26
SUPPLEMENT TO THE ANNUAL REPORT OF THE
No reliable statistics regarding the chief cause of mortality and sickness in
this locality are available. The village returns show that over 60 per cent of
deaths are due to " fevers." From enquiries made in the villages it is clear that
malaria is by far the most prevalent and serious disease. Hence it is highly
probable that a large proportion of deaths from " fevers " is due to malaria.
Also the great rise in the mortality during the period July to January may in this
instance be partly due to malaria, as the months of May and October are the
months when malaria is most prevalent.
Spleen rate.— In order to determine the presence of malaria in these villages,.
children between the ages of two and ten years were examined for evidence of
enlarged spleen. As far as possible over 50 per cent of children between these two
age limits in every village were secured for examination. Table I ( a ) gives the
findings.
In the villages in Malakapuram area the spleen rate varied from 48 per cent
to 85.5 per cent which is very high. In this area the adult spleen rate was also
taken and is fairly high as will be seen from Table I ( b).
Index of size of spleen.— With a view to ascertaining the index of the size of
the spleen for each village, the following measurements were taken in children
under 10 years with enlarged spleens :—
( i ) D i s t a n c e f r o m n i p p l e t o u m b i l i c u s .
( i i ) D i s t a n c e f r o m a p e x o f s p l e e n t o u m b i l i c u s .
( i i i ) D i s t a n c e f r o m a p e x o f s p l e e n t o m i d d l e l i n e .
With the help of these figures the exact positions of the apices of the enlarged
spleens of the cases in the village of the Malakapuram area were marked in the
standard abdominal chart of Col. Christophers. Table II shows the index of size
of spleen for the various villages.
Chart No. 4.—Not reproduced shows the positions of the apices of the enlarged
spleens in the Malakapuram area. From that it will be seen that the great
majority of spleens are fairly big and near the umbilicus, being 10 cm. or less from
the umbilicus.
Parasite rate.— The blood of every child examined irrespective of its having
an enlarged spleen or not, was taken for determining the presence or absence of
the malarial parasite in it. As a routine, both the thick and the thin films were
made on the same slide for every case. Before a slide was declared negative at
least 100 fields of the thin films and 50 fields of the thick films were examined.
Table III (a) gives the result of this examination.
The parasite rate is found to be far in excess of the spleen rate in most of the
villages. This was due to a great number of the children with no enlarged spleen
showing the parasite in their blood. It was also noted that a fair percentage of
the children with enlarged spleens yielded negative results. The findings are
detailed in Table III ( b).
In each village the type or types of the malarial parasite responsible for the
disease was also studied. Table III ( c ) gives details of the findings.
A few cases of infections with plasmodium malariæ were found in three out
of the ten villages visited ; Plasmodium vivax and falciparum were mainly
responsible for the cases in all the villages, the latter being the commoner of
the two.
•
Anopheles survey.—The visits to the villages happened to be made at a period
when malaria was at its highest. The late September and early October rains
had just stopped and all the geddas, ponds and ditches were full of anopheles
larvæ. Samples of larvæ and pupæ were collected from the various breeding
places in each village and bred out in the laboratory. In addition, a special search
was made for all the breeding places in and around the proposed sites of the
harbour labour camp and Malakapuram village, and a representative collection of
larvæ from each breeding place was obtained. Table IV gives the findings. The
names of the species bred out from the collections of each village are given in the
order of their numerical prevalence with special remarks, if any, regarding the
breeding places of each species.