“…Contrary to the beliefs of half a century ago, the disease is not dependent on a hot dry dusty climate, on malnutrition or on the presence of insect carriers (Mann, 1966), nor are the disabling sequellae related to the ecological factors (variations in climate, geography, virulence of the organism or susceptibility of the host) or to intensity of early microbiologic infection, but they are associated with the duration of the infection (Nichols et al, 1967). Apparently the common factor is a low standard of personal hygiene and cleanliness (Shah, 1959;Moore et al, 1965;Mann, 1966), and hence the disease thrives under conditions of poverty, overcrowding, ignorance (Shah, 1959;Werner et al, 1964) and undernourishment (Shah, 1959). Again, the duration of the infection and hence the serious complications are also thought to be determined by the living conditions of the subjects (Nichols et.…”