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Sex Transm Dis. 1997 May;24(5):267-71.

Antibody to Haemophilus ducreyi among trucking company workers in Kenya.

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Department of Medical Microbiology, University of Nairobi, Kenya.



To determine the prevalence, correlates, and incidence of Haemophilus ducreyi antibodies, a cohort of East African trucking company employees was evaluated.


Human immunodeficiency virus (HIV)-1-seronegative men working in six trucking companies in Mombasa, Kenya, were evaluated with a questionnaire and serologic testing for antibodies to H. ducreyi and other sexually transmitted pathogens. Men who were initially H. ducreyi seronegative were retested at 1 year of follow-up.


The H. ducreyi seroprevalence among 501 men at enrollment was 26.5%. Seropositivity was significantly associated with older age, married status, years of active sex life, number of sex partners in the past year, history of unprotected sex with a prostitute in the past year, and history of alcohol intake (all P values < 0.01). Occupational travel for more than 14 days per month was also significantly associated with H. ducreyi seropositivity (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.3-3.2). Using multivariate analysis, H. ducreyi seropositivity was independently associated with age, married status, history of sex with a prostitute, and history of alcohol intake. Presence of H. ducreyi antibodies was significantly associated with seropositivity to the other major genital ulcerative pathogens, Treponema pallidum (OR 4.3, 95% CI 2.2-8.3), herpes simplex virus type 2 (OR 4.9, 95% CI 2.0-11.5), and Chlamydia trachomatis (OR 3.2, 95% CI 1.5-6.9). These associations remained significant after adjusting for demographic and exposure variables. The incidence of seroconversion to H. ducreyi antibodies was 3.6 per 100 person years.


Serologic evidence of H. ducreyi infection was common among male trucking company employees. H. ducreyi seropositivity is an objective marker of high-risk behavior and is associated with serologic evidence of other ulcerative sexually transmitted diseases.


A prospective cohort study of 501 human immunodeficiency virus (HIV)-negative male trucking company employees from Kenya revealed high rates of infection with Haemophilus ducreyi, the causative agent of chancroid. At enrollment in March 1993, the seroprevalence of H ducreyi antibodies was 26.5%. Also detected were high rates of herpes simplex virus-2 (49%), Chlamydia trachomatis (41%), and syphilis (8%). Of the 368 men who were seronegative at enrollment, 241 were re-evaluated after 12 months of follow-up. There were 9 seroconversions (3.6/100 person years). Sexual contact with a prostitute in the preceding year was reported by 33% of truckers and only a third of these encounters involved condom use. Ever-use of condoms was reported by only 51%. H ducreyi seropositivity was significantly and positively associated with older age, occupational travel for more than 2 weeks per month, history of sex with a prostitute, high number of sex partners in the past year, unprotected sex with a prostitute in the past year, alcohol drinking, and infection with other sexually transmitted diseases. The significant association of H ducreyi and seropositivity to syphilis, herpes simplex virus-2, and C trachomatis (odds ratios: 4.3, 4.9, and 3.2, respectively) raises the possibility that a genital ulcer increases the likelihood of infection with a second ulcerative pathogen. Overall, these findings suggest that the seroprevalence of H ducreyi may be used as an indicator of the extent of high-risk sexual risk behavior in a population, as well as an objective end point for measuring the efficacy of behavioral interventions in communities where the HIV seroincidence is too low to serve this purpose.

[Indexed for MEDLINE]

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