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Chancroid Prevention
Prevention and control of chancroid is important for several reasons. Foremost among these is the association of chancroid with HIV transmission in parts of the world where both infections are endemic. Because chancroid lesions are often painful, patients often seek and receive treatment early, making it possible for partners to be notified and treated in a timely manner. Chancroid thrives in populations with high sexual activity, especially where many men are having sex with relatively fewer women, usually sex workers. If these factors can be reduced significantly, transmission will slow or even cease and chancroid prevalence will markedly diminish.

Successful chancroid control has been carried out in Thailand and other countries where multifaceted interventions have been implemented. Promotion of condom use, syndromic management of genital ulcers, treatment of patients who have reactive syphilis serology, contact tracing and treatment, education, and monthly presumptive treatment with azithromycin have contributed to reductions in chancroid and genital ulcer disease in Thailand and South Africa. Treatment of core groups in Canadian epidemics also has had a dramatic effect on the number of cases of chancroid.

Additional insights regarding chancroid prevention were provided by an H ducreyi human challenge model in which azithromycin not only successfully treated infection, but also blocked experimental reinfections for up to 2 months. Based on these observations it is now thought that the success of the South African intervention trial may have been due not only to azithromycin treatment efficacy, but also to the drug's prophylactic effect.