Endemic treponematoses in the Sudan. A report on a survey.

It has been recognized for many years that Africa contains a very large reservoir of endemic treponematoses, and all information on the foci of infection contributes to the goal of elimination of these diseases as public health problems.In 1959 the author undertook, at the request of the Sudanese Government, a number of pilot surveys in areas where the endemic treponematoses were thought to be prevalent. From the information acquired in these surveys and from official data it is clear that yaws and endemic syphilis are a major problem of public health in the Sudan. It is estimated that some 5 million people in six provinces are at risk, and that about 20% of the population in an area of 1 543 000 km(2) suffer from one or the other of the two diseases in the active clinical stage.In some localities yaws was found to be prevalent, and in some endemic syphilis. In others, the two infections were seen to co-exist; and it is suggested that, since little is known of the extent to which one infection confers protection against the other, the situation in the Sudan provides a perhaps unique opportunity for scientific studies of the interrelationship of these two diseases and their possible relationship with venereal syphilis.Another interesting finding, worthy of further investigation, was that mucous lesions occurred only in areas where syphilis was present and not where yaws alone was prevalent.