ArticleJMIR public health and surveillance2020
Antimicrobial Resistance of Neisseria Gonorrhoeae in a Newly Implemented Surveillance Program in Uganda: Surveillance Report.
Article in JMIR public health and surveillance, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Antimicrobial Resistance inMedicina (Kaunas, Lithuania) · 2026Pooled it
- A systematic review of Neisseria gonorrhoeae drug resistance development in South Africa.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Pooled it
- Phenotypic and genotypic characterization ofJAC-antimicrobial resistance · 2026Article
- Prevalence of HIV and associated sociobehavioral factors among men with urethral discharge syndrome attending public health facilities in Kampala, Uganda.BMC infectious diseases · 2026Article
- Inequalities in non-HIV sexually transmitted infections in Uganda: a 22-year sex disaggregated trend analysis using WHO Health Equity Assessment Toolkit data.BMC infectious diseases · 2026Article
- Pathways, outputs and impact of NIH-supported bioinformatics and genomics graduate trainees in Africa.Briefings in bioinformatics · 2026Review
- Addressing the silent epidemic of antimicrobial resistance in the African region: a scoping review of evidence gaps and research considerations.BMJ public health · 2026Article
- Gonococcal cervicitis among women seeking fertility care in Uganda: Prevalence, antimicrobial susceptibility patterns, and associated factors in a multicenter cross-sectional study.PLOS global public health · 2026Article
- Detection of Transfusion Transmissible Infections Among Voluntary Blood Donors at a Regional Blood Bank in Western Uganda: A Cross-Sectional Study.Research and reports in tropical medicine · 2026Article
- Distribution and Factors Associated withInfectious disease reports · 2025Article
- Common Patterns and Unique Threats in Antimicrobial Resistance as Demonstrated by Global Gonococcal Surveillance.Emerging infectious diseases · 2024Article
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- Whole genome analysis and antimicrobial resistance ofFrontiers in microbiology · 2023Article
- Antimicrobial susceptibility surveillance and antimicrobial resistance inFrontiers in microbiology · 2023Review
- Current Susceptibility Surveillance and Distribution of Antimicrobial Resistance inPathogens (Basel, Switzerland) · 2022Review
- STI prevalence, incidence, and partner notification among women in a periconception HIV prevention program in Uganda.International journal of STD & AIDS · 2022Article
- High burden of untreated syphilis, drug resistant Neisseria gonorrhoeae, and other sexually transmitted infections in men with urethral discharge syndrome in Kampala, Uganda.BMC infectious diseases · 2022Article
- Retrospective Analysis of Ugandan Men with Urethritis Reveals Mycoplasma genitalium and Associated Macrolide Resistance.Microbiology spectrum · 2022Article
- Implementation of the World Health Organization Global Antimicrobial Resistance Surveillance System in Uganda, 2015-2020: Mixed-Methods Study Using National Surveillance Data.JMIR public health and surveillance · 2021Article
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundNeisseria gonorrhoeae (commonly known as gonorrhea) has developed resistance to all first-line therapy in Southeast Asia. East Africa has historically had absent or rudimentary gonorrhea surveillance programs and, while the existence of antimicrobial-resistant gonorrhea is recognized, the extent of its resistance is largely unknown. In 2016, the World Health Organization's Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP) was initiated in Uganda to monitor resistance trends.
objectiveThis study characterizes gonorrhea and antibiotic resistance in a large surveillance program of men with urethral discharge syndrome from Kampala, Uganda.
methodsMen attending sentinel clinics with urethritis provided demographic information, behavior data, and a urethral swab in line with the World Health Organization's EGASP protocols for culture, identification, and antibiotic-sensitivity testing using 2 methods-disk diffusion (Kirby-Bauer test) and Etest (BioMérieux Inc). A subset of samples underwent detailed antimicrobial resistance testing.
resultsOf 639 samples collected from September 2016 to February 2018, 400 (62.6%) were culture-positive though 414 (64.8%) had microscopic evidence of gonorrhea. The mean age of the men from whom the samples were collected was 26.9 (SD 9.6) years and 7.2% (46/639) reported having HIV. There was high-level resistance to ciprofloxacin, tetracycline, and penicillin (greater than 90%) by Kirby-Bauer disk diffusion and 2.1% (4/188) had reduced azithromycin sensitivity by Etest. Of the early isolates that underwent detailed characterization, 60.3% (70/116) were culture-positive, 94% (66/69) isolates were either ciprofloxacin-resistant or ciprofloxacin-intermediate by Etest, 96% (65/68) were azithromycin-sensitive, and 96% (66/69) were gentamicin-sensitive. Resistance profiles were comparable between methods except for ceftriaxone (disk diffusion: 68/69, 99%; Etest: 67/69, 97%) and for gentamicin (disk diffusion: 2/8, 25%; Etest: 66/69, 96%) sensitivity.
conclusionsThis is the first report from a systematic gonorrhea surveillance program in Uganda. Findings demonstrated resistance or increased minimum inhibitory concentration to all key antigonococcal antibiotics. There was evidence of poor antibiotic stewardship, near-universal resistance to several antibiotics, and emerging resistance to others. Individuals in the population sampled were at exceptionally high risk of STI and HIV infection requiring intervention. Ongoing surveillance efforts to develop interventions to curtail antimicrobial-resistant gonorrhea are needed.
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