352 JAS. .3. SIMPSON — ENTOMOLOGICAL 



Sleeping Sickness. 



There can be little doubt that sleeping sickness is endemic in many parts of 

 Northern Nigeria, but the actual delimitation of these areas is a very difficult 

 matter. The occurrence of one or two cases in any village or town does not in itself 

 justify the conclusion that that place is an endemic focus. For example, a case 

 of sleeping sickness was discovered at Maiduguri, but after carefid enquiry it 

 was practically proved that the infection was obtained near Loko on the Benue. 

 To regard Maiduguri, therefore, as a sleeping sickness area on this account 

 would be erroneous and misleading. 



Apart from this, however, one European died of sleeping sickness contracted 

 either on the Garara River or in Bassa or Kabba Province, and cases have been 

 recorded in persons who have never left their native district. Of course it is 

 possible that the infection might have come from another locality, but in 

 default of any definite information on this point we must regard these areas 

 at any rate as suspected foci. These have been indicated on the appended map, 

 and the following notes may serve to show how scanty our knowledge of this 

 subject is, and also emphasise the necessity for an extended survey being organised 

 to ascertain the precise distribution of the disease. When this is done it will in 

 all probability be found that sleeping sickness exists in all the southern provinces 

 and practically throughout the Niger-Benue river system. It has been reported 

 from Sokoto and Katagum, but if cases did occur there it is probable 

 that they were introduced. I have purposely excluded these from the map 

 as the likelihood of these places being endemic foci is extremely remote. 



According to the Medical Ileport for 1906 four cases, all natives, were 

 recorded in that year, and the following note is added : — " Trypanosomiasis is 

 fairly common in certain parts of the Protectorate. Most cases were found on 

 the banks of the River Benue and in the Bassa Province." 



In 1909 three cases were found in natives. " There is, however, considerable 

 evidence to show that the disease is not imcommon on the Benue, but the portion 

 of the Protectorate where it is said to occur has not yet been thoroughly 

 examined. It is apparently confined to small areas and has never assumed the 

 form of epidemics such as have occurred in East Africa." 



Dr. J. W. S. Macfie who accompanied me during my trip in the Garara River 

 district, says, " As the result of the examination of 952 persons in twenty-seven 

 villages on the Garara River no case of trypanosomiasis was discovered. 7"1 per 

 cent, of the people were found to have a slight enlargement of the cervical 

 glands. From the statements of the headman at Izon, which is on the Nassarawa 

 bank of the Garara, it would apjDcar that sleeping sickness was once prevalent 

 there but that it has completely disappeared in recent years. From the report 

 of the Resident it would appear possible that sleeping sickness is not uncommon 

 in Agaie but not in epidemic form. One of the cases detected at Baro last 

 September (1910) was a man from Agaie." 



With regard to the outbreak in Baro referred to, in which five cases were 

 found, Drs. Ingram, Morrison and Macfie say : — " We are of opinion that the 

 occurrence of trypanosomiasis is sporadic in Baro. There is, however, to judge 

 from the prevalence of Glossina palpalis at this season of the year (August), no 

 reason why it should not become epidemic." It must be remembered, however. 



