Analysis of the sex ratio of reported gonorrhoea incidence in Shenzhen, China

Xiong, Mingzhou; Lan, Lina; Feng, Tiejian; Zhao, Guanglu; Wang, Feng; Hong, Fuchang; Wu, Xiaobing; Zhang, Chunlai; Wen, Lizhang; Liu, Aizhong; Best, John McCulloch; Tang, Weiming

Gonorrhoea is a pyogenic infection of the urogenital system caused by Neisseria gonorrhoeae (NG) that can cause epididymitis and prostatitis in men, and endometritis and pelvic inflammatory disease in women, 1 and can ultimately lead to infertility in men and women. 2 Females are more susceptible to NG infection than males due to differences in the structure of the respective reproductive systems, and nearly half of the female infections are asymptomatic. 3 4 According to the WHO estimates in 2008, gonorrhoea is the most frequently sexually transmitted bacterial infection in the world, with approximately 106.1 million new cases diagnosed every year. 5 In 2012, China reported 95 263 new gonorrhoea cases, resulting in an reported incidence of 7.07/100 000. The gonorrhoea epidemic was especially prominent in Guangdong, which reported 18 014 new cases with a reported incidence of 17.15/ 100, 000. 6 Over the past several decades, newly reported cases of gonorrhoea within Guangdong province consistently ranked within the top five provinces in China. Shenzhen, a part of the Guangdong province located in south coastal China and adjacent to Hong Kong, has witnessed an alarmingly rapid spread of sexually transmitted diseases (STDs) in recent years. 7 The reported gonorrhoea incidence in Shenzhen was 51.5/ Strengths and limitations of this study â–ª The reported gonorrhoea incidence is underestimated among both males and females, and this trend is significantly higher among females. â–ª The reported gonorrhoea incidence sex ratio has been overestimated by a factor of 7.9. â–ª Updated diagnostic criteria for gonorrhoea and a set-up active surveillance system in China are suggested to improve the accuracy of reported gonorrhoea incidence. â–ª False reference results and selection bias may exist, although we have tried our best to avoid them.