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Every effort is being made to popularise the treatment of bilharzia, which is voluntary. The great difficulty encountered is the length of time required for complete cure and the interference with agricultural work thus involved.

The accompanying list shows the cases discovered and treated at the various centres during the last three years : —

1926 1927 1928

2,447 718 742

cases.

ft

The methodical inspection of 19 schools throughout the province shows a percentage of 2.7 bilharzial cases as against 9.84 per cent, last year and 15.82

per cent, in 1926.

Of 1,761 people examined or re-examined during the year, on the infected irrigation farms 645 (36.6 per cent.) were found infected. 333 of these were new cases (18.8 per cent.) 256 cases previously reported as cured were found to be positive, and presumably re-infected.

Dongola Province.

The examination for this disease and the treatment of infected cases has continued to be on an entirely voluntary basis, thus it is impossible to give figures of any value for the whole population. There is a noticeable increased willingness on the part of the people to come forward for treatment. 12,213 persons came forward for examination and 2,259 persons were found to be infected; 1,480 received complete treatment.

Examination of school children for bilharzia infection gave a percentage in five vernacular schools of 7.4 and in forty four village schools of 15.7.

Anti-mollusc Work. This side of the work has been vigorously pushed. The distributarjr canals on the irrigation farms are dried off every 15 days and any remaining pools of water are treated with molluscicide. River pools are similarly treated.

White Nile Province.

The infection in this province is for the most part rectal in type and with few exceptions is from the river. In certain areas, water in pools and khors left by the falling river can be treated by molluscicides, but for the most part the planorbis snails are to be found in the shallow edges of the slowly flowing river. Mollusc destruction is thus impracticable as a general measure of anti-bilharzia work. The common variety found is planorbis boissyii. Fifty per cent, of snails taken from the river were found to be infected.

Treatment is optional, except in schools and at the quarantine stations at Kosti and El Dueim. Every effort is being made to enlighten the people as to the

ways in which the disease is contracted and re-transmitted to others through snails.

Efforts are being made to combat the transmission of the disease by :—-

(i) preventing fouling of the river edge. This can only be done at the Merkaz towns and over a limited length of river,

(ii) digging wells to provide an alternative water supply.

These are only used when the well supply is nearer than the river supply, but if suitably placed, they considerably diminish the numbers exposed to infection.

It is hoped to increase largely the number of these wells as it is considered that this is the line of action most likely to be effective in this province.