Title : Prevalence, Risk Factors, and Antibiotic Resistance of Neisseria Gonorrhoeae in Patients at STI Centers in Addis Ababa, Ethiopia: A Cross-Sectional case based Study
Abstract:
Background: Gonococcal infection is the most common sexually transmitted infection, affecting 82.4 million new adult cases each year. Early detection, treatment, and regular monitoring of antimicrobial resistance Neisseria gonorrhoeae are essential requirement to combat infection transmission. However, the burden and associated risk factors contribute to spread and develop antimicrobials resistance hasn’t been fully understood in Ethiopia. Thus, this study aimed to assess epidemiology, antimicrobial resistance profile, and risk factors associated with Neisseria Gonorrhoeae in selected health facilities in Addis Ababa, Ethiopia.
Methods: This case based cross sectional study was conducted from September 2023 to August 2024 in eight health facilities in Addis Ababa. Sample collection and processing, identification and antimicrobial susceptibility testing were performed according to CLSI guidelines. Socio-demographic and behavior data were collected using structured questionnaires. The data were analyzed using R and logistic regression to determine the associated risk factors. A p-value < 0.05 was considered statistically significant.
Results: Among 634 participants who were suspected of having STI, 125 (19.7%) were infected with Neisseria Gonorrhoeae. About three fourth of them were female (479 (75.6%)) and one fourth or 155 (24.4%) were male participants. Among the total study participants, 61 (39.4%) and 64 (13.4%) male and females respectively were positive for Neisseria Gonorrhoeae. About age categories, 25-29 adult aged (182, 30.1%) was highly infected, followed by young adult (153, 25.3%). Almost all tested isolates were developed resistance to Ciprofloxacin (100%), Penicillin (100%), and Tetracycline (99.2%). Azithromycin shows moderate resistance (4.8%). There is also some resistance rate to last resort treatment options i.e. Ceftriaxone and Cefixime showed 1.6% resistance. The prevalence rates of MDR, was 97%. Regarding risk factors; multiple sexual contact [AOR=4.4; 95%CI=1.9–8.2], having sex with prostitute [AOR=4.2; 95%CI=2.2–13.2], non-use of condom [AOR=4.2; 95%CI=2.2–13.2], were associated with the infection of N. gonorrhea.
Conclusions: The isolated N. gonorrhea revealed complete resistance to Ciprofloxacin, Penicillin and Tetracycline and some significant resistance was also emerging in last resort treatment options. Hence, strengthening surveillance, reproductive health education, and enhancing antimicrobial stewardship is a timely concern to combat the growing resistance to last-resort therapeutic options.
