— 57 Cases amongst British troops :— Khartoum . . . . . . . . . . 74 Khartoum North . . . . . . . . . . 82 Imported . . . . . . . . . . 11 No primary cases of malaria occurred amongst Sudan Defence Force troops or in Central Prison.

Deaths. 5 deaths occurred amongst the abovementioned cases and 8 more deaths were presumed as caused from malaria.

DIPHTHERIA.

The epidemic of diphtheria which began in Khartoum in August, 1927 had been controlled in that town bjr the end of the year and except for a few cases in February and March no further cases were reported until October, 1928.

The total number of cases in Khartoum was only 19 compared to 61 in # 1927 and 16 in 1926. In Khartoum North only 4 cases had been notified until September, but during the three months following the rains 15 cases occurred.

In Omdurman, the epidemic in 1927 began a month later than in Khartoum, but unlike the latter, it did not die down by the end of the year. Although there was some evidence of diminished intensity during the summer months of May, J une, Jilly and August, a marked exacerbation took place in September and October, dying down towards the end of the year.

In spite of all onr efforts it has not been possible to trace any source of infection in the majority of cases. The greatest difficulty has been experienced in rounding up contacts as the people do not appreciate the contagion and resent having their throats swabbed and having prophylactic injections.

During August and September it became increasingly difficult to deal with all the cases in the civil hospital compounds, so it was decided to rent a house adjacent to the hospital for cases which were convalescent or were carriers of the disease. A circular in Arabic pointing out the seriousness and symptoms of the disease was widely circulated and the district commissioner impressed upon all omdas and sheikhs the necessity of early notification.

Of the 104 cases notified during the year, 45 of these or 44 per cent, of the total were discovered as the result of swabbing the throats of contacts, few of these showed any febrile disturbance or were at all ill; in one instance a case was under treatment in hospital for chronic otitis media and it was only after an acute case of diphtheria occurred in the ward that the ear discharge was examined and found to contain virulent diphtheria bacilli; it was not un¬ common to find positive carriers among children who were supposedly suffering from a common cold, these harboured the disease in the nasal discharge.

In one instance, a child was treated for 5 days in its house for whooping cough and was eventually brought to hospital in a moribund condition due to diphtheria.

Deaths. 32 deaths occurred from this disease or 22 per cent, of the total notifications.

Case mortality:— Khartoum Khartoum North Omdurman Sexes:— Males Females . . 15.7 per cent.

. . 15.7 per cent.

. . 25.0 per cent.

Deaths:— 3 deaths. 3 deaths, 26 deaths.

86 Males 59 Females 19 13