112
290. In addition to these three epidemics which have occurred in the past
few years, it is probable that there have been minor increases of malaria asso-
ciated with the demolition of the areas required by the Improvement Trust for
Sandhurst Road and Princess Street, and also for the building of new chawls at
Koliwada. These local epidemics have all been due to similar causes, i.e., the
undertaking of construction work involving the production of numerous
temporary pools of water in areas in which permanent breeding places of
the malaria-carrying Neocellia stephensi existed, and in which the population
was already in some degree infected with malaria. The gradual increase of
endemic malaria in many parts of the City, resulting in many thousand of people
becoming infected with the disease, culminated in a more general epidemic
in 1908, in all probability partly as a result of the stress produced among the
poorer classes of the population by the abnormal rise in the price of food in
the latter part of 1907 and 1908.
291. As a general conclusion it may be stated that a consideration of all
the available facts leads to the opinion that, the anti-malaria work
carried out in the City prior to 1909 (with the exception perhaps of work at
Malabar Hill and Bhandarwada) has failed to prevent an increase of malaria.
Section 2.
292. RECENT RESULTS OF MALARIA PREVENTION .—In 1909
shortly after the commencement of the special investigation, the results of
which are detailed in this report, more vigorous measures of malaria prevention
were adopted in the City, especially in the neighbourhood of the Docks. These
measures have been referred to at length in a former section, and it is only
necessary to mention certain facts which appear to show that the measures
adopted have been of some value, and that a mitigation of malaria has followed
upon their adoption.
In support of this opinion it may be pointed out that —
(1) There has been a considerable reduction in the spleen rate of children
resident within the area in which the measures have been applied.
(2) There has been a marked reduction in the cases of fever admitted to
the local dispensaries.
(3) There has been a fall in the total mortality among people resident
in the area affected by malaria owing to proximity to the Dock Works.
(4) And more especially the mortality during October and November
and the deaths among young children within this area has shown
a great decrease.
293. Spleen Rate.—Early in 1909 before the adoption of the more vigrous
measures subsequently undertaken by the Municipality, Port Trust and Rail-
way Companies, an examination of 597 children resident in the Esplanade
section, the area immediately adjoining the New Dock Works, showed 438 or
73.38 per cent, to possess enlarged spleen. A second spleen census carried out
in this area late in 1910 showed 250 children out of 516 to have enlarged spleen
or 48.4J per cent., a difference of nearly 25 per cent. A similar reduction has
also been effected in the spleen rate among children resident in the portion
of the North Port which lies between Frere Road and the New Docks. Early
in 1909 among 366 children resident there 166 or 49.4 per cent. showed
enlarged spleen. Late in 1910 among 560 children examined there 200 or
35.7 per cent, showed enlarged spleen, a reduction of 13 per cent. In one
large chawl with a population of 1,200 the spleen rate dropped from 54 per
cent. to 29 per cent. at the end of 1909.
294. Fever admissions.—The fall in cases of fever admitted to the Frere
Road dispensary is equally striking. The total fever admissions at this
dispensary year by year since 1903 are as follows :—
Year.
1903
1904
1905
1906
1907
1908
1909
1910
Total fever
cases treated.
2,071
2,984
4,083
4,852
6,584
7,173
4,240
4,012
Total cases
treated.
5,014
6,605
8,367
10,160
11,420
11,686
8,158
7,951
Percentage
of fever
cases.
41.3
45.1
48.5
47.7
57.6
61.3
51.9
50.4