Pulmonary tuberculosis in East African native troops

Abstract

This is not a record of a planned research carried out as a whole time occupation: it is the record of investigations made, during a tour of duty as a Medical Specialist in the Royal Army Medical Corps in East Africa Command, in an attempt to answer certain questions which forced themselves upon my notice.

The literature dealing with Tuberculosis in East African natives is scanty and with one or two exceptions pessimistic. It was the realization than this pessimism was not entirely justified that gave the initial stimulus to these investigations.

Critical revision of t he case notes has revealed two major deficiencies: the routine investigations were not always made as regularly as they should have been and in some cases the treatment given was ill-advised. The irregularity of the routine investigations was due to pressure of other more urgent work. During the period in question there were two major outbreaks of Falciparum Malari and an epidemic of Typhoid Fever. During these outbreaks so much additional work was thrown upon the laboratory staff that routine investigations on chronic cases had to be deferred. The errors in treatment were due to ignorance on my part - an ignorance which it Was the main purpose of this investigation to rectify.

East African Natives suffering from Pulmonary Tuberculosis can obtain specialist treatment at three centres: Kibongoto Sanatorium, Tanganyika Territory; the Hospital f or Chest Diseases, Mombasa, Kenya: and Mulago Hospital, Kampala, Uganda. I was able to visit each of these hospitals and it was encouraging to find that a reasonable optimism prevailed at them all.

No account of these investigations would be complete without acknowledgement of the help so freely given to me on all sides. The East African native dislikes lying in bed. The Nursing Officers of Queen Alexandra's Royal Army Nursing Corps, who were in charge of the Tuberculosis wards, were indefatigable in their efforts to enforce strict rest in bed.