A lateral flow assay for Neisseria gonorrhoeae: a step forward for an inexpensive biomarker-based diagnosis of N gonorrhoeae at the point of care?

At least one million curable sexually transmitted infections (STIs) are acquired daily, and their long-term consequences affect reproductive health, psychological health, neonatal health, and fertility.1 In 2020, 82·4 million new gonorrhoea infections were estimated to have occurred in adults aged 15–49 years, with the African subcontinent reporting the highest prevalence of infection.2 A significant weakness in estimating the global burden of gonorrhoea has been the lack of quality data from many regions, caused by the unavailability and access to appropriate diagnosis, treatment, and care; inaccessibility of information about STIs; and stigma associated with seeking health care.3 Although gonorrhoea is treatable, N gonorrhoeae has developed resistance to all classes of antibiotics over many decades; in most regions ceftriaxone is the single recommended antibiotic for the treatment of uncomplicated infections.4 Cases of gonorrhoea resistant to this antibiotic have been documented and might be increasing in some areas,4 and there are currently no vaccines against N gonorrhoeae.4 Prompt diagnosis and antibiotic treatment of gonococcal infections is how infections are cured, and transmission is minimised and eliminated. [...]limitations of the study, as the authors discuss, include a midsize diagnostic study; samples were selected from only one district which raises the requirement for further testing in different geographical areas; and the need for standardised gold standard reference tests to compare performance. [...]an accurate and easy to use LFA-based point-of-care assay could advance policy changes and recommendations for the diagnosis of gonococcal infections, improve world statistics on prevalence, reduce gonococcal transmission and antimicrobial resistance, and make diagnostics accessible in lower-income settings.