Chancroid epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Nate Michalak, B.A.; Serge Korjian M.D.
Overview
UNAIDS and the World Health Organization estimate the global incidence of chancroid to be approximately 6 million cases per year. Chancroid is uncommon in developed countries but may be prevalent in areas of crack cocaine use and prostitution. Chancroid is a common cause of genital ulcer disease in developing countries. Lack of diagnostic testing and difficulty of culturing H. ducreyi make true incidence difficult to determine, therefore potentially leading to under-diagnosis of chancroid in both developed and developing countries. The male to female ratio of patients with chancroid ranges from 3:1 in endemic areas to 25:1 during outbreak situations. Chancroid is common in areas with high rates of Human Immunodeficiency Virus (HIV) infection because HIV infection is a risk factor for acquiring H. ducreyi.
Epidemiology and Demographics
Incidence
- UNAIDS and the World Health Organization estimate the global incidence of chancroid to be approximately 6 million cases per year.[1]
- A true incidence is difficult to determine due to lack of readily available diagnostic testing. H. ducreyi is difficult to culture so chancroid may be under-diagnosed.[2]
- Since 1987, reported cases of chancroid declined steadily until 2001. Since then, the number of cases reported has fluctuated, but still appearing to decline overall.[2]
Age
- Chancroid may develop in individuals of any age but is typically found in sexually active individuals with a mean patient age of 30 years.
Gender
- The male-to-female ratio of patients with chancroid ranges from 3:1 in endemic areas to 25:1 during outbreak situations.[1]
- Female sex workers with either symptomatic chancroid or as asymptomatic carriers serve as a reservoir for H. ducreyi.[1]
Race
- Although race is not a risk factor, chancroid is seen more commonly in African Americans and Hispanics in the United States.[3]
Developed Countries
- Chancroid is uncommon in the United States and other developed countries, but can been present in endemic areas associated with the use of crack cocaine and prostitution.
- In the United States, the Centers for Disease Control and Prevention reported 6 cases of chancroid in 2014.[4]
- The majority of cases in developed countries occur in individuals who have returned from chancroid-endemic areas in the world.
Developing Countries
- Chancroid is a major cause of genital ulcer disease in Africa, southeast Asia and parts of Latin America.[5]
- Acquiring epidemiological data is more difficult in developing countries due to greater lack of resources to test for H. ducreyi.
- Chancroid is common in countries that have high rates of Human Immunodeficiency Virus (HIV) infection, because HIV facilitates acquisition of H. ducreyi and vice versa.[1]
References
- ↑ 1.0 1.1 1.2 1.3 Spinola, S. M. (2002). "Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)". Infection and Immunity. 70 (4): 1667–1676. doi:10.1128/IAI.70.4.1667-1676.2002. ISSN 0019-9567.
- ↑ 2.0 2.1 Other Sexually Transmitted Diseases (STDs). Centers for Disease Control and Prevention (November 16, 2009). http://www.cdc.gov/std/stats08/other.htm Accessed January 15, 2016.
- ↑ Trees DL, Morse SA (1995). "Chancroid and Haemophilus ducreyi: an update". Clin Microbiol Rev. 8 (3): 357–75. PMC 174629. PMID 7553570.
- ↑ 2014 Sexually Transmitted Diseases Surveillance. Centers for Disease Control and PRevention (November 17, 2015). http://www.cdc.gov/std/stats14/tables/44.htm Accessed January 28, 2016.
- ↑ Refugee Health Guidelines. Centers for Disease Control and Prevention (May 29, 2014). http://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/sexually-transmitted-diseases/chancroid.html Accessed January 28, 2016.