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Province.

1911-12,

PERCENTAGE OF INFECTIONS IN NATIVE DIVISIONS.

1910.

Berekoum

Ahafo

Wenchi

629

691.

1.077

Tekiman ...

·045

Wam

Gaman

1.243

1911-12.

PERCENTAGE OF INFECTIONS IN ZONGAS,

1912-13.

1910.

Sunyani

Odumase

Wenchi

· 5.33

Tekiman

6.25

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96.

SIR,

(No. 23/2/13.)

37

Enclosure 3 in No. 4.

Medical Department,

Victoriaborg, Accra, 8th September, 1913.

I HAVE the honour to submit a report and maps by Dr. Wade on the present state of sleeping sickness in Ashanti.

The report is most interesting, and shows a lot of industry and time has been spent on it.

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The main features brought out in it may be summarised as follows:-

(1) The disease is endemic; occurs as sporadic cases; is very chronic in its course; the infection being apparently mild, causes no alarm for that reason to the indigenous inhabitants, who show a certain amount of resistance to infection.

(2) The infected indigenous population and permanent residents appear to be the reservoirs, and the strangers, mostly traders and carriers from the west and north, the carriers of the disease.

(3) The latter do not appear to be in any way connected with bringing the infection with them, and I consider there is ample evidence that the disease is rare in the Northern Territories, the cases that do occur having been infected elsewhere.

If the disease were common in that dependency it would long ago have come to light.

(4) The strain of trypanosome causing the disease appears to be mild, and while it finds a difficulty in establishing itself in the healthy indigenous native, it easily does so in the stranger from the north.

Dr. Kinghorn in 1910 was of this opinion.

(5) The possible connection between chronic insanity and trypanosomiasis is interesting, and the point was touched upon by Dr. Connal in the Laboratory Report for 1912, and is to be further investigated.

(6) The freedom of the indigenous cattle, and the almost universal infection of the imported ones, is interesting, and raises the question if the former could possibly harbour trypanosomes injurious to man.

(7) The morphological character of the trypanosomes which have been found, and this latter point could only be determined under suitable conditions in a laboratory.

(8) In round numbers, 40,000 people were examined in 1912-1913 out of an

estimated population of 60,000.

(9) Many difficulties were experienced in carrying out the work, and a too

critical eye must not be cast on it.

(10) Its main object was to ascertain definitely the actual state of the disease

and its history, and I venture to suggest it has succeeded.

(11) Wenchi, which showed the highest percentage in 1910, still heads the list

for the Divisions, but its percentage has gone down two-thirds.

(12) Odumase Zongo shows the highest percentage of infections, and all the

infected were North Country natives.

being on the main road going south.

This is probably due to its

3. The nomadic population, it will be seen, plays a large part in the propagation

of the disease.

4.

If I may be permitted I put forward the following measures, many of which

I have already drawn attention to:-

(1) Establish a segregation camp in a fly-free area, and equip it with a

Medical Officer, hospital, dispensary, and laboratory.

(2) Legislation to make notification and segregation compulsory, the latter only for such.time as the Medical Officer may consider necessary.

(3) Ascertain the trade routes and, as far as possible, have the traders and carriers systematically inspected before they enter the fly country.

(4) The Veterinary Officer to enquire into the source from which the humped

cattle acquire their infection.

(5) Clearings should be undertaken as advised by Dr. Wade.

(6) The Medical Officer, Sunyani, should have a permanent gang of carriers,

and should travel in his district.

PUBLIC RECORD OFFICE

Reference :-

C.O. 885

22 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO.

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