30

Southern Sudan.

The inhabitants of these provinces have until recently been largely cut off from communication with the outside world, and might well be expected to have little acquired immunity against this disease ; whilst at the same t me the ever-

increasing intercommunication and intermixing of previously isolated population

might be expected to favour the dissemination of disease.

It has not yet been possible to obtain much data as to the incidence of this disease, but such information as is available appears to indicate that the tubercul¬ osis incidence is not at present heavy, nor is there any indication of its increase.

It had been suggested that the incidence of pulmonary tuberculosis was heavy among the Shilluk, a negroid tribe which owing to its northern position has been longer exposed to infection by natives of the northern and central Sudan. A careful survey of the southern portion of this tribe was carried out. The villages inspected were those situated south of Kodok, and comprised approximately 50,000 people. Twenty men and two women were found infected with pulmonary tuberculosis. The youngest infected were two boys of 18 years of age. The infection had. for the most part originated while the patients had lived in a town, e.g. Malakal, Kodok, Tonga.

Five cases of surgical tuberculosis were seen, and five others were said to be undergoing treatment in hospital, bring'ng the total for all cases of tuberculosis to 37, equivalent to a percentage rate of .07. This would appear to be reassuring, but none the less the position as regards the incidence of this disease among the negroid population is being carefully watched.

TYPHOID FEVER.

132 cases of typhoid and para-typhoid fever with 31 deaths were reported this year, as against 52 cases with 10 deaths in 1927. To some extent this in¬ crease may be attributed to better d’agnosis and to a larger number of cases being

brought forward by their relations for treatment, but after all allowances have been made, it would appear that this disease is going through a phase of increased activity in the Sudan.

The following list shows the distribution of the cases : —

Place.

Europeans. Natives.

Admitted. Died. Admitted. Died.

Khartoum __ _ 22 3 Omdurman — — 28 7 Khartoum North — — 3 — Atbara .. — — 3 — Port Sudan 2 — 3 1 Wadi-Half a . — — 2 1 WadMedani — -- 5 o Nahud 2 Kassala . . . . . . — — 20 10 Gedaref — — 10 2 Makwar .. 1 — M dakal .. 2 — 24 5 “Ladv Baker” . . 5

Total 6 —• 126 31

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