14.S 



KALA-AZAH COMMISSION 



Age 

 incidence 



Sex 

 incidence 



Race 

 incidence 



In some cases, blood did not How freely until the needle had been withdrawn slightly. 

 The needle was wholly withdrawn as soon as blood appeared beyond its butt, the blood 

 thus obtained being suflleient for many slides. 



Ill all, 53 spleen punctures were done on tour anil in no case were any unfavouraVjlu 

 results noted. Every case was kept lying down for two hours after spleen puncture, 

 and then carried to his house, and told not to walk about till next day. This order was 

 often not obeyed, and I have met many cases, three hours after being punctured, walking 

 about unconcernedly. 



Of the 37 cases seen and reported on the J-ilue Nile, 24 were in boys and girls from 

 7 to 18, whereas of the 5 cases noted in Kassala Province, 4 were in men of from 20 to 30 

 and only 1 in a child. 



It would therefore appear as if the type of disease found in the Sudan is very similar 

 to that of India. In India, 50 per cent, of the cases quoted by Kogers were in children 

 and young adults up to 20 years of age. In the report of sporadic cases at Sylhet an 

 even higher percentage, namely 69 per cent., of cases under 20 years, is reported. 



This latter percentage more nearly agrees with our observations on the subject. 



.•\s regards sex incidence, of 42 cases, 8 only were females. I do not think that this 

 preponderance of male cases is in any way due to the objection of the natives to bring their 

 women folk for treatment, as seclusion of the female sex is not carried to such an extent in 

 these districts as in Egypt. Many women who were unable to come for treatment or whose 

 husbands were unwilling for them to leave their houses were visited in their houses. 



As far as can be seen no special race shows a predisposition for the disease, all seem to 

 be equally prone to infection. 



The following table shows the race incidence : — 



ToTAt. 



14 



.Seasonal 

 incidence 



As cases have been seen at various seasons of the year, it is dillicult to determine 

 the actual time of infection. From information gathered from native sources the disease 

 would seem to show itself at the end of the rains; this would seem to favour infection 

 taking place during the rains, the cool season. 



It must be remembered that during December and January the temperature is 

 generally low, and, assuming that a low temperature is a necessary factor in infection, 

 it is quite possible that the disease may be contracted during these months and, lying 

 dormant through the hot weather, only asserts itself during the following rains. 



This would point to a prolonged quiescent period, though, experimentally, it has been 

 found possible to demonstrate Leishman-Donovan bodies by spleen puncture within fifty 

 days of infection. 



