s Epidemiological Review of Gonococcal Infection

Gonorrhoea is a sexually transmitted infection caused by the diplococcus Neisseria gonorrhoeae. The infection is usually limited to the genital area, but it may also affect the pharyngeal or rectal mucosa, depending on sexual practices and can sometimes disseminate. This infection can also be vertically transmitted from a pregnant mother to the foetus at the time of delivery. Laboratory tests for the diagnosis of gonorrhoea are inexpensive and simple, with high sensitivity and specificity; antibiotic treatment is effective and can be administered during all stages of life. The current treatment for uncomplicated genital, rectal, and pharyngeal gonorrhoea is based on the use of third-generation cephalosporins as ceftriaxone and cefixime. For disseminated gonococcal infection, pelvic inflammatory disease, gonococcal meningitis or endocarditis, intravenous ceftriaxone and hospitalisation are recommended as the initial treatment. Despite the ease of diagnosis and treatment, the incidence of gonorrhoea has increased during the last decade, primarily among men who have sex with men. The most recent global data estimated by the World Health Organization (WHO) in 2005 revealed that there were 448 million new cases of curable STIs worldwide, of which 88 million were gonorrhoea, greater than 80% of all cases worldwide occur in developing countries. The Southeast Asia is the region where the highest rates of gonorrhoea incidence worldwide were registered , according to the WHO, in 2001, 27 million new cases of gonorrhoea were estimated to have occurred in, followed by Africa with 18.5 million cases occurring in and 7.5 million cases occurring in Latin America and the Caribbean. Education initiatives for sexual and reproductive health and systematic screening for gonorrhoea, especially among at-risk groups, are needed to produce substantial change in the incidence of this infection because it has been shown that interventions for curable sexually transmitted infections are cost effective.