Background
One of the critical agents responsible for sexually transmitted infections (STIs) remains Neisseria gonorrhoeae in several countries with increasing antimicrobial resistance. During routine diagnostic activities in the national public health laboratory, we observed an abnormal frequency in isolation of Neisseria gonorrhoeae. This retrospective study aims to characterize the epidemiology and temporal trends of Neisseria gonorrhoeae isolates in Togo from 2010 to February 2026.
Methods
We describe the trend of Neisseria gonorrhoeae isolations from clinical specimens at the “Institut national d’hygiène” in Lome from 2010 to 2026. Biological samples suspected of urinary and genital tracts infections and infertility assessment, were collected and were processed according to standard microbiological protocols. Isolate identification was performed. Demographic and specimen data were recorded and prevalence of isolate was calculated using EPI-info 7.2.5.0 and temporal trends were analyzed using linear regression and chi-square test for linear trend at a significance threshold of 0.05.
Results
A total of 583 Neisseria gonorrhoeae isolates were collected. The mean age was 31.5 years (median: 30 years). Gender distribution showed 95.6% males (n=561) and 3.7% females (n=22). By specimen type, urethral specimens predominated with 91.9% prevalence (536/583; 95% CI: 89.7-94.2%), followed by vaginal specimens (3.8%; 95% CI: 2.2-5.3%), urine (3.8%; 95% CI: 2.2-5.3%) and seminal specimens (0.5%; 95% CI: 0.0-1.1%). Annual isolation rates demonstrated a significant upward trend over the study period. Isolate numbers increased from 4 cases in 2010 to peak at 76 isolates in 2022, followed by 51-55 isolates annually in 2024-2025, with 13 isolates reported through February 2026. Linear trend analysis demonstrated a statistically significant increase in Neisseria gonorrhoeae isolation rates over time (p = 0.0017).
Conclusion
This study demonstrates a significant upward temporal trend in N. gonorrhoeae isolation in the national public health laboratory of Togo, highlighting the increasing burden of gonococcal infections with urethral specimens being the predominant source. The increasing trend in gonococcal infections highlights the need for enhanced surveillance, infection control programs, and public health interventions targeting STI prevention and management in the country.