OliSERVATIONS ON KARA-AZ All IN KASSALA I'KOVINCE 
11.1 
4. }[AFAZA. Jlut few Abyssiniaiis live hero, though a fair number pass througli, 
staying for a short time on their journey. Number of proven cases two (one an Abyssinian), 
and suspicious five. 
Captain E. B. Black found two Arab policemen with the disease at Senga, but they 
had contracted it at Mafaza; Dr. Andrew Balfour found the Leishinan parasites in smears 
from these cases. 
Captain S. L. Cummins also proved kala-azar in a Tumergi, avIio developed the disease 
at this station, and died in Cairo.^ 
Thus the total number of proved cases from here is five. 
5. SOF£ ami TOM AT. Two suspicious cases were seen at the former and one at the 
latter. 
A few Abyssinians visit these places, but seldom live for any length of time. 
These three cases were weak, emaciated, with large spleens and livers, and though in 
one case spleen smears were taken, and in the others peripheral blood films, yet in none 
were malaria or kala-azar found. They were placed on quinine, and it was hoped that 
they would be seen on my return journey, but as this was not the case, they were not 
included in Table “ B.” 
rough map is given on page 103 showing the surroundings of Kassala Province, with 
the number of suspicious and proved cases under each town. 
DEATH BATES. Though the registration of births is most inaccurate, that of deaths 
is fairly reliable. 
The number of deaths at the following places are given : — 
Year j 
Kassala 
1 Gedaref 
Gallabat 
Mafaza 
1906 . 
183 
.311 
26 
53 
1907 . 
299 
2.')4 
1.37 
104 
1908 . 
48 
.61 
.32 
36 
(to end of April) ' 
144 
153 
96 
108 
The last row shows the number of deaths in 1908, if the same rate were maintained 
during the remaining months of the year ; but this is quite unreliable, since the deaths 
appear usually greater during the last four months than during the first and middle four. 
Further, these populations vary very greatly, and so statistics are very unreliahle. 
However, the death rate at Mafaza seems to he steadily increasing. 
DURATION OF ILLNESS. The average duration of the posith'e cases was 
apparently lO-.S months, the longest being 2^ years, and the shortest months. 
The incidence of the disease seems to be from August to December, i.e. during and 
subsequent to the rainy and cool weather. Three definitely dated the beginning of their 
illnesses to .\ugust, one to September, and three to October. 
Tbis probably corresponds with a temperature below 75° F., anybow during the night 
hours, and so falls in with Rogers’ statement'- that the parasites develop best at a 
temperature helow 75° F. 
' Cummins, S. Tj., February, 1908, “ Kala-azar in the Anglo-Egyptiaii Sudan.” Journal of ///<■ U'njnl Army 
.Urdical Corps. 
Rogers, Leonard, 1907 :Milroy Lecture. Lecture II. 
Consideration 
of death rates 
Duration of 
illness 
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