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Ainhum is an ancient disease described in 1821 by Messum and its origin is still unknown. It is a tropical or semitropical disease seen in Blacks, Whites and Indians which affects the 5th and sometimes the 4th toe and causes spontaneous amputation. Females are more often affected than males, and there is a tendency to geographical clustering of cases and familial occurrence.

Throat swabs taken from a group of traditionally living people in a remote area of Venda, with no symptoms of sore throat, revealed the presence of Group A beta-haemolytic streptococci in 1,62% of subjects in the 5 - 25-year age group. This is significantly different from the picture in an urban population in Pretoria where the carrier rate was found to be 16,8%. The incidence is apparently not influenced by the low economic level in the rural area. The organisms in the rural area were found to be less sensitive to sulphafurazole than those in the urban area.

A study was performed in Pretoria on 232 unselected patients who presented with the complaint of sore throat. A throat swab was positive for Lancefield group A beta-haemolytic streptococci in 33,2% of these patients. The incidence was significantly higher in Black patients (45,5%) than in White patients (23,2%) and 12,1% of healthy controls showed a positive culture. No seasonal variation was detected. Throat swabs kept overnight at room temperature were falsely negative for beta-haemolytic streptococci in 43,2% of cases. A correlation was found with certain clinical signs.