^^6 SCIENCE IN AFRICA 



organized by hospital visitors in the homes of Africans, has proved 

 ineffective in view of the insanitary mode of hfe. Accordingly, 

 it has been concluded that the isolation of patients is indispensable 

 and special tuberculosis hospitals are being established. 



Hospital records provide another source of information, and 

 sometimes significant results can be deduced from them; for 

 example, in the Gold Coast there is some evidence that tubercu- 

 losis has increased recently, and that nearly every case which 

 enters hospital proves fatal. The case-mortality rate of tubercu- 

 losis is, in fact, very high throughout Africa, because patients do 

 not come for treatment until the disease has reached an advanced 

 stage, a fact which emphasizes the need for health visiting in towns. 



LEPROSY 



In contrast to the tubercle bacillus which has found a home 

 among Africans only during the last thirty years or so, the leprosy 

 bacillus [Mycobacterium leprae) has been with them since time im- 

 memorial, and some maintain that the real home of leprosy was 

 Africa, whence it has been transported all over the world. 



W. H. Hoffman (1932) points out that the northern belt of 

 Central Africa, from Nigeria to Abyssinia, is the most affected 

 portion of the globe. From the Ivory Coast the disease has been 

 reported in from 5 per cent to 6 per cent of the population, and 

 from limited parts of the Belgian Congo even in 1 2 per cent. About 

 half a million cases of leprosy are already known in Africa, so the 

 real num.ber cannot be less than a million. Leprosy is a house-to- 

 house disease, and the infection of whole families by everyday con- 

 tact is not by any means rare. There is evidence from good obser- 

 vers that there has been an increase of leprosy in some places in 

 recent years. Hoffman considers that the segregation of sufferers 

 from the disease in isolated colonies cannot attack seriously its 

 endemicity in Africa, because it is easily propagated by sufferers 

 who do not show visible signs, and frequently the most infective 

 cases cannot be selected for segregation. 



Until the last thirty years leprosy has been regarded as an incur- 

 able disease, but research has shown that the majority of cases in 

 early stages can be arrested and even cured, given adequate treat- 

 ment; advanced cases, though they may be improved, are usually 



