80
No. 39.
NYASALAND.
THE GOVERNOR to THE SECRETARY OF STATE.
81
The following table embodies the results of investigations which have already been conducted :-
Date.
District.
Medical Officer.
Number Examined.
Number. Per Infected. cent.
SIR,
(No. 66.)
(Received 7th April, 1914.)
Government House, Zomba, Nyasaland, 28th February, 1914.
WITH reference to my despatch No. 46 of the 7th instant, acknowledging your despatch No. 388 of the 8th of December,† on the subject of ankylostomiasis, have the honour to transmit a report on this disease compiled by the Principal Medical Officer from materials already in his possession.
2. The investigations carried out by Dr. Eldred, the Medical Officer stationed in the North Nyasa District, where ankylostomiasis is especially prevalent, cover most of the points set forth in the second paragraph of your despatch. His experi- ence appears to indicate the existence in the North Nyasa natives of a singular power of harbouring ankylostomes without suffering from the serious effects which are said to attend this malady in other countries, and his suggestion that this may be due to acquired racial tolerance of the disease is interesting.
3. With regard to the question of preventive measures raised in paragraph 2 (5) of your despatch I may state that District Residents were instructed some time ago to explain to the native chiefs and headmen the absolute necessity of establishing trench latrines in all villages and to make use, if necessary, of the provisions of the District Administration (Native) Ordinance, 1913, for enforcing cleanliness in this respect.
4. In view of the manner in which ankylostome infection is usually contracted, namely, by contact of the foot with exposed fæcal matter, it is evident that a proper latrine system must be the most indispensable of preventive measures. Unfortu- nately, it is extremely difficult in this country to induce the natives to resort regu- larly to such places, but I entertain confident hopes that by steady and continuous admonition and by enlisting the co-operation of the more intelligent chiefs the Dis- trict Staff will eventually succeed in overcoming the insanitary habits to which the majority of local natives are at present addicted.
I have, &c.,
G. SMITH,
Governor.
June to December, 1912 August, 1912
...
North Nyasa Zomba...
P. C. Conran
522
H. 8. Stannus
498
211 40-4 109 22.1
(adults)
12
(infants)
April, 1918 January to December, 1918 January, 1918 May, 1918
Boall NyBBA North Nyass Ruo (Chiromo)...
R. Bury
A. G. Eldred
50 1,500
24 650
48.0
48-8
G. M. Sanderson...
J
(Hille)
101 100
17 16.8
91 91.0
Totals
2,778
1,102
89.6
All the above were natives.
One European was diagnosed as suffering from ankylostomiasis in the North Nyasa District by Dr. A. G. Eldred early in 1912;
no other cases have since been noted.
It may be remarked in this connexion that as the usual route of infection is through the skin of the feet, from walking over infected soil or fæces, it is improb- able that the number of Europeans infected with this disease will at any time be large, owing to the protection afforded by boots.
2. The relatively large number of natives examined by Dr. Eldred will be specially noted. This Officer has made very careful observations as to the general health of those infected with ankylostomiasis, as compared with others not so infected. He tabulates his results as under :-
General Development.
Percentage of Individuals showing one or more of the symptoms detailed below.
Good.
Fair.
Bad.
Circulatory.
Anxemia.
Gastro- intestinal.
Pigmented
Joint Pains.
Tongue.
Per cent.
fer cont.
Per cent,
Infected Non-infected
70
28
1.5
68
81
1-0
Per cent. 17 18
l'er cent.
Per cent.
Per cent.
94
20
5
Per cent. 18
87
11
6
17
PUBLIC RECORD OFFICE
Reference :-
C.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
:
SIR,
Enclosure in No. 39.
Office of the Principal Medical Officer,
Zomba, Nyasaland Protectorate.
3rd February, 1914.. WITH reference to the Secretary of State's despatch, No. 388 of the 8th of December, forwarded under cover of your letter, No. 1318 of the 26th ultimo, I have the honour to submit a statement of the nature and scope of the investigations on ankylostomiasis which have been carried out by Medical Officers of this Protec- torate, and of the curative and prophylactic measures which have been instituted in the North Nyasa District, an area specially selected for the observance of results. A full report of Dr. Eldred's work in the North Nyasa District will appear in due course in the Annual Medical Report of the Protectorate for the year 1913.
It will be noted that the investigations which have already been undertaken follow more or less closely the lines indicated by the Medical and Sanitary Com- mittee for Tropical Africa. Up to the present there has been no systematic exam- ination of the European population, and Medical Officers have accordingly been instructed to report on this particular aspect of the question.
*9749: not printed.
| No. 246 in African No. 1008.
Dr. Eldred makes the following note in reference to this table :-" Under general development they have been divided into good, fair, and bad; 'good' indi- cates good development of physique as represented by the native of this district, as a rule, both intellectually and (North Nyasa), and not of Africa in general.
it is seen that as far as general develop- physically, the type is anything but high. ment is concerned the presence of ankylostomes has no effect. Again, with anæmia, circulatory changes, and joint pains, just as many uninfected people show these changes; and so many other diseases may produce these symptoms, for malaria, yaws, syphilis, leprosy, and a host of chronic ulcerations exist in this district. The pig- mented condition of the tongue is just as common in non-infected natives. The pres- ence of ankylostomes evidently does affect the gastro-intestinal tract in these people, but here again it must be remembered that many of these cases are complicated by bilharzia, and that digestive troubles are very common in the uninfected native. As has been said, the average type of native here is not particularly well developed, but occasionally exceptionally fine men, comparing favourably with the best type of African one could pick out, are seen. Such men, on being examined, have in most cases been found to be harbouring ankylostomes, and it certainly could not be said that their health was affected. Thirty carriers were taken on a journey of 300 They were all miles, and the capability of each individual as a worker was noted. examined for ankylostomes, and 50 per cent. of them were found to be infected. The infected ones worked just as well and appeared to have just as much stamina as the uninfected. Five of these thirty men were decidedly better than any of the fest, as workers, and three of the five had ankylostomes. . Of the infected individuals