Certain aspects of trypanosomiasis in some African dependencies

Abstract

Although epidemic sleeping sickness may cause serious depopulation, the occurrence of a few cases should not be regarded as a calamity. Provided that there is adequate contact between the medical staff and general population there is no fear of such wholesale devastation as occurred formerly. Mass treatment of itself will reduce an epidemic to reasonable proportions. Constant vigilance is necessary, but fear of fresh disasters should not lead to unnecessarily severe and irksome restrictions. At present the disease is fairly mild, though patches of virulent infection occur. The proportion of severe nervous cases in Uganda, the Congo and the Sudan is not much higher than in Nigeria. Control measures should not interfere with general development. The restriction and settlement of population in unsuitable areas might cause more damage through poor nutrition and famine than sleeping sickness would have done. Most of Tanganyika Territory is infested with tsetse. Sleeping sickness is no longer serious as the population of infected areas has been concentrated in special treatments. There were only 168 cases in 1937. Cattle trypanosomiasis is the important problem. The fly-free areas are over-populated and overstocked. Soil impoverishment and erosion are increasing, and will continue to do so unless spread of tsetse is stopped and new areas reclaimed. A cattle assess on the four to five million cattle there would provide funds for soil and grazing control for tsetse research. A cheap and easy method of reclamation, to be used when required, is essential. In Uganda and the Sudan sleeping sickness is under control. The populations of the old epidemic areas have been moved to less dangerous regions. They are inspected regularly and cases treated. In both countries the restriction of population is causing overcrowding and soil impoverishment. It is hindering development and will have to be reconsidered. In Nigeria the disease is being controlled by mass treatment and the establishment of dispensaries and concentration by communal labour, and, as a last resource, the movement and concentration of population; 300,000 cases have been treated in the last 7 years. In many of the main epidemic areas the infection rate is now a tenth of the old figure. In moving population the object is to secure the maximum improvement and development and to try to make the new settlements demonstrations for the rest of the country. People are being helped to build model compounds, and villages are being laid out properly.