24 
A. A. SANDOSHAM 
A Commission was sent out by the Rockefeller Foundation to the Orient in 1915 to 
determine to what degree Uncinaria infection is a menace to the health and working efficiency 
of the people of the country under consideration. The report drawn up by Darling, Barber 
and Hacker (1920) contains a fund of detailed information. Great impetus was given to 
general sanitation and control of hookworm disease as a result of the survey of hookworm 
infection in the Straits Settlements (Singapore, Malacca and Penang) commenced by Barnes 
and Russell of the Rockefeller Foundation in co-operation with the Medical Department. 
They introduced the Willis-Molloy flotation technique for the examination of faeces which 
is still used as a routine diagnostic method in the clinical laboratories of Malayan hospitals. 
Strahan and Norris (1934) reported that elephantiasis was prevalent in North Province 
Wellesley and the present writer identified Microfilaria malayi Brug, 1927 from blood films 
sent by them. Subsequent researches by Poynton and Hodgkin (1938) showed that filariasis 
was endemic in the low lying areas where the big rivers run to the sea and that Mansonia 
longipalpis and M. uniformis were mainly concerned in transmission. Polunin (1951) found 
endemic filariasis in widely spread areas of the Malayan hinterland both among the Aborigines 
and the Malays. 
Buckley (1938) investigated the cause of “sawah-itch” a dermatitis among the rice- 
cultivators of Negri Sembilan, and incriminated the cercaria of Schistosoma spindale Montgo- 
mery, 1908. The writer (this Study , p. 195) has recently found that cercarial dermatitis 
in Malaya can also be caused by cercaria of the “Elvae” group. 
The Annual Reports of the Medical Department record findings of routine stool exami- 
nations but these do not give an accurate picture of the incidence of worm infections in Malaya. 
The writer examined one portion from each of 1,300 faecal samples sent to the routine labo- 
ratory from patients at the General Hospital, Singapore. On comparing results it was noted 
that whereas the Willis-Molley method is efficient in detecting hookworm infection, it is less 
reliable for Ascaris and Trichuris infections. When only unfertilised eggs of Ascaris are 
present it is seldom detected by the salt flotation technique while Clonorchis (imported), 
Schistosoma (imported) and Strongyloides infections are never reported upon although Clonor- 
chis eggs were present in 2.5 per cent and Strongyloides larvae in 6.0 per cent of these patients. 
Less than 2 per cent of these patients had sought admission to hospital for treatment of helmin- 
thiasis. An examination of 150 faecal samples from members of the public belonging to the 
same social class showed a close similarity to the findings of hospital patients. This suggests 
that the incidence of hookworm, Ascaris and Trichuris infections reported by hospitals gives 
some indication of their incidence among the population as a whole. 
The war introduced several factors which are likely to have altered the incidence and 
infection rates of worm parasites among the Malayan people. Among these may be mentioned 
the large influx of troops into Malaya from north India and Japan, the return from Siam and 
Burma of Malayans who had gone there as forced labour, the low nutritional state that was 
prevalent during the war and for some time after, and the general deterioration in sanitary 
standards. 
Worm Parasites of Animals . — On the veterinary side, Ford (1902) published an account 
of “Aortic Worms” in the Veterinary Record and Gnoh Lean Teck (1905) made a more extend- 
ed study of these in buffaloes and oxen. Daniels (1905) listed a number of worms from 
domesticated animals and discussed their importance. Purvis, Orr, Joseph, Narayanan, 
Lancaster, and other Veterinary Officers in Malaya made extensive collections of parasitic 
helminths, which have been studied by themselves and by others like Adams (1932) and Robin- 
son (1934). Buckley (1937-8) described Stephanofilaria kaeli from the “Krian sore” of cattle 
and incriminated certain species of Culicoides as carriers of Onchocerca gibsoni. 
STUD. INST. MED. RES. 
