PUBLIC RECORD OFFICE
Reference :-
C.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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this cause were only two." "In the Tamils, on the other hand, five out of 32 deaths were attributed to this disease, either alone or in the main." In the Report of the Advisory Committee for the Tropical Diseases Research Fund for 1909, Stanton gives an account of ankylostomiasis among Tamil coolies employed on
I have, &c.,
S. LUCY, Senior Health Officer,
Federated Malay States,
rubber estates.
The Principal Medical Officer,
Federated Malay States, Kuala Lumpur.
SIR,
Office of the Health Officer, Selangor,
Kuala Lumpur, 27th March, 1914,
In reply to your letter No. 31/14 of the 14th February, 1914, I have the honour to send herewith a list of the estates in Ulu Selangor and Ulu Langat, and the number of cases of ankylostomiasis admitted to hospital from each estate.
The term ankylostomiasis has a double meaning. Some medical men diagnose a case as such simply because a few eggs have been found in the fæces; on the other hand, there are others who apply the term to a case where, in addition to the finding of eggs in the stools, there is an extreme anæmia which cannot be traced to any other cause.
I know of no estate in my districts where a thorough investigation has been made to find out the exact percentage of coolies harbouring the worm; but the common opinion among medical men is that at least 75 per cent. of the Tamil coolies are infected, the vast majority of them never showing any symptoms.
In Kuala Lumpur there are 200 Tamil coolies engaged in night-soil work under conditions which expose them to grave risks of becoming heavily infected— yet during the past year the hospital admission rate for ankylostomiasis was only 3.5 per cent, and there were no deaths.
As regards the measures which have been taken to cope with it, so far I am It is aware there has been on no estate any general crusade against the worm. usual, in the case of hospital patients, to examine the stools microscopically, and, if eggs are discovered, to prescribe a vermifuge; but the stools of non-hospital coolies are not as a rule examined.
As regards Trench and pit latrines have been constructed on most estates. ankylostomiasis it is a debatable point whether these do harm or good. On the one hand the general pollution of the soil around the lines is prevented; on the other it is natural to suppose that there is a concentration of the infection in the ground immediately surrounding the latrine, and as everyone walks barefooted over this area the risks of infection are presumably increased.
It is through the courtesy of the Medical Officers in charge of the various hospitals that I have been able to complete the attached list-for the returns sent in give only the total number treated, and do not show from what estate each came.
I have, &c.,
A. R. WELLINGTON, Health Officer, Selangor.
The Senior Health Officer,
Federated Malay States.
SIR,
Health Office, Taipeng, 2nd March, 1914.
I HAVE the honour to forward particulars of the prevalence of ankylos- tomiasis.
2. The only figures available in this office are those obtained from the hospital reports, and the deaths within the Sanitary Board limits of Taipeng. The figures show that there were 578 cases of ankylostomiasis in the 24 estate hospitals, with only four deaths. The total population of the estates served by these 'hospitals is roughly 23,450. Chersonese Estate furnishes 304 cases, with three deaths. On this estate all newly arrived coolies, except those recruited locally, are examined for ankylostoma.
3. In the Plus Central Hospital, all patients admitted into hospital are examined for the disease.
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4. As far as I know this is not done in other estates in Perak North, so that it will be seen that the above figures do not in any way represent the extent of ankylostomiasis. In my experience ankylostoma is especially dangerous in preg- nant women, and in unhealthy estates malaria complicated by ankylostoma is responsible for the high death-rate.
5. According to the hospital returns, there were 29 deaths attributed to ankylostomiasis, but cases are sent to Taipeng Hospital for the whole of Larut, and 29 deaths is probably not a correct estimate of the amount of ankylostomiasis present.
I have, &c.,
H. M. C. GREEN, Health Officer, Perak North.
To the Senior Health Officer,
Kuala Lumpur.
RETURN OF PREVENTION OF DISTRIBUTION OF ANKYLOSTOMIASIS IN THIS COUNTRY. DEATHS attributed to ankylostomiasis on estates in Perak South, 47.
I have no figures except those of the estate hospitals, in which the diagnosis is hardly worth looking at.
In Perak South into the estate hospitals were admitted 922 cases as per list* attached.
J. T. CLARKE,
The Senior Health Officer,
Federated Malay States, Kuala Lumpur.
Health Officer, Perak South, Ipoh.
Health Department, Negri Sembilan,
Seremban, 25th February, 1914.
In the year 1913 ANKYLOSTOMIASIS is spread widely over Negri Sembilan. there were 340 cases, with 66 deaths, treated in the Government hospitals, out of
a total number of cases treated for all diseases of 17,070.
In estate hospitals there were 824 cases treated, with 61 deaths.
The mortality caused by ankylostoma for 1913 for the entire State was -88 p.m. living.
It cannot be said to be more severe in one district than another, e.g., Kubang had 131 cases, whilst Jindaram, which is close by, had but two cases; St. Leonards had 91 cases, and Sua Betong (Coast) had two.
In the estate hospitals beta-naphthol and thymol are the drugs employed.
The means which has been found most beneficial in dealing with this disease on estates is as follows:-
All coolies in batches of fifteen or so are admitted to hospital, given a purga- tive overnight, and stools examined in the morning. Then all those who require treatment are detained in hospital or are treated as out-patients. In this way a labour force can be all examined three to four times in the year, and early cases diagnosed before any clinical symptoms are manifest.
J. R. DELMEGE,
Health Officer, Negri Sembilan,
Health Office, Coast,
Port Swettenham, 14th March, 1914.
Ankylostomiasis in the Coast District.
To what extent the Coast District is affected with ankylostomiasis is not
at all clear. Doctors in this district are not agreed as to what constitutes ankylos- tomiasis, and while this is so it is impossible to place much reliance upon their reports. One estate doctor and his assistants last year reported 63 per cent. of Another over 10,000 admissions to their hospitals as due to ankylostomiasis." estate doctor reported 7.64 per cent. out of more than 4,000 admissions as due to ankylostomiasis. The Medical Officer in charge of the Government hospitals reported 4.13 per cent. of over 5,000 admissions as ankylostomiasis. In 1910 and 1911 I was in charge of Klang Hospital, and 1-89 per cent of the admissions were cases of ankylostomiasis, in my opinion. Recently 144 unselected Tamil immigrants
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