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AuthorChemaitelly, Hiam
AuthorMajed, Alzahraa
AuthorAbu-Hijleh, Farah
AuthorBlondeel, Karel
AuthorMatsaseng, Thabo Christopher
AuthorKiarie, James
AuthorToskin, Igor
AuthorAbu-Raddad, Laith J.
Available date2023-09-06T18:29:55Z
Publication Date2021-03-01
Publication NameSexually Transmitted Infections
Identifierhttp://dx.doi.org/10.1136/sextrans-2020-054515
CitationChemaitelly, H., Majed, A., Abu-Hijleh, F., Blondeel, K., Matsaseng, T. C., Kiarie, J., ... & Abu-Raddad, L. J. (2021). Global epidemiology of Neisseria gonorrhoeae in infertile populations: systematic review, meta-analysis and metaregression. Sexually transmitted infections, 97(2), 157-169.‏
ISSN13684973
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85085978808&origin=inward
URIhttp://hdl.handle.net/10576/47313
AbstractObjective To provide an in-depth systematic assessment of the global epidemiology of gonorrhoea infection in infertile populations. Methods A systematic literature review was conducted up to 29 April 2019 on international databases and WHO regional databases, and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All prevalence measures of gonorrhoea infection among infertile populations, based on primary data, qualified for inclusion. Infertile populations were broadly defined to encompass women/men undergoing infertility evaluation or treatment (infertility clinic attendees and partners). Pooled mean prevalence by relevant strata was estimated using random-effects meta-analysis. Associations with prevalence and sources of heterogeneity were explored using metaregression. Risk of bias was assessed using four quality domains. Findings A total of 147 gonorrhoea prevalence studies were identified from 56 countries. The pooled mean prevalence of current gonorrhoea infection was estimated globally at 2.2% (95% CI 1.3% to 3.2%), with the highest prevalence in Africa at 5.0% (95% CI 1.9% to 9.3%). The mean prevalence was higher for populations with tubal factor infertility (3.6%, 95% CI 0.9%-7.7%) and mixed cause and unexplained infertility (3.6%, 95% CI 0.0% to 11.6%) compared with other diagnoses, such as ovarian and non-tubal infertility (0.1%, 95% CI 0.0% to 0.8%), and for secondary (2.5%, 95% CI 0.2% to 6.5%) compared with primary (0.5%, 95% CI 0.0% to 1.7%) infertility. Metaregression identified evidence of variations in prevalence by region and by infertility diagnosis, higher prevalence in women than men and a small-study effect. There was a trend of declining prevalence by about 3% per year over the last four decades (OR=0.97, 95% CI 0.95 to 0.99). Conclusions Gonorrhoea prevalence in infertile populations is several folds higher than that in the general population, with even higher prevalence in women with tubal factor infertility and in individuals with secondary infertility. These findings support the potential role of gonorrhoea in infertility and suggest that some infertility is possibly preventable by controlling gonorrhoea transmission.
Languageen
PublisherBMJ Journals
Subjectepidemiology (general)
gonorrhoea
infertility
Neisseria gonorrhoeae
TitleGlobal epidemiology of Neisseria gonorrhoeae in infertile populations: Systematic review, meta-analysis and metaregression
TypeArticle
Pagination157-169
Issue Number2
Volume Number97
dc.accessType Open Access


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