oa South African Medical Journal - Endemic syphilis in Africa : the Njovera of Southern Rhodesia
The world-wide distribution of extra-venereal syphilis in primitive peoples is noted. As civilization advances the incidence lessens to be replaced by perhaps an equal or even greater amount of venereal syphilis as the villages become towns. That a number of nuclei or residua of such infections are present in Africa is more than likely. One such variety, called njovera by the Karangas n the south-east of Southern Rhodesia, is descriptionbed. As a result of public health measures employed over a number of years it is rapidly declining in prevalence. In Sindebele the word njovela is used for syphilis and some cases were noted under that label in the south-west. In the northwest the Batongas call it siakwelele. The significance of a nipple chancre in the mother of a syphilitic child (' throwback' infection) in the recognition of extra-venereal syphilis is stated. It is recommended that all such cases noted by medical officers in the bush should be reported to district medical officers of health so that the localities of endemic syphilis in Africa may be plotted. That some may consider the condition to be yaws is beside the point. Both conditions, if both there are, react extremely well to a single injection of 2.4 mega units of penicillin retard, and both, if both there be, have the same ultimate complications. Both, therefore, are treponematoses which are well rid of. A smaller dose of 1.2 mega units may be given in regions where the numbers are too large to justify the expense of the larger dose. Africa is a vast continent with many political and few geographical frontiers to disease. Even so, the treponemal diseases can be controlled if tackled on a comprehensive scale.
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