Urinary bilharziasis: A campaign of diagnosis and treatment in Dongola Province, Sudan, November, 1921 to March, 1924

Abstract

Summary 1. An account of 740 cases of urinary bilharziasis treated by more than 10,000 injections of antimony tartrate. 2. Of these intravenous injections more than 9,000 were administered by native Sudanese assistant medical officers unaided. There were no misadventures beyond two small abscesses. 3. Of the 740 treated cases 520 were re-examined up to 2¼ years after treatment. 28, or 5·4 per cent., were still infected. Of these, 10 abandoned treatment prematurely. The percentage of those who received a full course now infected is 3·5. 4. Only 17 fresh cases could be found in the infected areas from the urines of 731 untreated people. 5. The urines of 200 girls were examined with negative results. 6. The possibility of antimony-resistant patient or parasites is suggested. 7. While not neglecting the recognised general and personal measures, I consider that antimony tartrate is the prophylactic agent par excellence. 8. Observations on etiology:— (a) Connection between pumping schemes and infestation apparent only. (b) Constant presence of rocky hills at the back of infected areas. 9. The results of this short period of work in a heavily-infected area do, I consider, justify one in the hope and belief that the disease may be reduced to a minimum by means of systematic treatment with antimony tartrate. Dongala is not an easy province to manage. It lies too near to Egypt, and many of its young men work in Egypt and return to Dongola for leave. Moreover, no other prophylactic measures whatever have been undertaken during this period, beyond an attempt to educate the natives by verbal propaganda.