Epidemiology of gonorrhoea

Last updated

Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae . [1]

Contents

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. [2]

Canada

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). It was also increasing faster among men than women (85.2% versus 39.5% in 2010–2015). People between 15 and 29 years old had the highest rate. Geographically, the highest gonorrhoea rates in 2015 were found in the Northwest Territories, Nunavut and Yukon. [3]

Nordic countries

Notified cases of gonorrhea among men in Nordic countries (2000-2020) Notified cases of gonorrhea among men in Nordic countries (2000-2020).svg
Notified cases of gonorrhea among men in Nordic countries (2000–2020)
Notified cases of gonorrhea among women in Nordic countries (2000-2020) Notified cases of gonorrhea among women in Nordic countries (2000-2020).svg
Notified cases of gonorrhea among women in Nordic countries (2000–2020)

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]

Greenlandic women have the highest incidence rate. In contrast to the other Nordic countries, in Greenland, the numbers of cases among women and among men are almost equally high. Incidence rates are significantly lower in the other Nordic countries. However, cases are rising in Denmark, Iceland, Norway and Sweden. The Faroe Islands has relatively few cases. [4]

United Kingdom

Rates of selected STI diagnoses among England residents accessing sexual health services by ethnicity and STI, 2022 Figure 3 - Rates of selected STI diagnoses among England residents accessing sexual health services by ethnicity and STI, 2022.svg
Rates of selected STI diagnoses among England residents accessing sexual health services by ethnicity and STI, 2022

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. [5]

Diagnoses were increasing in people of all ages in England, but the rise was highest among young people aged 15 to 24 years. [5] This trend was also detected in Scotland. [6]

United States

Sexually transmitted disease surveillance 2020 Sexually transmitted disease surveillance 2020.pdf
Sexually transmitted disease surveillance 2020

Sexually transmitted disease surveillance 2020 published by the Centers for Disease Control and Prevention (CDC) showed that, in 2020, a total of 677,769 cases of gonorrhea were reported to the CDC, a 45 percent increase from 2016, [7] 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. During 2019–2020, the overall rate of reported gonorrhea increased 5.7%; rates increased among both males and females and in three regions of the United States (Midwest, Northeast, and South); rates of reported gonorrhea increased in 36 states and two US territories. [8]

Since 2013, rates have been higher among men compared to women, likely reflecting cases identified in both men who have sex with men (MSM) and men who have sex with women only. Although there are limited data available on sexual behaviors of persons reported with gonorrhea at the national level, enhanced data from jurisdictions participating in a sentinel surveillance system, the STD Surveillance Network (SSuN), suggest that about a third of gonorrhea cases occurred among MSM in 2020. During 2019–2020, rates increased among both men and women, but increases were greater among women (15%) compared to men (6.6%) which may reflect differences in diagnosing and reporting of cases among MSM in 2020. As extragenital infections are often asymptomatic and are likely identified by screening, diagnoses among MSM may have been reduced in 2020 due to the effect of the COVID-19 pandemic on screening coverage. [8]

Gonorrhoea can quickly develop resistance to antibiotics used to treat infection, and in 2020, about half of all infections were estimated to be resistant to at least one antibiotic. Since 2010, almost all circulating strains in the United States, based on gonococcal isolates collected through sentinel surveillance in the Gonococcal Isolate Surveillance Project (GISP), remain susceptible to ceftriaxone, the primary treatment for gonorrhea; only 0.1% of isolates displayed elevated ceftriaxone minimum inhibitory concentrations (MICs) in 2020. In 2020, 5.8% of isolates had elevated azithromycin MICs; the proportion was higher among MSM compared to men who have sex with women only (9.2% vs 4.3%). [8]

Related Research Articles

<span class="mw-page-title-main">Chlamydia</span> Sexually transmitted infection caused by the bacterium Chlamydia trachomatis

Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. Most people who are infected have no symptoms. When symptoms do appear they may occur only several weeks after infection; the incubation period between exposure and being able to infect others is thought to be on the order of two to six weeks. Symptoms in women may include vaginal discharge or burning with urination. Symptoms in men may include discharge from the penis, burning with urination, or pain and swelling of one or both testicles. The infection can spread to the upper genital tract in women, causing pelvic inflammatory disease, which may result in future infertility or ectopic pregnancy.

<span class="mw-page-title-main">Pelvic inflammatory disease</span> Infection of uterus, fallopian tubes, ovaries or the inner surface of pelvis

Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, mainly the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be no symptoms. Signs and symptoms, when present, may include lower abdominal pain, vaginal discharge, fever, burning with urination, pain with sex, bleeding after sex, or irregular menstruation. Untreated PID can result in long-term complications including infertility, ectopic pregnancy, chronic pelvic pain, and cancer.

<span class="mw-page-title-main">Syphilis</span> Sexually transmitted infection

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms depend on the stage it presents: primary, secondary, latent or tertiary. The primary stage classically presents with a single chancre though there may be multiple sores. In secondary syphilis, a diffuse rash occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. Latent syphilis has no symptoms and can last years. In tertiary syphilis, there are gummas, neurological problems, or heart symptoms. Syphilis has been known as "the great imitator" because it may cause symptoms similar to many other diseases.

Urethritis is the inflammation of the urethra. The most common symptoms include painful or difficult urination and urethral discharge. It is a commonly treatable condition usually caused by infection with bacteria. This bacterial infection is often sexually transmitted, but not in every instance; it can be idiopathic, for example. Some incidence of urethritis can appear asymptomatic as well.

<i>Neisseria gonorrhoeae</i> Species of bacterium

Neisseria gonorrhoeae, also known as gonococcus (singular) or gonococci (plural), is a species of Gram-negative diplococci bacteria first isolated by Albert Neisser in 1879. As an obligate human pathogen, it primarily colonizes the mucosal lining of the urogenital tract; however, it is also capable of adhering to the mucosa of the nose, pharynx and rectum, and the eyes. It causes the sexually transmitted genitourinary infection gonorrhea as well as other forms of gonococcal disease including disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum.

Men who have sex with men (MSM) are men who engage in sexual activity with other men, regardless of their sexual orientation or sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spread of sexually transmitted infections such as HIV/AIDS between all sexually active males, not strictly those identifying as gay, bisexual, pansexual or various other sexualities, but also for example male prostitutes. The term is often used in medical literature and social research to describe such men as a group. It does not describe any specific kind of sexual activity, and which activities are covered by the term depends on context. The alternative term "males who have sex with males" is sometimes considered more accurate in cases where those described may not be legal adults.

HIV/AIDS in China can be traced to an initial outbreak of the human immunodeficiency virus (HIV) first recognized in 1989 among injecting drug users along China's southern border. Figures from the Chinese Center for Disease Control and Prevention, World Health Organization, and UNAIDS estimate that there were 1.25 million people living with HIV/AIDS in China at the end of 2018, with 135,000 new infections from 2017. The reported incidence of HIV/AIDS in China is relatively low, but the Chinese government anticipates that the number of individuals infected annually will continue to increase.

Venereology is a branch of medicine that is concerned with the study and treatment of sexually transmitted diseases (STDs). The name derives from Roman goddess Venus, associated with love, beauty and fertility. A physician specializing in venereology is called a venereologist. In many areas of the world, the specialty is usually combined with dermatology.

<span class="mw-page-title-main">Genital ulcer</span> Ulcer located on the genital area

A genital ulcer is an open sore located on the genital area, which includes the vulva, penis, perianal region, or anus. Genital ulcers are most commonly caused by infectious agents. However, this is not always the case, as a genital ulcer may have noninfectious causes as well.

<span class="mw-page-title-main">Gonorrhea</span> Sexually transmitted infection

Gonorrhoea or gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. Infection may involve the genitals, mouth, or rectum. Infected males may experience pain or burning with urination, discharge from the penis, or testicular pain. Infected females may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. Complications in females include pelvic inflammatory disease and in males include inflammation of the epididymis. Many of those infected, however, have no symptoms. If untreated, gonorrhea can spread to joints or heart valves.

<span class="mw-page-title-main">Sexually transmitted infection</span> Infection transmitted through human sexual behavior

A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of transmitting them on to others. The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes cases with no symptomatic disease. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.

Since the first HIV/AIDS case in Laos was identified in 1990, the number of infections has continued to grow. In 2005, UNAIDS estimated that 3,700 people in Laos were living with HIV.

HIV/AIDS in Jordan is characterized by a low prevalence rate compared to other regions, but the situation remains a concern due to potential for increase and the social and economic consequences that could result. As of 2007, the UNAIDS estimated that there were approximately 380 people living with HIV/AIDS (PLWHA) in Jordan. Despite the relatively low numbers, the country faces challenges in addressing the epidemic, including inadequate surveillance systems, limited adoption of preventive practices, and persistent stigma and discrimination against PLWHA.

The Philippines has one of the lowest rates of infection of HIV/AIDS, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

HIV/AIDS in El Salvador has a less than 1 percent prevalence of the adult population reported to be HIV-positive. El Salvador therefore is a low-HIV-prevalence country. The virus remains a significant threat in high-risk communities, such as commercial sex workers (CSWs) and men who have sex with men (MSM).

Honduras is the Central American country most adversely affected by the HIV/AIDS epidemic. It is estimated that the prevalence of HIV among Honduran adults is 1.5%.

<span class="mw-page-title-main">Gonococcemia</span> Medical condition

Gonococcemia is a rare complication of mucosal Neisseria gonorrhoeae infection, or Gonorrhea, that occurs when the bacteria invade the bloodstream. It is characterized by fever, tender hemorrhagic pustules on the extremities or the trunk, migratory polyarthritis, and tenosynovitis. It also rarely leads to endocarditis and meningitis. This condition occurs in 0.5-3% of individuals with gonorrhea, and it usually presents 2–3 weeks after acquiring the infection. Risk factors include female sex, sexual promiscuity, and infection with resistant strains of Neisseria gonorrhoeae. This condition is treated with cephalosporin and fluoroquinolone antibiotics.

<span class="mw-page-title-main">Epidemiology of syphilis</span> Eradication efforts and prevalence of syphilis

Syphilis is a bacterial infection transmitted by sexual contact and is believed to have infected 12 million people in 1999 with greater than 90% of cases in the developing world. It affects between 700,000 and 1.6 million pregnancies a year, resulting in spontaneous abortions, stillbirths, and congenital syphilis. In Sub-Saharan Africa syphilis contributes to approximately 20% of perinatal deaths.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

Human sexual promiscuity is the practice of having many different sexual partners. In the case of men, this behavior of sexual nondiscrimination and hypersexuality is referred to as satyriasis, while in the case of women, this behavior is conventionally known as nymphomania. Both conditions are regarded as possibly compulsive and pathological qualities, closely related to hyper-sexuality. The results of, or costs associated with, these behaviors are the effects of human sexual promiscuity.

References

  1. "Gonorrhea – CDC Fact Sheet (Detailed Version)". U.S. Centers for Disease Control and Prevention. 17 November 2015. Archived from the original on 2 September 2016. Retrieved 27 August 2016.
  2. Kirkcaldy RD, Weston E, Segurado AC, Hughes G (September 2019). "Epidemiology of gonorrhoea: a global perspective". Sexual Health. 16 (5): 401–411. doi:10.1071/SH19061. PMC   7064409 . PMID   31505159.
  3. Choudhri Y, Miller J, Sandhu J, Leon A, Aho J (February 2018). "Gonorrhea in Canada, 2010-2015" (PDF). Canada Communicable Disease Report. 44 (2): 37–42. doi:10.14745/ccdr.v44i02a01. PMC   5933854 . PMID   29770097.
  4. 1 2 Nordic Medico-Statistical Committee (NOMESCO); Nordic Social Statistical Committee (NOSOSCO). "Sexually transmitted diseases in the Nordic countries". Nordic Health and Welfare Statistics. Retrieved 2023-07-07.
  5. 1 2 "Sexually transmitted infections and screening for chlamydia in England: 2022 report". GOV.UK. Retrieved 2023-07-07.
  6. "Gonorrhoea infection in Scotland - Gonorrhoea infection in Scotland - Publications". Public Health Scotland. Retrieved 2023-07-07.
  7. Garcia, Michael Ray; Leslie, Stephen W.; Wray, Anton A. (2024), "Sexually Transmitted Infections", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32809643 , retrieved 2024-09-20
  8. 1 2 3 National Center for HIV, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of STD Prevention (10 April 2023). "Sexually transmitted disease surveillance 2020". U.S. Centers for Disease Control and Prevention. Retrieved 2023-07-07.PD-icon.svg This article incorporates text from this source, which is in the public domain .