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Prevalence and epidemiological patterns of Neisseria gonorrhoeae infection in sub-Saharan Africa, 1964–2025: Systematic review, meta-analyses, and meta-regressions

Author

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  • Aisha Osman
  • Hina Akram
  • Bayan Alemrayat
  • Sumaya Al-Maraghi
  • Manale Harfouche
  • Laith J Abu-Raddad

Abstract

Background: Neisseria gonorrhoeae (NG) infection is a global health concern because of its morbidity and increasing antimicrobial resistance. Sub-Saharan Africa is believed to carry a disproportionately high burden of NG infection, but the epidemiology of NG infection in this region has not been comprehensively synthesized. This study systematically reviewed and analyzed NG prevalence in sub-Saharan Africa to characterize prevalence patterns and identify populations at risk. Methods and findings: A systematic review was conducted and reported following PRISMA guidelines. Embase, PubMed, Scopus, and Web of Science were searched from inception to June 4, 2025. Eligible studies reported NG prevalence in sub-Saharan Africa. Random-effects meta-analyses generated pooled prevalence estimates, and random-effects meta-regression analyses identified associations and sources of heterogeneity. Conclusions: NG prevalence remains markedly high in this region but has declined over time. These findings highlight the need for strengthened surveillance, expanded prevention and diagnostic strategies, and continued monitoring of gonococcal antimicrobial resistance to support effective control efforts in sub-Saharan Africa. Why was this study done?: What did the researchers do and find?: What do these findings mean?:

Suggested Citation

  • Aisha Osman & Hina Akram & Bayan Alemrayat & Sumaya Al-Maraghi & Manale Harfouche & Laith J Abu-Raddad, 2026. "Prevalence and epidemiological patterns of Neisseria gonorrhoeae infection in sub-Saharan Africa, 1964–2025: Systematic review, meta-analyses, and meta-regressions," PLOS Medicine, Public Library of Science, vol. 23(6), pages 1-100, June.
    • Handle: RePEc:plo:pmed00:1004936
    DOI: 10.1371/journal.pmed.1004936
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