The Chancroid – The silent sexually transmitted disease

THE Chancroid is a sexually transmitted genital ulcer disease which causes painful sores on the genitalia. This infection is spread from one individual to another solely through sexual contact.

While it may not be one of those infections that are well known, Professor Horace Fletcher, obstetrician and gynaecologist at the University Hospital of the West Indies (UHWI), said this is probably because it is on the decrease in Jamaica.

“I believe these diseases are not so common anymore as people are better nourished and able to resist them better,” Professor Fletcher said.

In a recent paper entitled Poverty, Folate Deficiency, Human Immunodeficiency Virus and Ulcerated Vulval Sexually Transmitted Diseases in Jamaica done by members of the Department of Obstetrics and Gynaecology at the UHWI and the Comprehensive Clinic in the Ministry of Health, it was explained that that ulcerated sexual infections (like the Chancroid) have been on the decrease in Jamaica since the 1950s. The paper noted that this is likely to be due to improvement in healthcare provision, with the introduction of antibiotics and the increased use of condoms as well as improved social conditions.

However, some researchers believe the Chancroid is relatively common in the developing world.

One of the main reasons for persons not being able to readily identify the disease is that the early signs are sometimes mistaken for syphilis. However, the ulcers generally grow to a larger size, and are more painful than those associated with syphilis.

The Chancroid may lead to swelling, tenderness, and inflammation of the lymph nodes in the groin, a side effect not associated with syphilis.

The open sores caused by Chancroid infection increase a person’s risk of acquiring other sexually transmitted infections, including HIV, which is why it is so important to get rid of the disease.

Within one day to two weeks after getting infected, a person will get a small bump in the genitals. The bump becomes an ulcer within a day of its appearance.

The disease is characterised by several factors:

* The size of the ulcer ranges 1/8 inch to two inches.

* It has sharply defined borders/irregular or ragged borders.

* It has a base covered with a grey or yellowish-grey material.

* The base bleeds easily if traumatised or scraped.

* Painful lymphadenopathy (chronically swollen lymph nodes, locally known as wax and canal) occurs in 30 to 60 per cent of patients.

Patients who have one or more painful genital ulcers combined with tender enlargement or disease of the glands, especially the lymphatic glands, are suggestive of having the disease.

Men too can have the disease. Uncircumcised men are at much higher risk than circumcised men of getting the disease from an infected partner. However, it is believed that about half of infected men have only a single ulcer while women frequently have four or more ulcers with fewer symptoms.

A Chancroid infection can get better on its own. However, some people may have months of painful ulcers and draining. Antibiotic treatment usually clears up the lesions quickly with very little or no scars.