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8/23/1954 - East Africa High Commission: -4 Filariasis Research Unit by John B. George

NOT FOR PUBLICATION INSTITUTE OF CURRENT ORLD AFFAIRS JBG Africa High Com dssion Filariasis Research Unit Washington D O August Mr Walter S Rogers Institute Current World Affairs Fifth Avenue New York New York Dear Mr Rogers The initiative establishment Filariasis R search Unit taken United Kingdom through Colonial Medical Research Committee The Medical Research Council small October which intended enlarged later Research Unit under Colonial Office This action stimulated introduction apparently effective filaricidal drugs recognition seriousness diseases arrived after experience percent disability American military personnel infected areas Pacific during World War II__ It could disease having equiva effect Africa where areas population infected would ranked major problem The Medical Council Research Team remained East Africa months members stayed Director designate Colonial Research Unit Filariasis Research Unit European staff Director Africans under administrative control High Commission June I Further staff began arriving In appeared Unit would cease facilities being given Medical Survey Administrative authority reaches Filariasis Research through executive officer Administrator High Oommission though scientific oversight retained Colonial Medical Research Committee London The Unit headquarters located Mwanza south shoredO Victoria Lake Province Tanganyika The staff authorlzation766nsistelof Director physicians helminthologist entomologist three European laborato technicians photographer librarian The original European strength Director June In authorized vacancies filled except physician photographer At positions hysicisn helminthologist photographer Librarian vacant Installations Mwanza headquarters consist staff housing laboratory shared Medical Survey Begun January The group diseases produced round worms family Filarioidea The worms lodge parts human connective tissues lymphatic tissues their offspring called microfilsriae blood Rymph spaces permanent staff houses completed while laboratory remained under construction The housing available Tauganyika Government laboratory Mwanza hospital obtained through Director Medical Services Taugauyika Expenditures F R U follows Recurrent I1 Extraordinary I_ Total Of extraordinary expenditure probably spent joint headquarters F R U Medical Survey Revenue The expenditure joint headquarters entirely C D W funds under Scheme R Another capital expenditure under Scheme R entirey C D W funds Twothirds recurrent expenditure provided under Scheme R C D W funds remaining third being contributed East African territories Kenya Uganda Tanganyika providing equal amounts The objectives procedures Unit similar those Medical Survey specific field inquiry dealing filaria infections disease The first needs measure ffect disease economy welfare East Africa determine medica problem present serious ascertain relative importance several filarial diseases present The basic question answered prior expensive remedial action whether disease serious demands control whether economic importance expense large scale measures prevention treatment would Justified A careful survey large samples population examined district recognized means obtaining valid estimates disease effects during various stages The assessment bancroftial filariases three territories involves colection widespread areas night blood films count population suffering elephantiasis hydrocoele Such surveys described primary Filariasis Rsearch Unit retiring enior member High Commission A A second series research targets would finding exeeriment methods controS1ing disease either attacking human means drugs control insect carriers combined The testing control methods envisaged expected involve difficulty expense The second method cearing vectors involve order allow disease human reservoirs continuous vigilance years However advantage method would other insect borne diseases malaria The first method rendering infective mosquito means drugs procedure which would inevitably demand degree cooperation native authorities District officials The third detailed field investigation would concerned treatment patients ecially effectiveness drugs developed since All three programs accomplished before initial question regarding disease economic deterrent accurately answered Research would concentrate filarial infections common East Africa thought three number Bancroftial Fiariasis Onchocerciases Dipetalonemiasis infection Dipetaonema persians The first transmitted species mosquito stages produces elephantiasis hydrocoele second trans mitted biting causes abnormaitles sometimes blindness third vector unidentified little known infection history II apparentl causes serious inconvenience All common feature adult worms which belong family somewhsre infected individual which offspring called microfilariae blood The separate diseases different vectors produce ifferent symptoms Operations during hampered facilities shortage staff limited efforts devoted prineinally study single hetrazan disease bancroftial filarlasls During continued further investigations initiated protostib dipetalonemiasis plans finding vector Perstans investigate effects means tests human volunteers Up major research effort directed bancroftia filariasis onchocerciases The surveys determine seriousness diseases deterred somewhat satisfactory methods diagnosis The microfilariae count proved unsatisfactory diagnosing bancroftial infections attempt evolve satisfactory method using tests succeeded By survey almost completed Tanganyika totaS people examined May survey begun Kenya With bancroftial filariasis incidence detectable microfilariae night blood individuals tested found warmer areas ocean large waters In worst areas forty sixty percent tests positive A ptchy distribution infections found hyperendemic areas thought correspond presence suitable disease vectors A small percentage infected persons showed manifestations eephantlasis hydrocoele Elephantiasis found proportioned incidence microfilariae approaching percent areas The incidence hydrocoele found times elephantiasis affecting percent adults ocalities Despite likelihood million peopSe East Africa infected parasite investiga tions shown majority African patients unlike Alied JBG Z soldiers during World War II suffer crippling symptoms during early stags South Pacific disease quite different East Africa The problem represented stage afflictions elephantiasis hydrocoele which cause considerable working The economic importance disease cripFling effects genital filariasis elephantiasis Onchocerciasis exists serious several vaguely demarked areas Uganda better known locales Kenya cases reported Southern Highlands Province Tanganyika although found during survey On basis recorded Kenya disclosing certain areas Nyanza Province percent population suffer severe itching percent adult population areas bSind effects opined constitute serious local problem general major Dip etalonema Perstans bancroftial filariasis found patchy distribution though unusual diseases common single The shore Lake Victoria favored range infection By satisfactory support theory infection dipetalonema perstans human disclosed Researches methods controlling disease areas pressed cooperation territorial medical departments resulte appreciable amount knowledge The investi gation control disease through treatment human Infe6tlons reported advanced stage hetrazan protostib neostibosan solustibosan arsenamide having tested I0 patients Results hetrazan protostib availabSe In bancroftial fiariasis hetrazan nroved effective reducing transmlssibility disease human hosts Quickly rrolonged Feriod eliminates larval forms microfilariae peripheral blood providing means control keering parasite blood accessible biting insect Administered orally dispensed unskilled staff East African natives tolerate arger doses elsewhere world allowing shorter effective treatment The difficulty present expensive cheaper means present investiga target Large scale control through hetrazan prevented knows microfilariae level below which vector become infected significant degree Protostib proved effective enough reducing mlcrofi ariae blood through attack adult parasites But advantages expensive needing injected under medical supervision The effects attack adult worms harmfu patient Though advantage being effective against other diseases schistosomiasis injected filariasis judged unsuitable large scale Tests showed there wiing onchocerciasis human there continuing investigation because eliminating vector reasonable JBG Investigations control means eradicatino vector bancroftiaS fiarlasis reiminary stages mntomooglcal investigations identify vectors Ukara Is nroress since December Anohole_s_ ambiae identified important vector plans large scale research mosquito Projects actual elimination intended undertaken collaboratlon other services A Malaria Unit Oolonlal Insecticides Research Unit Some determine incidence microfilariae animsls Another project investigation respect vector elimination disease onchocer ciasis precluded through success experiment Kenya Medical Department By disease incidence children years dropped percent percent result eliminatin vector S heave dosin rivers DD appSied means aircraft In Uganda where vector S damnosu_m Colonial Insectidides Unit recommendation Belgian Cono specialist carried experimental spraying insecticides aircraft In studying problem curing bancroftial filariasis individual patients opposed collective preventive measures experiments effect hetrazan preventin onset manifesta tions patients symptom bancroftiasis undertaken Ukara Island Ky malnsn accompanying experiment protostib Ukara In bancroftian elephantiasis genital filariasis changes found hetrazan value preventin recurrent attacks fever Protostib brought relief could obtained safely easily hetrazan Hetrazan protostib cured proportion patients simple filarlal hydrocoe changes again hetrazan safer The treatment onchocerciasis drugs difficult problem since cause disease presence microfiarlae producln drugs which micro filariae adult worms The administration effective drugs therefore necessarily makes patient condition temporarily worse there danger rsuting Hetrazan rotostlb other tested against onchocerciasis It found treatment hetraz expensive uncomfortable halted itchin returned changed skins normal effect believed permanent The treatment caused apparently unharmful temporary chanes In advanced ptients considerable treatment observations needed before known hetrazan harmful This carried officer Kenya Department A evaluation hetrazan preventive regular dosage cited Final results nrotostib tests available It strongly microfilarlcidal value treatment oncho cerciasis depend effect adult worms The disease dipeta onemiasis seemed unaffected hetrazan number circu microfilariae persians remainin unchanged during treatment This finding coincides results recorded earlier other workers JBG The fullest cooperation Unit erritorial medical departments officers contacted field announced intent A method estimating hetrazan content blood elaborated Tanganyika Government chemist Blood sides provided Chief Entomologist Tsetse Research Virus Research Institute In Annual Report Unit which written professional scientific rather readers papers contributed Kenya medical personnel Sincerely JBG Footnotes I East Africa High Commission Interterritorial Cooperation Work _East Ari Oentral Lezis Asembly Despatch N May P E Mitchell Chairman East AfricaHigh Commission Secretary State Colonies paragraph East Africa High Commission Fil riasis Me search Annua Report Colonial Office Annual_R epgrt Pn Ea Africa Hizh Oommission Sources Filariasis Research Eas A frica High_C mmission Departmental Annual Reort No East Africa High Commission Fi arias_is Rsear Unit Apn Report Ffl_laripis Researoh Un A Re Fi ariasiS Research Annual_ Reort Digest Activities Medical Research Organisations Die A nnual Re ors19 2of_theMedic Research Organ_isations Est Afri_ca Medical Survey Anuu Reort Interterritorial Cooperation Work East Africa Central LeislatieA DespatchNo igthM P E Mitchell Chairman East Africa High Oommission Secretary State Colonies Annual Report_ofthe Chief Account Officer_for_the_ Financial_ Stat _ements Rew0 Th Director Audit Kenya Colonial Office Annual Report Annu __Repor Egst Af Hih Oommssion I50 Annual Report_on East Af High_ C0mmlss E B Worthington A_ SurveY R ch_and Scientific Services Ea_ Africa