West (24.1% among males and 17.2% among females). […] In 2016, among the 50 states and the District of Columbia that submitted data in the race and ethnicity categories according to Office of Management and Budget (OMB) standards, the rate of reported gonorrhea cases remained highest among Blacks (481.2 cases per 100,000 population). […] The national rate of reported gonorrhea cases reached a historic low in 2009, but increased each year during 20092012.

• #16 Sexually Transmitted Diseases, 2013 – MN Dept. of Health

  https://www.health.state.mn.us/diseases/reportable/dcn/sum13/std.html

  Surveillance for gonorrhea and chlamydia are monitored through a passive surveillance system by receiving patient case and laboratory reports. […] Gonorrhea, caused by Neisseria gonorrhoeae, is the second most commonly reported STD in Minnesota. In 2013, 3,872 cases (73 per 100,000 population) were reported, representing a 26% increase from 2012. This is the highest reported rate of gonorrhea in the last decade. […] Communities of color are disproportionately affected by gonorrhea, with nearly one half of cases reported among blacks. The incidence of gonorrhea among blacks (611 per 100,000) is 26.5 times higher than the rate among whites (23 per 100,000). […] Gonorrhea rates are highest in the cities of Minneapolis and St. Paul. The incidence in Minneapolis (359 per 100,000) is over 1.5 times higher than the rate in St. Paul (230 per 100,000), seven times higher than the rate in the suburban metropolitan area (49 per 100,000), and 15 times higher than the rate in Greater Minnesota (23 per 100,000). Geographically in 2013, Minneapolis had the largest increase in cases at 28% and Greater Minnesota had a 27% increase in cases.

• #17 Epidemiology of Gonorrhea: A Global Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7064409/

  Better understanding of the international epidemiology of gonorrhea may inform national and international prevention and control strategies and among whom to focus resources. […] The World Health Organization (WHO) estimated the pooled 2016 global prevalence of urogenital gonorrhea (the proportion of the worlds population with gonorrhea in a given year) to be 0.9% in women and 0.7% in men, corresponding to a total of 30.6 million gonorrhea cases worldwide. […] National case report data complement WHO estimates and allow interpretation of trends. […] In many countries, gonorrhea case rates have increased recently. […] The rate of gonorrhea diagnoses in England rose steadily from 2008 (28.9 per 100,000) to 2018 (101.1 per 100,000), with a momentary decline in 2016. […] The marked inequities by race/ethnicity and among indigenous peoples are not explained by differences in individual behavior.

• #18 2023 Update: U.S. Surveillance of Sexually Transmitted Infectionslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na58149/2024/11/26/2023-update-us-surveillance-sexually-transmitted

  Although rates of bacterial STIs have largely stabilized, case counts remain high. […] The incidence of bacterial sexually transmitted infections (STIs) climbed sharply during the last decade, with especially high numbers for syphilis (including congenital syphilis). Now, a 2023 CDC surveillance report of case numbers for syphilis (209,253), gonorrhea (601,319), and chlamydia (1,648,568) suggests that the trend may be abating. […] Gonorrhea rates fell by 8% for the second year in a row, with the largest reduction among women. […] Rates of gonorrhea and chlamydia were highest among African Americans.

• #19

  https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)

  Gonorrhoea is a preventable and curable sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, which is primarily transmitted through vaginal, oral or anal sex. […] In 2020, WHO estimated 82.4 million new infections with N. gonorrhoeae among adults aged 15 to 49 years. Prevalence of gonorrhoea is highest among vulnerable populations such as men who have sex with men, sex workers, transgender women and adolescents and young people in high burden countries. […] WHO has recognized gonorrhoea as a significant public health problem and has set ambitious targets to reduce the global burden through prevention, diagnosis, and treatment strategies. The Global Health Sector Strategies on HIV, viral hepatitis and STIs 20222030 aims to reduce the incidence of N. gonorrhoeae infection by 90% by 2030, compared to 2020 baseline. WHO is working with countries and partners to improve people-centred case management approaches, ensure appropriate treatment recommendations and effective testing and partner services strategies, support the development of new easy to use and affordable diagnostics and treatment, vaccine development and improve surveillance.

• #20 Gonorrhoea – Annual Epidemiological Report for 2022

  https://www.ecdc.europa.eu/en/publications-data/gonorrhoea-annual-epidemiological-report-2022

  For 2022, 70 881 confirmed cases of gonorrhoea were reported in 28 European Union/European Economic Area (EU/EEA) countries, with a crude notification rate of 17.9 cases per 100 000 population, representing a 48% increase in the crude notification rate compared with 2021 and an 59% increase compared with 2018. […] The gonorrhoea notification rate for the EU/EEA in 2022 is the highest recorded since European surveillance of sexually transmitted infections began in 2009. […] National rates of reported gonorrhoea infection varied considerably across the EU/EEA in 2022, between less than one case to more than 75 cases per 100 000 population. […] Age-specific rates were highest among 20- to 24-year-olds, both for men (99.6 cases per 100 000 population) and women (48.1 cases per 100 000 population). Women aged 20 to 24 years old had the highest increase in notification rate in 2022: 63% compared with 2021. […] Men who have sex with men (MSM) accounted for more than half the reported cases (60%) in 2022.

• #21 Eurosurveillance | Rapid increase in gonorrhoea and syphilis diagnoses in England in 2011

  https://www.eurosurveillance.org/content/10.2807/ese.17.29.20224-en

  There has been a rapid rise in the number of gonorrhoea and syphilis diagnoses in England during 2011, an increase of 25% and 10% respectively. […] Large increases of both gonorrhoea (61%) and syphilis (28%) were observed among men who have sex with men. […] The rise in gonorrhoea rates is worrying in an era of decreased susceptibility to treatments.

• #22 Trends of chlamydia and gonorrhea infections by anatomic sites among men who have sex with men in south China: a surveillance analysis from 2018 to 2022 | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19987-5

  Chlamydia and gonorrhea notifications are rapidly rising in men who have sex with men (MSM). Currently, there are limited data on the prevalence of chlamydia and gonorrhea across various anatomical sites. Our study aimed to explore the prevalence, association and changing trends of urethral and rectal chlamydia and gonorrhea among MSM in Guangdong Province, China. […] We included 4856 men in the analysis. Rectal chlamydia significantly increased from 13.8% to 26.4% over the past 5 years (average annual percentage change [AAPC] 19.2%, 95%CI 1.0-40.6, p=0.043). […] To conclude, our findings reveal a high prevalence of chlamydia infections among MSM, particularly in the rectal area. Comprehensive chlamydia and gonorrhea health services are necessary for MSM to improve sexual health. […] In China, the prevalence of chlamydia and gonorrhea infections among MSM in 2018 ranged from 13.9 to 22.5%, and 5.3 to 11.0%, respectively.

• #23 Trends of chlamydia and gonorrhea infections by anatomic sites among men who have sex with men in south China: a surveillance analysis from 2018 to 2022 | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19987-5

  Our research identifies a consistent and high prevalence of chlamydia and gonorrhea among Chinese MSM from 2018 to 2022. […] This study found that from 2018 to 2022, the overall prevalence of chlamydia infection among MSM has consistently remained at a high level, exceeding that reported by MSM sentinel surveillance in Australia (6.2%). […] Our surveillance data revealed a significantly increase prevalence of rectal chlamydia among MSM from 2018 to 2022. […] This study found that the uptake of chlamydia and gonorrhea testing among MSM remained consistently low between 2018 and 2022.

• #24 Epidemiology of Gonorrhea: A Global Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7064409/

  The category of sex workers (SWs) encompasses a diverse population who exchange sexual activity for income, employment, survival (e.g., food or shelter), and/or drugs. […] Air travel and increased globalization fuel rapid human mobility across international borders, which in turn can facilitate international spread of infectious diseases. […] Recently identified cases of ceftriaxone-resistant strains, seemingly spread via international travel, highlight the importance of condom use and other safer sex approaches during travel. […] As this review highlights, gonorrhea disproportionately affects marginalized populations. […] Increasing gonorrhea incidence and emerging antimicrobial resistance, which will undermine prevention and control efforts, will likely worsen and compound these health inequities. […] Continuing to advance our understanding of the epidemiology of gonorrhea is critical.

• #25 Epidemiology of Gonorrhea: A Global Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7064409/

  Although understanding the local epidemiology of gonorrhea is critical for local efforts, understanding the multinational epidemiology may support development of national and international prevention and control policies and strategies. […] The World Health Organization (WHO) estimates that ~87 million new gonococcal infections occurred among 15-49 year olds in 2016. Gonorrhea rates are rising in many countries. […] International travel can facilitate spread of gonorrhea, including resistant strains, across international borders. […] We highlight critical gaps in epidemiological knowledge, including data on gonorrhea among transgender persons and the burden of extragenital gonorrhea. […] Even as we continue to gather data, action informed by currently available data is needed now to confront this growing international threat.

• #26 Epidemiology and pathogenesis of Neisseria gonorrhoeae infection – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-neisseria-gonorrhoeae-infection

  Global incidence — The precise global burden of N. gonorrhoeae is difficult to establish because of the lack of diagnostic capability and/or reporting systems in many parts of the world. The World Health Organization (WHO) has estimated the global incidence of several sexually transmitted infections (STIs) among individuals aged 15 to 49 years based on data from regions that have good case-based surveillance systems as well as data from population-based studies. In 2020, the estimate for N. gonorrhoeae was 82.4 million cases, a small decrease from 2016 but higher than the goal needed to achieve a 90 percent reduction in the incidence of gonorrhea by 2030. […] The WHO African Region had the highest incidence rate, followed by the South-East Asia region. In one review of infections during pregnancy in sub-Saharan Africa, the prevalence of sexually transmitted and reproductive tract infections was comparable with that of malaria. The prevalence of N. gonorrhoeae during pregnancy ranged from 1.5 percent in West and Central Africa to 4.9 percent in East and Southern Africa.

• #27

  https://www.who.int/initiatives/gonococcal-antimicrobial-surveillance-programme

  The Gonococcal Antimicrobial Surveillance Programme (GASP) […] The Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) is a focused sentinel surveillance, where men presenting with urethral discharge are consecutively identified in sentinel sites and clinics. By the end of 2023, EGASP was implemented globally in 10 countries from the majority of WHO Regions. […] High quality and representative gonococcal antimicrobial resistance (AMR) data is imperative to monitor AMR trends, identify emerging AMR, and inform refinements of global, international and national clinical management guidelines and public health policies. The WHO Global Gonococcal Antimicrobial Surveillance Program (GASP) has been documenting the emergence and spread of AMR in gonorrhea globally since 1992. […] To ensure adequate sentinel surveillance of antimicrobial resistance in order to inform treatment guidelines in all countries. […] The WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) was established to overcome the limitations of the original GASP framework.

• #28 Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002344

  Antimicrobial resistance (AMR) in Neisseria gonorrhoeae seriously compromises the management and control of gonorrhea. […] The World Health Organization (WHO) Global Gonococcal Antimicrobial Surveillance Programme (GASP) is key to monitoring AMR trends, identifying emerging AMR, and informing regular refinements of treatment guidelines and public health policy globally. […] Enhanced international collaborative actions are crucial for the control of gonorrhea, including improved prevention, early diagnosis (development of accurate, rapid, point-of-care tests), partner management, and enhanced surveillance (including population-based surveillance and surveillance of treatment failures and antimicrobial use). […] The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), a collaborative global network of regional and subregional reference laboratories, was initiated in 1990 to monitor gonococcal AMR worldwide.

• #29

  https://www.who.int/initiatives/gonococcal-antimicrobial-surveillance-programme

  The Gonococcal Antimicrobial Surveillance Programme (GASP) […] The Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) is a focused sentinel surveillance, where men presenting with urethral discharge are consecutively identified in sentinel sites and clinics. By the end of 2023, EGASP was implemented globally in 10 countries from the majority of WHO Regions. […] High quality and representative gonococcal antimicrobial resistance (AMR) data is imperative to monitor AMR trends, identify emerging AMR, and inform refinements of global, international and national clinical management guidelines and public health policies. The WHO Global Gonococcal Antimicrobial Surveillance Program (GASP) has been documenting the emergence and spread of AMR in gonorrhea globally since 1992. […] To ensure adequate sentinel surveillance of antimicrobial resistance in order to inform treatment guidelines in all countries. […] The WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) was established to overcome the limitations of the original GASP framework.

• #30 JMIR Public Health and Surveillance – Antimicrobial Resistance of Neisseria Gonorrhoeae in a Newly Implemented Surveillance Program in Uganda: Surveillance Report

  https://publichealth.jmir.org/2020/2/e17009/

  Background: Neisseria gonorrhoeae (commonly known as gonorrhea) has developed resistance to all first-line therapy in Southeast Asia. East Africa has historically had absent or rudimentary gonorrhea surveillance programs and, while the existence of antimicrobial-resistant gonorrhea is recognized, the extent of its resistance is largely unknown. In 2016, the World Health Organizations Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) was initiated in Uganda to monitor resistance trends. […] This is the first report from a systematic gonorrhea surveillance program in Uganda. Findings demonstrated resistance or increased minimum inhibitory concentration to all key antigonococcal antibiotics. […] Ongoing surveillance efforts to develop interventions to curtail antimicrobial-resistant gonorrhea are needed.

• #31 JMIR Public Health and Surveillance – Antimicrobial Resistance of Neisseria Gonorrhoeae in a Newly Implemented Surveillance Program in Uganda: Surveillance Report

  https://publichealth.jmir.org/2020/2/e17009/

  In 2016, the WHO initiated its Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) in Uganda to monitor patterns of resistance. […] EGASP strengthens and streamlines reporting mechanisms for specified alert values for antimicrobial resistance, thus facilitating timely responses. […] Herein, we report initial antimicrobial resistance and epidemiological results of the gonorrhea surveillance program in Kampala, Uganda. […] The antimicrobial resistance profiles reported here have profound public health implications; they support arguments for expanded surveillance programs and investment in first-line antibiotic supplies which could improve population health and slow the spread of antimicrobial-resistant gonorrhea in Uganda. […] The emergence of gonorrhea with decreased sensitivity to current first-line antibiotics raises the specter of untreatable multidrug resistance. […] Antimicrobial resistance can readily develop in sub-Saharan Africa because of limited surveillance and poor antimicrobial stewardship. […] This study has clearly demonstrated resistance to and increased minimum inhibitory concentration for vital antigonococcal antibiotics.

• #32 Gonococcal Isolate Surveillance Project (GISP) Profiles | STI Statistics | CDC

  https://www.cdc.gov/sti-statistics/gisp-profiles/index.html

  The Gonococcal Isolate Surveillance Project (GISP) was established in 1986 to monitor trends in antimicrobial susceptibilities of N. gonorrhoeae strains in the United States in order to establish an evidence-based rationale for selection of gonococcal therapies. GISP is a sentinel surveillance system based on a collaboration between participating STD clinics and their state or local public health authorities, regional laboratories, and CDC. […] In 2017, GISP expanded in a subset of clinical sites to conduct N. gonorrhoeae surveillance in non-urethral isolates (i.e., pharyngeal, rectal, and endocervical isolates). The Enhanced Gonococcal Isolate Surveillance Program (eGISP) was established to help understand if the pharynx and/or rectum may be anatomic niches that select for or foster resistance and to evaluate if gonococcal susceptibility patterns vary between men and women.

• #33 Gonococcal Isolate Surveillance Project (GISP) Profiles | STI Statistics | CDC

  https://www.cdc.gov/sti-statistics/gisp-profiles/index.html

  The Gonococcal Isolate Surveillance Project (GISP) was established in 1986 to monitor trends in antimicrobial susceptibilities of N. gonorrhoeae strains in the United States in order to establish an evidence-based rationale for selection of gonococcal therapies. GISP is a sentinel surveillance system based on a collaboration between participating STD clinics and their state or local public health authorities, regional laboratories, and CDC. […] In 2017, GISP expanded in a subset of clinical sites to conduct N. gonorrhoeae surveillance in non-urethral isolates (i.e., pharyngeal, rectal, and endocervical isolates). The Enhanced Gonococcal Isolate Surveillance Program (eGISP) was established to help understand if the pharynx and/or rectum may be anatomic niches that select for or foster resistance and to evaluate if gonococcal susceptibility patterns vary between men and women.

• #34 Gonococcal Isolate Surveillance Project (GISP) Profiles | STI Statistics | CDC

  https://www.cdc.gov/sti-statistics/gisp-profiles/index.html

  GISP continues to be the core antimicrobial-resistant gonococcal surveillance system in the US. Findings from GISP have directly contributed to the CDCs STD Treatment Guidelines released in 1993, 1998, 2002, 2006, 2010, 2015, and 2021 and the Gonorrhea Treatment recommendation updates released in 2000, 2004, 2007, 2012, and 2020. Findings from GISP have also directly contributed to CDCs AR Threats Reports in 2013 and 2019. Expanding GISP supports the ability to detect changes in susceptibility patterns across different populations and to detect resistant infections sooner for improved surveillance and public health response. […] A subgroup of clinical sites began contributing gonococcal isolates to eGISP beginning in 2018. A total of 7 sites participated in eGISP in 2022 contributing 1,473 gonococcal isolates during the year.

• #35 Gonorrhea – Local Public Health Agency Resources | Colorado Department of Public Health and Environment

  https://cdphe.colorado.gov/sti-hiv-vh/antibiotic-resistant-gonorrhea/gonorrhea-local-public

  Strengthening the U.S. Response to Resistant Gonorrhea (SURRG) began in 2016 to enhance domestic gonorrhea surveillance and infrastructure, build capacity for rapid detection and response to resistant gonorrhea through increased culturing and local antibiotic susceptibility testing, and rapid field investigation to stop the spread of resistant infections. […] Combatting Antibiotic Resistant Gonorrhea and Other STIs (CARGOS) started in 2024 to monitor trends in antimicrobial susceptibilities of gonorrhea and other STIs in the U.S. and strengthen state and local capacity to rapidly detect and respond to threats of Antimicrobial Resistance (AMR). […] The project also aims to gain a better understanding of the epidemiological factors contributing to resistant gonorrhea. There are 19 different CARGOS sites and jurisdictions across the US that collect and analyze data. They help guide national recommendations for the public health response to the growing threat of resistant gonorrhea.

• #36 Gonorrhea – Local Public Health Agency Resources | Colorado Department of Public Health and Environment

  https://cdphe.colorado.gov/sti-hiv-vh/antibiotic-resistant-gonorrhea/gonorrhea-local-public

  Strengthening the U.S. Response to Resistant Gonorrhea (SURRG) began in 2016 to enhance domestic gonorrhea surveillance and infrastructure, build capacity for rapid detection and response to resistant gonorrhea through increased culturing and local antibiotic susceptibility testing, and rapid field investigation to stop the spread of resistant infections. […] Combatting Antibiotic Resistant Gonorrhea and Other STIs (CARGOS) started in 2024 to monitor trends in antimicrobial susceptibilities of gonorrhea and other STIs in the U.S. and strengthen state and local capacity to rapidly detect and respond to threats of Antimicrobial Resistance (AMR). […] The project also aims to gain a better understanding of the epidemiological factors contributing to resistant gonorrhea. There are 19 different CARGOS sites and jurisdictions across the US that collect and analyze data. They help guide national recommendations for the public health response to the growing threat of resistant gonorrhea.

• #37 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Antibiotic-Resistant-Gonorrhea-Surveillance-Projects.aspx

  Californias Antibiotic-Resistant Gonorrhea (ARGC) Center of Excellence is the online hub for information and resources on antibiotic-resistant gonorrhea to help health care providers and health departments prepare for and respond to antibiotic-resistant gonorrhea within California. For general information on gonorrhea, please see the CDPH STD Control Branch gonorrhea webpage. […] Included below is a summary of the current CDPH STD Control Branchs ARGC and gonorrhea surveillance project: […] Combatting Antimicrobial Resistant Gonorrhea and Other STIs (CARGOS) began in 2024 with four strategies: […] Strengthen local epidemiologic capacity to detect, monitor, and respond to AR in STIs. […] To improve coordination of AR in STI preparedness and outbreak response activities. […] Enhance local laboratory testing for surveillance, reporting, and response.

• #38 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Antibiotic-Resistant-Gonorrhea-Surveillance-Projects.aspx

  Californias Antibiotic-Resistant Gonorrhea (ARGC) Center of Excellence is the online hub for information and resources on antibiotic-resistant gonorrhea to help health care providers and health departments prepare for and respond to antibiotic-resistant gonorrhea within California. For general information on gonorrhea, please see the CDPH STD Control Branch gonorrhea webpage. […] Included below is a summary of the current CDPH STD Control Branchs ARGC and gonorrhea surveillance project: […] Combatting Antimicrobial Resistant Gonorrhea and Other STIs (CARGOS) began in 2024 with four strategies: […] Strengthen local epidemiologic capacity to detect, monitor, and respond to AR in STIs. […] To improve coordination of AR in STI preparedness and outbreak response activities. […] Enhance local laboratory testing for surveillance, reporting, and response.

• #39 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Antibiotic-Resistant-Gonorrhea-Surveillance-Projects.aspx

  Enhance coordination between epi-lab-health information technology. […] California Combatting Antimicrobial Resistant Gonorrhea and Other STIs Project (CA CARGOS) began in August 2024. […] CARGOS replaces the earlier legacy ARGC programs: […] Strengthening the United States Response to Resistant Gonorrhea (SURRG): a collaborative effort initiated in 2016 that emphasized rapid detection and response to drug-resistant gonorrhea in eight areas around the country; included California. […] Gonococcal Isolate Surveillance Project (GISP) and enhanced Gonococcal Isolate Surveillance Project (eGISP): Established in 1886 to monitor US antibiotic resistance trends in gonorrhea. […] Health equity is achieved when everyone has an equal chance to be healthy regardless of race, ethnicity, income, gender, religion, sexual identity, and disability.

• #40 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Antibiotic-Resistant-Gonorrhea-Surveillance-Projects.aspx

  Californias Antibiotic-Resistant Gonorrhea (ARGC) Center of Excellence is the online hub for information and resources on antibiotic-resistant gonorrhea to help health care providers and health departments prepare for and respond to antibiotic-resistant gonorrhea within California. For general information on gonorrhea, please see the CDPH STD Control Branch gonorrhea webpage. […] Included below is a summary of the current CDPH STD Control Branchs ARGC and gonorrhea surveillance project: […] Combatting Antimicrobial Resistant Gonorrhea and Other STIs (CARGOS) began in 2024 with four strategies: […] Strengthen local epidemiologic capacity to detect, monitor, and respond to AR in STIs. […] To improve coordination of AR in STI preparedness and outbreak response activities. […] Enhance local laboratory testing for surveillance, reporting, and response.

• #41 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Antibiotic-Resistant-Gonorrhea-Surveillance-Projects.aspx

  Enhance coordination between epi-lab-health information technology. […] California Combatting Antimicrobial Resistant Gonorrhea and Other STIs Project (CA CARGOS) began in August 2024. […] CARGOS replaces the earlier legacy ARGC programs: […] Strengthening the United States Response to Resistant Gonorrhea (SURRG): a collaborative effort initiated in 2016 that emphasized rapid detection and response to drug-resistant gonorrhea in eight areas around the country; included California. […] Gonococcal Isolate Surveillance Project (GISP) and enhanced Gonococcal Isolate Surveillance Project (eGISP): Established in 1886 to monitor US antibiotic resistance trends in gonorrhea. […] Health equity is achieved when everyone has an equal chance to be healthy regardless of race, ethnicity, income, gender, religion, sexual identity, and disability.

• #42 Surveillance and updates for gonorrhoea

  https://www.ecdc.europa.eu/en/gonorrhoea/surveillance-and-disease-data

  This disease surveillance report presents an overview of the epidemiological situation for communicable diseases and related health issues that are under European Union (EU) and European Economic Area (EEA) surveillance. […] The Euro-GASP network carries out sentinel surveillance of gonococcal antimicrobial resistance in the EU/EEA and is strengthening capacity for gonococcal culture and antimicrobial susceptibility testing through laboratory training and EQA schemes. In addition the network performs molecular typing of Neisseria gonorrhoeae.

• #43 Gonorrhea – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/gonorrhea

  PAHO’s Latin American Surveillance Network of Antimicrobial Resistance (ReLAVRA for its Spanish Acronym) aims at reporting the magnitude and trends of antimicrobial resistance in the Region, using routine data of microbiology laboratories. […] WHO’s Gonococcal Antimicrobial Surveillance Programme (GASP) tackles this public health problem through a worldwide laboratory network that is coordinated by regional coordinating centers, including ReLAVRA.

• #44 Enhancing gonorrhea surveillance in China by testing females in gynecology clinics: Lessons learned from a pilot survey | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238710

  China has a high burden of gonorrhea, but an imbalanced male-to-female (M/F) ratio of reported cases. […] The objective of this study is to investigate the cause of this imbalanced M/F ratio and develop strategies to enhance gonorrhea surveillance, particularly among females. […] This study showed a significant correlation between M/F ratios and the relative contribution of female gonorrhea testing, especially in gynecology clinics. Enhancing gonorrhea testing among females should be advocated to improve surveillance in China. […] The high M/F ratio of reported gonorrhea cases at the Chinese NNDRS may indicate that testing among females is insufficient and likely implies an underestimation of the prevalence of gonorrhea in China. […] Therefore, intensifying testing among females will likely provide a more accurately M/F ratio. A program termed Screen more, Find more should be advocated by NCSTDC as a national strategy in China to identify more female cases of gonorrhea.

• #45 Gonorrhoea: a systematic review of prevalence reporting globally | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06381-4

  The World Health Organization (WHO)s global target is a 90% reduction in gonorrhoea cases by 2030. To monitor progress towards this goal, STI trend monitoring at the national level is recommended. This should include routine prevalence assessments (every two to three years) of bacterial STIs among general populations of men and women (e.g. including pregnant women, women attending family planning clinics, military recruits and men undergoing employment physicals). […] National prevalence estimates are an essential indicator of the state of gonorrhoea and STI control at state level and globally. […] Gonorrhoea prevalence monitoring is one of four key components of national STI surveillance programmes that is recommended by WHO to reduce the burden of gonorrhoea infections by 90% between 2018 and 2030. […] From our review, it is clear that substantive prevalence data among representative samples of the general population were seriously lacking on a worldwide basis. We identified national population-based data from only four countries (USA, UK, Peru, and New Caledonia), all pre-dating 2013.

• #46

  https://ibis.utah.gov/ibisph-view/indicator/important_facts/GonCas.html

  Rate of newly reported cases of gonorrhea by date of diagnosis per 100,000 population. […] Reported gonorrhea rates are calculated by dividing the number of cases within the population of interest by the total number of persons within that population, then multiplying by 100,000. […] Although much less common than chlamydia infections, gonorrhea, caused by the bacterium ”Neisseria gonorrhoeae”, is a priority public health concern in Utah. […] Following a doubling of the Utah gonorrhea rate from 2003 to 2006, when the rate peaked at 35.2 cases per 100,000 persons, the Utah gonorrhea rate decreased annually to the lowest reported rate of 9.8 in 2011. […] From 2011 to 2022, gonorrhea rates increased 830.6% to 91.2 cases per 100,000 persons. […] In 2022, gonorrhea rates in the state were higher in males (118.4 cases per 100,000 persons) than in females (63.1 cases per 100,000 persons).

• #47 Estimated Incidence and Prevalence of Gonorrhea in the United States, 2006-2019 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36598837/

  We extend recent work estimating incidence and prevalence of gonococcal infections among men and women aged 15 to 39 years in the United States in 2018 by applying the same modeling framework to estimate gonococcal incidence and prevalence during 2006 to 2019. […] The model is informed by cases from the Nationally Notifiable Disease Surveillance System, data from the National Survey of Family Growth, and data on other factors known to impact gonococcal incidence and prevalence. […] There were 1,603,473 (1,467,801-1,767,779) incident cases of gonorrhea estimated in 2019. Per-capita incidence increased 32%, from 1101 (1002-1221) to 1456 (1333-1605) infections per 100,000 persons. […] The burden of gonorrhea has increased among men and women aged 15 to 39 years since 2013. An increasing proportion of incident infections are among men. Additional biomedical and behavioral interventions are needed to control gonococcal transmission.

• #48 Gonorrhoea: a systematic review of prevalence reporting globally | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06381-4

  The World Health Organization (WHO) recommends periodic gonorrhoea prevalence assessments in the general population or proxies thereof (including pregnant women, women attending family planning clinics, military recruits, and men undergoing employment physicals for example) and in population groups at increased risk, including men-who-have-sex-with-men (MSM) and sex workers. […] Current prevalence monitoring was shown to be highly suboptimal worldwide. Serial prevalence monitoring of critical epidemiological variables, and guidelines to optimize prevalence study conduct and reporting beyond antenatal settings are recommended. […] Gonorrhoea is substantially underdiagnosed and underreported worldwide. Even in high-income economies with well-established STI surveillance systems, it is estimated that more than half of infections are unidentified or unreported.

• #49 Gonorrhoea – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/sexuallytransmittedinfections/gonorrhoea/

  Gonorrhoea is a curable sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The numbers affected are likely to be underestimated as up to 86% of women and 55% of men have no symptoms. […] 6,824 cases notified in 2023 […] 132.5 The national notification rate per 100,000 population.

• #50 Gonorrhoea: a systematic review of prevalence reporting globally | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06381-4

  The World Health Organization (WHO) recommends periodic gonorrhoea prevalence assessments in the general population or proxies thereof (including pregnant women, women attending family planning clinics, military recruits, and men undergoing employment physicals for example) and in population groups at increased risk, including men-who-have-sex-with-men (MSM) and sex workers. […] Current prevalence monitoring was shown to be highly suboptimal worldwide. Serial prevalence monitoring of critical epidemiological variables, and guidelines to optimize prevalence study conduct and reporting beyond antenatal settings are recommended. […] Gonorrhoea is substantially underdiagnosed and underreported worldwide. Even in high-income economies with well-established STI surveillance systems, it is estimated that more than half of infections are unidentified or unreported.

• #51 Gonorrhoea: a systematic review of prevalence reporting globally | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06381-4

  The World Health Organization (WHO)s global target is a 90% reduction in gonorrhoea cases by 2030. To monitor progress towards this goal, STI trend monitoring at the national level is recommended. This should include routine prevalence assessments (every two to three years) of bacterial STIs among general populations of men and women (e.g. including pregnant women, women attending family planning clinics, military recruits and men undergoing employment physicals). […] National prevalence estimates are an essential indicator of the state of gonorrhoea and STI control at state level and globally. […] Gonorrhoea prevalence monitoring is one of four key components of national STI surveillance programmes that is recommended by WHO to reduce the burden of gonorrhoea infections by 90% between 2018 and 2030. […] From our review, it is clear that substantive prevalence data among representative samples of the general population were seriously lacking on a worldwide basis. We identified national population-based data from only four countries (USA, UK, Peru, and New Caledonia), all pre-dating 2013.

• #52 Gonorrhoea – Annual Epidemiological Report for 2022

  https://www.ecdc.europa.eu/en/publications-data/gonorrhoea-annual-epidemiological-report-2022

  For 2022, 70 881 confirmed cases of gonorrhoea were reported in 28 European Union/European Economic Area (EU/EEA) countries, with a crude notification rate of 17.9 cases per 100 000 population, representing a 48% increase in the crude notification rate compared with 2021 and an 59% increase compared with 2018. […] The gonorrhoea notification rate for the EU/EEA in 2022 is the highest recorded since European surveillance of sexually transmitted infections began in 2009. […] National rates of reported gonorrhoea infection varied considerably across the EU/EEA in 2022, between less than one case to more than 75 cases per 100 000 population. […] Age-specific rates were highest among 20- to 24-year-olds, both for men (99.6 cases per 100 000 population) and women (48.1 cases per 100 000 population). Women aged 20 to 24 years old had the highest increase in notification rate in 2022: 63% compared with 2021. […] Men who have sex with men (MSM) accounted for more than half the reported cases (60%) in 2022.

• #53 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections

  Gonorrhea is the second most common notifiable sexually transmitted infection (STI) in the United States. This infection is caused by the gram-negative bacterium Neisseria gonorrhoeae and is transmitted through sexual activity or perinatally during vaginal delivery. Reported cases of gonorrhea have remained high in recent years, particularly among sexually active persons who are 20 to 29 years of age. […] In 2023, a total of 601,319 cases of Neisseria gonorrhoeae (gonorrhea) were reported in the United States, making gonorrhea the second-highest reported bacterial STI. […] There are significant differences in the incidence of gonorrhea based on sex, age, race/ethnicity, and region of residence. […] Since 2014, the rates of reported gonorrhea cases among males have been significantly higher than in females. In 2023, the gonorrhea rate (cases per 100,000 population) was 228.3 in males versus 130.7 in females. […] Based on the estimated incident cases among all ages in 2018, the total lifetime direct medical cost of gonorrhea in the United States was estimated at $271 million. […] Gonococcal infections are a significant public health problem in the United States.

• #54 Sexually Transmitted Infections Surveillance, 2023 | STI Statistics | CDC

  https://www.cdc.gov/sti-statistics/annual/index.html

  Gonorrhea dropped for a second year declining 7% from 2022 and falling below pre-COVID-19 pandemic levels. […] There were more than 2.4 million STIs reported in the United States in 2023; however, there are promising signs the epidemic may be slowing. […] While these data are encouraging, reportable STIs remain unacceptably high and disparities persist.

• #55 2023 Update: U.S. Surveillance of Sexually Transmitted Infectionslogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na58149/2024/11/26/2023-update-us-surveillance-sexually-transmitted

  Although rates of bacterial STIs have largely stabilized, case counts remain high. […] The incidence of bacterial sexually transmitted infections (STIs) climbed sharply during the last decade, with especially high numbers for syphilis (including congenital syphilis). Now, a 2023 CDC surveillance report of case numbers for syphilis (209,253), gonorrhea (601,319), and chlamydia (1,648,568) suggests that the trend may be abating. […] Gonorrhea rates fell by 8% for the second year in a row, with the largest reduction among women. […] Rates of gonorrhea and chlamydia were highest among African Americans.

• #56 Gonorrhea – 2016 STD Surveillance Report

  http://med.iiab.me/modules/en-cdc/www.cdc.gov/std/stats16/Gonorrhea.htm

  Gonorrhea is the second most commonly reported notifiable disease in the United States. […] The combination of persistently high gonorrhea morbidity in some populations and the threat of cephalosporin-resistant gonorrhea reinforces the need to better understand the epidemiology of gonorrhea. […] In 2016, a total of 468,514 cases of gonorrhea were reported in the United States, yielding a rate of 145.8 cases per 100,000 population. […] During 20152016, the rate of reported gonorrhea cases increased 18.5%, and increased 48.6% since the historic low in 2009. […] The South had the highest rate of reported gonorrhea cases (166.8 cases per 100,000 population) among the four regions of the United States in 2016. […] During 20152016, gonorrhea rates increased in 96.1% of states and the District of Columbia and decreased in 3.9% of states.

• #57

  https://ibis.utah.gov/ibisph-view/indicator/important_facts/GonCas.html

  Rate of newly reported cases of gonorrhea by date of diagnosis per 100,000 population. […] Reported gonorrhea rates are calculated by dividing the number of cases within the population of interest by the total number of persons within that population, then multiplying by 100,000. […] Although much less common than chlamydia infections, gonorrhea, caused by the bacterium ”Neisseria gonorrhoeae”, is a priority public health concern in Utah. […] Following a doubling of the Utah gonorrhea rate from 2003 to 2006, when the rate peaked at 35.2 cases per 100,000 persons, the Utah gonorrhea rate decreased annually to the lowest reported rate of 9.8 in 2011. […] From 2011 to 2022, gonorrhea rates increased 830.6% to 91.2 cases per 100,000 persons. […] In 2022, gonorrhea rates in the state were higher in males (118.4 cases per 100,000 persons) than in females (63.1 cases per 100,000 persons).

• #58

  https://ibis.utah.gov/ibisph-view/indicator/important_facts/GonCas.html

  Gonorrhea rates in Utah are well below rates in the U.S. […] The overall rate for gonorrhea in the U.S. in 2022 was 194.4 cases per 100,000 persons. […] Persons who test positive for gonorrhea are confidentially interviewed by a disease intervention specialist (DIS) from a local health department (LHD) to educate the patient, ensure proper treatment, and to obtain sexual partner information for follow up. […] The Centers for Disease Control and Prevention currently recommends that patients with gonococcal infections be treated with a mono antibiotic therapy to improve gonorrhea treatment effectiveness, and potentially slow the emergence of antibiotic resistance.

• #59 Gonorrhoea – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/sexuallytransmittedinfections/gonorrhoea/

  Gonorrhoea is a curable sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The numbers affected are likely to be underestimated as up to 86% of women and 55% of men have no symptoms. […] 6,824 cases notified in 2023 […] 132.5 The national notification rate per 100,000 population.

• #60 Chlamydia, gonorrhea and infectious syphilis in Canada: 2021 surveillance data update – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/diseases-conditions/chlamydia-gonorrhea-infectious-syphilis-2021-surveillance-data.html

  Pre-pandemic, gonorrhea rates were rising rapidly. The 2021 gonorrhea rate was lower than the 2019 rate, although, 124% higher than the 2012 rate. […] In 2021, 32,192 cases of gonorrhea were reported from all 13 Canadian provinces and territories for a rate of 84.2 cases per 100,000 population. […] Between 2012 and 2019, national rates of reported gonorrhea cases (male, female, and other or unspecified sex) increased annually (the 2019 rate was 151% higher than the 2012 rate). […] Nationally reported rates of gonorrhea increased slightly (by 4%) between 2020 and 2021. […] The national rate of reported gonorrhea cases in 2021 was two times higher than the rate in 2012. […] From 2012 to 2021, rates of reported cases of gonorrhea were higher among males than females. […] Between 2012 and 2018, reported rates of gonorrhea increased for males (191%) and females (96%). Male rates rose faster annually than female rates, further widening the gap between male and female gonorrhea rates. […] From 2020 to 2021, reported rates of gonorrhea increased similarly among both males (4%) and females (3%).

• #61 Chlamydia, gonorrhea and infectious syphilis in Canada: 2021 surveillance data update – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/diseases-conditions/chlamydia-gonorrhea-infectious-syphilis-2021-surveillance-data.html

  Pre-pandemic, gonorrhea rates were rising rapidly. The 2021 gonorrhea rate was lower than the 2019 rate, although, 124% higher than the 2012 rate. […] In 2021, 32,192 cases of gonorrhea were reported from all 13 Canadian provinces and territories for a rate of 84.2 cases per 100,000 population. […] Between 2012 and 2019, national rates of reported gonorrhea cases (male, female, and other or unspecified sex) increased annually (the 2019 rate was 151% higher than the 2012 rate). […] Nationally reported rates of gonorrhea increased slightly (by 4%) between 2020 and 2021. […] The national rate of reported gonorrhea cases in 2021 was two times higher than the rate in 2012. […] From 2012 to 2021, rates of reported cases of gonorrhea were higher among males than females. […] Between 2012 and 2018, reported rates of gonorrhea increased for males (191%) and females (96%). Male rates rose faster annually than female rates, further widening the gap between male and female gonorrhea rates. […] From 2020 to 2021, reported rates of gonorrhea increased similarly among both males (4%) and females (3%).

• #62 Gonorrhea – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/gonorrhea

  Gonorrhea is spread by having unprotected vaginal, anal, or oral sex with someone who has gonorrhea, or from mother-to-child during childbirth. […] Increased resistance to most antibiotics used to treat gonococcal infections has been reported worldwide, raising concerns about the eventual development of untreatable gonococcal infections with serious sexual and reproductive health consequences. […] While there are documented increases in gonococcal resistance to antimicrobial drugs, only 36% of the countries in the Americas systematically monitor this resistance to support treatment decisions. […] The WHO guidelines for the treatment of gonorrhea recommends that local antimicrobial resistance (AMR) data should guide national treatment guidelines. […] However, it is becoming harder to treat some forms of gonorrhea infection, because the bacteria have developed resistance to nearly all the antibiotics used for its treatment.

• #63 Cost-effectiveness of the Strategies for Surveillance of Antimicrobial-resistant Gonorrhea in the US: a Modelling Study | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.07.29.24311166v2

  The Gonococcal Isolate Surveillance Project (GISP) is a sentinel surveillance system to monitor the spread of antimicrobial-resistant (AMR) gonorrhea. Under GISP surveillance strategy, urethral isolates are utilized for monitoring the spread of the resistance and the obtained estimates are used for informing the gonorrhea treatment guidelines. […] In 2017, the enhanced Gonococcal Isolate Surveillance Project (eGISP) was established which also includes the non-urethral isolates. Using eGISP estimates for informing the gonorrhea treatment guidelines is an alternative surveillance strategy that can be used. […] The current GISP surveillance strategy significantly reduces the costs and increases the health benefits compared to no surveillance. However, switching from the current strategy to eGISP strategy is cost saving and should be considered in order to improve the population health and reduce the financial burden of gonorrhea.

• #64 Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002344

  WHO recommends that treatment guidelines are refined based on data from recent and quality-assured gonococcal AMR surveillance and that the use of an antimicrobial in empiric treatment is discontinued when the rates of therapeutic failures and/or AMR reach a level of 5%. […] The cumulative number of countries reporting gonococcal AMR data for any antimicrobial increased from 56 in 2009 to 77 in 2014. […] WHO GASP data from 2009-2014 showed continued widespread resistance to penicillin, tetracycline, and ciprofloxacin; increasing resistance to azithromycin; and emergence of decreased susceptibility and resistance to ESCs. […] The vast majority of verified treatment failures are from well-resourced countries. Accordingly, these reports do not reflect the true global public health burden of ESC treatment failures, since surveillance data from resource-constrained settings are scarce.

• #65 Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002344

  WHO recommends that treatment guidelines are refined based on data from recent and quality-assured gonococcal AMR surveillance and that the use of an antimicrobial in empiric treatment is discontinued when the rates of therapeutic failures and/or AMR reach a level of 5%. […] The cumulative number of countries reporting gonococcal AMR data for any antimicrobial increased from 56 in 2009 to 77 in 2014. […] WHO GASP data from 2009-2014 showed continued widespread resistance to penicillin, tetracycline, and ciprofloxacin; increasing resistance to azithromycin; and emergence of decreased susceptibility and resistance to ESCs. […] The vast majority of verified treatment failures are from well-resourced countries. Accordingly, these reports do not reflect the true global public health burden of ESC treatment failures, since surveillance data from resource-constrained settings are scarce.

• #66 Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002344

  Gonococcal AMR is a major problem globally, but the AMR situation varies in different parts of the world and changes over time. […] In general, there is a need for greater involvement and increasing country-level ownership through advocacy, capacity-building, strengthened communications, and linkages with broader interventions to control AMR.

• #67 JMIR Public Health and Surveillance – Antimicrobial Resistance of Neisseria Gonorrhoeae in a Newly Implemented Surveillance Program in Uganda: Surveillance Report

  https://publichealth.jmir.org/2020/2/e17009/

  In 2016, the WHO initiated its Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) in Uganda to monitor patterns of resistance. […] EGASP strengthens and streamlines reporting mechanisms for specified alert values for antimicrobial resistance, thus facilitating timely responses. […] Herein, we report initial antimicrobial resistance and epidemiological results of the gonorrhea surveillance program in Kampala, Uganda. […] The antimicrobial resistance profiles reported here have profound public health implications; they support arguments for expanded surveillance programs and investment in first-line antibiotic supplies which could improve population health and slow the spread of antimicrobial-resistant gonorrhea in Uganda. […] The emergence of gonorrhea with decreased sensitivity to current first-line antibiotics raises the specter of untreatable multidrug resistance. […] Antimicrobial resistance can readily develop in sub-Saharan Africa because of limited surveillance and poor antimicrobial stewardship. […] This study has clearly demonstrated resistance to and increased minimum inhibitory concentration for vital antigonococcal antibiotics.

• #68 Department of Public Health announces first cases of concerning gonorrhea strain | Mass.gov

  https://www.mass.gov/news/department-of-public-health-announces-first-cases-of-concerning-gonorrhea-strain

  Boston — The Department of Public Health (DPH) today announced it has detected a novel strain of gonorrhea in a Massachusetts resident that showed reduced response to multiple antibiotics and another case with genetic markers that indicate a similar drug response. This is the first time that resistance or reduced response to five classes of antibiotics has been identified in gonorrhea in the United States. […] The Massachusetts cases were detected by DPH’s State Public Health Laboratory as part of disease surveillance activities. Field epidemiologists in DPH’s Division of Sexually Transmitted Disease

• #69

  https://link.springer.com/article/10.1007/s40471-017-0094-z

  Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae. In this review, we summarize recent updates in gonorrhea epidemiology, laboratory diagnosis, antimicrobial resistance, treatment, and prevention and control approaches. […] Gonorrhea rates are increasing in the USA, driven primarily by increases among men and likely among men who have sex with men. Continued emergence of antimicrobial resistance, declining antimicrobial options, and changes in sexual behavior further challenge current treatment, prevention, and control efforts. […] Efforts to reduce gonorrhea incidence and address antimicrobial resistance face substantial challenges. Research areas of the greatest need and of the greatest potential impact include development of new antimicrobials and rapid tests for resistance, identification of highly effective public health prevention and control approaches, and development of a gonorrhea vaccine.

• #70 Epidemiology of Gonorrhea: A Global Perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7064409/

  Although understanding the local epidemiology of gonorrhea is critical for local efforts, understanding the multinational epidemiology may support development of national and international prevention and control policies and strategies. […] The World Health Organization (WHO) estimates that ~87 million new gonococcal infections occurred among 15-49 year olds in 2016. Gonorrhea rates are rising in many countries. […] International travel can facilitate spread of gonorrhea, including resistant strains, across international borders. […] We highlight critical gaps in epidemiological knowledge, including data on gonorrhea among transgender persons and the burden of extragenital gonorrhea. […] Even as we continue to gather data, action informed by currently available data is needed now to confront this growing international threat.

• #71 JMIR Public Health and Surveillance – Automating Case Reporting of Chlamydia and Gonorrhea to Public Health Authorities in Illinois Clinics: Implementation and Evaluation of Findings

  https://publichealth.jmir.org/2023/1/e38868/

  Background: Chlamydia and gonorrhea cases continue to rise in Illinois, increasing by 16.4% and 70.9% in 2019, respectively, compared with 2015. Providers are required to report both chlamydia and gonorrhea, as mandated by public health laws. […] Public health laws mandate that these sexually transmitted infections be reported to Illinois Department of Public Health (IDPH) by health care providers and clinical laboratories within 7 business days. […] ELR and electronic case reporting (eCR) are creating a paradigm shift in public health surveillance. ELR is the automated messaging of laboratory reports of notifiable cases and has been widely adopted in the United States. eCR is the automated generation of case reports from EHRs and subsequent reporting to public health agencies. […] These approaches represent an advancement toward better semantic interoperability to support public health surveillance, greatly reducing the burden of reporting from clinical providers and improving the completeness and timeliness of those reports.

• #72 JMIR Public Health and Surveillance – Automating Case Reporting of Chlamydia and Gonorrhea to Public Health Authorities in Illinois Clinics: Implementation and Evaluation of Findings

  https://publichealth.jmir.org/2023/1/e38868/

  The primary goal of this project was to pilot standards-based eCR for chlamydia and gonorrhea in 2 participating jurisdictions (public health agencies of the states of Illinois and Oregon), study the completeness of data between ELRs and eCRs, and disseminate the findings to promote adoption. […] The eCR approach to public health surveillance successfully identified and created automated case reports for chlamydia and gonorrhea cases in the selected Illinois clinics. This approach also demonstrated a more complete case report with additional demographic, clinical, and treatment information. eCR reduced the burden of reporting cases on clinical providers and represents a promising future of greater semantic interoperability between health care systems and public health by automating the case report using health care data standards in a scalable manner.

• #73 New data show sustained declines in chlamydia, syphilis among doxy-PEP users | CIDRAP

  https://www.cidrap.umn.edu/antimicrobial-stewardship/new-data-show-sustained-declines-chlamydia-syphilis-among-doxy-pep-users

  A study conducted at a sexual health clinic in San Francisco found sustained significant declines in cases of chlamydia and syphilis among those who used doxycycline post-exposure prophylaxis (doxy-PEP) nearly 2 years after it was introduced, with a smaller effect on gonorrhea, researchers reported yesterday in Clinical Infectious Diseases. […] Implementation of the intervention was based on a randomized trial, conducted in San Francisco and Seattle, that in 2023 showed significant declines in chlamydia, syphilis, and gonorrhea among doxy-PEP users compared with those who received standard care. […] The analysis showed a significant decline in all individual STIs in the doxy-PEP group, most notably (83%) for combined rates of chlamydia and syphilis and less for gonorrhea. […] The study authors note that while gonorrhea rates did initially decline in users after starting doxy-PEP, they began to increase again toward the end of the analysis, which could indicate that gonorrhea resistance to doxycycline is increasing.

• #74

  https://link.springer.com/article/10.1007/s40471-017-0094-z

  Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae. In this review, we summarize recent updates in gonorrhea epidemiology, laboratory diagnosis, antimicrobial resistance, treatment, and prevention and control approaches. […] Gonorrhea rates are increasing in the USA, driven primarily by increases among men and likely among men who have sex with men. Continued emergence of antimicrobial resistance, declining antimicrobial options, and changes in sexual behavior further challenge current treatment, prevention, and control efforts. […] Efforts to reduce gonorrhea incidence and address antimicrobial resistance face substantial challenges. Research areas of the greatest need and of the greatest potential impact include development of new antimicrobials and rapid tests for resistance, identification of highly effective public health prevention and control approaches, and development of a gonorrhea vaccine.

• #75 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Antibiotic-Resistant-Gonorrhea-Surveillance-Projects.aspx

  The most effective strategies to control a potential antibiotic-resistant gonorrhea outbreak must also address racial equity issues. […] In order to contain the potential threat of a widespread antibiotic-resistant gonorrhea outbreak, we need to work together with local health jurisdictions and clinics to provide culturally competent and trauma-informed testing and care. […] The STD Surveillance Network (SSuN) is a collaborative network of state, county, and/or city health departments funded by the CDC to conduct sentinel and enhanced STD surveillance activities.

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