OBSERVATIONS ON KALA-AZAR IN KASSALA PROVINCE 113
4. MAFAZA. But few Abyssinians live here, though a fair number pass through, staying for a short time on their journey. Number of proven cases two (one an Abyssinian), and suspicious five.
Captain R. B. Black found two Arab policemen with the disease at Senga, but they had contracted it at Mafaza;:Dr. Andrew Balfour found the Leishman parasites in smears from these cases.
Captain S. L. Cummins also proved kala-azar in a Tumergi, who developed the disease
at this station, and died in Cairo.!
Thus the total number of proved cases from here is five.
5. SOFIand TOMAT. Two suspicious cases were seen at the former and one at the
latter.
A few Abyssinians visit these places, but seldom live for any length of time. These three cases were weak, emaciated, with large spleens and livers, and though in
one case spleen smears were taken, and in the others peripheral blood films, yet in none were malaria or kala-azar found. They were placed on quinine, and it was hoped that they would be seen on my return journey, but as this was not the case, they were not included in Table “ B.”
A rough map is given on page 103 showing the surroundings of Kassala Province, with
the number of suspicious and proved cases under each town.
DEATH RATES. Though the registration of births is most inaccurate, that of deaths
is fairly reliable.
The number of deaths at the following places are given :—
Year Kassala Gedaref Gallabat Mafaza
TOO eS ee 183 311 26 | 53
Sy RO 299 254 187 poith: ald
1908 445 \eiack te! 4a. | 51 32 36 (to end of April)
= 144 153 | 96 108
The last row shows the number of deaths in 1908, if the same rate were maintained during the remaining months of the year; but this is quite unreliable, since the deaths appear usually greater during the last four months than during the first and middle four.
Further, these populations vary very greatly, and so statistics are very unreliable. However, the death rate at Mafaza seems to be steadily increasing.
DURATION OF ILLNESS. The average duration of the positive cases was apparently 10-5 months, the longest being 2} years, and the shortest 34 months.
The incidence of the disease seems to be from August to December, 7.e. during and subsequent to the rainy and cool weather. Three definitely dated the beginning of their
illnesses to August, one to September, and three to October.
This probably corresponds with a temperature below 75° F., anyhow during the night
hours, and so falls in with Rogers’ statement? that the parasites develop best at a
temperature below 75° F. |
t Cummins, S. L., February, 1908, “ Kala-azar in the Anglo-Egyptian Sudan.” Journal of the Royal Army Medical Corps.
2 Rogers, Leonard, I.M.S., 1907 Milroy Lecture. Lecture II.
Consideration of death rates
Duration of
illness