title: Gonorrhea surveillance in Ghana, Africa.
abstract: OBJECTIVE
  We face the specter of global transmission of highly resistant Neisseria gonorrhoeae. The U.S. Department of Defense's Armed Forces Health Surveillance Center has engaged many military and civilian partners (including Ghana) in a sexually transmitted infections (STI) program to address emerging needs in STI surveillance. We implemented gonorrhea surveillance in Ghana to fill the gap in knowledge regarding gonorrhea prevalence and antimicrobial resistance characterization in Ghana.
  
  
  METHODS
  Gonorrhea surveillance was conducted from June 2012 to March 2013 as one of the AFHSC surveillance network partners at two Ghana Armed Forces (GAF) military clinics. The population encompassed a convenience sampling of patients presenting with STI symptoms. Urine was taken for nucleic acid amplification testing (NAAT). A urethral or cervical/vaginal specimen was obtained for culture and antibiotic susceptibility testing.
  
  
  RESULTS
  13/220 (6%) specimens tested were positive by culture (7 of which were confirmed); and 39/213 (18%) specimens tested were positive by NAAT. Positive results were biased toward men. Cultures were resistant to ciprofloxacin, penicillin and tetracycline and sensitive to cephalosporins.
  
  
  CONCLUSIONS
  This investigation provides data on gonorrhea prevalence and resistance profiles in Ghana hitherto poorly characterized. We note significant resistance to fluoroquinolones without the presence of resistance yet to the cephalosporins.
authors.affiliation: Naval Medical Research Center, Biological Defense Research Directorate, Silver Spring, MD 20904.
authors.forename: Christopher
authors.initials: C
authors.lastname: Duplessis
authors.affiliation: U.S. Naval Medical Research Unit No. 3, NAMRU-3, PSC 452 Box 5000, FPO AE 09835-9998, 3A Imtidad Ramses Street, Adjacent to Abbassia Fever Hospital Abbassia, Cairo, Egypt 11517.
authors.forename: Naiki
authors.initials: N
authors.lastname: Puplampu
authors.affiliation: Ghana Armed Forces, Ghana Africa General Headquarters Burma Camp-Accra.
authors.forename: Edward
authors.initials: E
authors.lastname: Nyarko
authors.affiliation: Ghana Armed Forces, Ghana Africa General Headquarters Burma Camp-Accra.
authors.forename: John
authors.initials: J
authors.lastname: Carroll
authors.affiliation: U.S. Naval Medical Research Unit No. 3, NAMRU-3, PSC 452 Box 5000, FPO AE 09835-9998, 3A Imtidad Ramses Street, Adjacent to Abbassia Fever Hospital Abbassia, Cairo, Egypt 11517.
authors.forename: Helena
authors.initials: H
authors.lastname: Dela
authors.affiliation: Ghana Armed Forces, Ghana Africa General Headquarters Burma Camp-Accra.
authors.forename: Akussah
authors.initials: A
authors.lastname: Mensah
authors.affiliation: Ghana Armed Forces, Ghana Africa General Headquarters Burma Camp-Accra.
authors.forename: Akussah
authors.initials: A
authors.lastname: Amponsah
authors.affiliation: Armed Forces Health Surveillance Center (AFHSC) and Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), 11800 Tech Road, Suite 220, Silver Spring, MD 20904.
authors.forename: Jose
authors.initials: J
authors.lastname: Sanchez
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006069:Gonorrhea / Q000453:epidemiology* / Q000382:microbiology*; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000302:isolation & purification; D010044:Outpatient Clinics, Hospital; D011159:Population Surveillance; D015995:Prevalence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents