In the course of an experiment in malaria control in an inland region of Kenya and Tanganyika, by the use of house spraying with dieldrin, routine catches were maintained of mosquitos resting in artificial outdoor shelters. During the 18 months of the pre-spraying period, catches in the South Pare district of Tanganyika mainly consisted of the principal vectors, Anopheles gambiae Giles and A. funestus Giles, together with small numbers of A. rivulorum Leeson.During the three years following the spraying, A. funestus disappeared almost completely from the catches, while A. rivulorum showed an increase of about seven times above its former level.

The effects of DDT on the behaviour and mortality of Anopheles gambiae Giles, A. funestus Giles, Mansonia uniformis (Theo.) and Culex pipiens fatigans Wied., entering experimental huts, have been studied with the assistance of gas-chromatographic techniques.Sixty to 70% of A. gambiae and 70–80% of M. uniformis were deterred from entering verandah-trap huts treated indoors with a nominal dosage of 200 μg/cm2 of DDT active ingredient. Gas chromatographic techniques indicate that the chemical basis of the deterrency was a steadily diminishing outflow of DDT from the hut, either as a dust or vapour, and the build-up of deposit on the untreated overhanging eaves to 0·02 to 0·27 μg/cm2 seven months after treatment. A. funestus was less deterred than A. gambiae and M. uniformis, but the behaviour of C. p. fatigans was almost unaffected by the DDT deposit.Overall mortalities were highest in A. funestus and M. uniformis, lower in A. gambiae and extremely low in C. p. fatigans.There was a marked irritant effect of the DDT deposit on recently blood-fed A. gambiae, some 50–70% being driven out of the treated huts. This behaviour occurred to a lesser degree in A. funestus but was absent in M. uniformis and C. p. fatigans. The chemical basis of the irritant effect was indicated to the extent that surviving mosquitoes, that left the treated hut, showed 1·5 ng/insect of DDT. Mosquitoes that died, whether indoors or after leaving the hut, picked up amounts ranging from 7 to 20 ng/insect.

A description is given of a verandah-trap hut designed to assess the egress and survival of mosquitos escaping through the eaves of the type of window-trap hut used in insecticide testing in East Africa.Fifty-one per cent. of females of Anopheles gambiae Giles in all gonotrophic stages and 19 per cent. of those recently fed left the hut each night, with 15 and 30 per cent., respectively, of the egress occurring through the eaves.Ninety per cent of females of Mansonia uniformis (Theo.) in all gonotrophic stages and 91 per cent. of those recently fed left the hut each night, with 69 and 66 per cent., respectively, of the egress occurring through the eaves.It was concluded that, owing to the high proportion of individuals of M. uniformis that leaves by the eaves, the verandah-trap hut was of a more suitable design for studying the house-frequenting habits of this species, and of other species with similar habits, than the simple window-trap hut.

In order to determine whether giving iron to iron-deficient children increases their susceptibility to malaria, 213 Gambian children aged between 6 months and 5 years with iron-deficiency anaemia were randomized to receive either oral iron or placebo during the rainy season when malaria transmission is maximal. Haematological and iron measurements improved significantly in the group given iron. Regular morbidity surveys showed that fever associated with parasitaemia occurred more frequently in the iron-treated group than in the placebo group. This difference was not significant for all parasitaemias grouped together, but became significant and progressively larger for parasitaemias of ten or more positive fields per 100 high power fields (P less than 0.025), and for parasitaemias of 50 or more positive fields per 100 high power fields (P less than 0.01). Three children in the iron-treated group but none in the placebo group had more than one episode of fever and parasitaemia. Splenomegaly rates rose appreciably during the study in both groups, but in children at age 2 years the splenomegaly rate at the end of the study was significantly greater in the iron-treated group. We concluded that there is a significantly increased risk of fever associated with severe malarial parasitaemia for children with iron-deficiency anaemia given iron during the season of maximal malaria transmission in this part of The Gambia.

Audiological and other long-term neurological sequelae were determined in 157 cases and their controls matched for age, sex and village 6 to 12 months after an epidemic of group A meningococcal meningitis in rural West Africa. 19 cases (12.1%) and 3 controls (1.9%) had moderate or severe neurological sequelae of any type (P less than 0.001); 6 cases (3.9%) and no controls had severe or profound sensorineural hearing loss (P = 0.03). There was no difference in conductive hearing loss between cases and controls. Other cranial nerve sequelae (except visual defects) and generalized neurological and motor and co-ordination sequelae were also significantly increased in cases. Sensorineural hearing loss and other cranial nerve sequelae occurred significantly more frequently in males than in females, and co-ordination sequelae more frequently in cases aged 10 years or more than in younger cases. Sensorineural hearing loss and loss of visual acuity were found significantly more frequently in cases whose treatment was delayed for 4 d or more, compared with those who received treatment sooner.

A verandah-trap hut, designed to enable assessment to be made of the numbers of mosquitos that leave an experimental hut through the open eaves, together with studies on the egress from it of Anopheles gambiae Giles and Mansonia uniformis (Theo.) have been described by Smith (1965). It was found that, in the Umbugwe area of Tanzania, A. gambiae rarely left an untreated hut by the open eaves when window traps were available for egress. M. uniformis, on the other hand, left largely by the eaves and was caught in the verandah traps. MethodsA dichlorvos (DDVP) dispenser was suspended in the middle of one hut, half-way between the ridge and the eaves, in order to study the effects of the insecticide both on the egress and on the mortality of A. gambiae and M. uniformis entering naturally. A second (untreated) hut was used as a control. The same methods of counting and collection were used as described in Part I, with additional observations to determine mortalities. Dead mosquitos were collected on the floor indoors and in the verandah and window traps. Delayed mortalities over a period of 24 hours were determined for mosquitos caught alive in the window and verandah traps. Experimental-hut assessments of kill inflicted by dichlorvos were complicated by the mode of action of the insecticide; it is brought into contact with the mosquito as a vapour that diffuses from a dispenser, and thus mosquitos confined in window traps are subjected to the fumigant action of the insecticide diffusing through the funnels of cotton netting. Additional studies were therefore made to assess the fumigant effect of dichlorvos in the window traps and in the verandah trapsThe results are based on daily counts and. collections, from 2nd March to 30th April 1964, from the hut treated with dichlorvos and from the untreated control hut. The dichlorvos was dispensed from a Ciba XI type dispenser opened on 2nd March.

Mortality from meningococcal disease was determined during an epidemic in a rural area of The Gambia with few medical resources, but where a system of registration of births and deaths had been established before the introduction of a primary health care programme. 33 deaths were recorded among 127 patients, a case mortality rate of 26%. 84% of deaths occurred within the first 24 h of illness and many patients died before they could reach any source of treatment. Previous studies, based on regional statistics or on hospital series, may have underestimated mortality from epidemic meningitis in Africa. Mortality from this infection will be reduced only if treatment can be made readily accessible to patients early in the course of their illness.

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