Have you ever noticed something unusual down there and instantly panicked, but felt too awkward to talk about it? When it comes to Sexually Transmitted Infections (STIs), we often avoid the topic, either out of fear, stigma, or plain discomfort. However, ignoring it will not make it disappear. One such lesser-known STI is chancroid, a curable infection that causes painful sores in the genital area and often goes undiagnosed because people don’t know what to look for.
We spoke to Dr Subhashree Samantaray, Associate Consultant, Infectious Diseases, Manipal Hospitals, Bhubaneswar, who explained this condition and its treatment measures.
What Is Chancroid?
Chancroid, also known as soft chancre, is a sexually transmissible genital ulcerative disease, caused by a bacterium named Haemophilus ducreyi. It can cause painful 'dirty' ulcers on the external genitalia along with the development of painful enlarged lymph nodes, also called bubo in the groin.
Who Is Most at Risk?
It is a highly contagious yet curable disease and is known to facilitate the transmission of HIV and other STIs. According to the Indian Journal of Dermatology, Venereology and Leprology (IJDVL), the disease is most prevalent in the developing countries of Asia, Africa and Latin America, especially among people of low socioeconomic strata.
Though the disease can affect people of any age, it's most common in younger, sexually active individuals, particularly those aged 21 to 30 years, as stated in StatPearls.
"Estimating the true global incidence of chancroid is a big challenge because of the non-availability of facilities for microbiological diagnosis in most places. One sexual contact is reported to have a 0.35% chance of transferring the illness to another person," said Dr Samantaray.
How Common Is Chancroid Today?
-1744023767946.jpg)
Before 2000, chancroid was the most prevalent STI with a prevalence of up to 69%. Currently, the prevalence of this disease has declined to <10% in India and other Western countries, probably due to increased sexual health awareness, better public health measures, socioeconomic development and the introduction of syndromic management, as per a 2016 study.
Symptoms of Chancroid
"Chancroid has a short incubation period of 3–7 days. A typical chancroid lesion is characterised by the triad of undermined ulcer edge, purulent dirty grey base and moderate to severe pain. 50% of affected cases can have multiple ulcers and untreated cases may persist for months to years. Painful, inflammatory inguinal lymphadenopathy, mostly unilateral, is seen in about 30-60% of cases, which may even undergo suppuration," added Dr Samantaray.
The disease is more common in males than females because of the human anatomy and the lesser severity of infection in females. But, the occurrence of chancroid can stimulate other STIs like genital herpes and gonorrhoea. Although rare, extragenital lesions may occur through autoinoculation, affecting areas like the thighs, fingers, anal canal, and oral cavity.
How Is It Diagnosed?
Molecular diagnostic techniques can confirm the presence of H. ducreyi in clinical samples. However, these methods are costly and challenging to implement in remote healthcare settings.
What Are the Treatment Guidelines?
CDC and WHO have released guidelines for syndromic management of STIs which include genital herpes, syphilis, donovanosis and chancroid. Similarly, the Ministry of Health & Family Welfare along with NACO (National AIDS Control Organization) has released National STI/RTI Control and Prevention guidelines for a syndromic approach to sexually transmitted infections, in which seven colour-coded STI kits are recommended based on patient symptoms, shared Dr Samantaray.
These kits are free of cost at the designated STI/RTI Clinics in the state. Patients suspected of having chancroid can be given the white kit, blue kit or black kit based on the clinical presentation. It is also essential to treat the sexual partners using the same kits for a duration of six weeks to six months, depending on severity. In addition, all the patients presenting with STI are advised to get immunised against Hepatitis B as per Indian guidelines, considering the high risk of co-infection.
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]