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Review
. 2023 Jun;12(6):1505-1525.
doi: 10.1007/s40121-023-00814-0. Epub 2023 Jun 1.

Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis

Ariel Bardach  1 , Tomás Alconada  1 , Carolina Palermo  1 , Carlos Rojas-Roque  1 , María Macarena Sandoval  1 , Jorge Gomez  2 , Thatiana Pinto  3 , Agustin Ciapponi  4
Affiliations
Review

Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis

Ariel Bardach et al. Infect Dis Ther. 2023 Jun.

Abstract

Introduction: Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC).

Methods: We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries' ministries of health, and the IHME's Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies.

Results: We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00-2.00%) from 48 studies and 5.68% (95% CI 4.23-7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as "good" in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries' surveillance systems hinder the comparison of data.

Conclusion: The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea.

Trial registration: The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025).

Keywords: Caribbean; Economics; Epidemiology; Gonorrhoea; Latin America; Systematic review.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare: Jorge Gomez and Thatiana Pinto are employed by GSK. Jorge Gomez hold shares in GSK. Ariel Bardach, Tomás Alconada, Carolina Palermo, Carlos Rojas-Roque, Maria Macarena Sandoval, Agustin Ciapponi received funding from GSK to complete the work disclosed in this manuscript. Authors declare no other financial and non-financial relationships and activities and no conflicts of interest. This study was supported by GlaxoSmithKline Biologicals SA in the form of grants awarded and all costs associated with the development and publication of this manuscript.

Figures

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Fig. 1
Flow chart
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Fig. 2
Number of cases of gonococcal infection in the genitourinary tract in Mexico, 2011–2021 [146]
See this image and copyright information in PMC

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