Rising incidence of gonorrhea in Taiwan amid the COVID-19 pandemic: a nationwide surveillance study

Background The protracted battle against coronavirus disease 2019 (COVID-19) has had a profound impact on various facets of society. The epidemiology of several diseases underwent alterations following the implementation of social restrictive strategies and non-pharmaceutical interventions (NPI). Methods In response to these changes, we conducted a retrospective nationwide surveillance study to investigate the prevalence of sexually transmitted infections during the pandemic. Weekly incidences of gonorrhea, syphilis, human immunodeficiency virus (HIV), and enterovirus were extracted from the national surveillance database. Results Over the period from 2015 to 2022, a sustained increase in gonorrhea notifications was evident (linear trend with a rising slope of 0.24 and an R-squared value of 0.62). When comparing the pre-pandemic period (2017–2019) with the pandemic period (2020–2022), a significant surge in gonorrhea notifications was observed (85 notifications per week pre-pandemic vs 143 notifications during the pandemic, representing a 68% increase, P < 0.01). Further interrupted time series analysis revealed a significant monthly increase of 3.79 gonorrhea notifications during the pandemic. Conversely, declines in syphilis, HIV, and enterovirus incidences were noted (186 vs 177, 41 vs 25, and 3906 vs 2863 weekly notifications for syphilis, HIV, and enterovirus, respectively). A literature review indicated conflicting epidemiological trends in different regions. Conclusions Our study highlights a significant rise in gonorrhea notifications during the pandemic. Despite disruptions to gonorrhea testing and medical services, and the implementation of NPI, there was no significant decrease in the incidence of gonorrhea in Taiwan. Gonorrhea emerged as a critical public health concern during the pandemic.