Report of the Director of Medical Services / British Guiana.

  • British Guiana. Medical Department.
Date:
[1944]
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: Report of the Director of Medical Services / British Guiana. Source: Wellcome Collection.

    17/32 (page 17)
    fections of syphilis, the ratio was 1 case of tsyphilis to 2.9 gonorrhoea or 1 to 3 nearly. In other words, there were 3 new cases of gonorrhoea to each new case of early syphilis diagnosed. Attention is drawn to two interesting facts. The total number of cases of gon¬ orrhoea is the largest so far recorded for the past 6 years. The number of female admissions —304—for acute gonorrhoea is also the largest ever recorded. It is possible and quite probable that these figures have resulted from the ac¬ tivities of the follow-up and epidemiological services. CHANCROID AND GRANULOMA PUDENDI. The incidence of chancroid shows an increase of 3 cases above the 1943 figure and in the case of granuloma pudendi, there has been a decrease in the number recorded for 1943. LYMPHO-GRANULOMA INGUINALE. The number of cases showed a decrease of 6 on that recorded for 1943. ATTENDANCES. There was a definite rise in the number of attendances during Clinic sessions. All applicants recorded a total of 39,269 attend¬ ances for treatments, consultations and physical examinations. This is the highest number of attendances ever recorded. It represents an increase of 4,096 over that for 1943 and 6,072 over that for 1942, a year in which this Clinic bad the highest number of admissions for venereal disease. There is a steady upward trend in attendances. The attendances for Intermediate treat¬ ments show decline. These attendances are for irrigations, douches, and dressings. The decline is mainly due to the use of sulpbanamides in treatment of gonorrhoea. The attendances, though they reach a fairly high aggregate, are nevertheless far below what they should really be, having regard to the number of applicants for treatment. The attendances roughly reveal a rate of 8.7 per applicant and of those diagnosed venereal disease, a rate of 9.6; and for those diagnosed syphilis, a rate of 10.1 per patient and for early syphilis 9.8 per patient. It is hoped that with further amenities for provision of treatment occupied with fun. ther educational measures, the attendance ratio will considerably improve. DEFAULTING OR DELINQUENCY. Arising from the statistical data for at¬ tendances is the subject of Defaulting. The incidence of defaulting is, I think, abnormally high. Five hundred and ninety-five cases have been returned undiagnosed mainly because patients failed to attend long enough to permit a definite diagnosis to be made. Together with these cases returned with diagnosis pending must be associated the large number of repeated delinquencies which are reflected in the attend¬ ance ratio cited above. Many reasons have previously been ad¬ vanced to account for the great incidence oi defaulting and it has been the object of these previous reports to suggest ways and means to surmount as many obstacles to regular attend¬ ance as possible. A follow-up scheme has been frequently emphasised in previous reports as a means to holding patients to treatment. The appointment of two Welfare Officers to work with the Clinic was implemented during the early months of the year under review. These officers have carried out their new duties cap¬ ably. This evaluation of their efforts is well borne out, by the substantial number of de¬ linquents they have returned to treatment. They dealt with 644 delinquents in the first three months after they assumed duty and subsequently with 1,069 delinquents during the latter half of the year. It would appear from these data supplied that a monthly reduc¬ tion in delinquency of 25 per cent, has been effected. In perusing the records of these delin¬ quencies, it is observed that “Indifference” coupled with or born of ignorance supplied the most urgent reason for defaulting. It would appear that further educational efforts and compulsory measures may assist substantially to reduce defaulting. The use of short term intensive treatments may also help substantially in treatment of early syphilis. EPIDEMIOLOGICAL ACTIVITIES. The work of the Welfare Officers includes that of “Case Finding”. Their reports cover a total of 355 contacts made up of 272 female