Table 3

 Summary of studies of the association between male circumcision and chancroid

First authorDesignLocation,
 >date of 
 > casesOutcome, 
 >sizeCircumcisedAssessment of 
 >circumcisionCrude RR 
 >(95% CI)Adjusted RR 
 >(95% CI)Comments
*Of the 150 GUD cases, 89% of ulcers were clinically diagnosed as chancroid, and 50% of these were culture positive for H ducreyi. The remaining ulcers were diagnosed as syphilis (4%), genital herpes (5%), and LGV (2%). Of the 316 urethritis patients, 213 (67%) were culture positive for N gonorrhoeae.
Rakwar30Cross sectionalMombasa, Kenya 1993Trucking company employeesH ducreyi seropositiveH ducreyi seronegative50187%Clinical examination1.22 
 >(0.8 to 2.0)1.11 
 >(0.5 to 2.1)Adjusted for age, marital status, history of CSW contact, history of alcohol intake, travel
Hand7Case controlNew York State 1945US Naval HospitalClinically diagnosed chancroidAsymptomatic controls152922%Clinical examination0.04 
 >(0.02 to 0.09)0.13 
 >(0.06 to 0.29)Adjusted for race
Lloyd39Cross sectionalLondon 1932STD clinic attendersClinically diagnosed chancroidAsymptomatic controls11023%Clinical examination0.40 
 >(0.05 to 3.43)
Barile38Case-controlUS military, Japan 1962US servicemenPenile lesionsAsymptomatic controls8243%Clinical examination0.04 
 >(0.01 to 0.16)21/35 lesions had a definitive diagnosis, and 8 were H ducreyi
Nasio40Case-controlNairobi, Kenya 1993STD clinic attendersCulture positive H ducreyi ulcerUrethritis66089%Clinical examination0.59 
 >(0.32 to 1.09)0.66 
 >(0.35 to 1.24)Among HIV negative men only.
Cameron41CohortNairobi, Kenya 1985STD clinic attendersGenital ulcer disease*Urethritis29373%Clinical examination0.62 
Hart42Cross sectionalAustralian military 1970STD clinic attendersClinically diagnosed chancroidOther STD clinic attenders197057%Clinical examination0.21 
 >(0.14 to 0.29)Comparison group included 52% no aetiology, 3% with herpes, 15% gonorrhoea, 14% urethritis