What is Bejel?
Bejel, also known as endemic syphilis, is a non-venereal disease caused by the bacterium Treponema pallidum subspecies endemicum. It is part of a group of diseases referred to as
treponemal infections, which also includes yaws and pinta. Unlike venereal syphilis, bejel is primarily spread through close personal contact and is prevalent in arid regions of the Middle East and North Africa.
How is Bejel Transmitted?
Bejel is transmitted through direct contact with the
infectious lesions of an infected person. This often occurs among children through sharing utensils, or through other close physical interactions in communal living settings. Transmission is less commonly associated with sexual contact, distinguishing it from venereal syphilis.
What are the Symptoms of Bejel?
The symptoms of bejel are similar to those of syphilis but manifest differently due to the mode of transmission. The disease progresses through three stages: Primary Stage: Initial lesions, or
mucous patches, appear in the mouth, which are often painless and may go unnoticed.
Secondary Stage: Lesions can spread to other parts of the body, particularly affecting the skin and bones. Skin lesions are often accompanied by bone pain.
Tertiary Stage: If left untreated, the disease can progress to a more severe form, affecting the skin, bones, and cartilage, leading to significant disfigurement.
How is Bejel Diagnosed?
Diagnosis of bejel is challenging due to its similarity to other
treponemal diseases. A combination of clinical assessment and serological tests is used. Blood tests, such as the Venereal Disease Research Laboratory (VDRL) test and the Rapid Plasma Reagin (RPR) test, are commonly employed, followed by specific treponemal tests like the Treponema pallidum particle agglutination assay (TPPA) to confirm the diagnosis.
What is the Treatment for Bejel?
Bejel is effectively treated with
antibiotics, primarily penicillin. A single dose of benzathine penicillin is usually sufficient for early stages, while more advanced stages may require a longer course of treatment. Alternative antibiotics, such as tetracycline or erythromycin, can be used for those allergic to penicillin.
What are the Complications of Untreated Bejel?
If left untreated, bejel can lead to severe complications, particularly in the skin and bones. Chronic cases can result in deformities and disabilities due to the destructive nature of the tertiary lesions. Social stigmatization is also a significant concern due to the visible disfigurements caused by the disease. How can Bejel be Prevented?
Prevention of bejel focuses on improving living conditions and education about the disease. Public health initiatives aimed at reducing overcrowding and promoting
hygiene practices are essential. Community-based treatment programs and mass antibiotic distribution have been successful in reducing the prevalence of bejel in affected areas.
What is the Global Impact of Bejel?
Bejel primarily affects communities in rural and impoverished regions, contributing to the cycle of poverty and disease. While it is not as widespread as other
infectious diseases, its impact on affected populations is significant, highlighting the need for continued surveillance and targeted interventions.
Conclusion
While bejel is a relatively neglected disease, it remains an important public health issue in specific regions. Ongoing efforts to improve diagnosis, treatment, and prevention are crucial in reducing its impact. Enhanced awareness and education can help break the transmission cycle and improve the quality of life for those affected by this disease.
