Learn about Bejel (Endemic Syphilis), a chronic but curable disease. Explore its Symptoms, Causes, Diagnosis, treatment options, and Prevention strategies for better health.
If you’ve never heard of Bejel, you're not alone. It’s a disease that often flies under the radar, despite affecting many children in poverty-stricken, unsanitary regions. While it shares similarities with syphilis, Bejel is different in many ways—and it’s important to understand its Symptoms, Diagnosis, treatment, and ways to prevent it, especially if you’re living in or working with communities that face these challenges.
So, let’s dive in and break this down in a way that’s easy to understand.

What is Bejel?

Bejel, also known as endemic syphilis, is a chronic, yet curable bacterial infection. Unlike the sexually transmitted form of syphilis that we’re more familiar with, Bejel isn’t passed through sexual contact. It is most commonly seen in arid, poor regions of the Middle East, Africa, Central Asia, and even parts of Australia.
The disease, which is caused by the Treponema pallidum bacteria (the same bacteria that Causes syphilis), often spreads in environments with poor hygiene and sanitation. Children are particularly vulnerable, especially when they’re living in conditions where cleanliness is hard to maintain.
You may also hear Bejel referred to by other names depending on the region, such as siti, dichuchwa, njovera, and belesh. But no matter the name, the key takeaway is that Bejel is curable and preventable with the right care.

How Does Bejel Spread?

The transmission of Bejel is different from its more infamous cousin, syphilis. Instead of being sexually transmitted, Bejel spreads through direct contact, especially if there's broken skin or contamination from unsanitary objects. Think of a child using a shared drinking vessel or eating utensils in a community where hygiene is lacking. These seemingly small acts can spread the infection, making children in these environments especially vulnerable.

What’s troubling is that because Bejel is so closely related to syphilis, it can sometimes be mistaken for the sexually transmitted version, which can delay proper treatment. The bacteria primarily affects the skin, bones, and mucous membranes—often causing painful patches and ulcers in the mouth, throat, and even nasal passages.

Symptoms of Bejel

When Bejel strikes, the symptoms can be both visible and painful. Here are the common signs to watch for:

Mouth and Throat Ulcers: Sores often develop in the mouth and throat, which can be quite painful and make eating or swallowing difficult.
Swollen Lymph Nodes: You may notice swelling in the lymph nodes, particularly in the neck.
Bone Pain: As the disease progresses, deep bone pain, especially in the legs, is a common symptom. In some cases, bones may even become deformed.
Gummy Lesions: In more severe cases, lesions can develop that may break through the palate or other soft tissue areas.
It’s essential to catch these Symptoms early, especially in children, to prevent long-term damage to the bones or other organs.

How is Bejel Diagnosed?

Diagnosing Bejel can be a bit tricky, mainly because its Symptoms overlap with other conditions. The primary method for confirming the disease is through microscopic examination of samples taken from sores or lymph fluid. This helps doctors identify the Treponema pallidum bacteria. However, antibody tests aren’t always definitive, so a Diagnosis will often depend on the patient’s history, Symptoms, and the environment they live in.
Doctors take a comprehensive approach to ensure an accurate Diagnosis and rule out other possible conditions that could be causing similar Symptoms.
Treatment for Bejel
The good news? Bejel is completely curable. The standard treatment involves large doses of benzathine penicillin G, which is injected into the muscle. Even in advanced stages, this treatment can effectively cure the disease, although it may require multiple doses if it’s progressed too far.
If penicillin isn’t an option, tetracycline can be used as an alternative. However, tetracycline can cause permanent discoloration of developing teeth, so it’s generally not prescribed for children unless absolutely necessary.

What’s the Prognosis?

Once treated with antibiotics, Bejel is fully curable. The sooner it’s caught, the easier it is to treat, and the fewer Complications a patient will experience. However, if left untreated, Bejel can lead to severe bone deformities and other long-term health issues. That’s why it’s critical to address any signs of Bejel as soon as possible.
Prevention: The Key to Ending Bejel
While there’s no vaccine for Bejel, the World Health Organization (WHO) has made great strides in reducing its prevalence. The widespread use of penicillin in high-risk areas has been crucial in curbing the spread of Bejel.
However, the most effective way to prevent Bejel from spreading is by improving sanitation and living conditions in affected areas. When people have access to clean water, proper hygiene, and better overall health infrastructure, the likelihood of Bejel spreading dramatically decreases. It’s a long-term goal, but one that’s within reach with global cooperation and commitment.
Final Thoughts

Bejel may not be on everyone’s radar, but understanding this disease is crucial for improving public health, especially in areas with poor sanitation. With early detection and proper treatment, Bejel can be fully cured. But, the key to wiping it out lies in improving living conditions and hygiene practices across the globe.
If you live or work in a region where Bejel is common, staying informed about its Symptoms and treatment options could make all the difference in ensuring a healthier future for everyone. Let's continue the conversation and raise awareness so that no one has to suffer in silence.
If you or someone you know is showing signs of Bejel, don’t hesitate to seek medical help. It’s not just about treatment; it’s about providing a better quality of life for those who are at risk.