1.1 Introduction
Gonorrhea is currently the second most prevalent bacterial sexually transmitted infection (STI) and disease worldwide and, accordingly, gonorrhea remains a major public health concern. Historically, the strict human pathogen Neisseria gonorrhoeae has caused gonorrhea for thousands of years. The term gonorrhea can be attributed to the second century Greek physician Galen who coined the disease “as flow of seed”.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Neisseria gonorrhoeae (N. gonorrhoeae) is the causative agent of gonorrhea, which is one of the most prevalent sexually transmitted diseases (STD) and causes male ur-ethritis, female endocervicitis, and severe reproductive complications. It also increases the transmission of hu- man immunodeficiency virus, resulting in substantial morbidity and socioeconomic consequences (Cohen, 2012). The World Health Organization (WHO) estimated 106 mil- lion new cases of gonorrhea worldwide in 2008 (CDC, 2008). In
Nigeria, patients with N. gonorrhoeae visited STD clinics or hospital outpatient departments for treatment and 95,263 cases of gonorrhea were reported in 2012, making gonor- rhea the sixth most common infectious disease and the first most common STD (Zhang et al., 2015).
Management of N. gonorrhoeae infection is a serious challenge in the setting of increasing antimicrobial resist- ance (AMR) (Gerbase et al., 1998). The importance of AMR surveillance has been extensively elucidated (Olsen et al., 2011), particularly as treatment options for gonorrhea decreased because of the spread of resistance to sulfonamides, penicillin, tetracyc-line, and quinolone.
Nigeria established a national surveillance program to monitor AMR in 1987. Twenty-five N. gonorrhoeae AMR surveillance sentinel sites were distributed in 25 provinces of Nigeria based on the medical resource distribution and geographical representativeness, which were established by the Africa Center for Disease Control and Prevention (CDC). N. gonorrhoeae resistance cases were sent to Africa CDC by sentinel sites. Since 1992, Nigeria has been a part of WHO Western Pacific Regional (WPR) Gonococcal Antimicrobial Surveillance Programme. How- ever, we found that only two studies reported N. gonorrhoeae resistance to antimicrobials based on nationwide data from the surveillance program (Ye et al., 1994). Whereas, more than a hundred reports on N. gonorrhoeae AMR were based on data from one or a few surveillance sentinel sites, and these studies had obvious differences in settings, methods, findings, and some other characteristics. We conducted this systematic review in order to provide a comprehensive understanding of N. gonorrhoeae resistance to antmicrobials in Nigeria.
1.3 Statement of the Problem
Investigation reveals the following problems of the antimicrobial resistance and pathogenesis of Neisseria Gonorrhea research work;
Neisseria Gonorrhea resistance to antimicrobials is recognized by the WHO as a major health threat of the 21st century. Antimicrobial resistance threatens the effective prevention and treatment of an ever increasing range of infections. Infections such as tuberculosis and septicemia the scourge of earlier centuries - are once again killing patients at frightening rates.
Neisseria Gonorrhea resistance is driven by the continued use of antimicrobials and it is unlikely that the threat of resistance can be effectively mitigated by the discovery of new antimicrobials. We have used, or are using, our so-called drugs of last resort. There is nothing left in the armory and investments in new drugs are missing, we are moving into the post-antimicrobial era.
Neisseria gonorrhoeae infections may present as a broad range of symptoms and can affect urogenital, anorectal, pharyngeal, and conjunctival areas. Severe cases can lead to disseminated gonococcal infections, endocarditis, and meningitis; and in women, to pelvic inflammatory disease (PID).
1.4 Aim and Objectives of Study
The aim of the study is to examine the antimicrobial resistance and pathogenesis of Neisseria Gonorrhea. In achieving this aim, the following objectives were set out as follows;
- To determine the antimicrobial resistance in pathogenesis of Neisseria Gonorrhea
- To examine the evidence on N. gonorrhoeae resistance to penicillin, tetracycline, ciprofloxacin, ceftriaxone and spectinomycin in Nigeria
1.5 Research Questions
The researchers will attempt to answer the following research questions;
- What are the causes of Neisseria Gonorrhea in human body?
- Is there any side effect of antimicrobial resistance?
- Can antimicrobial resistance be used to prevent pathogenesis of Neisseria Gonorrhea in human body?
1.6 Significance of the Study
The study is crucial in global public health challenge and threatens our ability to treat infectious diseases such as; N. Gonorrhoeae. Resistance to first-line drugs also increases health care costs, since infections last longer (more days at the hospital) and become more expensive to treat.
The study will serve as reference material for subsequent researcher in the field or related topics, and also the study will be relevant to Doctors, Nurses, and Microbiologist.
1.7 Scope of the Study
The study focuses on the antimicrobial resistance and pathogenesis of Neisseria Gonorrhea.
1.8 Limitation of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this institution to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
- Research material: availability of research material is a major setback to the scope of the study.
