Kala Azar in Shensi Province of North China

Clow, J. Menzies (1943) Kala Azar in Shensi Province of North China. PhD thesis, University of Glasgow.

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Abstract

535 cases of confirmed kala azar treated in Sian, Shensi are recorded, and the history, epidemiology, pathology, diagnosis, complications and treatment of the disease with the relevant literature are reviewed. The following opinions are expressed from observation of the cases. 1. That Shensi province is an endemic focus of kala azar, and that with war conditions the disease may be assuming epidemic proportions. 2. That immigrants into an endemic area of kala azar are probably more susceptible to the infection than the natives, especially when the former are undernourished refugees and soldiers. 3. That the dog may be a reservoir for leishmaniasis infection in Shensi and that phlebotomus is common in the area. 4. That cancrum oris, pneumonia, dysentery, and acute granulocytopoenia are the most important and fatal complications of kala azar in the area, and that the pathogenesis of cancrum oris may be closely related to that of acute granulocytopoenia. Three cases of acute granulocytopoenia, developing during the treatment of kala azar with neostam, are reported in detail. 5. That cases of kala azar which have been cured are not liable to reinfection. 6. That the finding of Leishman-Donovan bodies on completion of treatment does not necessarily mean that the case is not cured. 7. That the mortality of the series was 14.25% but only one fifth of these died of uncomplicated kala azar, and that the mortality could probably be reduced by earlier treatment. 8. That the presence of anaemia is a critical factor in prognosis. 9. That M & B '744' promises to be one of the most useful drugs for the treatment of kala azar, but that solustibosan or neostibosan are probably safer drugs to use for the initial stages of treatment in very ill children. 10. Finally, attention has been drawn to the importance of H. L. Chung's work on the epidemiology of kala azar in the Peiping area. The application of this knowledge, with an effective scheme of treatment and follow-up, shows the way to the possibility of effective kala azar control in the Shensi area.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Medicine, Epidemiology, Parasitology
Date of Award: 1943
Depositing User: Enlighten Team
Unique ID: glathesis:1943-79559
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 04 Mar 2020 16:59
Last Modified: 04 Mar 2020 16:59
URI: http://theses.gla.ac.uk/id/eprint/79559

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