Changes in Haemoglobin Values and Hepatosplenomegaly Produced by Control of Holoendemic Malaria.

In many parts of the tropics the mean haemoglobin values of rural populations are very much lower than the values accepted as normal elsewhere. For example, among Bougainville Islanders Cotter et al. (1958) found means of 13.09 and 11.97 g./100 ml. for adult males and females respectively. They suggested controlled experiments were needed to assess the relative importance of each individual factor that could be contributing to such low levels. This paper describes an experiment to determine the effects on haemoglobin values of three years' malaria control in part of the Sepik District, New Guinea. The concomitant changes in clinical hepatosplenomegaly are also described. Draper (1960) has quoted conflicting findings on the importance of malaria as a cause of anaemia in African infants, and he noted that little was known about its effect on adults who had acquired some immunity. In Taveta-Pare, a hyperendemic malarious area of Tanganyika, he found that malaria control for three years was accompanied by great improvement in the mean haemoglobin values of all age-groups. However, he reported that there had also been a general rise in living standards in the area during the same period. There are considerable malariological differences, especially in malarial-species ratios and adult palpable spleen rates, between New Guinea and East Africa.