Chancroid was endemic in most parts of the world well into the 20th century. In Europe and North America, a steady decline was seen after the discovery of penicillin in 1943. Reduction started, however, with changes toward reduced prostitution and improved sanitary conditions. Nowadays, the prevalence of chancroid is less than 1% in developed countries. The few cases that are detected are usually imported from endemic countries or are associated with commercial sex work (CSW) and the use of crack cocaine and other illegal drugs. Periodic health examinations and treatment of sex workers and other high-risk groups have largely contributed to the near-eradication of chancroid in these European coun-tries. In some cities in the United States, however, especially among high-risk communities, the H. ducreyi prevalence can be as high as 20%.[22,23]
Chancroid is still ubiquitous in tropical resource-poor countries located in Africa, Asia, Latin America, and the Caribbean.[6,21] In southern and eastern African countries, the H. ducreyi seroprevalence can be as high as 68% among CSW, but this could be overdiagnosis because in Africa the etiology of ulcers is often clinically directed.
In west and central African countries the prevalence of chancroid among STI patients was significantly lower.[8'24]
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