Page 157 - Bahrain Gov Annual Reports (III)_Neat

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There was no Typhus, although a special segregation camp and vaccine were held in readiness
to use if the occasion arose.
Dysentery figures were very good, exactly 50 per cent, less than the previous year. As usual,
it was predominatingly Amoebic.
Venereal Disease.
This is on the increase. Fortunately, people know it can be cured and come readily. 1,194
cases were seen, 25 per cent, more than last year. 2,763 injections were given and much " 693."
Ophthalmia.
This is as prevalent as ever, chiefly in the form of acute and chronic trachoma. More and more,
the Arab is realising the wisdom of more prolonged and intensive treatment, and repeatedly comes for
advice.
Malaria and anti-malarial control.
The lowest recorded level was reached this year, namely 10 per cent, before anti-malarial mea-
sures were adopted it was 20 to 25 per cent. Slowly but surely its value is being realised, since control
was started five years ago. A stricter supervision has been enforced in the towns this year, and
domestic drinking water jars are regularly being broken, if houses refuse to comply with advice. All
offenders are personally visited twice a week and punished accordingly, and a great deal of culicine
breeding has thereby been reduced. In addition, every house in Manama and Muhharraq is examined
once a week. Outside control in the gardens was reduced owing to lack of transport, and the major
part of the work was therefore in the towns and their environs.
R. A. F. anti-malarial control was handed over to their own expert personnel in September,
owing to the increasing size of their Muharraq Camp. The R.A.F. Middle East medical Authorities
were also very anxious to keep their incidence of malaria cases at J to 1 per cent., which is a very
ambitious ideal, but very necessary for ground staff, many of whom are experts and not easily or
quickly replaced. Total number of R.A.F. malaria patients this year was 56.
The present treatment of Malaria is now a combined course of Quinine and atebrin, given
together, with only 60 grains of Quinine used, and no Pamoquin. This is satisfactory in most cases,
more especially benign tertian, but cannot be relied on for the malignant form. Treatment in these
difficult cases is the same basically, but reinforced with two or three intramuscular or intravenous
injections.
It is very interesting to note that a similar combined treatme' as occasionally used here
since 1941. It has now been made the standard method of treatment for all the Services from 1944.
A great deal of research has revealed that this method will probably be the most effective and most
quinine saving, but as explained it is often found not strong enough for <. tain malignant types,
unless reinforced by injections.

The Services* programme of treatment is as follows
Days i and 2. Quinine grains 30, and atebrin 2, daily.
Days 3 and 4. Atebrin 3, daily.
Day 5. Rest.
Days 6,7, 8 and 9. Quinine grains 15, and pamoquin 3, daily.

The Bahrain Government present course of treatment is:—
Days i and 2. The same but with Atebrin 3 daily.
Days 3, 4, 5, 6 and 7. Atebrin 4 daily.
(Quinine Hydrochlor: Injections may or may not be used during the first 3 days in grain
5 to y\ doses.)
The Bahrain Government course is also influenced by the fact that patients usually will not stay
longer than from four to six days.