Antimicrobial Resistance in Sexually Transmitted Infections Poses Growing Concern in Nigeria

A recent report has highlighted the increasing threat of antimicrobial resistance (AMR) in sexually transmitted infections (STIs) in Nigeria. The 2023-2024 Nigeria Demographic and Health Survey revealed that 14% of men and 16% of women aged 15-49 have had an STI or STI-related symptoms within the past 12 months. Despite this high prevalence, fear of stigma often leads individuals to self-medicate, exacerbating the problem of AMR.

The misuse of antibiotics is a significant factor contributing to AMR. A survey conducted by Nigeria Health Watch found that nearly half of respondents obtain antibiotics through informal sources or self-prescription, while 35.6% purchase them from chemists or patent medicine vendors. This poorly regulated drug supply chain has worsened AMR in the treatment of STIs, with studies showing that 72.4% of community pharmacies and 89.3% of patent medicine vendors sell antibiotics without a prescription.

Globally, over one million people are newly infected daily with the four most curable STIs: syphilis, gonorrhea, trichomoniasis, and chlamydia. If left inadequately treated, these infections can lead to severe health consequences, including pelvic inflammatory disease, infertility, and even death. The report “Irresistible” published on Impact Global Health notes that the lack of an approved vaccine and limited availability of effective treatments have made drug-resistant gonorrhea an escalating global concern.

To combat AMR in STIs, the report recommends strengthening antimicrobial stewardship, improving surveillance and diagnostics, ensuring sustainable funding, regulating antibiotic sales, and engaging communities. Nigeria has taken steps to address AMR through its One Health AMR National Action Plan 2.0, but more targeted action is needed to address the growing challenge of AMR in STIs specifically.

The World Health Organization (WHO) advises doctors to adjust treatment based on a patient’s resistance profile, but in many low- and middle-income countries, diagnostic tests required to identify resistance are not easily available. As a result, health workers often rely on local surveillance data or past treatment trends to estimate the best option for their patients.

With 164 products being developed globally to tackle STIs that carry the risk of AMR, and 52 products already approved, there is hope for addressing this growing concern. However, sustained efforts are needed to ensure the effective use of these new treatments and to prevent the further spread of AMR. Nigeria stands at a critical juncture, and with the right policies, investment, and community engagement, it can lead in safeguarding antimicrobials and saving lives.