PUBLIC RECORD OFFICE
Reference :-
C.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
31
the number of those infected is larger than the percentages given above would indicate.
In ulcer cases, for instance, I find that over 75 per cent. of the patients also suffer from hookworm disease whilst in patients suffering from yaws it is exceptional to find one who does not harbour the parasite.
I wish also to draw attention here to the connection between ankylostomiasis and heart and kidney diseases; and the following figures from 124 consecutive cases found to be suffering from this disease will show this to be the case :—-
Cases.
142
Heart Disease. 24
Renal Disease.
48
Thus showing that rather more than 16 per cent. of these cases have some form of heart affection and over 33 per cent. are suffering from renal disease in some degree.
As slight degrees of abnormality in the renal functions are more easily made out than in the case of the heart, it is not making an outrageous assumption to assume that the number of those suffering from heart disease, due to this disease of ankylos- tomiasis, in a stage not sufficiently gross to be perceptible in an ordinary clinical investigation, is at least 25 per cent. larger than the above figures show.
It is now the customary mode here, in examining patients and finding either of these diseases present, to examine at once for ankylostoma ova before subjecting patients to treatment directed to these maladies; and although the figures obtained are not as yet sufficiently large to adduce as proof, it is, I am confident, excellent practice and points to ankylostomiasis as the causative factor in over 60 per cent.
of the cases.
Treatment directed to the heart or kidney without primary removal of this parasite is, in hospital practice, at any rate, followed by speedy recurrence of the malady with all its symptoms.
Cases of enteritis, with symptoms of dysentery, are also frequently found to be produced by the hookworm and outnumber those caused by ambæ many times
over.
With regard to the cases examined, I should state that the specimens have been obtained from every part of the island (and this includes the Southern Grena- dines and Carriacou) and indicate the extent of the measures which will need to be taken in dealing with the suppression of the parasite.
Whilst noting, however, the universality of the disease there are several areas in which it is more than usually prevalent. Of these I may mention the Gouyave district, and the country around Mt. Moritz in the St. George's district.
The scattered Hindu population of the island is very largely infected, and many of the worst cases of heart disease occur in connection with this in these people. It is exceptional to examine the excrementa of members of this community with a negative result.
It is interesting to note, in this connection, that Dobson found that 75 per cent. of 1,250 cases examined by him in India were infected with ankylostoma.
In conclusion, I beg to draw attention to the large number of the lower animals which are capable of infection with this worm, and recommend that work be done as early as possible to discover to what extent the animal population of the island is infected, so that prophylactic measures may be adopted with regard to them.
From an economic standpoint I cannot too strongly urge the use of the most drastic measures with regard to the suppression of this disease otherwise the Colony must, sooner or later, be saddled with the maintenance of an ever increasing population of chronic heart and kidney diseased paupers; and, at the same time, have its labour market crippled with these cases whilst in the making.
At the present time the yearly cost to the Government for the treatment of these cases is enormous, and must increase unless effective, measures to deal with. the situation are put into force.
R. P. COCKIN.
N.B.-Throughout this report I have spoken of A. duodenale and have omitted all mention of Necator americanus. Both varieties occur and the effects of both are, as far as is known, identical.
December 1st, 1911.
R. P. C.
$5
ANKYLOSTOMIASIS.-CASES TREATED IN THE COLONY Hospital from JANUARY 18T TO AUGUST 31st, 1913.
St. George's.
St. David's.
St. John's.
St. Mark's.
St. Patrick's.
St. Andrew'L
Carriacou.
118
8
2
77
48
26 September, 1913.
15
Enclosure 4 in No. 8.
10
W. S. M.
Acting Resident Surgeon.
THE REVISED LAWS OF Grenada. Chapter XLI.
THE ANKYLOSTOMIASIS ORDINANCE.
GRENADA.
CAP. 41,
Ordinance No. B of 1910.
AN ORDINANCE TO PROVIDE AGAINST THE SPREADING OF THE DISEASE called ANKYLOSTOMIASIS.
[June 1, 1910. 1.-(1.) It shall be lawful for the local sanitary authority, on the report of any Compulsory Medical Officer, by a written order to require any person who, in the opinion of such and detention Medical Officer, is suffering from ankylostomiasis to attend for treatment at a public of infected dispensary or to go or be taken to and to remain in a public hospital for treatment.
(2.) If any person neglects or refuses to comply with any requirement of any such order he shall be guilty of an offence against this Ordinance.
treatment
persons.
2. Any person who while under medical treatment for ankylostomiasis leaves Power to take any hospital without the permission of the Medical Officer in charge of such hospital hospital in- may be taken back to such hospital by any officer or servant thereof, or by any member fected persons of the police force on the order of the Medical Officer of such hospital.
back to
leaving without permission.
3.-(1.) It shall be the duty of every district sanitary inspector to report to the Loosd local sanitary authority whenever he has reason to believe that the privy accommoda- authority, tion on any estate is insufficient or unsuitable by reason of the number of persons owners of residing and employed on the estate.
may require
estates to pro- vide suitable
modation.
(2.) On receipt of any such report the local sanitary authority, if satisfied as to privy - the want of proper accommodation, shall serve a notice on the owner or occupier of the estate requiring him to provide and maintain sufficient and suitable accommoda- tion for the use of persons residing and employed on the estate in the form to be prescribed and within a period to be specified in the notice, or requiring him to put and maintain the existing privy accommodation in a clean and efficient condition.
(3.) If the owner or occupier of an estate upon whom such a notice has been served makes default in complying with the requisitions named in the notice, the local sanitary authority shall cause a complaint relating thereto to be made before the Magistrate of the district; and the Magistrate shall thereupon summon such owner or occupier to appear before him and may make an order on such owner or occupier requiring him to comply with all or any of the requirements of the notice and to pay the costs of the proceedings.
(4.) Any such owner or occupier not obeying a Magistrate's order made here- under shall, if he fails to satisfy the Court that he has used due diligence to carry out such order, be liable to a fine not exceeding Ten Shillings for each day during which such default continues; and any such owner or occupier knowingly and wilfully acting contrary to any such order shall be liable to a fine of Twenty Shillings per day during such contrary action.
4. (1.) When privy accommodation shall have been provided in accordance Penalty for with this Ordinance, the local sanitary authority may cause public notices to be defecating in affixed on the estate prohibiting all persons from defecating in any place other than place than the place provided for the
83511
purpose.
places other
provided on
an estate for
F?
the purpose.
: