23 -

It is seen from these figures that the incidence of blackwater fever is not heavy, that it is distributed over the Sudan generally, cases being reported in every province excepting Khartoum, Haifa, Red Sea, Bahr-el-Ghazal and Darfur Provinces, that no cases occurred amongst British officials, that three cases occurred in Europeans living in southern areas under semi-native conditions.

In every case there was evidence of previous malaria.

DYSENTERY.

A total of 1,334 cases of dysentery occurred in 1928 as against 1,172 in 1927. This increase was in proportion to the increase of total admissions to hospitals. Of these 1,334 cases, 1,116 were amoebic and 248 were bacillary. A total of 59 cases occurred among Europeans, of these 38 were bacillary and 21 were amoebic.

The bacillary type of dysentery appears only to have established itself among the native population in provinces such as Khartoum, the Blue Nile, Berber and the Red Sea Provinces where there is considerable contact with Europeans and even in these provinces the cases are confined to the vicinity of the towns or areas with a considerable European population such as the irrigated area of the Gezirah.

The bacillary type is the commonest type among Europeans and particularly so when the Europeans are in considerable numbers. In Khartoum Province, out of a total of 33 cases occurring among the British population, 29 were bacillary and only four amoebic. Similarly, in the irrigated area of the Blue Nile Province out of 27 European cases, 24 were bacillary and three amoebic.

On the other hand in the Sennar district of the Blue Nile Province, where the European population is small, out of a total of 81 cases all were found to be amoebic.

The following list shows the total number of cases admitted for amoebic and bacillary dysentery respectively during each of the last eight years :—

1921 1922 1923 1924 1925 1926 1927 1928

Amoebic 477 390 504 605 483 543 835 1086 Bacillary 89 48 27 111 326 271 337 248

Total 566 438 531 716 809 814

_ 1172 1334

Percentage of' all dysentery admissions to f- 3.0 2.4 2.9 3.6 4.3 3.7 4.5 4.2 total admis¬ sions

GUINEA WORM.

North of the 9th parallel cases of this disease are only occasional; south of this parallel the disease increases greatly in frequency and next to yaws and chronic ulcers is the most common cause of temporary disablement. Even in these southern latitudes the country becomes relatively waterless for the early months of the 37ear, and the natives are compelled to water at a few permanent watering places. These watering places whether wells, rivers or storage ponds, are very liable to become infected and thus large numbers of the natives watering there contract the disease. The question of dealing with these infected watering