Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily affects the genital tract but can also infect the rectum, throat and eyes.
The infection spreads through vaginal, anal or oral sex and can also be passed from mother to child during childbirth, causing serious eye infections in newborns.
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Globally, gonorrhoea remains a major public health concern. In 2020, more than 82 million new infections were recorded globally, according to the World Health Organisation (WHO).
Nigeria also reports thousands of cases yearly, though many infections go undiagnosed due to asymptomatic cases, limited testing and under-reporting.
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Resistance to drugs
Multiple studies show that antibiotic resistance is making gonorrhoea much more complicated, and sometimes impossible, to treat. Standard antibiotics that once cured the infection reliably no longer work as effectively.
According to the WHO, there has been widespread resistance to older, cheaper antibiotics worldwide.
The global health body noted that in some countries, particularly high-income countries with the best surveillance, cases of the infection that are resistant to all known antibiotics are recorded.
Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi or parasites evolve to resist the medicines designed to kill them. When resistance develops, infections last longer, become harder to manage and spread more easily.
According to the US CDC, AMR develops mainly through misuse or overuse of antimicrobial medicines.
PREMIUM TIMES’ investigation last year found rising treatment failures for common infections such as urinary tract infections (UTIs), malaria and typhoid across Nigeria.
AMR is categorised as one of the principal public health problems of the 21st century, threatening effective prevention and control, according to health bodies and professionals.
Super gonorrhea
The growing resistance of Neisseria gonorrhoeae to antibiotics has led to what is now called “super gonorrhoea”, an infection that no longer responds to most available treatments.
The bacterium has developed resistance to nearly every antibiotic used against it over the decades, including penicillins, tetracyclines, macrolides and fluoroquinolones.
Teodora Wi, Medical Officer for Human Reproduction at the WHO, stated that the crisis is more likely to worsen over time.
“These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” Ms Wi was quoted to have said.
“The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” she added.
The US CDC also reported that among the known antibiotics for the disease, ceftriaxone is currently the only one highly effective for treatment.
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Untreated infection
If left untreated, gonorrhoea can cause severe and long-term complications. In women, it can lead to pelvic inflammatory disease (PID), infertility and increased risk of ectopic pregnancy.
In men, it can cause epididymitis and infertility.
The infection can also spread through the bloodstream, a condition known as disseminated gonococcal infection, which causes fever, joint pain and skin lesions. Though uncommon, this can be life-threatening.
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