^^2 SCIENCE IN AFRICA 



determining the incidence is proved by the returns from moun- 

 tainous and well-drained places such as Mlanje and Zomba, 

 which show 22*2 per cent to 28'3 per cent of hookworm infesta- 

 tion compared with 53 per cent and 64 per cent in Port Herald 

 and Karonga, which are both low lying and poorly drained. 

 In Northern Nyasaland a heavy child mortality was traced to 

 intestinal infection by worms resulting in cirrhosis of the liver. 

 In Tanganyika helminths account for 19 per cent of all diseases 

 and 34 per cent of all deaths at Government institutions. In 

 Kenya perhaps the most complete data on hookworm infestation 

 ever recorded among a backward people were obtained during 

 the campaign in the Digo District in 1927-8. Preliminary exami- 

 nation indicated that every individual was parasitized, so treat- 

 ment with anti-helminthic drugs, carbon tetrachloride and oil 

 of chenopodium, was applied indiscriminately. As a proof of 

 the wholesale parasitization one village was selected, being appa- 

 rently healthier than most, and was subjected to detailed study at 

 a time of year, at the end of the dry season, when infection should 

 have been at its lowest. H. D. Tonking (1935) records the results: 

 every individual was infected and the average number of hook- 

 worm eggs was 466 per cubic centimetre of faeces. 



The remedial measures against helminthiasis, especially hook- 

 worm, depend largely on improved sanitation and general stan- 

 dards of living, and above all the establishment of latrines in every 

 village. It is clear that extensive treatment campaigns can be of 

 little permanent value until steps are taken against reinfestation. 

 Accordingly, a two-stage policy is generally adopted in most terri- 

 tories, consisting firstly of propaganda for the establishment of 

 latrines and secondly of efforts to reduce infection by treatment. 

 Practically the whole of rural Africa is still in the first stage. 



rrPHOID FEVER 



Typhoid, para-typhoid, and the associated diseases are un- 

 doubtedly prevalent in most parts of Africa. According to hospital 

 returns, Africans do not appear to suffer from them to the same 

 extent as Europeans, but authorities in the Belgian Congo do not 

 subscribe to this opinion, since severe epidemics of typhoid have 

 been known, especially in Katanga and the Bas Congo. Diagnosis 



