Gonorrhea in the Russian Federation: incidence, active case detection and laboratory diagnostics

Background. Gonorrhea is a possible cause of pelvic inflammatory complications, reproductive health disorders and adverse pregnancy outcomes. The problem of gonococcal antimicrobial resistance remains actual. Aims. Analysis of incidence, circumstances of case detection, and methods of laboratory examination for gonococcal infection used in the Russian Federation. Methods. Analysis of state federal statistical surveillance data for 2011–2024. Results. In 2011–2019, the incidence of gonorrhea decreased fivefold, the incidence of total STI — by 2.5 times. In 2020, the incidence of gonorrhea decreased by 13%, STI — 25%. After gonorrhea incidence increase in 2021 and 2022, it was reduced by 4% in 2023, by 15% in 2024. During COVID-19 pandemic, there was a decrease of proportion of patients detected in hospitals (from 1.6% in 2019 to 0.8% in 2020–2024); at medical examinations (from 3.0% in 2019 to 1.7% in 2023); and actively by dermatovenereologists (from 16.2% in 2019 to 12.4% in 2023). In 2019–2024, the proportion of cases confirmed by molecular-biological laboratory examination increased from 27 to 57%. In 2024, molecular-biological, microbiological or both methods were not used to diagnose gonococcal infection in state medical organizations respectively of 13, 42 and 5 constituent entities of the Russian Federation. Conclusion. The distinctive features of gonorrhea incidence dynamics during COVID-19 pandemic are lack of acceleration in decline rate in 2020, and incidence increase in 2021 and 2022, due to an increase in the number of cases among Russian citizens. Against the background of a resumption of gonorrhea incidence decrease in 2023 and 2024, there is no recovery of active case detection measures. The access to highly sensitive laboratory methods in medical organizations of state healthcare system of a number of constituent entities of the Russian Federation is not ensured.