Systematic review and meta-analysis show ongoing high prevalence of Neisseria gonorrhoeae infection in Canada, suggesting need for improved surveillance and prevention.
Key Points
The aim is to synthesize evidence on the prevalence and patterns of Neisseria gonorrhoeae infection in Canada over several decades.
Conducted a systematic review of studies published up to August 7, 2025.
Followed the Cochrane framework and PRISMA guidelines.
Performed random-effects meta-analyses to generate pooled prevalence estimates.
Used meta-regression analyses to identify associations and sources of heterogeneity.
Analyzed data from 136 publications covering 226 prevalence measures from 1969 to 2025.
Overall pooled prevalence for urogenital infection in the general population was 1.0%.
Among men who have sex with men, urogenital prevalence was 0.9%, anorectal was 2.6%, and oropharyngeal was 1.6%.
In STI clinic attendees, urogenital presence was 7.5%, anorectal was 2.5%, and oropharyngeal was 5.0%.
Symptomatic women's prevalence was 15.9% and men's was 37.4%.
Meta-regression analyses highlighted long-term decline and variation based on population type.