Post-operative malaria

Since 1924 the incidence of malaria fever after operations has been investigated. These researches can be divided in two different periods, that is, from 1924 to, roughly, 1947, when malaria was endemic and hyperendemic in British Guiana, and from 1947 up to now, when the extensive anti-malarial campaign carried out by Dr. G. Giglioli has eradicated this disease completely from this colony. In the first period, out of the total of 14,027 operations, 3,445 were performed on patients who had suffered from malaria some time or another prior to operation. In 13.5 per cent of these cases, post-operative malaria fever was registered, but this percentage varied considerably when this category of patients had been subdivided in various groups according to the finding at the physical and clinical examinations, in relation to the malaria history. No cases of similar post-operative fever were registered in the 10,582 cases of operations in non-malaria subjects. During the second period of time 14,124 operations have been performed in the same class of patients as during the first period and only five cases of post-operative malarial fever have been registered, and all five in patients admitted from the Brazilian district with a typical history of recent attacks of malaria. Age, sex, race and nature of the operation did not influence the incidence of malaria, but the form of anaesthesia was of great importance. Spinal and local anaesthesia were associated with the highest incidence of post-operative malaria and particularly with attacks occurring a few hours post-operatively. It is postulated that adrenaline in the anaesthetic solution or the stress of the operation induced contraction of the spleen with the release of malaria parasites into the blood streams. (AU)

The primary aspects of the disease syndrome of Bancroftian Filariasis in British Guiana

As I had opportunity to conclude in my previous paper on filariasis, from which I quote, the conditions leading to the more commonly described states of bancroftian filariases are:(1) The emigration of the adult worm from its normal habitat or its development elsewhere than in the genital area. (2) The death of the adult worm. (3) Complications associated with the blockageof the lymphatic system, as the blockage alone of the lymphatic system is not a sufficient cause to produce elephantiasis. (4) Bacterial complications, keeping well in mind that there is not any particular bacterial agent associated with the filarial infection, nor that the bacterial agent is per se the cause of any of the pathological manifestations of filarial infection