Medical report / British Honduras.

  • British Honduras. Medical Department.
Date:
[1935]
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: Medical report / British Honduras. Source: Wellcome Collection.

    25/46 (page 17)
    A few cases of benign tertian malaria are encountered, but the majority of cases seem to be due to the subtertian parasite. Blackwater Fever is endemic. I have only seen four cases in four months, but a past history of the condition has been obtained from many more patients. The high incidence of subtertian infections and the extremely common habit of people treating themselves in a haphazard manner by a few casual doses of quinine are probably predisposing fac¬ tors to the development of the disease Anaemia of varying grades of severity is common both in the town and district gen¬ erally. It is most often seen in infants and children and is frequently associated with en¬ largement of the spleen, abdominal distension, and oedema of the legs. The prevalence of malarial anaemia may be justly attributed to neglect in obtaining thorough treatment of recurrent mild attacks of malaria. This situation arises partly from the mental attitude of many people towards illness, which is regarded as an essential and inevitable part of the routine of their lives, partly from their objection to taking quinine in solution. Quinine in the form of capsules, sugar-coated tablets, together with “bilious pills” and numerous other patent medicines enjoy a considerable sale. Considering that a large number of these cases suffer from chronic malarial gastritis possibly with associated achlorhydria, it is not surprising that the drug is not absorbed in these forms and is ineffective. In the mahogany camps of San Jose and Sierra de Agua, the incidence of malaria is extremely high. The conditions of life are very favorable to the propagation of the disease —the camps are situated in low-lying forest clearings where no drainage is possible, and the labourers huts are situated in close proximity to one another. On account of the tran¬ sitory character of the camps, the expense of measures aimed at mosquito control would be prohibitive. Free quinine in solution is supplied to the labourers by the Company. Measles and Whooping Cough.—The district has been swept by an epidemic of these two infectious diseases this year. Measles first made its appearance in the town of Orange Walk in July, and spread to the outlying villages in order of their proximity. During the months of September and October a considerable number of deaths occured among in¬ fants and children in the district suffering from the sequelae. The common sequlae were bronchitis, broncho-pneumonia, dysentery, and malaria. Broncho-pneumonia was in the nature of a capillary bronchitis, exceedingly acute in type, and uniformly fatal. The dysentery took a chronic form, and was responsible for several deaths among the younger children. The mortality was highest among artificially fed infants and undernourished children. Helminthiasis.—Very few children in the district are free from this condition. In the town of Orange Walk, owing to legislation insisting on the provision of a latrine for each house, ankylostomiasis is very rare, but cases of oxyuriasis and ascariasis abound. One case of the former completely mimicked the clinical features of a case of post-epilep¬ tic coma; the appropriate antihelminthic treatment produced a complete cure. Ascariasis frequently gives rise to chronic bronchitis with expectoration of blood-specked sputum, and probably to occasional cases of pneumonia; numerous worms are present in the sputum. In the outlying villages which do not come within the scope of the Sanitary Inspec¬ tor, ankylostomiasis is rife. Dysentery—This condition is common in the hot season, with the onset of cooler weather the incidence showed a marked decline. The majority of cases are amoebic and bacillary in type, mild in character, and with the exception of infants and chronically undernourished children, respond readily to treatment. Some cases of diarrhoea with blood and mucus in the stools are undoubtedly due to malaria, and a number to worms. Both types clear up rapidly under the specific treatment. Infantile Mortality The total number of live births during the year was 210. Forty-three deaths occured in infants under the age of one year, of which 14 were certified by the Medical Officer. The epidemic of measles and whooping cough have been largely responsible for the high infantile mortality, but other factors have undoubtedly played a part in exposing infants and lowering their resistance to infection, viz;