Report of Work for the RELIEF AND CONTROL OF UNCINARIASIS IN BRITISH GUIANA Up to March 31, 1915'. THE ROCKEFELLER FOUNDATION ' INTERNATIONAL HEALTH COMMISSION 61 BROADWAY, NEW YORK, U. S. A. Report on Work for the RELIEF AND CONTROL OF UNCINARIASIS IN BRITISH GUIANA Up to March 31, 1915, BRITISH GUIANA 1. Plan of Work. All work in British Guiana is conducted on the intensive plan, which contemplates, as nearly as practicable, the complete relief and control of uncinariasis within restricted areas. 3. Extent of Operations. Work in the Peters' Hall District, lying on the East Bank of the Demerara river, near Georgetown, terminated during the quarter ending March 31, 1915; and operations in three areas (A, B, C) on the West Bank were begun. The time spent in each of these districts is shown below: Date Work Opened Date Work Closed EAST BANK: Area A Nov. 1914 March 30, 1915 " B March 1914 Jan. 33, 1915 " C Sept. 1914 Jan. 16, 1915 WEST BANK: Area A Feb. 1, 1915 — " B Jan. 9, 1915 — " C March 34.1915 — In comparing the results in the areas on the West Bank with those in the areas on the East Bank, it should be borne in mind that work on the West Bank is still in progress. I. RESULTS BY AREAS UP TO MARCH 31, 1915 1. Locating the Infected. The oensus of persons living on both the East and West Banks, up to March 31, 1915, was 19,713. Of these, 17,438, or 88.5 per cent., have been microscopically examined for uncinariasis; 10,653, or 61.1 per cent., of those examined have been found infected; and first treatment has been given to 8,837, or 83.9 per cent., of those infected. Table 1 exhibits these results in detail for each of the six areas where work has been in progress: 2 Taoie 1 GRAND EAST 3AM WEST BANK TOT ID TO 'AL Are i A Area B Area C TOTAL Area A Area B Area C No . P.C. No. P.C. No. P.C. No. P.C. No. P.C. No . P.C. No. P.C. TJo- P.C. No. 1. Census .... 19712 10380 3986 3532 2832 9333 4003 4954 376 2. Examined.•■ 17438 68.5 9537 91.9 ?5?5 89.7 ?203 90.0 3756 97.? 79Q1 64.7 318? 79.5 4633 93.3 26.1 3. Infested... 10652 61.1 5590 58.6 1759 49.3 1918 59.8 1913 69 .4 5063 64.1 3009 63.2 2981 64.5 73 73/5 4. Given First Treatment 6827 82.9 5160 92.3 1514 86.1 1876 97.8 1770 93.5 3667 72.4 1300 64.7 2367 79.4 2. Treating the Infected Until Cured. The number of persons found infected, up to March 31, 1915, was 10,653. Of these, 5,838, or 54.7 per cent., have been shown by microscopic re-examination to have been cured. The remaining 4,834, or 45.3 per cent., consist of persons who remain under treatment (2,412, or 22.6$); of persons who have removed from the areas (1,957, or 18.4$); of persons who could not be treated (447, or 4.2$) but who remain in the district as foci of infection; and of persons who died (8, or .08$) but whose death was not connected with thymol administration. Table 2 gives these figures in detail for each area: Table 3 GRAND ..... EAST I ANK WEST sank TOTi a TO! AL Ares A Are i B Are J. C 1 TOTAL Area A Are- B Ar -a C No. P.C. No. P.C. No. P.C. No. P.C. No. P.C. No. P.C. No. P.C. No. P.C. No. 1. Infected. . . 10653 5590 1759 1918 _ 1913 1 5063 3009 3981 73 3. Cured 5838 54.7 4109 73.5 1131 63.7 1437 74.4 1561 81.6 1719 34.0 409 30.4 1310 43.9 3. Under treatment 3413 33.6 484 8.7 176 10.0 333 11.6 85 4.5 1938 38.1 886 44.1 1043 35.0 4. Removed from area 957 18.4 710 13.7 330 18.3 304 10.6 186 9.7 1347 34.6 663 33.0 513 17.3 73 100. 5. Not treated 447 4.2 380 5.0 143 8.1 57 3.0 81 4.3 167 3.3 51 3.5 116 3.9 — — 6. Died* 8 .08 7 .1 — — 7 .4 — -- L_i .03 — 1 .03 — — 3. Per Capita Cost of Examinations. Up to March 31, 1915, a total of 110,963.82 had been expended in British Guiana for examining 17,438 persons. From this the per capita coat of examinations is found to be $.62. Table 3 shows in detail the figures for each area: ♦Death not connected with thymol administration. 3 Table 3 Cost Per Person Examined Amount Expended Number of Persons Examined GRAND TOTAL, $.62 $10,963.62 17,438 EAST BANK: Total .90 8.545.39 9.537 Area A .53 1,900.04 3,575 " B 1.24 3,964.33 3,206 " C .45 •1,235.07 2,756 Supervision by Dr.Howard — 1,445.95 WEST BANK: Total .31 2.418.23 7.901 Area A .32 1,004.14 3,180 " B .30 1,386.01 4,623 " C .29 28.08 98 4. Educational Work. Table 4 exhibits the progress made in educational work. It indicates that a total of 34 lectures have been given (34 to public; 4 to school; and 6 to special audiences); and that these 34 lectures have been attended by 8,935 persons (4,618 at public; 692 at school; and 3,615 at special lectures). Based on the census of these districts, of 19,713 persons, we find that 8,925, or 45.3 per cent., have attended lectures and been educated in the measures necessary to relieve and control uncinariasis: Table 4 TOTAL PUBLIC SCHOOL SPECIAL No. Atten- dance No . Atten- dance No. Atten- dance No. Atten- dance TOTAL 34 8925 24 4618 4 692 6 3615 EAST BANK: Total 26 5270 17 1638 4 692 5 2940 Area A 2 440 — — - — 2 440 Area B 13 3512 10 1400 2 312 1 1800 Area C 11 1318 7 238 2 380 2 700 — WEST BANK: Total 8 3655 7 2980 _ —, 1 67 5 Area A 3 1234 3 1234 — — — Area B 4 1989 3 1314 — — 1 675 Area C 1 432 1 432 — — - -- 5. Preventive Measures. Measures for the prevention of uncinariasis are conducted by a staff of sanitary inspectors appointed by the government The type of latrine adopted is the ordinary pit privy with a bank of clay around the top of the pit to keep out surface waters. The dimensions of the pit are three feet long, two feet wide, two and one-half feet deep. The pit is dug shallow to prevent the tapping of ground water, which rises 4 very high during the wet seasons. In Table 5 the symbol D indicates a privy where night soil falls on the ground but is protected from flies, fowls, and animals; E, one built for concealment only, with no protection from flies, fowls, and animals; and F represents no latrine accomodation. The improvement in sanitation of areas A, B and C on the East Bank is not indicated clearly in this table because of an error in making the initial sanitary survey. The number of homes inspected should have been reported as 3638, instead of 3130. On the supposition, however, that the incorrect figures afford a true average, we find that the percentage of homes with latrine accomodation was raised from 40.3$ when the work began to 66.6$ when it ended,- an increase of 36.4$. The initial sanitary survey on the West Bank is still in progress. From figures now available the number of homes with privies is shown to be 1,380, or 45.8$ of the total: Table 5 ; f Inal Inspection Initial Inspection i ryi oe of Privy t 'ype of Pj "ivy Total A B C D E F Total A B C D E F TOTAL EAST BANK: Total .... 3638 1440 317 881 2130* 307 1267 Area A 844* 129 366 449 " B 535* 157 93 275 " C 751 31 187 543 WEST BANK: Total 3789 1167 113 1509 Area A 1149 630 56 463 " B 1499 536 47 916 " C 141 1 10 130 II. RESULTS BY AREAS FOR FIRST QUARTER, 1915 1. Locating and Treating the Infected. The report for the first quarter 1915 shows that a census was taken of 9,334 additional persons; that 7,957 ♦Figures incorrect; total for East Bank should have been 3,638; for Area A, 909; for Area B, 978. 5 persons were examined; b,090 found infected; 3,767 given first treatment; and 2,127 cured. Table 6 gives figures for work accomplished in each of the six areas during the quarter ending March 31, 1915: Table 6 1 TOTAL EAST BAKK WES1 BANK Total Area A Area B Area C Total Area A Area B Area C 1. Census 9334 2 *2 9332 4003 49 54 376 2. Examined .... 7957 56 56 7901 3180 4623 98 3. Infected 5090 28 28 — — 5062 2009 3981 73 4. Given first treatment.• 3767 100 99 1 3667 1300 2367 5. Cured 2137 408 344 12 53 1719 409 1310 — 2. Per Capita Cost of Examinations. The per capita cost of examinations during the quarter ending March 31, 1915, was $.36. The amount expended was $3,834.92; the number of persons examined, 7,957. Table 7 itemizes these figures for each area: Table 7 Cost Number of Per Person Amount Persons Examined Expended Examined TOTAL $.36 $2,834.92 7,957 EAST BANK: Total 7.44 416.69 56 Area A 7.44 416.69 56 " B " C — — — WEST BANK: Total .31 2 .418.23 7.901 Area A .32 1,004.14 3,180 " B .30 1,386.01 4,623 " C .29 28.08 98 3. Educational Work. There were eight lectures delivered during the quarter to a total of 3,655 persons. Seven of these lectures were public, attended by 2,980 persons; and one was to a special audience of 675 persons. A report on the educational work in each area is given in Table 8: 6 Table 8 Kind of Lectures TOTAL Public School Sp ecial Atten- Atten- Atten- Atten- No. dance |no . dance No . dance No . dance TOTAL 8 3655 7 3980 — — 1 675 EAST BANK: Total _ — — * —. — Area A " B " C - - — — — WEST BANK: Total 8 3655 7 3980 1 675 Area A 3 1334 3 1234 — — - — " B 4 1989 3 1314 — — 1 675 " c ! 1 433 1 432 — — - — III. RESULTS BY VILLAGES UP TO MARCH 31, 1915 1. Locating the Infected.. Table 9 shows by villages the progress made in examining and treating the inhabitants. This table gives the supporting figures upon which Table 1 is based: Table 9 Census Examined Infected Given First Treatment GRAND TOTAL 19713 17438 10653 8837 EAST BANK: Total 10380 9537 5590 5160 Area A: Total 3986 3575 17 59 1514 LaPenitence 1487 1346 581 516 Alexander Ville 1905 1791 860 745 Meadow Bank 530 467 277 318 Houston Front 74 71 41 35 Area B: Total 3563 3306 1918 1876 Agrioola 1330 1310 635 631 Eccles 343 333 361 356 Bagotstown 780 681 393 383 Peters Hall 718 646 386 376 . Providence Pasture 389 336 243 340 Area C: Total 3833 2756 1913 1770 Mocha 356 244 148 140 Arcadia 189 176 124 110 Covent Garden 359 348 223 308 Prospect 83 80 41 38 Diamond Front 80 78 56 50 Big Grove 1129 1111 829 767 Little Grove 399 386 381 360 Craig 310 305 191 179 Hope | 38 28 30 18 7 Table 9 (continued) Census Examined Infected Given First Treatment WEST BANK: Total S3 33 7901 5063 3667 Area A: Total 4002 3180 2009 1300 Best — -- Vreed-en-Hoop 660 86 53 — Pouderoyen 1263 1109 641 412 Goed Eortuin 1060 1043 654 539 LaGrange 1019 943 661 349 Area B: Total 4954 4623 3981 3367 BagotvilJLe 1973 1846 1194 1039 North Bagotville 917 875 574 493 South Bagotville 1055 971 630 546 Canal No. 1 1641 1491 1035 650 L'Heureuse Adventure.. 190 178 116 109 Vaux Hall 317 301 189 183 Beauvosin 141 134 78 67 L'Oratoire 119 117 65 55 Bordeaux 42 41 31 27 Genieve 81 73 58 42 Mesdelices 60 56 48 41 Jacoba Constantia .... 77 74 54 51 Fitioo 153 133 96 76 J ava 18 14 9 — DeRidder's Faith 75 63 45 — Sans Souci 99 95 69 — Studley Park 33 29 31 — DeKinderen — — — — The Lock 337 194 146 — Toe Vlugt 88 86 50 45 LaRetraite 351 340 175 155 Stanleytown 902 860 537 478 Area C: Total 376 98 73 Good Intent — — — — Sisters — — — — Vive le Force 327 98 72 — Potosi 74 — — — Free and Easy 75 — — — 3. Treating the Infected. Until Cured. Table 10 shows by villages the progress made up to March 31, 1915, in curing the infected persons. The supporting figures for Table 3 are given in this table: Table 10 Infected Cured Under Treatment Removed From Area Not Treated Died* GRAND TOTAL 10652 5e28 2412 1957 447 8 EAST BANK: Total 5590 4109 484 710 280 7 Area A: Total .. . . 1759 1121 176 320 142 LaPenltence 581 339 67 139 36 - Alexander Ville 860 543 109 132 76 - Meadow Bank 277 208 42 27 _ Houston Front 41 31 — 7 3 _ Area B: Total 1918 1427 223 204 57 7 Agricola 635 485 50 74 24 2 Eccles 261 210 25 22 3 1 Bagotstown 393 282 40 58 11 2 Peters Hall 386 279 66 27 13 1 Providence Pasture 243 171 42 23 6 1 Area C: Total 1913 1561 85 186 81 Mocha 148 134 — 8 6 _ Arcadia 124 106 -- 5 13 _ Covent Garden 223 196 — 21 6 - Prospect 41 36 — 4 1 - Diamond Front 56 46 1 3 6 _ Big Grove 829 622 75 104 28 _ Little Grove 281 239 8 22 12 _ Craig 191 165 1 18 7 - Hope 20 17 — 1 2 - WEST BANK: Total 5062 1719 1938 1347 167 1 Area A: Total 2009 409 886 663 51 Best — — — — Vreed-en-Foop 53 — — 53 — - Pouderoyen 641 98 314 210 19 - Goed Fortuin 654 295 239 88 32 - LaGrange 661 16 333 312 - Area B: Total 2981 1310 1042 512 116 1 Basrotville 1194 587 438 114 54 1 North Bagotville 574 280 207 58 29 South Bagotville 620 307 231 56 25 1 Canal No. 1 1025 279 370 345 31 L'Heureuse Adventure.. 116 56 53 3 4 _ Vaux Hall 189 99 83 4 3 _ Beauvosin 78 24 42 7 5 _ L'Oratoire 65 29 26 2 8 - , Bordeaux 31 15 12 4 - - Genieve 58 8 34 16 - - Mesdelices 48 4 27 6 1 - Jacoba Constantia .... 54 18 33 - 3 - Fitico 96 16 60 13 7 - Java 9 — — 9 - - DeRidder's Faith 45 — — 45 - - Sans Souci 69 — — 69 - - Studley Park 21 — — 21 - - DeKinderen — — — — - - The Lock 146 — — 146 - - 8 •Death not connected with thymol administration. 9 Table 10 (continued) Infected Cured Under Treatment Removed From Area Not Treated Died* WEST BANK (continued) Area B (continued) Toe Vlugt 50 40 5 3 3 LeRetraite 175 103 53 15 5 - Stanleytown 537 303 176 36 33 - Area C: Total 73 73 __ Good Intent — — — — — - Sisters — — — — — - Vive le Force 73 — — 73 — - Potosi — — — — — - Free and Easy — — — — — - IV. RESULTS BY VILLAGES FOR FIRST QUARTER, 1915 1. Looatlng and Treating the Infected. Table 11 gives figures by villages showing what was done during the first quarter 1915 in examining for, treating, and curing uncinariasis. Table 11 Census Examined Infected Treated Cured GRAND TOTAL 9334 7957 5090 3767 3137 EAST BANK: Total 3 56 38 100 408 Area A: Total 3 56 38 99 344 I,AiP«Tvi tpncft 1 4 3 47 147 1 51 34 53 194 Mpnrionr Rank Houston Front — 1 1 — 3 Area B: Total 13 Agri on la — 5 Kr:r?lf“5 3 — — — — 1 Providence Pasture _ — — — 3 Area C: Total __ 1 53 — — 3 Arcadia — — — — — ... —- ... — TMftfTCPd Front — Rio- f.rnvp 1 4 — , 35 - 10 Hope - — — — 1 •Death not connected with thymol administration. 10 Table 11 (continued) Census Examined Infected Treated Cured WEST BANK: Total 9332 7901 5062 3667 1719 Area A: Total 4C02 3180 2009 1300 4C9 Best — — — — — Vreen-en-Foop 660 86 53 — — Pouderoyen 1263 1109 641 412 98 Goed Fortuin 1060 1042 654 539 295 LaGrange 1019 943 661 349 16 Area B: Total 4954 4623 2981 2367 1310 Bagotville 1972 1846 1194 1039 587 North Bagotville . 917 875 574 493 380 South Bagotville 1055 971 620 546 307 Canal No. 1 1641 1491 1025 650 279 L'Heureuse Adventure ... 190 178 116 109 56 Vaux Hall 317 301 189 182 99 Beauvosin 141 124 78 67 24 L'Oratolre 119 117 65 55 39 Bordeaux 42 41 31 27 15 Genieve 81 73 58 42 8 Mesdelices 60 56 48 41 14 Jacoba Constantia 77 74 54 51 18 Fitico 152 133 96 76 16 Java 18 14 9 — — DeRidder's Faith 75 62 45 — — Sans Souci 99 95 69 — — Studley Park 33 29 21 — — DeKinderen -- — — — — The Lock 237 194 146 — Toe Vlugt 88 . 86 50 45 40 LaRetraite 351 340 175 155 103 Stanleytown 902 860 537 478 302 Area C: Total 376 98 72 Good Intent — — — — Sisters — — — — — Vive le Force . 227 98 72 — — Potosi 74 — — — — Free and Easy 75 — — — —