New Public Iealt roble fAfrica
UNTIL RECENT TIME malaria (such as Bayer in Germany, Bur-
w a considered one of thc rJujii I~I~~IHu loughss and Welconi in England.
chief hindrances to pioges Human Blood Fluke Has Replaced Ledele, Parke Davis. Abbott, in
many regions of the world. But the U.S.) all are carrying inten-
with a better knowledge of the t) sive drug screening programs.
biology of the mosquito vectors M a l rS iis a or DlOc k t ro gress None has, as yet, succeeded in
and the skillful use of insecticides. finding an efficacious one.
it became possible to control ina- Often drugs that work wel with
laria. infected laboratory' animals prove
The disease now considered by By IENIZY VAN DER SCHALIE to be inadequate when tested on
many experts as most likely to humans. But even if compounds
retard development in Africa is incidence is clearly evident; the FOUR programs were then under- on that share. But, both species are found for relieving suffering,
called human blood fluke, Bithar- Sudan is faced with the problem taken concurrently to test of blood fluke are now slowly the best way to combat this dis-
ziasis or Schistosomiasis. As im- . of checking a situation in which whether it would be possible to climbing in incidence even though ease will involve combating and
plied in its common name, this human blood fluke is just begin- reduce the infection rate. effort was made to keep the dis- controlling the snails that serve
disease results from the presence ning to increase at a steady rate. These four programs were nor- ease from getting established as intermediate hosts.
of trematode worms or "fukes" In many ways both countries are moally carried by groups in differ- there. It is now at 10 per cent
liv;ng in the adult worm stage in quite similar. For example, al- ent parts of the country and at and is climbing at a steady rate. ALL CONTROL programs de-
the rich venous blood 'vessels sur- though the people of Egypt and different times. The teams organ- Plans are under way to put an- mand a degree of coordination
rounding the intestines or around the Sudan are ethnically differ- ized for work in the Quliub proj- other million acres under culti- and cooperation that seldom exists
the urinary bladder. ent; they are for the most part ect engaged in: 1) medical work vation. even in more highly developed
Ihe eggs produced by the adult Islamic and ablutions are prac- involving measuring incidence and regions. But, especially in under-
worms escape from the iuman ticed in both regions. Both are treating with antimony drugs; 2) T IE SUDANESE are very pro- developed areas it often is almost
sanitation involved providing wells gressive and are making good impossible to bring all the facets
and latrines; 3) health education use of the funds they earn. Whole concerned into a well devised
was carried on to inform the peo- villages are being reconstructed functioning campaign.
ple of the villages about the dan- with many improvements in such For example, in Egypt there
gers of contaminating water and problem areas as sanitation. were four main phases involved
being exposed to infection; and 4) The Gezira echeme is typical in the control work: medicine,
biology of the snails - a program of many similar projects through- sanitation, health education and
in which the distribution of in- out Africa. Most such programs biology of snails. But, almost ev-
( fected snails was determined and are doomed to failure unless means ery other activity of community
the snails of the tract were then for controlling human blood fluke life was involved.
eradicated with a molluscicide can be developed. Religion, which in this instance
I (copper sulphate). At present there is no drug was Islamic and called for an at-
Incidentally, the first treatment that is satisfactory as a cure for tempt to teach the people to per-
of this tract cost about thirteen human schistosomiasis. A oum- form ablutions but to do so away
thousamd dollars for the chemical her of well known laboratories (Concluded on Page ii)
alone. ------ -' -_---'~
The next year there were half
as nany snails but just as many
sites of snail infection; in the
third year conditions were back the silk sh i rtd res
to the state they were before any
treatment!
IT IS CLEAR that at present it a c ic h
is not possible to control schis-
tosomiasis even when all known
measures are applied. The inci-
- ' dence in the Nile Delta is known
to be at least 60 per cent with the
people suffering from both species
of human blood fluke.
On the other hand, the inci-
dence for about 500 miles along
the Nile from Cairo to the Aswan dresses . . . also, In our
Dano is now only about 6 per cent
and this region is infested only mai flo q. Sportshop
Women washing clothes in an African stream can easily be infected with the vesicular type.
by sebistosomiasis. The disease is prevalent where water is found. If Egypt succeeds in building
the new High Dam at Aswan the
body with the feces or in lhe urine . mainly agricultural with cotton uppr Nile region aill have per-
When the eggs reach water in the main crop. Both are depend- enNial irrigation and with that
nuure (canals, drains, ponds) a ent on the Nile for the water used system the area will become in-
srall larva hatches and it pune- in their irrgation programs sod fusled a heavily as is the Delta.
trotes certain species of snail. these waters harbor the same vec- The question might well be raised
tor snals and the inhabitants are whether ill health will not take
AFTER ABOUT a month of d subject to both species of Schus- away most of the advantages
selopment in the snail, as- tosomiasis. gamd from a four crop systrm
other free swimming larva (a ccr- b w
carium) is released. Humans in X"ET, THE STATUS of human
contact with water containing cer- blood fluke in these regions is HE ENGLISH started a very
carie are then liable to infection. strikin'ly dificrent. sucesaful irrigation project
These minute larvae, which are While Egypt clearly shows the known as the Gezira Scheme.
hardly visible to the naked eye adverse conditions brought ' about A large canal which parallels
bore into the body of people ex- by Bilharesasis, the Sudan is faced the Blue Nile was constructed
hosed to infection by drinking. with the problem of having the about 40 years ago; a million acres f
'swiummun" uu''"ut'ng fields, wash benorfits of a wonderfuh irric;.tiomn sre planted to cotton and othes
;ra clothes, watering the gamoosa scheme cancelled out by the dis- crops. This region with only 16 .
p fornmon''btutuos, and so 0 ease situation that cail develop inches of rainfall has a climax
c is now known that this blood there. flora of scrub acacia and was in " af,,,,
fluke was widespread throughout The struggle against Bilharzia- habited by only a few nomatic
Africa for many centuries. Eggs sis in Egypt has been long and dif- bedoumn people. It has now been'
of Bilharzia worms were found in ficult. It is estimated that at least transformed into a remarkably
the intestines of mummies in half of the population is afflicted successful project wvith a popula-
Egypt. with it. Lion of 300,000 and with an eco-
In many undeveloped regions I A special project was under- nomic development that is the
this disease is usually in a latent taken between 1951 and 1954 in a envy of many other Afican
form and the incidence is often 5,000 acre tract on the Delta countries.
relatively low (about 5 per cent). about 12 kilometers north of Cairo. The profits of the scheme are
But when areas hithr to wild and Following a house to house survey shared so that 40 per cent stays
uncultivated become subject to to register all the inhabitants of with the company, the sharecrop-
intensive cultivation and irriga- the five main vill. ges, it was de- pers get another 40 per cent, and
tion schemes and when water pow- termined that more than half of the government receives 20 per
er developments are initiated, the the 32,000 inhabitants were in- cent. Viitually all of the govern-
incidence of this disease begins to fected. mental activities are supported
rise at an alarming rate. The iii -
eidence can rise to a level at - - -
S 0,l1v ed'itted from the best-loved
w cn the in ean pro uceu irY .
well cancel out the benefits tro- 3 ClassiCs ... and the most
duced by the agricultural develop-
ments. ATSigniicant! with news of
the softly pleated skirt.
AT PRESENT two countries in !)Afiaerevywllti-
Africa serva very aw'clh to il-
lustrate these extremes in the h
groxwth and development of Bil-
harziasis: Egypt and the Sudan. TO0M 0-A
tIs Egypt floe harmful effects of
the disease with its unusually highE
Henry van der Schalie
professor of zoology and Cu andliberty
ator of Mollusks in the Miu state an erty
seum of Zoology.
SUNDAY, FEBRUARY 22, 1959 Page Nine