82
Post-mortem Examinations.-Since June, 1913, post-mortem examinations have been done on 32 bodies (adults). Sixteen (50 per cent.) were found to be infected with anklostomes. In two cases it was noted that the infection was considerable, but in the others only small numbers of parasites were found. Ecchymosis of the intestinal mucosa was seen in several, and in one case, though the number of ankylostomes was small, damage to the mucous membrane appeared to be considerable.*
The causes of death, in two cases with considerable ankylostome infection, were pneumonia in one and tuberculosis of the lung in the other.
Conclusions.--Cestode infections are very common, and must have a deleteri- ous effect, especially in intestinal disease.
Ankylostome infections are also very common, but the number of parasites is mostly small. It is difficult to say how much injury the ankylostomes can do, but no definite case of ankylostome anæmia has been seen.
The deleterious effect
of even the small infections must increase the liability of the patient to other disease.
Ascaris and Oxyuris vermicularis infections are very frequently found in natives weakened by disease, usually intestinal disease.
Prophylaxis. Apart from the treatment of natives very little can be done towards the prevention of entozoal infections until the natives have been educated to improve their insanitary habits, and to be more particular in the preparation and cooking of their food.
Lokoja,
5th November, 1914.
83
sanitation, a question of time, patience, and persistently continued efforts, and, above all, money. The natives themselves know this disease, but do not regard it
in a serious manner.
Dr. R. W. Gray, who has spent five-and-a-half years in Assam, where ankylos- tomiasis is very prevalent amongst the tea garden coolies, is of the opinion that the disease in Southern Nigeria is of a mild form. He has never seen the same severe anæmia in Nigeria as he has in Assam. The treatment that has been adopted has been thymol, grains 10, daily, or beta-naphthol, grs. 15; the result has been a success in the gaols, but those attending the dispensaries seldom return for a second dose.
H. B. S. MONTGOMERY,
for Principal Medical Officer.
24th December, 1914.
Station.
Numbers Bxamined.
Number Percentage.
WESTERN.
Lagos Hospital Lagos Prison
**88223
986a368
Infection.
Remarks.
Ibadan reports 69 cases in 8 years with
8 destlig. Natives say it is injurious to
their children, prevalent in Ibadan district,
52
50
40
•
G. J. PIRIE,
Epe ...
80
Nil
Nil
Medical Officer.
Aro
80
16.6
earth fetish, and call it Okele.
Ebute Melta
100
Badagry
Yaba
68
75 84
PUBLIC RECORD OFFICE
Reference :-
LTCO. 885
24 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
Enclosure 2 in No. 67.
ANKYLOSTOMIASIS IN THE SOUTHERN PROVINCES OF Nigeria.
I ATTACH a detailed list of stations in the Southern Provinces of Nigeria where Medical Officers made investigations with reference to the above.
In none of the stations mentioned was a European found to be infected with ankylostomiasis, although fifty were examined, and there is no record of a European infected. I myself am only acquainted with one case of European infection during my fifteen-and-a-half years in West Africa, and it was not in Nigeria.
From the evidence and the figures in attached list there is no doubt that ankylostomiasis is widely spread over the whole of the southern portion of Nigeria from east to west, and it has been recognized as such by the Medical Officers for a considerable time past. Dr. Chichester writes :—
"I have ten years' experience of that portion of Nigeria known as Southern Nigeria (till end of 1903), and have travelled all over the area.
"In 1904, I found ankylostomiasis widespread in the Asaba and Onitsha country on each side of the Niger, extending up river 100 miles to Adah, and down river some 40 miles. Everywhere I noticed the prevalence of anemia and was at first somewhat puzzled until I found the cause to be ankylostomiasis."
From the reports received it is not evident that a great deal of ill-health and disability can be attributable to this disease. But no doubt it enters very largely into the death rate when its victims are attacked by other diseases. Thus it is almost invariably found in cases of dysentery, and is no doubt one of the causes of so many of these cases ending fatally.
In the investigation carried on in the various stations there was no evidence of a double infection of malaria and ankylostomiasis playing an active part in the anæmia and other symptoms, the general consensus of opinion being that malaria was prevalent in infantile life, while ankylostomiasis only made its appearance in early adult life, the number of cases in which both were present being negligible. As far as the Medical Officers were able to ascertain, the disease has very little effect on the health and growth of the children.
A large proportion of the figures were obtained from the gaols, no children being available for examination. One must remember that huge areas of this country are yet in a very unsettled state, and it is not possible to carry out investi- gations with the same ease as in other portions of the Colonial Empire, nor are the same means applicable to the treatment of any outbreak. It is a matter of
CENTRAL.
Udi ...
18
9
50
Onitslia
102
80
78
Warri
46
27
59
Benin
148
49
84
Forcados
120
28
28.9
Hapele
172
150
87.2
17
12
72
59
82
Okwoga
Aboh
EASTERN. Degema
180
86-5
7-6
Okigwi
25
Bouny
96.8
Opolio
Owerri
100
10
Ilu ...
Ogoja
Nil
Nil
Obudu
100
Afikpo
Ukpo
Eket
100
Ikot Ekpene Abkaliki
6454
| | ភីភីឌ| វីឌគ
** **Z8||
11838-368
Nil
Nil
90
No. 68. TRINIDAD.
70 per cent, of those examined.
No cases observed.
H. B. S. MONTGOMERY,
for Principal Medical Officer.
COLONIAL OFFICE to THE INTERNATIONAL HEALTH COMMISSION.
[Answered by No. 80.]
SIR,
Downing Street, 12th February, 1915. WITH reference to the letter from this Department of the 23rd December last, I am directed by Mr. Secretary Harcourt to inform you that the Governor of Trinidad reports that he would be exceedingly glad to avail himself of Dr. Washburn's services, to act as local director of the ankylostomiasis campaign, seeing that Colonel Dodd, the Medical Officer in Charge, has now returned to this country to offer his services to the War Office.
* No. 54.
G 2
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