MURRAY J F, MERRIWEATHER A M, FREEDMAN M L
Bull World Health Organ. 1956;15(6):975-1039.
A form of endemic syphilis exists in the Bakwena Reserve of the Bechuanaland Protectorate known by the local name of "dichuchwa". It is similar to bejel, njovera and the endemic syphilis reported elsewhere in the world. The Government of the Protectorate, with the assistance of WHO and UNICEF, began in November 1953 a mass campaign in the Reserve to control this disease and, at the same time, to study its epidemiological, clinical, social and therapeutic aspects. The seropositivity rate in the Reserve was found to be 37%.Dichuchwa is a childhood and family disease, usually spread non-venereally. The early lesions are similar to secondary lesions of sporadic venereal syphilis, and are often followed by tertiary lesions affecting mainly the skin, nasopharynx and long bones. Primary lesions are rare but may occur under certain epidemiological conditions if the inoculum is sufficiently large; thus a mother may develop primary sores on the nipples through suckling an infected infant. Lesions of the cardiovascular and central nervous systems and congenital syphilis are also rare. Superinfection of an already infected and allergic host is probably the chief reason for the frequency of the tertiary lesions.Treatment of the disease with penicillin is very effective, and the authors believe that mass treatment of cases and contacts combined with an improvement in the standards of hygiene could eradicate the disease.
在贝专纳兰保护地的巴克韦纳保护区存在一种地方性梅毒，当地称之为“迪楚瓦病”。它与非性病性梅毒、恩乔韦拉病以及世界其他地方报道的地方性梅毒相似。在世界卫生组织和联合国儿童基金会的协助下，保护地政府于1953年11月在该保护区发起了一场大规模防治这种疾病的运动，同时研究其流行病学、临床、社会和治疗方面的情况。发现该保护区的血清阳性率为37%。迪楚瓦病是一种儿童和家庭疾病，通常通过非性途径传播。早期损害类似于散发性性病梅毒的二期损害，随后常出现三期损害，主要影响皮肤、鼻咽和长骨。一期损害很少见，但在某些流行病学条件下，如果接种量足够大，也可能发生；例如，母亲在哺乳感染婴儿时，乳头可能出现一期溃疡。心血管和中枢神经系统损害以及先天性梅毒也很少见。已经感染且过敏的宿主发生重复感染可能是三期损害常见的主要原因。用青霉素治疗这种疾病非常有效，作者认为对病例和接触者进行大规模治疗并提高卫生标准可以根除这种疾病。
