ENDEMIC DISEASES

LEPROSY.

There is little leprosy in the northern and central zones of the Sudan, but southwards the disease becomes increasingly familiar until southern Bahr-el- Ghazal and Mongalla are reached, where the incidence is high.

The North.

Tn the north, lepers are dealt with at Omdurman. Segregation is not compulsory, but sheikhs and omdas are encouraged to send in their infected people. This colony is admirably conducted by a surgeon of the Church Missionary Society. The patients are not self-supporting, but are given a generous and selected diet. The colony is especially useful for testing experi¬

ments in drugs and treatment.

The report of the surgeon in charge is given below :—

Report on Leper Hospital, Omdurman, by C.M.S. Surgeon.

“The number of inmates on December 31st 1928 were 47; 32 men and 15 women. During the year there have been 5 admissions, 4 deaths and 4 left without leave.

Outpatients. There are 22 patients on the books, 11 men and 11 women and girls. Two of the girls have been free from all signs of the disease for a year, but attend monthly for inspection.

Medical Treatment—General. Courses of 914 have been given to those with positive Wasserman. During the last two months each patient has received raw liver daily. It was felt that they were in need

of cod liver oil, but that it was of prohibitive expense.

Specific. 29 of the inmates and all the outpatients are in stage 1, 2 or 3 of Group II. (“Leprosy” Rogers and Muir). For the first four months weekly intramuscular injections of Wigbtiana oil were given starting with

4 c.c. and going to 3 c.c. The second four months the patients received graduated doses of Alepol intramuscularly from £ c.c. to 5 c.c. bi-weekly.

The last four months patients have had bi-weekly intravenous injections of Alepol combined with Potassium Iodide by mouth. The initial dose given is \ c.c. of Alepol with 10 grains of Potassium Iodide a day. The

reaction is checked by the patient’s temperature and the dose increased until they are taking 5 c.c. bi-weekly and 30 grains Potassium Iodide daily, which should keep their temperature at about 99.

Patients showed little or no general reaction to the Wigbtiana oil or the intramuscular Alepol; they complained of pain at the site of injections, but with Potassium Iodide and Alepol some of the patients have shown marked reaction. There have been no fatal cases. None of the inmates have become bacteriologically negative, but two of the outpatient girls have had negative skin results.