PUBLIC RECORD OFFICE
Reference :-
C.O. 885
23 PUBLIC RECORD OFFICE, LONDON
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8584
96
No. 51.
WINDWARD ISLANDS.
THE GOVERNOR to THE SECRETARY OF STATE.
(Received 11.26 a.m., 20th May, 1914.)
TELEGRAM.
YOUR despatch of 25th March, Grenada,* paragraph No. 4. Please select the two Medical Officers for Grenada. With regard to St. Vincent and St. Lucia, see despatchest reaching 25th May.-SADLER.
10658
No. 52.
MEMORANDUM BY DR. H. L. BURGESS ON THE INCIDENCE OF ANKYLOSTOMIASIS.
EXTRACTED FROM THE ANNUAL Reports of the Gambia, Sierra Leone, Gold Coast, SOUTHERN AND NORTHERN NIGERIA, AND OTHER RECENT reports, Gambia, 1911, 1912.-No cases of ankylostomiasis were recorded during either of these years.
Sierra Leone, 1911.-During the year eight cases were treated. The parasite is fairly common around the wells and cesspits of Freetown, but treatment for conditions resulting from infection is not very frequently sought.
Sierra Leone, 1912.-The Medical Officer in charge of the clinical laboratory at the Colonial Hospital, Freetown, reports that, out of 111 examinations of fæces, ankylostomes were found in 18. At the Colonial Hospital three cases were treated, with one death.
were
Gold Coast, 1911.-An examination of the natives in the prisons and hospitals revealed 64 cases. The in- and out-patient returns show that two cases treated, with one death.
Gold Coast, 1912.-Examination of fæces in the Accra laboratory disclosed Amongst the the presence of ankylostomes in 20 out of 52 natives examined. Europeans, two were found to harbour this parasite.
Examinations of fæces from the inmates of the various prisons and native hospitals resulted in the discovery of 49 cases.
Southern Nigeria, 1911.-The number of people infected by ankylostomes is extremely high probably about 75 per cent.--but fortunately the infection does not appear to give rise to serious symptoms. Most of the serious cases have been observed among prisoners, and it seems more than probable that prison life lowers the system and causes symptoms of the disease to become more pronounced.
Ankylostomum duodenale can be very frequently met with if sought, even in persons who would from appearances never be suspected of harbouring it. Only when the worm, from its numbers, leads to severe ill-health do patients seek
treatment.
At Sapele some observations were made on a number of cases which occurred in the prison.
In the Western Province, only 52 cases of ankylostomiasis were definitely diagnosed. A careful examination of the fæces of natives shows that a large proportion of them have a few ankylostome eggs, but the infection is seldom so great as to cause symptoms of the disease.
During the year 423 cases were treated.
Southern Nigeria, 1912.-There is little doubt that, as was suggested in last year's report, there is a very high percentage of infection with ankylostomes among bush" natives. Dr. Wyler's interesting paper on the subject throws a vivid light on the insanitary conditions obtaining in some villages, which render the infection practically universal in the neighbourhood.
* No. 86.
Nos. 54 and 55,
97
The importance of the disease is considerable, as the debilitated condition sometimes produced by it renders the sufferer more liable to other affections which may easily produce a fatal termination, as was the case in Calabar Prison towards the latter part of the year.
Calabar accounts for a large proportion of ankylostomiasis, just as Sapele did the previous year, and this favours the supposition that it is more a question of observation than difference of distribution.
In the Eastern Province there were 225 cases infected with Necutor americanus. Of 225 cases of ankylostomiasis, 18 ended fatally (8 per cent. of the cases). In 1911 There is no actual there were 29 cases, with 1 death, and 5 cases in 1910. increase in the prevalence of the disease, but the fact is, it has been more generally recognized; microscopical examination of fæces shows 80 per cent. of those examined to be infected. From post-mortem examinations it is found to be invari- ably associated with dysentery amongst the natives.
Ankylostomiasis is very prevalent in the north of the Central Province. The disease is very chronic and it greatly debilitates the people.
Dr. Wyler, in some observations on ankylostoma infection in the Udi District of the Central Province, found that out of 200 cases examined, 199 were infected. Ova were He found both Ankylostoma duodenale and Necator americanus. quickly found (within a minute or two, and often seen in the first field) in 187 It is of interest that the one uninfected case was a man of out of the 200 cases. some education, formerly an interpreter, who had worn boots for seventeen years.
The following conclusions were arrived at by Dr. Wyler as the result of his observations:-
year.
Hookworm infection is practically universal among the natives of the
Udi District.
The average individual infection is a heavy one.
Both Ankylostoma duodenale and Necator americanus are found. Pure infections occur in about 44 per cent. of the cases.
About 79 per cent. of the population is anæmic, though the anæmia is
rarely profound.
Northern Nigeria, 1911.-No case of ankylostomiasis was recorded during the Northern Nigeria, 1912.-This affection accounted for one European and seven native admissions, and of the latter one ended fatally.
Northern Nigeria, 1913.-Dr. W. B. Johnson, West African Medical Staff, Northern Nigeria, being struck by the amount of debility and emaciation met with amongst prisoners in the Zungeru gaol (notwithstanding a quite generous and varied diet), conceived it possible that this malnutrition might be due to helminthic infection; he accordingly examined the stools of all the convicts in the gaol, includ- ing a few new admissions, until the total examined reached 200.
The investigation extended from December, 1912, to March, 1913, and brought to light the fact that 42 per cent. of these people had ankylostomiasis.
Dr. Johnson considers that the effect of this high percentage of ankylostome infection upon nutrition, and, consequently, upon disease mortality amongst prisoners, is so serious a factor, and the effect of expelling the worms so encour- aging, that it is worth drawing attention to the matter.
The following tribes or races were represented among the prisoners examined
in the Zungeru gaol; the percentages of infection with ankylostomes is also shown :-
Hausa Kanuri
Nupe
Fulani
Yoruba
Ibo
38.0 per cent.
57.1 per cent.
364 per cent.
42.9 per cent.
42.9 per cent.
57.1 per cent.
57.1 per cent.
16.6 per cent.
Dr. Manning, the Principal Medical Officer, states that there is evidence of almost universal entozoal infection, and that ankylostomes have been by far the
C
Pagans
Coast Races
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