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YAWS.

Yaws is not commonly found to the north of the 9th parallel, but to the south of that line it is widespread in its incidence. In the 1927 report, yaws was described as the most widespread and most crippling disease affecting the negroid races of the upper reaches of the White Nile and its tributaries. This is probably still the ca e, but a very great diminution in the incidence of primary and secondary cases as a result of wide-spread treatment is becoming increasingly obvious. This is particularly noticeable in the Upper Nile Province, in the sleeping sickness areas of Mongalla Province, and in the central area of the Bahr- el-Ghazal.

In the Upper Nile Province the attempt to render a definite area of the country completely free of the disease by the treatment of all infectious cases had to be discontinued owing to political unrest, and an interesting experiment in the complete elimination of a disease from a self-contained area was thus interfered with, but on the other hand the increase in the number of dispensaries throughout the province has led to a marked general advance in combating the disease. In certain areas of this province, notably the Bahr-el-Zeraf area and the Shambe- Yirrolarea, the condition of die population has been completely changed in the course of the last few years. Whereas previously a large proportion of the population showed • xtensive secondary lesions and were largely incapacitated for work, or hunting, now it is not only rare to see active signs of the disease in these areas, but in addition there is an obvious general improvement in the nutrition and well-being of the population.

The invariable mode of treatment for this disease in its active manifestations is Novarsenobenzol. In the majority of cases it is not possible to persuade the patient to stay for more than two injections. It is found, however, that active lesions nearly always clear up after the second injection. The aim in view is to cure all active manifestations of the disease in as many cases as possible, so as to render th m non-infectious and thus prevent the transmission of the disease-

The decrease in the incidence of this in disease the sleeping sickness areas is indicated by the following figures, which show the number of active cases of this disease seen and treated during the last three years :—

1926 1927 1928

6,193 593 639

The following is the total number of Novarsenobillon injections given for yaws in the Upper Nile Province for the years 1027 and 1928 respectively. It is anticipated that in spite of the further spread of medical work the number of injections given for this disease during the next few years will shew a steady decrease :—

1927 l928

29.607 21,468