Tropical sexually transmitted infections (excluding lymphogranuloma venereum)

Chancroid and donovanosis are causes of genital ulceration found mainly in tropical areas. Chancroid ulcers are painful with a ragged edge and whitish base. Donovanosis ulcers are classically beefy-red and bleed to the touch. Chancroid was identified early on as a risk factor for HIV transmission amongst heterosexuals and this led to a renewed interest in genital ulcers. The incidence of both conditions has recently decreased significantly, while the incidence of genital herpes has increased. Improved control of all causes of genital ulceration should be a priority in countries where HIV and genital ulcers are prevalent. The non-venereal treponemal diseases include yaws, endemic syphilis and pinta. All three have similarities with venereal syphilis. A global eradication programme in the 1950s and 1960s was successful at the time but there appears to have been a recent resurgence of yaws and endemic syphilis in some isolated communities. A new yaws eradication programme using mass treatment with azithromycin has been launched recently by WHO.