Tuberculosis mortality in the negro population of Antigua, British West Indies, over the last hundred years

An investigation of death records since 1857 has been carried out in Antigua, West Indies, to find out the mortality from tuberculosis over the century in the negro inhabitants. The island is favourably placed for such a survey, because censuses have been taken at frequent intervals, births and deaths registration and the recording of the cause of death have been good over the period in question, and it has been possible to separate the records of those of African descent from those of other races. The population is an agricultural one, self-contained, whose numbers fluctuated between 29,000 and 54,000. The crude death rate from the disease at the beginning of the hundred years was 4.6 per 1,000; it fell to 0.46 in 1947-56. Standardised against the England and Wales population of 1901 the corresponding figures were 4.66 and 0.48. The fall in mortality was uniform except for one decade of severe droughts and economic depression. For the last thirty years the mortality has been roughly the same as that of the United Kingdom. In the mid-nineteenth century tuberculosis accounted for 11 percent of all deaths; a century later the percentage was 4. Over the whole century the variations in the sex ratio of all tuberculosis deaths were not statistically significant, but at times there have been considerable differences between the sex ratio of the disease at different ages. The mortality curves at ages for each sex show a material fall with each succeeding decade of the century. A study of cohort mortality curves in Antigua shows more similarities with corresponding curves in England and Wales than might have been expected in a tropical locality. It is also possible to infer from these curves that a likely cause of the mid-nineteenth century epidemic of tuberculosis in the island was the freeing of the slaves in 1834, who went straight from the isolation of relatively healthy estate life to the congestion of crowded and unhygienic villages. The evidence of the negro tuberculosis mortality in Antigua suggests that perhaps too much emphasis may have been placed in the past on race as being a major factor in influencing mortality rather than on elements in the environment. (AU)

The incidence and mortality of disease in Antigua, West Indies, in recent years

Statistics for a self-contained negro community of 50,000 living in the West Indian island of Antigua are presented, showing the following: The incidence of disease in 368,834 consecutive cases seen at dispensaries over the years 1953 to 1962, expressed as per 100,000 cases seen. The order of frequency of disease in 25,843 consecutive admissions to the general hospital, Antigua, over the years 1949 to 1962, expressed as per 10,000 admissions. The death rates from all causes occurring from the year 1953 to 1962 inclusive, expressed as per 100,000 population. Information has been given to enable the reader to assess the accuracy of these figures (AU)

The cancer death rate in the coloured population of Antigua, West Indies, over the last seventy years

A survey of all death certificates in Antigua has been made during an investigation of the cancer death rate in the coloured inhabitants of the island. It revealed that 1,410 deaths since 1887 have been due to malignant disease, which when calculated as deaths per 100,000 living showed a rate of about one-third of that prevailing in England and Wales at present. Cancer has a higher mortality among females per 1,000 at ages than among males in Antigua, especially during the later child-bearing years. Cancer of the uterus and of the digestive system is commoner per 1,000 cancer deaths in Antigua than in England and Wales, whereas in the respiratory system and in the female breast it is not so common in the colony. A comparison of the data from Antigua with similar material from adjacent colonies, although the latter is scanty and incomplete, indicates that there is little difference between the total cancer death rate, the death rates from cancer of the stomach, uterus and of the breast severally in Antigua on the one hand, and in the neighbouring territories on the other. The sex ratio of cancer deaths is two females to one male; this appears to be the ratio throughout the British West Indies. The carcinoma sarcoma ratio in Antigua, 50 to 1, is very much higher than other published reports of the ratio in the negro. The death returns do not suggest that cancer has been increasing much in this part of the West Indies during the last half century, though it is possible that there may have been an increase in late middle life (Summary)

The mortality of yellow fever in Antigua, West Indies, since 1857

The last epidemic of yellow fever in Antigua West Indies, was in 1859. Its decline as a cause of death coincide with the withdrawal of the British garrison about the time of the Crimean War, since when the number of non-immunes arriving inthe Colony has been very much less. The disease was mainly one of December and January, i.e. at the end of the rainy season, but while the mean humidity was still high. The mortality in males was twice as high as that of females, and 84 per cent of the deaths were in white persons, although the majority of the population was black (AU)

The epidemiology of tetanus in the Negro race over the last 100 years in Antigua, The West Indies

In Antigua, the West Indies, all deaths have been medically certifiable by law since 1856. In a survey through the death registers, all deths recorded since 1857 as having been due to tetanus have been investigated and it has been shown that 1,700 were due to tetanus neonatorum, and 434 to the traumatic, non-neonatal form of the disease. Tetanus neonatorum. In this large series it was evident that neonatal tetanus was a very serious cause of death in the last quarter of the nineteenth century, when one third of all neonatal deaths were due to it; it killed 3.5 per 1000 of all living births over a long period of years. The mean age of death was days (standard devition 3.1), and the sex ratio of male to female deaths was 1000 to 852, whereas the ratio of the sexes at live births was 1,000 to 852, whereas the ratio of the sexes at 1,000 to 967 females. The greatest mortality was in the first half of the year, which is the driest and most dusty season. The mortality fell after the turn of the century with the introduction by the midwives of antiseptic methods for the treatment of the umbilicus of the infant. Traumatic tetanus. During the century under survey, 434 deaths occurred in Antigua from traumatic tetanus; its mortality varied between 13 and 21 per 100,000 for many decades, and did not fall significantly until the early thirties, since when the rate has continued to decline and is now of the order of 2 per 100,000 annually. Its greatest mortality occurs early in the year when, associated with the dry season, the sugar canes are cut and carried, thus bringing a predominantly agricultural population into intimate contact with its carrying animals. The ages of maximum mortality in bothn sexes are (a) in childhood and adolescence, and (b) after the prime of life. The rate for males is approximately three times that of females at most ages after adolescence. This difference in the rate, in so far as Antigua is concerned, is probably not a sex difference, but is associated with the fact that males work in the fields more than do females. The data obtained from Antigua correspond with similar data about coloured people in the United States, and appear to be in harmony with what is happening elsewhere in the Caribbean(AU)

The tuberculosis mortality in the negro population of Antigua, West Indies, over the last 100 years (abstract only)

The crude death rate from this disease at the beginning of the period was 4.6 per 1,000 and fell to 0.46 in 1947 to 1956. For the last 30 years the mortality has been aproximately the same as that of the United Kingdom. In the 19th Century tuberculosis accounted for 11 percent of all deaths while at the present time the percentage is 4. It is suggested that following the liberation of the slaves, a severe epidemic of tuberculosis occurred among the inhabitants of the newly found villages, causing a very high mortality, and that this mortality was at its peak or had recently started to decline when accurate death returns first became available (AU)

Arthropod-borne encephalitis viruses in the West Indies area. Part IV: A serological survey of Antigua, W.I

In a serum survey of 387 residents of Antigua, dengue immunity has been demonstrated to be widespread from the late teens on. Younger children have low immunity rates, an indication of little or no transmission of dengue in recent years. Evidence provided by the data for the occurrence of infections with St. Louis, Ilheus and yellow fever viruses cannot be considered as proof that these agents have been present, since dengue immunity rates approach universality in the older age groups and obscure interpretation of other Group B reactions observed. There is no evidence that infections have occurred with Mayaro, Eastern, Western and Venezuelan equine encephalitis and Manzanilla viruses (AU)