Letter: Liver flukes: a warning.

Abstract

<h3>Background</h3> Brazil has a nationwide antimicrobial susceptibility surveillance program for Neisseria gonorrhoeae. Gonorrhoea, however, is not a notifiable disease and there are limited data on the burden of infection in the country. <h3>Methods</h3> We searched Embase PubMed, LILACS, Scielo for studies in any language providing data on the prevalence of urogenital gonorrhoea in 2000 or later in Brazil, with a sample size of 50 or more, and that used an internationally recognized diagnostic test on urine, urethral, or cervicovaginal specimens. The latest search was done on 10 November, 2020. In addition, we searched abstracts from the Brazilian STI congress (years 2010 to 2019) and Ministry of Health reports. The Spectrum-STI statistical model was used to estimate prevalence trends in 15–49 years-old men and women in the general population (excluding STI patients, HIV-positive populations and Transgender women). Prevalence trends were estimated for sexually active women and men, female sex workers and men who have sex with men. For populations with 3 or fewer prevalence data points Spectrum-STI uses time constant prevalence ratios from the WHO 2016 global STI estimates. Population size estimates were from Brazil’s National Survey of Knowledge, Attitudes and Practices of HIV and other STIs (PCAP-2013). <h3>Results</h3> We identified 48 studies that met the study entry criteria providing 47 data points for women and 7 for men. After excluding studies done exclusively in HIV positive individuals or individuals seeking STI treatment we had 29 data points for women and 6 for men. The Spectrum-STI national prevalence estimate for 2020 for adult women was 0.63%(0.13–2.23) and for men 0.70%(0.16–2.44). <h3>Conclusion</h3> The prevalence of urogenital gonorrhoea in Brazil appears to be low. Data on the prevalence in men, however, are very limited. The results from this study are being used to inform the design and prioritization of new surveillance surveys.