Gonococcal cervicitis among women seeking fertility care in Uganda: Prevalence, antimicrobial susceptibility patterns, and associated factors in a multicenter cross-sectional study
4 affiliations
- 1Department of Obstetrics and Gynecology, Kampala International University, Ishaka, Uganda
- 2Department of Pediatrics and Child Health, Kampala International University, Ishaka, Uganda
- 3Department of Ophthalmology, Kampala International University, Ishaka, Uganda
- 4Department of Sciences, University of Rwanda, Kigali, Rwanda
Abstract
Gonococcal cervicitis can contribute to reproductive tract complications and infertility, yet evidence from fertility-care settings in Uganda remains limited. This study determined its prevalence, antimicrobial susceptibility patterns, and associated factors among women seeking fertility care at three tertiary hospitals in Uganda. We conducted a multicenter cross-sectional study involving 402 women seeking fertility care at three tertiary hospitals in Uganda from 10th September 2025 and 10th January 2026. Endocervical swabs were cultured for Neisseria gonorrhoeae, and isolates underwent antimicrobial susceptibility testing. Factors associated with gonococcal cervicitis were assessed using bivariable and multivariable logistic regression. Of the 402 participants, 34 had culture-confirmed gonococcal cervicitis, for an overall prevalence of 8.5% (95% CI, 6.1%–11.6%). Site-specific prevalence was 10.4% at the Jinja Regional Referral Hospital and 7.5% at both Lira and Kayunga Regional Referral Hospitals, with no significant between-site difference (p = 0.598). Among the 34 isolates, susceptibility was highest to ceftriaxone and azithromycin (94.1% each), whereas resistance was common to penicillin (64.7%), ciprofloxacin (58.8%), and tetracycline (58.8%). Independent factors associated with gonococcal cervicitis were having three or more lifetime sexual partners (adjusted odds ratio [AOR], 5.25; 95% CI, 1.65–16.72), vaginal douching (AOR, 5.59; 95% CI, 1.83–17.03), current oral contraceptive use (AOR, 8.32; 95% CI, 2.94–23.54), HIV seropositivity (AOR, 5.00; 95% CI, 1.82–13.76), and a new sexual partner in the previous 3 months (AOR, 7.92; 95% CI, 2.68–23.41). Gonococcal cervicitis was common among women seeking fertility care at these Ugandan tertiary hospitals. The observed resistance to penicillin, ciprofloxacin, and tetracycline, together with preserved susceptibility to ceftriaxone and azithromycin, supports culture-informed treatment and targeted screening in fertility clinics.
Related
- Importance of the gonococcal MtrCDE efflux pump system in decreasing bacterial susceptibility to zoliflodacin: implications for future clinical treatment of gonorrhea
- Economic Barriers to Antimicrobial Susceptibility Testing as a Structural Contributor to Antimicrobial Resistance in Low- and Middle-Income Countries: A Narrative Review.
- A call for sharing phenotypic antimicrobial susceptibility data alongside bacterial genome sequence data in public archives
- Antimicrobial Susceptibility of Genital Ureaplasma spp. and Mycoplasma hominis
- Rapid identification and antimicrobial susceptibility testing of pathogenic microorganisms from positive blood cultures
BibTeX
@article{amina2026gonococcal,
title = {{Gonococcal cervicitis among women seeking fertility care in Uganda: Prevalence, antimicrobial susceptibility patterns, and associated factors in a multicenter cross-sectional study}},
author = {Mohamed Mire Amina and Musa Kasujja and Marie Pascaline Sabine Ishimwe and Amina Aden Ahmed and Hudaifa Iman Yusuf and Theodore Nteziyaremye and Bahja Ahmed Mumin and Ali Abdow Hafsa and Mohamed Farah Ismail and Adam Abdrahim Sulaiman Ebaid and Jean de Dieu Rukamba and Ronard Musinguzi and Sawda Abdikarim Sheikh Isse and Theoneste Hakizimana},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0006796},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006796},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Gonococcal cervicitis among women seeking fertility care in Uganda: Prevalence, antimicrobial susceptibility patterns, and associated factors in a multicenter cross-sectional study
AU - Mohamed Mire Amina
AU - Musa Kasujja
AU - Marie Pascaline Sabine Ishimwe
AU - Amina Aden Ahmed
AU - Hudaifa Iman Yusuf
AU - Theodore Nteziyaremye
AU - Bahja Ahmed Mumin
AU - Ali Abdow Hafsa
AU - Mohamed Farah Ismail
AU - Adam Abdrahim Sulaiman Ebaid
AU - Jean de Dieu Rukamba
AU - Ronard Musinguzi
AU - Sawda Abdikarim Sheikh Isse
AU - Theoneste Hakizimana
PY - 2026
DA - 2026/09/08
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0006796
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006796
AB - Gonococcal cervicitis can contribute to reproductive tract complications and infertility, yet evidence from fertility-care settings in Uganda remains limited. This study determined its prevalence, antimicrobial susceptibility patterns, and associated factors among women seeking fertility care at three tertiary hospitals in Uganda. We conducted a multicenter cross-sectional study involving 402 women seeking fertility care at three tertiary hospitals in Uganda from 10th September 2025 and 10th January 2026. Endocervical swabs were cultured for Neisseria gonorrhoeae, and isolates underwent antimicrobial susceptibility testing. Factors associated with gonococcal cervicitis were assessed using bivariable and multivariable logistic regression. Of the 402 participants, 34 had culture-confirmed gonococcal cervicitis, for an overall prevalence of 8.5% (95% CI, 6.1%–11.6%). Site-specific prevalence was 10.4% at the Jinja Regional Referral Hospital and 7.5% at both Lira and Kayunga Regional Referral Hospitals, with no significant between-site difference (p = 0.598). Among the 34 isolates, susceptibility was highest to ceftriaxone and azithromycin (94.1% each), whereas resistance was common to penicillin (64.7%), ciprofloxacin (58.8%), and tetracycline (58.8%). Independent factors associated with gonococcal cervicitis were having three or more lifetime sexual partners (adjusted odds ratio [AOR], 5.25; 95% CI, 1.65–16.72), vaginal douching (AOR, 5.59; 95% CI, 1.83–17.03), current oral contraceptive use (AOR, 8.32; 95% CI, 2.94–23.54), HIV seropositivity (AOR, 5.00; 95% CI, 1.82–13.76), and a new sexual partner in the previous 3 months (AOR, 7.92; 95% CI, 2.68–23.41). Gonococcal cervicitis was common among women seeking fertility care at these Ugandan tertiary hospitals. The observed resistance to penicillin, ciprofloxacin, and tetracycline, together with preserved susceptibility to ceftriaxone and azithromycin, supports culture-informed treatment and targeted screening in fertility clinics.
SN - 2767-3375
ER -