Report on Work for the RELIEF AND CONTROL OF UNCINARIASIS IN SOUTHERN UNITED STATES From Jan.1,191c, to June 30,1915. Report on Work for the RELIEF AND CONTROL OF UNCINARIASIS IN SOUTHERN UNITED STATES From Jan.1,191c, to June 30,1915. Report on Work for the RELIEF AND CONTROL OF UNCINARIASIS IN SOUTHERN UNITED STATES From Jan.1,151c, to June 30,1915. SOUTHERN UNITED STATES. 1. Scope of Report. This report gives a summary of all work conducted by the State Boards of Health in the Southern United States in which the Rockefeller Sanitary Commission and the International Health Commission have participated. It covers work accomplished from the early months of 1910 up through June 30, 1915. 3. Types of Work. Three main types of work have been followed during this period: (l) educational work; (3) dispensary work; and (3) intensive community health work. l) Educational Work. The first type of work was directed along general educational lines toward informing the public regarding uncinariasis in all its phases, and toward securing the interest and co-operation of the important agencies in the South. Of greatest importance among these agencies were the physicians, the school forces, and the press. 3) Dispensary Work. The second type of work was the dispensary work, the way for which was paved by the educational work. Dispensaries for the free examination and free treatment of uncinariasis, and for acquainting the people by lecture and the printed page with the essential facts about this and other CL preventlble diseases, were operated with the county as the unit. This type of work was engaged in from January, 1911, until December 31, 1915, but was not quite completed. During the first half of 1915 it was practically completed, with the aid of the International Health Commission, along lines approved by the State Boards of Health and the Rockefeller Sanitary Commission. 3) Intensive Community Health Work. The third type of work has been known as the intensive community health work. It is directed primarily toward the cure and prevention of uncinariasis within circumscribed areas by: (l) curative measures 'and (2) sanitary measures. The aims of these two measures are: I. COMMUNITY WORK: Chapter I — Results in Completed Communities - Up to June 30 1915 (pages Chapter II - Results in Communities Not Completed - Up to June 30, 1915 (pages Chapter III- Results in Communities Completed and Not Completed - Quarter Ending June 30, 1915 (pages II. DISPENSARY WORK: Chapter I — Results in Dispensary Work - Up to June 30, 1915 (pages Chapter II - Results in Dispensary Work - Quarter Ending June 30, 1915 (pages 3. Cumulative Figures Given. In Chapters I and II of the report on community work and in Chapter I of the report on dispensary work, cumulative figures are given, representing total results to date; the other two chapters are devoted to summarizing the work of the calendar quarter ending June 30, 1915. 4. Extent of Operations. Practically all of the work in which the Rockefeller Sanitary Commission co-operated was conducted on the dispensary plan. Intensive community work was not attempted until the latter part of 1913, when it was desired to make, within restricted areas, an effective demonstration of what could be accomplished against uncinariasis by reducing as far as practicable the percentage of infection and by improving as far as practicable the privy conditions at farm homes. This type of work in its trial stages gave such promise that, with the co-operation of the International Health Commission as successor to the Rockefeller Sanitary Commission, it is gradually being extended by certain states and is coming to be looked upon more and more as an effective working instrument. With increasing experience, the results are yielding more definite and more satisfactory results. This is particularly emphasized in the type of privies being built. At first some of the privies constructed were of a very crude type, but the majority of those now being built are of a much higher grade of workmanship and are much more effective for preventing soil-pollution. With the aid of the International Health Commission, dispensary work was continued after December 31, 1914, -by the states of Alabama, Georgia, Kentucky, Tennessee, and Texas, where there were still a number of heavily infected counties which had not been visited by dispensaries. However, dispensary work in all of these states was brought to a close during the quarter ending June 30, 1915, except in Kentucky. In that state the dispensary work did not begin until July, 1913, and dispensaries have been operated only for a six-months' period during th9 summer and fall. The work has had to be interrupted during the winter months of each year because the heavily infected counties were not accessible during these months. This has made it necessary to continue dispensary work in Kentucky somewhat longer than in the other states. Table 1 indicates the length of time spent in dispensary work and in community work in each of the eleven Southern States with which the Commissions have cooperated: Table 1 DISPENSARY WORK Length of 1 Time in Operation I COMMUNITY WORK Length of Time in Operation State Opened Closed Opened Closed y- m. | y* m. Ala. Jan.l, 1911 April 30,1915 4 4 Ark. Oct .1, 1911 Dec. 31, 1914 3 3 Ga. Oct.l, 1911 June 30, 1915 3 9 Ky.* July 1, 1913 In progress 3 0 1 Jan. 1, 1915 In progress 0 6 La. Jan. 1, 1911 Dec. 31, 1914 4 0 Oct. 1, 1914 In progress 0 9 Miss. Jan. 1, 1911 Dec. 31, 1914 4 0 Oct. 1, 1914 In progress 0 9 N. C. Jan. 1, 1911 June 30, 1914 3 6 Apr. 1, 1914 May 1, 1915 1 1. s. c. Jan. 1, 1911 Dec. 31, 1914 4 0 July 1, 1914 In progress 1 0 Tenn. Oot. 1, 1911 June 30, 1915 3 9 Tex. July 1, 1913 June 30, 1915 3 0 Va. July 1, 1911 Dec. 31, 1914 3 6 Apr. 1, 1914 In progress 1 3 The cumulative statistics given in this report represent these respective periods of operation. * Dispensary work suspended during winter months. I. COMMUNITY WORK. Chapter I - Results in Completed Communities - Up to June 30. 1515.* 1. Plan of Work. Community work has been conducted in two ways: (l) on the group-community plan and (3) on the single-community plan. In the former, two or more communities (usually three) are grouped together under the super- vision of one field director with an assistant for each community, and comprise a working unit; in the latter, each separate community is considered a working unit and the entire time of a field director and his assistant is devoted to it. The single-community plan was followed in all of the early community work; later, the group-oommunity plan has come to be regarded as more effective and may be said to have replaced the single-community plan. The group-oommunity plan is economical and at the same time permits of relatively larger numbers of people being reached simultaneously. In many instances the county boards of supervisors willingly grant the appropriation requested, with the understanding that the work may not reach more than three communities in the county. The influence of the work in this small area, they consider, will radiate into the surrounding territory. In other instances, the county boards feel that all portions of the oounty should definitely share the value of the work, and they are willing to make much larger appropriations to accomplish this end. In such cases, one series of communities after another is worked until the county is reasonably well covered. Where time is an important factor the length of the working period may be shortened if the county will make provision for two or three additional health inspectors, with the aid of whioh the number of communities making up each series is accordingly increased. 3. Extent of Operations. Since community work as such was first started early in May, 1914, work in twenty-eight communities has been completed: in fourteen on the group-community plan and in fourteen on the single-community plan For comparative purposes, in the tables throughout the report the communities are arranged according to the plan under which they were worked, with the * Figures in this chapter are cumulative. group-communities first, although chronologically, since the group-community plan developed from the single-community plan, this arrangement should be reversed. The state and county in which the communities are located; the names of the director and assistant' director who conducted the work; and the length of time spent in each community, are indicated in Table 2: Table 3 Assistant Length of Time Community State County Dlreotor Director Work Began Work Ended m. 1. North Carolina II Scotland D.C.Absher & M.W.Steele S. McKay T. Oot. 17, 1914 Nov. 1, 1914 Moh. 31, 1915 Moh. 31, 1915 14 Sneads Grove .... 5 Johns Station ... II " " " " F.P.Paoe Nov. 7, 1914 Moh. 31, 1915 4 34 Pitt M.E.Champion W.S.Tuttle Nov. 31, 1914 Mch. 31, 1913 10 Wayne P.W.Covington Dec. 13, 1914 Smiths Chapel ... " Kolbe Curtice Dec. 13, 1914 Apr. 14, 1915 4 3 Kolbe Curtice & Miss Livermore Feb. 1, 1915 Kitohlngs Mills.. May 1, 1915 3 2 South Carolina Aiken F.M.Routh F.C.Polk Jan. 33, 1915 Apr. 37, 1915 3 4 Feb. 6, 1915 Apr. 37, 1915 Otts " ■ Uch. 6, 1915 Apr. 37, 1915 1 31 Vlrg' a Southampton E.L.Flanagan W.M.Flanagan Jan. 15, 1915 May 31, 1915 16 Mch. 39, 1915 Apr. 10, 1915 July 34, 1915 July 34, 1915 N n 14 Single Communities1 Louisiana Cameron G.C.McKinney Mrs.G.C. Oct. 3, 1914 Dec. 31, 1914 39 3 „ Livingston G.B.Adams McKinney 38 Oct. 3, 1914 Dec. 31, 1914 Lincoln Prentiss J.D.Baucum Henry Boswell Oot. 10, 1914 Sept .33, 1914 Dec. 31, 1914 Mch. 31, 1915 21 Mississippi J.E.Friday 10 Forrest P..N.Whitfield G.G.Hampton Jan. 9, 1915 June 19, 1915 North Carolina II Sampson Robeson John Collinson D.C.Absher J.L.Tregellas S.R.McKay May 9, 1914 May 33, 1914 Sept.30, 1914 Oct. 17, 1914 31 35 Philadeiphus .... 4 Nash M.E.Chamoion June 30, 1914 Nov. 14, 1914 34 Columbus P.W.Covington Kolbe Curtice Aug. 1, 1914 Dec. 5, 1914 Mount Pleasant .. Mash W.H.Klbler C.D.Ferrell Sept.19, 1S14 Dec. 31, 1914 3 12 II Sampson John Collinson Oot. 31, 1914 Dec. 31, 1914 Reidvlile South Carolina Spartanburg F.M.Routh Aug. 8, 1914 Dec. 9, 1914 Cherokee F.D.Rodgers Aug. 39, 1914 Dec. 13, 1914 14 Albemarle Virginia Albemarle W.M.Bray Emma B.Gault May 1, 1914 Dec. 31, 1914 7 — Communities are arranged (l) according to the plan under which they were worked, as group or single; (3) by states; and (3) chronologically. 3. Tvoe of Communities Selected. Different industries and inodes of life • prevail in the different communities. In no two of them are conditions quite the same, but the majority are strictly rural. Some idea of the geographical nature of communities in which the intensive work has been conducted will be gained by glancing at Table 3. This shows that for each of the twenty-eight communities the average area was 26 square miles; the average number of inhabitants 825; the average number of families 161. Of. these 161 families, 68, or 42 per cent, were tenants. Each community had an average of three 7 schools. The average length of time spent in each community was 90 days. In point of area, the largest community worked was Hallsborc, with 63 square miles; the smallest, Courtland, with one square mile. In point of population, Albemarle was the largest, with 1,473 inhabitants; Otts the smallest, with 308 inhabitants. In the average population of each community the white race exceeded the black by 50 per cent. Table 3 Area (So.Mi.) Number of Inhabitants Number of Families Number of Tenant Families Number of Schools Number of Bays Work Was In Progress Community* Total White Colored Indian Total White Colored Indian Total White Colored Indian AVERAGE 36 825 453 393 161 99 99 1 SB 3S SS a 3 90 Group Communities SI 6w4 314 3 133 67 65 1 72 31 51 2 50 Sinsle Communities .... 30 1036 635 391 8 190 113 53 3 64 35 37 3 4 130 TOTAL 719 231051 12691 8475 153 45072 3513 39 ),8?5 ? 89 1994 §1 77 2523 Group Communities ioo 6436 3fe46 4400 4i 18Sl 936 8 1601 387 714 26 706 Single Communities .... 419 14369 8745 4075 in 3656 1583 744 32 894 493 380 31 51 1817 Group Communities: Saint Johns 17 637 349 363 26 136 77 55 4 94 14 80 - 2 165 Sneads Grove 16 743 353 490 — 136 49 89 - 120 2 118 - 2 150 Johns Station 30t 582 166 401 15 130 37 89 4 107 22 85 - 2 144 Falkland 40i 491 338 163 — 103 64 39 - 66 33 33 - 3 130 Grimesland 34 677 389 288 — 144 93 51 - 80 42 38 - 2 109 Rosewood 11 564 300 384 — 127 73 55 - 83 38 54 - 3 109 Smiths Chapel ie. 757 415 343 — 157 81 76 - 96 36 60 - 3 123 Eureka 13, 586 £79 307 — 134 60 64 - 78 27 51 - 3 89 Kltchings Lillis 35 SSI 276 715 — 307 61 146 - 143 24 119 - 3 94 Bethoar 16 411 335 176 — 99 54 45 - 60 £5 35 - 2 60 Ott 6 9 308 135 173 — 63 33 35 - 44 16 38 - 2 52 Courtland i 343 234- 108 — 63 53 30 - 31 13 13 - - 136 Sebrell 43 743 336 407 — 149 74 75 - - - - - - 117 Sedley 46) 885 601 284 — 167 139 58 - - - - - 3 105 Single Communities: Cameron 1» 1300 1040 260 — 234 173 53 - - - - - 6 90 Maurepas 45 1017 913 104 — 189 164 35 - 44 32 12 - 2 89 Choudrant 60 1180 788 392 — 185 121 64 - 97 60 37 - 7 79 Wheeler 14 1108 936 173 — 221 193 38 - 117 90 37 - 4 190 Eaton Grove 37 956 545 411 — 178 106 72 - 63 37 35 - 5 169 35 875 683 192 166 135 43 67 40 27 - 3 144 33 941 369 561 ill 186 63 101 32 138 34 63 21 2 147 Red Oak 30 1135 540 595 199 100 99 151 59 92 3 147 Hillsboro 63 1245 765 460 — 345 159 66 - 15 10 5 - 4 136 Mount Pleasant 37 eoi 633 169 — 154 124 30 46 39 17 - 2 103 3r' 551 383 368 115 60 55 38 19 19 — 3 61 Reidville .. 1088 188 - - - 123 Sunnyslde 30 699 — — 119 T 105 i Albemarle 33 1473 1003 471 — 335 196 83 - 139 93 36 - 344 * The state and oounty in which the community is located; the name of the director and assistant director; and the tins consumed in completing the work, will be found in Table 3, p. 6. 1 The tcta.l of this column is 1,787 in excess of the total of columns headed "White," "Colored," and "Indian." This is because the 1,088 persons in Reidville and the 699 persons in Sunnyside community have not been itemised by races. 3 The total of this column is 307 in excess of the total of columns headed "White," "Colored," and ''Indian.." This is because the 168 families in Reidville and the 119 families in Sunnyside community have not beer, itemized by races. 8 4. Sanitary Improvement. Of the many results of community work, one of the most important is perhaps the permanent sanitary improvement which it effects. From Table 4 it will be seen that whereas 46.9 per cent (2,115) of the 4,507 homes in the twenty-eight communities were without privies of any kind when the intensive work wa3 begun, only 13.1 per cent (547) were without privies when it ended. This represents an actual reduction in the percentage of families without privies of 34.8 per cent, or a relative reduction of 74.2 per cent based on the previous percentage. In seven of the communities (Kitchings Mills, Otts, Courtland, Philadelphus, Red Oak, Hallsboro, Ingold) not a home was left without a privy. In these seven communities, embracing 1,102 homes, 587 families, or 53.3 per cent, were without privies when the work started. From 53.3 per cent the percentage without privies was lowered to zero. In these seven communities, therefore, the task undertaken and accomplished was even more difficult than that undertaken in the average community,’since the number of families without privies in all of the communities at the beginning of work averaged 34.8 per cent. The real extent to which the sanitation of these communities has been improved cannot be indicated in a statement such as Table 4. This shows merely the number of homes with privies and the number without privies at the beginning and .at the close of the work. Many homes credited with having privies at the beginning of the work had merely the open-seat, open-back, insanitary type, practically none of which could be depended upon to prevent soil-pollution. During the progress of the work almost all of these were changed to privies either of the pit type or of some other type approved by the respective State Boards of Health. Thus, while in many cases the number of homes with privies has not been largely increased, the effectiveness of the privies for preventing the spread of filth-borne diseases has been very greatly improved. Table 4 shows by communities the actual reduction in the number of homes without privies: 9 4 Number of Families in Community Perce ies Number of Families Community* ntage of Famil Without Privies With Privies Without Privies With Privies When Work Ended When Work Began When Work Ended When Work Began When Work Ended When Work Began When Work Ended When Work Began TOTAL 4507 13.1 — 46.9 87.9 53.1 547 3115 3960 3393 Group Communities ... 1851 13.6 94.7 87.4 5.3 334 1753 1617 1099 Single Communities .. 3656 11.8 51.3 88.3 48.7 313 1363 3343 1393 Grouo Communities: Saint Johns 136 1.5 58.1 98.5 41.9 3 79 134 ‘ 57 Sneads Grove 138 33.3 50.0 66.7 50.0 46 69 93 69 Johns Station 130 30.8 48.5 79.3 51.5 37 63 103 67 Falkland 103 5.8 11.7 94.3 88.3 6 13 97 91 Grimesland 144 6.9 33.6 93.1 67.4 10 47 134 97 Rosewood 137 14.3 37.6 85.8 73.4 18 35 109 93 Smiths Chapel 157 5.1 48.4 94.9 51.6 8 76 149 81 Eureka 134 8.1 47.6 91.9 53.4 10 59 114 65 Kitohings Mills . . . 307 0.0 55.1 100.0 44.9 — 114 307 93 Bethcar 99 37.3 70.7 73.7 39.3 37 70 73 39 Otts 68 0.0 48.5 100.0 51.5 — 33 68 35 Courtland 83 0.0 3.7 100.0 96.3 — 3 83 79 Sebrell 149 33.6 40.9 66.4 59.1 50 61 99 88 Sedley 187 16.0 16.6 84.0 83.4 30 31 157 156 Single Communities: Cameron 334 5.3 40.3 94.6 59.8 13 90 313 134 Maurepas 189 30.6 38.6 79.4 71.4 39 54 150 135 Choudrant 185 38.6 60.0 71.4 40.0 53 111 133 74 Wheeler i 331 6.3 60.6 93.6 39,4 14 134 307 37 Eaton Grove 176 16.9 55.6 83.1 44.4 30 99 148 79 Salemburg 168 11.3 57.7 88.7 43.3 19 97 149 71 Philadelphus 186 0.0 64.0 100.0 36.0 — 119 186 67 Red Oak 199 0.0 45.3 100.0 54.8 — 90 199 109 Hallsboro 345. 0.0 61.6 100.0 38.4 — 151 345 94 Mount Pleasant .... 154 16.3 65.6 83.8 34.4 35 101 139 53 Ingold 115 0.0 66.9 100.0 33.0 — 77 115 38 Reidville 188 38.3 41.0 61.7 59.0 73 77 116 111 Sunnyside 119 16.0 71.4 84.0 38.6 19 85 100 34 Albemarle 385 10.5 37.4 89.5 73.6 30 78 355 307 * Figures for work outside of community boundaries are excluded 5. Examining and Treating Infected Persons. In the intensive work, although greatest stress is placed upon the side of sanitary improvement, curative work is also conducted. In some of the communities, however, in which a reasonably heavy infection was expected, it has been found after the infection survey is well under way that the infection is negligible. In such cases the further examination of the people has been discontinued, as it would be a useless expense. Work within such communities is then devoted in the main to privy-building. In the twenty-eight communities completed up to June 30, 1915, the total population was 23,105 persons. Of this number, 17,005, or 73.6 per cent, were microscopically examined for uncinariasis; 3,919, or 21.6 per cent, of those examined were found infected; 3,598, or 90.8 per cent, of those infected were treated; and or 30.5 per cent, of those treated were found by microscopic re-examination to be cured. The percentage of infection was highest in the Smiths Chapel community, with 43.2 per cent; lowest in the Courtland community, with 3.5 per cent. In five of the communities (Bethcar, Otts, Cameron, Hallsboro, Red Oak) more than 90 per cent of the population was microscopically examined; in eight others (Saint Johns, Kitohings Mills, Courtland, Sebrell, Sedley, Wheeler, Salemburg, Philadelphus) more than 80 per cent; and in twelve communities (Smiths Chapel, Eureka, Bethcar, Otts, Courtland, Sebrell, Sedley, Cameron, Eaton Grove, Salem- burg, Hallsboro, Albemarle) every person found infeoted was treated. Detailed results for each community are exhibited in Table 5: Table 5 Percentage of Persons Humber of Persons Community* Population Micro- scopically Examined Found Infected Treated r-i Tl e> M 3 O Micro- scopically Examined Found Infected Treated r-i T) 4) U 3 o TOTAL 33105 73.6 31.6 90.8 30 ,53 17005 3919 3598 9932 Group Communities ... 9736 71.8 33.0 81.5 18.6! 6353 1440 1173 318! Single Communities .. 14369 74.8 33.1 97.8 33.8" 10753 3479 2425 775“ 637 88.7 33.1 97.3 44.0 565 187 183 80 Sneads Grove 743 56.3 38.3 71.3 8.3 417 118 84 7 Johns Station 583 73.5 33.3 93.7 31.6 438 143 133 43 Falkland 491 67.6 16.9 41.1 17.4 333 56 33 4 Grimesland 677 38.3 17.8 69.6 50.0 359 46 33 16 Rosewood 584 75.7 18.3 98.8 46.3 443 81 80 37 Smiths Chapel 757 67.0 43.2 100.0 8.6 507 319 319 19 Eureka • 586 77.6 10.8 100.0 46.9- 455 49 49 332 Kitohings Mills ... 991 86.5 8.3 3.8 857 71 3 Bethoar 411 91.0 39.1 100.0 8.3 374 109 109 9 Otts 308 91.9 31.3 100.0 3.3 382 60 60 2 Courtland 342 81.3 3.5 100.0 100.0 381 7 7 7 743 81.5 19.5 100.0 44. la 606 118 118 53„ Sedley 885 50.5 16.8 100.0 447 75 75 2 Slneie Communities: Cameron ;. 1185 1300 91.3 39.5 100.0 83.3 350 350 318 Maurepas 1017 74.6 34.6 98.9 3.33 759 363 360 63 Choudrant 1180 51.5 41.1 — 608 350 366 Wheeler 1108 87.3 5.1 95.9 29.8 966 49 47 14 Eaton Grove 956 61.9 19.1 100.0 34.6 593 114 114 38 Salemburg 875 86.3 33.3 100.0 57.8 754 351 351 145 Philadelphus 941 81.4 38.3 81.1 6.8 766 317 J.77 13 Red Oak 1135 96.1 35.8 81.1 13.1 1091 381 328 30 Halleboro 1345 99.4 38.7 100.0 19.4 1337 479 479 93 Mount Pleasant .... 801 77.9 15.9 96.0 4.2 634 99 95 4 Ingold 551 66.3 37.9 89.3 n.9a 365 103 91 103 Reidville 1088 30.3 17.9 5.1 — 339 59 3 Sunnyside 699 73.1 6.1 90.3 14.3 511 31 38 4 Albemarle 1473 65.6 3.7 100.0 86.1 966 36 36 31 • Figures for work outside of oommunity boundaries are excluded. 1 It is the oustom to administer from one to three treatments. These treatments generally produoe oures. For determining positively whioh oases have been cured, a mlorosooplo re-examination is required from two to eight weeks after treatment. Often this re-examination is not feasible. Consequently, the number of persons recorded as oured0is reduoed. “ The percentage of persons oured has been obtained by deducting 346 from the total number of persons treated (3,698), leaving 3,353 as the adjusted total of persons treated on whioh to base the percentage of persons oured. In Choudrant, Reidville, Kltohlngs Mills, and Sedley ooramunlties, miorosoopic re-examinations for determining the number of persons cured, were not made; consequently, the number of persons treated in these communities (Choudrant 366, Reidville 3, Kitohings Mills 3, Sedley 75; total 346) is deducted from the figures for persons treated in all of the communities. By making this deduction the true proportion of persons oured to persons treated is preserved. 1 2 See note following Table 5. 6. Per Capita Expenditure: Average for Each Community. The per capita expenditure by the International Health Commission in the twenty-eight communities completed up to June 30, 1915, was approximately #1.02. The total amount expended was approximately #23,505.24; the total population, 23,105 persons. Practically all of the expense in these twenty-eight communities, marking the earliest stage in community work, was borne by the International Health Commission; later, however, the local agencies (states, counties, and communities) have come to share very largely in financing this work. Table 6 gives the per capita expenditure, the amount expended, and the population for each community: Table 6 ?er Capita . Expenditure'1 Amount g Expended Community Population TOTAL *1.03 *23.505.24 33.105 Group Communities ... Single Communities .. 1.05 8,431.4b 15,073.81 8,735 14,369 Grouio Communities: 777.33 637 1.23 .86 637.68 743 1.04 604.30 583 1.61 792.33 491 .88 597.33 677 1.06 621.01 584 .91 689.03 757 .98 573.43 586 Kltohlngs Hills ... .51 .90 503.18 371.34 991 411 .71 318.40 308 2.81 959.59 342 .78 575.88 743 .58 510.13 885 Single Communities: .64 838.80 1,300 .36 877.54 1,017 .63 736.38 1,180 1.51 1,770.80 1,108 1.65 1,575.08 956 .47 410.08 875 1.46 1,370.04 941 1.31 1,370.04 1,135 .95 1,174.33 1,345 Mount Pleasant .... 1.30 1.03 959.96 5S8.53 801 551 1.05 1,146.36 1,088 1.40 978.60 699 Albemarle .88 1,397.39 1,473 1 Represents expenditure by International Health Commlc-ion only; amounts expended by states, counties, or oommunitien excluded. 3 xhe amount expended in each community is figured as follows: Pro-rate and charge director's salary and expenses by aotual Time spent in each community. For instance, if in three communities the work in the first consumed 110 days; in the second 90 days (starting 30 days after the first); and in the third 60 days (starting 50 days after the first), the method of calculating per oaplta oost bCharge to the first community the full salary and expenses of the director for 30 day3, plus one-half salary and expenses for 30 days, plus one-third salary and expenses for 60 days, plus full salary of mlorosooplst for 110 days To the second community oharge one-half salary and expenses of the director for 30 days, plus one-third salary and expenses for 60 days, plus full salary of mlorosooplst for 90 days. To the’third community charge one-third salary and expenses of the director for 60 days, plus full salary of the mlorosooplst for 60 days. The sum of the amouilts obtained for each of the three communi- ties will then give the total net expenditure for the working unit. In cases where one community is worked as a unit, charge to the community the full salary and expenses of the director plus full salary of the mlorosooplst for the act.al time spent in the community. 7. Comparison of Results: Group-Community Plan with Single-Community Plan. Table 7 affords an interesting comparison of average results per working unit under the two methods of operation: the group-community plan and the single- community plan. We find that for a per capita expenditure 8 per cent less, the group-community plan covered an area 100 per cent larger, reached 70 per cent more persons and 90 per cent more families, and did this in 7 per cent fewer days than the single-community plan. From this it would seem that the group-community plan is much the more effective: Table 7 STYLE WORKING OF UNIT Percentage of Difference in Favor of Com- Groups of Communities Single Community munities Worked in Groups 1. Per capita expenditure, Average $.97 $1.05 8.2% 2. Area covered (sq.mi.), Average 60 30 100.0 3. Census of areas covered. Average .... 1747 1026 70.3 4. Families in areas covered, Average .. 370 190 94.7 5. Length of time spent in areas Average 121 130 7.4 6. Communities worked, Number 14 14 7. Working units, Number 5 14 .... 8. Communities per working unit, Number. 2-4/5 1 — In Table 8 the total figures are given from which the averages in Table 7 were derived: Table 8 STYLE OF WORKING UNIT Difference in Favor of Com- munities Worked in Groups* Groups of Communities Single Community 1. Expenditure, Total $8,431.43 $15,073.81 $6,642.38 3. Area covered (sa. mi.), Total 300 419 119 3. Census of areas covered, Total 8736 14369 - 5633 4. Families in areas covered, Total .... 1851 2656 805 5. Length of time spent in areas (days), Total 706 1817 i - 1111 * A minus sign (-) denotes difference in favor of single-community plan. 8. Comparison of Per Capita Expenditures: Group-Communltv Plan with Single- Community Plan. Table 9 shows the per capita expenditure for communities worked under the group plan to be $.97, as compared with $1.05 for communities worked under the single-community plan. The figures for each of the nineteen working units (fourteen on the single and five on the group-ccmmunity plan) completed up to June 30, 1915, are given in detail: Table 9 JNITIES WORKED IN GROUPS COMMUNITIES WORKED SINGLY Per Capita Amount Per Capita Amount Community Expenditure Expended Population Community Expenditure Expended Population TOTAL $.97 $8,431.43 8,736 total "..777777..] $1.05 $15,073.81 14,369 Saint Johns Cameron .64 838.80 1,300 Sneads Grove ...... 1.03 3,019.81 1,961 Maurepas .86 877.54 1,017 Johns Station Choudrant .62 736.38 1,180 Falkland 1,168 Wheeler 1.51 1,770.80 1,108 1.65 1,575.08 9b6 Rosewood Salemburg 1 .47 410.08 875 Smiths Chapel .9e 1,883.46 1,937 Phlladelphus 1.46 1,370.04 941 Red Oak 1.21 1,370.04 1,135 Kitchings Mills ... Hallsboro .95 1,174.33 1,345 .64 1,092.43 1,710 Mt. Pleasant 1.30 959.96 801 Otts Ingold 1.03 568.52 551 Reidvllle 1.05 1,146.36 1,086 Sebrell 1.04 3,045.59 . 1,970 Sunnyslde -| 1.40 976.60 699 Sedley 1 Albemarle .88 [ 1,397.39 1,473 It will be seen that the work was most expensive in the Eaton-Grove community (single), where the expenditure per person was $1.65; and least expensive in the Choudrant (single), Cameron (single), and Kitchings Mills-Bethcar-Otts (group) communities, where the expenditure per person was, respectively, $.62, $.64, and $.64. The results in the Kitchings Mills-Bethcar-Otts group of communities, worked as a single unit, were particularly gratifying. For a per capita expenditure averaging $.64 it was possible, in a period of time extending but three months four days, to have privies constructed at 190 of the 374 homes in these communi- ties, reducing the percentage of families without privies from 58.0 per cent (217) to 7.2 per cent (27); to examine 82.6 per cent (1413) of the 1710 persons residing in these communities; to treat 46.3 per cent (ill) of the 17.0 per cent (240) who were found infected; and to cure 4.6 per cent (ll) of those who were treated. The total area of these communities was fifty square miles. Chapter II - Results In Communities Not Completed - Up to June 30, 1915.* 1. Extent of Operations ♦ In addition to the twenty-eight communities in which work has been completed (see Chapter I), work was in progress in ten other communities but had not been completed up to June 30, 1915. Figures for the uncompleted work in these communities are given in this chapter. Final figures on the completed work in each community will be presented in the report for the quarter during which the work is completed. The statistics in this chapter are interesting principally as showing how far the work has advanced in these communities. The figures are not final and no definite conclusions can be drawn from them: they are therefore presented without text discussion. The tables are arranged in the following order: Table 10 - Extent of Operations. Table 11 - Type of Communities Selected. Table 13 - Sanitary Improvement. Table 13 - Examining and Treating Infected Persons. Table 14 - Per Capita Expenditure: Average for Each Community. Table 15 - Per Capita Expenditure: Comparison of Group-Community Plan with Single-Community Plan. 3. Results. The results of work in communities not completed up to June 30, 1915, are summarized in Tables 10 to 15, which follow without text discussion EXTENT OF OPERATIONS Table 10 Work Continued Ler lgth of Time Community State County Director Assistant Director Vfork Began Until Cl, d. Grout) Communities: R.N.Whitfield G.G.Hampton & B.R.Ott Apr. 1915 June 30, 1915 37 Mississippi 3* Pine Gr.-Rodgers. II G.G.Hampton & 30, 1915 30 I.B.Dubase Apr. 10, 1915 June 2 South East n n » G.G.Hampton & 30, 1915 J. J.Edwards May 39, 1915 June i 1 n Prentiss Henry Boswell P.M.Eason Apr. 10, 1915 June 30, 1915 3 30 it it n J.E. Friday Mch. 37, 1915 June 30, 1915 3 3 Altitude " " " n M.Boswell May B, 1915 June 30, 1915 1 33 Bethlehem South Caro- 1915 June 30, 1915 Darlington F.M.Routh F.C.Polk May 1, 3 — «1 Kolbe Curtice May 1, 1915 June 30, 1915 3 — Providence ’ " " J.Q.Peeples May 1, 1915 June 30, 1915 2 Single Communities: J.S.Lock Miss McPherson Moh. 6, 1915 June 30, 1915 34 Straight Creek... Kentucky Bell * Figures in this chapter are cumulative. TYPE OF COMMUNITIES SELECTED. 15 Table 11 Area (Sq.mi.) r of bants Number of Families Number of Tenant Families tH Number of Days Work Was In Progress Community Numbei Inhabil Total «5 © U E-« OI TJ © M d o TOTAL 7892 43.13 36.33 98.33 63.73 3892 1331 1339 158 Group Communities ... Single Communities .. 6796 1096 34.5 90.3 36.3 25.5 97.7 100.0 63.7 3902 990 1079 353 1077 252 158 Group Communities: Sunrise Pine Grove-Rodgers. South East New Site Marietta Altitude Eethlehem Antioch Providence Single Communities: Straight Creek .... 386 373 358 1168 1063 898 979 883 788 1096 43, e 63.5 57.4 25.3 16.0 37.3 44.7 41.9 90.3 30.3 38.4 29.7 58.6 39.5 53.1 35.8 40.8 25.5 84.3 90.1 100.0 100.0 100.0 100.0 100.0 100.0 62.7 169 337 148 395 170 345 436 370 830 990 51 91 44 173 67 130 113 151 259 353 43 82 44 173 82 130 113 151 359 252 158 EXAMINING AND TREATING INFECTED PERSONS. 0 Figures for work outside of community boundaries are excluded. * See footnote 1 following Table 5, page 10. 3 These percentages are not based on the number of persons reported in the columns headed "Population,11 "Number of Persons Microscopically Examined," "Number of Persons Found Infected," "Number of Persons Treated," and "Number of Persons Cured", as shown in Table 13. Instead, the figures on which the percentages are based are shown below as "Adjusted Totals": 4 Number of Persons Population Examined Infected Treated Cured Totals in Table 13 3893 1331 1339 158 ADJUSTED TOTALS 3063 1005 988 158 Difference 830 336 341 — In Providence community the number of persons reported examined exceeded the popula- tion; and in Marietta community the number reported treated exceeded the number reported found injected. The figures for Providence community have therefore been omitted in the adjusted totals for all four headings (788 from "Population," 830 from "Number of Persons Microscopically Examined," 359 from "Number of Persons Found Infected," and 359 from "Number of Persons Treated;" while the 67 persons reported found infected and the 83 persons reported treated in Marietta community have been omitted from the adjusted totals under the headings "Number of Persons Found Infected," and "Number of Persons Treated." An effort will be made to adjust this in the next report. The percentage of persons cured is based on 352 as the number of persons treated. In no community except Straight Creek has the work advanced to the stage where microscopic re-examinations for determining cures are made. Consequently, the true proportion of persons cured to persons treated is preserved by omitting figures for persons treated in communities other than Straight Creek. PER CAPITA EXPENDITURE: AVERAGE FOR EACH COMMUNITY. Table 14 Community Per Capita Expenditure1 Amount Expended*3 Population TOTAL $.50 S3.947.55 7.892 Croup Communities ... .42 2,866.43 6,796 Single Communities .. .99 1.081.13 1.096 Groun Communities: Sunrise 1.21 468.09 386 Pine Grove-Rodgers. 1.08 402.92 373 South East .52 134.40 258 New Site .43 506.38 1,168 Marietta .35 376.04 1,063 Altitude .25 222.60 898 Bethlehem .26 252.00 979 Antioch .29 252.00 883 Providence .32 252.00 788 Single Communities: Straight Creek .... • .99 1,081.12 1,096 See footnote i following Table 6, page 11. 2 See footnote following Table 6, page 11. Table 15 IN GROUPS SINGLY COMMUNITIES WORKED UUMMUIUTIES WUrUU^JJ Community IPer Capita Expenditure Amount Expended Population Community Per Capita. Expenditure Amount Expended Population TOTAL $.42 $2,866.43 6,796 TOTAL $.99 $1,081.12 1.096 Sunrise Pine Grove-Rodgers .. South East New Site .99 .35 1,005.41 1,105.02 756.00 1,017 3,129 .99 1,081.12 1,096 Altitude Bethlehem Antioch Providence .29 2,650 PER CAPITA EXPENDITURE: COMPARISON OF GROUP-COMMUNITY PLAN WITH SINGLE-COMMUNITY PLAN Chapter III - Results in Communities Completed and Not Completed Quarter Ending June 30, 1915.* The figures in this chapter relate solely to results accomplished, in community work during the quarter ending June 30, 1915. These figures are in- cluded in the statistics in Chapters I and II, but for comparative purposes are here presented separately. Table 16, in which the results for the quarter are summarized, shows that a total of 190 new privies were erected in the seventeen communities where work v/as in progress at different periods during the quarter. The number of persons microscopically examined in these communities was 4,834; the number found infected, 1,456; the number treated, 1,453; the number cured, 158. Work was in progress a total of 1,131 day3. RESULTS IN COMMUNITY WORK DURING QUARTER ENDING JUNE 30, 1915. Table 16 Sanitary Improvement Examining and Treating Infected Persons Number of Persons Period of Operation Community Number of New Privies Built Micro- scopically | Examined Found Infested Treated 1 Cured From To Number of Days total 190 1 4634 1456 1452 158 — 1131 Completed Communities: Eaton Grove 19 68 36 36 38 April 1, 1915 June 19, 1915 79 Kitchlngs Mills ... — — — — — April 1, 1915 April 37, 1915 36 Bethcar 16 — — — — April 1, 1915 April 37, 1915 36 Otts — -- — — — April 1, 1915 April 27, 1915 26 Courtland — 105 11 9 8 April 1, 1915 May 31, 1915 60 Sebrell 11 606 118 118 53 April 1, 1915 July 34, 1915; 114 Sedley 1 447 75 75 — April 10, 1915 July 34, 1915“ 105 Uncompleted Communities Straight Creek .... 17 686 147 147 70 April 1, 1915 June 30, 1915 90 Sunrise 34 16S 51 43 — April 3, 1915 June 30, 1915 86 Pine Grove-Rodgers. 36 337 91 83 — April 10, 1915 June 30, 1915 81 South East 7 148 44 44 — May 30, 1915 June 30, 1915 32 New Site 14 395 173 173 — April iO, 1915 June 30, 1915 81 Marietta 16 170 67 83 — April 1, 1915 June 30, 1915 90 Altitude 6 345 130 130 — May 8, iS15 June 30, 1915 53 Bethlehem 9 438 113 113 — May 1, 1915 June 30, 1915 60 Providence 9 830 359 359 — May 1, 1915 June 30, 1915 60 Antiooh 5 370 151 151 — May 1, 1915 June 30, 1915 60 See footnote 1 following Table 5, page 10. " Included as completed during second quarter, 1915, because Work was so nearly finished on June 30, 1915. * Figures in this chapter are non-cumulative. II. DISPENSARY WORK. Chapter I - Re sult3inDispensary^york^-^Up^tOjJune^30^1915. * 1. Plan of Work. The dispensary plan of work has three main features: (l) the Dispensary Work nroper, consisting of the microscopic examination of all persons submitting specimens and the treatment of all persons found infected; (3) an Infection Survey, consisting of the mioroscopio examination of a minimum of two hundred rural children of school age (6-18 yearsj taken at random in each county; and (3) a Sanitary Survey, consisting of the inspection of privy conditions at at least one hundred rural homes in each county. The infection and sanitary surveys are made a3 incidental features of the work, without increasing very greatly the expenditure of either time or money. 3. Extent of Operations. Dispensary work was concluded on June 30, 1915, in Georgia, Tennessee, and Texas. It had previously been closed in Alabama, Arkansas, Louisiana, Mississippi, North Carolina, South Carolina, and Virginia. This leaves only one state - Kentucky - in which dispensary work is still in progress. 3. Persons Miorosoopioally Examined. The total nupiber of persons micro- scopically examined for uno-inariasis in the eleven Southern states, up to June 30, 1915, by the field staff and state laboratories combined, was 1,381,863. Of these, 1,193,997, or 86.4 per oent, were examined by the field staff; and 187,866, or 13.6 per oent, by the state laboratories. Table 17 shows by states the number of persons examined by both agenoies up to June 30, 1915: * Figures in this ohapter are cumulative. Table 17 State TOTAL1 By Field Staff 3y State Laboratory TOTAL, 1,331,86-3 1,123,397 187,866 Alabama, 60,331 57,250 3,081 Arkansas, 54,465 52,970 1,495 Georgia, 153,633 137,740 15,893 Kentucky, 302,309 138,030 74,379 Louisiana, 59,548 55,003 4,546 Mississ tppi, ,.. 174,1682 166,633- 7,545 North Carolina,. 330,872* 278,664J 43,308 South Carolina,. 72,144 58,787 13,357 Tennessee, 96,760 93,090 3,670 Texas, 85,701 83,314 3,387 Virginia 101.933 82,537 19.405 4. Persons Treated. A total of 736,184 persons was treated for uncinariasis in the eleven Southern States up to June 30, 1915. This includes the work of the field staff and practicing physicians. The number of persons treated by the field staff was 471,613, or 64.9 per oent; by the practicing physicians, 354,571, or 35.1 per cent. Table 18 exhibits for each state the number of persons treated, and shows separately the number treated by the field staff and by practicing physicians: Table 18 State TOTAL1 | By 1 Field Staff By Practicing Physicians TOTAL, 736,184 471,613 254,571 Alabama, 53,160 45,019 8,141 Arkansas, 10,393 6,970 3,433 Georgia, 101,361 67,079 34,383 Kentucky, 103,693 37,916 65,777 Louisiana, 50,514 37,335 13,289 Mississippi, ... 113,737, 73,9193 38,818 North Carolina,. 160,689J 98,990 61,699 South Carolina,. 51,337 38,411 13,936 Tennessee, 38,353 36,401 1,952 Texas, 28,341 33,574 5,667 Virginia, 35,706 17,109 8,597 5. Counties Having Dispensary Work Completed. The total number of counties having dispensary work completed up to June 30, 1915, was 693. Table 19 shows 1 Includes both first and second campaigns. 2 Owing to exclusion of Ashe county, N.C., from dispensary record, 505 has been deducted from the figures previously recorded for North Carolina dispensary work,-under heading of "Number of Persons Microscopically Examined." a Owing to exclusion of Ashe county, N.C., from dispensary record, 32 has been deducted from the figures previously recorded for North Carolina dispensary work under heading of "Number of Persons Treated." 21 by states the number of counties in which dispensary work has been completed Table 19 Up to During Prior to June 30, Second Second STATE 1915 Quarter,1915 Quarter,1915 TOTAL, .A 693 66 637 Alabama, 60 60 Arkansas, 43 —. 43 Georgia, 134 41 93 Kentucky, 33 — 33 Louisiana, 49 — 49 Mississippi, ... 76 — 76 North Carolina,. 99 — 991 South Carolina,. 41 — 41 Tennessee, 61 9 53 Texas, 67 16 51 .Virginia, ■ 31 — 31 6. Counties Having Infection Surveys Completed. Infection surveys were completed in 685 counties up to June 30, 1915. Table 30 shows by states the number of counties in which infection surveys have been completed: Table 30 Up to During Prior to June 30, Second Second STATE 1915 Quarter,1915 Quarter,1915 TOTAL, I.. 685 51 634 Alabama, 39 39 Arkansas, 48 — 48 Georgia, 130 28 93 Kentucky, 23 — 32 Louisiana, 55 —■ 55 Mississippi, ... 78 — 78 North Carolina,. 100 — 100 South Carolina,. 33 — 32 Tennessee, 71 9 62 Texas, 61 14 47 Virginia, 59 — 59 7. Counties Having Sanitary Surveys Completed. Up to June 30, 1915, sanitary surveys had been completed in 753 counties. The number of counties in each state in which this work has been completed in shown in Table 31 (on page 23): One less than previously reported, owing to exclusion of Ashe county, North Carolina from dispensary record. Table 31 Up to During Prior to June 30, Second Seoond STATE 1915 Quarter,1915 Quarter,1915 TOTAL, 753 63 689 Alabama, 50 50 Arkansas, 50 — 50 Georgia, 131 39 93 Kentucky, 37 — . 37 Louisiana, 55 — 55 Mississippi, ... 77 — 77 North Carolina,. 100 — 100 South Carolina,. 41 — 41 Tennessee, 80 8 73 Texas, 64 16 48 Virginia, 67 — 67 Chapter II - Results in Dispensary Work - Quarter Ending June 30. 1915.* 1. Persons Microscopically Examined. The total number of persons micro- scopically examined for uncinariasis in the Southern States during the quarter ending June 30, 1915, was 59,143. Of these, 57,993, or 98.1 per cent, were examined by the staff; and 1,150, or 1.9 per cent, by practicing physicians. The number examined by both agencies in each state where dispensary work wa3 in progress is shown in Table 33: Table 32 TOTAL By Field Staff By State Laboratory State TOTAL, 57,993 1,150 Georgia, 35,133 466 Tennessee, ... 7,903 573 Texas, . . II 15,068 14,957 111 3. Persons Treated. A total of 14,793 persons was treated for uncinar- iasis during the quarter. Of these, 14,757, or 99.8 per cent, were treated by the field staff; and 35, or 0.3 per cent, by practicing physicians. Table 33 gives by states the number of persons treated by eaoh agency: Table M State TOTAL By Field Staff By Practicing Physicians TOTAL, 14,793 14,757 35 Georgia, 9,958 9,958 Tennessee, 828 838 — Texas, 4,006 3,971 35 3. Results Itemized By States. Figures in detail showing the results accomplished in the states of Georgia, Tennessee, and Texas, where dispensary work was in progress during the quarter ending June 30, 1S15, are given in the following pages: * Figures in this chapter are non-curaulative. GEORGIA 1) WORK OF FIELD DIRECTORS a« Examinations :i S g a H W W lr! >p *a ‘Tl o S: g K f,' E K t-< t-> r Ch I| ti o o a o o o w td 1—* l—* t/5 |»3,SrtK’CHSH,i3»ihB3(iC5'«3«o'(Jt)^3CSP'!'l>iirtct'r rtetirO O HP Hp.B (» H« d-HCj >i h (-‘•'S O 43tHl»OB®®EOi)(on'<*SHOrt'D‘ •9 90OSOXO It ID a •< (-' 4 1 >< cf K H O rt OOO) O p H h Pi*< Mg y a, a o h-h p o h o P? & M M '0 PC C+PPWP O P* P* CD 0> POP P D* H & P P O OQ *o O B 0» H aaWtdK3)S (»H;rep®opooooo»-‘M-ci)OoCoa>ootrM-ooo®P(i>pp>S»aa>oo’d®o!3‘ P-tBpOHOOCOPOSjCOrop. t-J Q. O O H »-■ O H- to MO. ? » N P3 4 ’o4 P-CJtJ p, ® a ® S t->09 tj- i-j p t-> p. c+ at i-'Oq (#Spp5'ppt34«PH40tict a H H* a avucDan- c+ h m- i5 (d» o O M d Pi opp oopo O OH-* P M M M* H H P P P H d O H ft? 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O to O ft* M H 4* | ->J Ol M CJ) M M CJlWM CO GJ 0) Fifth B O to M to M a> Sixth H* 1j 0) «» cn CD MM GJ CO M MM Gl H* ti 05 to M Ol 00 UlCO->3GJtotoO)toMMtnODGl CDGlOMM M CO 4 M CO M 4* Total © ro ccayiooiwaiOffiaKOit-fflH-offloouiwoiwoiuKDUi-jw^uitooiiMODmtotntoK^o 00 o C)M->30lOlC0M.CD(X>4a505(0 05 0lCr>O 05 n — 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Ascaris ►rti Pa M H i f i i i i i i r i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i 1 Kymenclepi s PJU P 1 t t 1 1 1 f 1 1 1 1 1 1 1 ( 1 1 t t 1 1 1 1 1 1 1 f 1 1 1 1 1 f 1 1 1 f f f 1 1 I Trichocep1 s a> 1 t t 1 1 1 1 1 1 1 1 1 t 1 f 1 ! 1 f 1 1 f 9 1 1 1 f 1 1 1 1 | f f 1 f f 1 f f | 1 oxyurls i i i i f f i t i t i i i i i i i i i i i i i i i i t i i i i i t i i i i i i r i 1 T.Saginata i t i i f i i c i f f i i i i i i i i i t i i i i I f i i i i i i i i r i f i r i 1 T.Solium MO 1 1 t 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 f 1 1 1 f 1 1 1 1 1 1 t 1 1 I 1 1 f 1 1 Strongyl'es n> PJO Total for COrt- 1 1 1 1 t f 1 1 1 1 1 1 1 1 1 1 1 1 1 9 V 1 1 1 1 1 1 1 1 1 1 1 1 I 1 ! 1 1 1 1 1 Other too t 1 1 1 1 I f 1 I I 1 1 1 1 ! f 1 t f t 1 » 1 1 L 1 r ( 1 1 t 1 9 1 1 1 1 t I II ' | Parasites H MMtototoWGJtoto M Ol hJ W GJ M CO to W to CO MMtoM4toMMCDGJC0toto to to o No. Gl toWOOCOMOOM->JM->JtoCOOOlOto->J->J4CJ5toMOlG10l Gl cr 4* Atten- M M MM M W HW MMM M MM MMM M O M w M OPOooHcowffipPOoiOMoaro cbWo>fjiiPi-,oiiPa>oi(j)tnatJc«cooi--'a!-vitriiPw dance O M P coi*^toioo3rotjitn-noMa3t-,->j to 3 P OOW(t)UiG)0lCJiUlOUiaiCJiOCnaitnOOO4^M(\)OH^WW0lO^OC0Ol-vIMOCUtU'1CD Gl P. CJ 4 No. o c+ M CO Gl M CJltoMM M Gl M Ol GJ to to M 05 M* O ->3 GJ (0 M <0 05 4 05 4' 05 M ->1 -9 CO 05 Ol 00 M M 4 M 4 COOCO M CJ1 05 to O to 3* (l fo M to to M M GJ to M CD Atten- o o M 05 Gl to to 05 CD GJ CO 00 Ol M Ol Gl CO CO Ol CO COCO CO M -\J O COCO M o rf CO O) M 4* GJ M 0) to Gl 00 TO to O CD GJ 05 to -O to C/I 00 CD CO CO CO Gl 05 Gl O dance M p C/I 05 O GJ Gl O to CO Gl O 05 Gl -O CO CO Gl M O O O OO O Gl 00 CO 0^1 co H O to No. to W M M M GJ M M M M Gl M MMM o n to Gl M to Atten- o H* CO -O CM CO Gl 05 05 CJ1M GJ ->J Gl dance p Ul Ol >P 07 O O 07 O Ol OO 070701 4* M 26 GEORGIA (continued) 1) WORK OF FIELD DIRECTORS c. Infection Survey Field Number Number Percentage of County Director Examined Infected Infection TOTAL 13549 5186 41.3 Bibb Whittle 395 168 5.7 Butts Rodgers 307 85 4.3 Catoosa Henry 311 33 10.4 Clay Wood 379 333 85.0 Clayton Howell 555 149 36.8 Bade Henry 300 11 5.5 Fannin Caldwell 313 107 50.3 Fayette* Buchanan 377 77 38.1 Forsyth Verner 347 51 30.6 Gilmer Caldwell 453 350 55.1 Habersham Dedwylder 443 166 37.4 Haralson Howell 356 67 36.1 Jasper Collinson 475 70 14.7 Johnson Riser 493 448 91.0 Laurens Whittle 573 543 94.8 Lee Wood 403 187 46.4 Lincoln Collinson 335 15 6.4 Lumpkin* Verner 107 48 44.9 Marion Moore 489 407 83,3 Meriwether Buchanan 331 59 35.5 Morgan Collinson 739 59 8.1 Murray Dedwylder 373 65 34.0 Newton* Riser 359 95 36.5 Oglethorpe Riser 313 66 30.9 Pauld ing Howell 313 46 31.7 Putnam Rodgers 933 360 38.1 Randolph Wood 513 391 76.3 Schley Spaulding Moore Buchanan 410 378 316 93 53.7 34.6 Taylor* Moore 406 384 69.9 Union Verner 300 137 45.7 Upson Buchanan 330 33 10.0 Walker* Henry 545 35 4.6 ■Whlte 1 Dedwylder 319 175 5.4 * These figures are in addition to figures reported for these counties in previous reports. 27 GEORGIA [continued) 1) WORK PE FIELD DIRECTORS d. Sanitary Survey County Field Director Tvoe M CO 131 Total Positive 118 Uncinaria Positive to: 00 oo Ascaris w w Hymeno- lepis h- 1- Tricho- ceohalus Oxyuris Taenia Saginata Taenia Nana M [I t—' Strongy- loides * These are credited to counties from which they were sent in 1 1 In State c o' n> ►■i o M, rr « H- O p ENLISTING PHYSICIANS 1 1 Reporting 1 1 Reporting "Treating Uncinar’xs 1 1 No. Persons Reported Trtc by Physicians 7646 No.Letters Mailed tc o -) o ■J t-j ; EDUCATIONAL 3S08Q No.Pieces Literature JD.i-Strlb *d in 3 t i i No. • Public By Addresses i Atten- dance i i No. School l i i Atten- dance CO No. Special | 380 Atten- dance 3) WORK OF CENTRAL OFFICE 4) EXPENDITURES Local Funds Iniiisst* d irect st; lTE STATE COUNTY Inter- Rent o 08 +i .<3 3t|^03-0->3diC1 1902 Total Positive CO WHH COW COCO CO CO W C CO W O CO WCDOCOCDOOOOl CD CD tn Unclnaria Positive to: £ s H* 3 rf >-*■ 0 3 n rf* M H CJl CO CO 03 M CO 02 CJl a CD 03 CD rf^OOlCDOOM-OCCi 1015 Ascaris ii i i i i i i i t i i i i i ii i i i i r t i ’ i ! i i i 1 ( Hymenolepis M CO W H CO U? O M M 00-0 163 Trichocephalus M W O CO M MM 03 M Oxyuris M ...1 T.Saginata M M MH CO M M 03 OJ W CO O) W O CO 02 CD 184 T.Nana *In addition to figures previously reported County Field Director | Number of Persons Treated Educational Work Tre atments for Uncinariasis Tres i Pa it. ra ner f11 its ic Li fO] r Other ceases First Second Third Fourth (Fifth Sixth Total Ascaris |Hymenolepis in P. O o .G O •H u ■H a 5 |T.Saginata IT.Nana |Strongylo's 03 u Q) a D SfSSkf" Parasites Kind of Lectures Public Sohool Special o S3 Atten- dance o 1 G t> o ■+■* G 55 o 525 Atten- dance TOTAL 838 773 745 2346 - 96 5663 15 2260 Benton Rude 105 96 §4 — — 295 4 475 2 300 — Carroll Rude 158 138 135 — — - 431 3 200 4 700 Chester Robinson 350 388 288 — — - 866 10 632 2 380 — Dyer Townsend 5 500 — — — — Fayette Robinson 2 2 2 — -- - 6 10 207 — — — — Lauderdale Townsend 2 2 2 — — - 6 5 350 — — — — Macon Yancey 212 194 171 — — - 577 16 1450 — — — — Madison Robinson 23 23 23 — — - 69 14 599 1 300 — Tipton Townsend 3 2 2 — — - 6 5 ■ 350 — — — — Trousdale Yancey 33 36 36 — — - 64 18 600 6 580 — — Crockett Rude 2 3 2 — — - 6 4 300 — — — — ta. Treatments and Educational Work. TENNESSEE (continued) 1) WORK OF FIELD DIRECTORS c. Infection Survey County Field Director Numb e r [ Examined Number Infected Percentage of Infection TOTAL — 318? 506 15.9 Chester Robinson 654 200 30.6 Crockett Rude 384 2 .53 Fayette* Robinson and Lee 231 14 6. Humphreys Graves 207 3 1.4 Macon Yancey 835 196 33.7 Madison Robinson 300 19 9.5 Trousdale Yancey 273 28 10.3 Wayne Graves 213 24 11.3 Decatur Graves i 300 20 10. * Partially surveyed in 1911. County Field Director nvoe of Privv Sanitary Index A B C D E F Total TOTAL 4 36 734 845 1609 5.1 Crockett Rude 2 5 66 158 233 3.9 Decatur Graves 6 148 82 236 6.9 Dyer Townsend 40 74 114 3.5 Humphreys Graves 105 113 218 4.8 Macon Yancey 72 143 315 3.3 Tipton Townsend 98 61 159 6.1 Trousdale Yancey 3 8 89 137 226 5.2 Wayne Graves 7 114 67 306 I 6.3 d. Sanitary Survey 31 TENNESSEE (continued) 2) WORK OF STATE LABORATORY Total Exams., Examinations for Physicians and Miscellaneous Examinations for Our Staff* 573 Ul -o w Total Specimens CD ui 00 Ul Total Positive -a o> ->3 O Uncinaria tJ H* »-• I-* (-> Ascaris Hymeno- lepis H* ' H1 M Tricho- cephalus CO CO Oxyuris □ A -*• rh **■ < cl rt- 0 CO CO Taenia Saginata CO CO CO CO Jaenia Nana ♦These are credited to counties from which they were sent in. 3400 In State ►2* o o ►D *<: CD O H- P (0 ENLISTING PHYSICIANS l l i Reporting l i i Reporting "Treating Uncinar's i i i No.Persons Reported sssims 1300 No.Letter Mailed “n v; c 30 OP 3P . tccp 3 » :j m, | EDUCATIONAL OO O O o No. Pcs. Litera'e TH atr . h-1 CO No. Public CD 3500 Atten- dance CO No. School > u 4 CD CO CO <6 CO 450 Atten- dance co No. Speoial 350 Atten- dance 3) WORK OF CENTRAL OFFICE 4) EXPENDITURES Local Funds Inter- national Health Comm. TOTAL* Indirect* Direct STATE STATE COUNTY From Other Sources Rent neat, Light &c Postage M O cT °a ■H Q> g-h- P-OCfi $15 6. 40. 15. ft269.81 ft4334.S3 4504.44 ♦Indirect expenditures, including estimated state funds, are not added in total with direct expenditures. TXXA5 1) WORK OF FIELD DIRECTORS a. Examinations. Leon Wood Rusk Tyler Madison Van Zandt Pains Cherokee Trinity Camp, * Morris,* Franklin,* Titus* Bowie Hopkins Delta H9 o *-3 f4 ' County Outlaw Davis Campbell Trezevant Outlaw Davis Davis Campbell Trezevant Davis Outlaw Campbell Trezevant Field Director 300.OC 00 c o o o Appropriated 198.65 184.00 198.78 199.88 147.65 163.55 38.80 198.79 300.00 300.00 177.65 198.73 300.00 p? CO CO CO CD *4* •>3 Expended i I .1 i i i i i i i i i i ill i i i i i i i i i i 1 Sec'g Appr'n o e H P* cf H- O d o H, o p H* CR S3 CD 4* 4* O 4“ CD 03 Advertising CO CO 03 CO COCO CO CO oi CO CO CO co cd cd w W(DcD-oui»^cnocn 03 CO CD Holding Dispensaries ill i I i I i I l i i I ill i f)iiiiiii 1 1 Educational Wk iii i i i i t i i i i i iii i i i t i i i i i i 1 1 School Work ill i i i i f I i *i i I ill i i i i i i i t i i 1 1 Securing Drs. Endorsement iii i i i i i i t i i i 1 Work in Homes 0)03 01 02 03 Ol H* OJ O) 03 O) 03 o 00(0 03 WCnHOJ 409 Total M MCO M CO M CD CO CD 03 4*CDM -O^CDCDCDUl on cd 4* o -o*>aoo»^cn«ooo-o->j CP CO CD 4> (D O (0 O •>} H (J) (D O) 14957 Total Number i Ej H ci H O n w M O) CD HHO)(DHCD CO CD 00 O M^OICJICD-^CDMO •cno?CD-o03^J*£* to 00 CO Total Positive M H CD (D 1—' 03 CO M CD co cd cd c *-j‘^03crai-^ t *H F-< x: 4-7 u d o U-. & ■H U-i A +> X •H H q3 +» O E-« Asoaris I Hymenolepis •n P- <1) o o & o r-» E-* n) •H >. X o ai 1 I E-* n a m a> H S’ O u 4^ 01 CD V ,C Q u m O 0) T~i HMm riDij hoo. Public School Special o 5C 1 C u V o 4-> d +» 03 C Tj o 5C Atten- dance o 5*1 Atten- dan c e TOTAL 3S71 489 13 4473 123 11767 ?? ?31C 5i 4732 Leon Outlaw 804 42 1 — -- - 847 2$ 2090 g 1305 Wood Davis 117 87 3 — — - 207 20 1734 ii 2110 3 183 Rusk Campbell 869 124 — — -- - 993 1 400 24 1762 17 1406 Tylsr Trezevant 268 41 2 — — - 331 4 309 3 355 2 325 Madison Outlaw 156 5 1 — — - 162 25 1960 6 580 i 50 Van Zandt Davis 155 53 1 — — - 222 26 841 e 1705 2 52 Rains Davis 35 24 2 — - 61 8 342 3 338 2 95 Cherokee Campbell 553 25 — — - 578 - - - - - - ... - — 5 225 3 375 10 1087 Trinity Trezevant 617 — — — -- - 617 5 500 2 780 2 350 C&rap,* Franklin,* Davis 104 56 3 -•— — - 163 32 1037 5 640 Titus* Bowie Outlaw S3 22 — — — - 105 - 32 1410 Hopkins Campbell 160 — — — -- - 160 - - - - - - - - — c 412 Delta Trezevant 27 — — — — - 27 | a 919 2 222 b. Treatments and Educational 7.'ork •Camp, Morris, Franklin, and Titus counties were worked as one county. 33 TEXAS (continued) l) WORK OF FIELD DIRECTORS c. Infection -Survey County Field Director Number Examined Number Infected Percentage of Infection TOTAL 7372 3410 46.2 Leon Outlaw 957 670 70. Wood Davis 470 104 22. Ru3k Campbell 1118 660 58. Tyler Trezevant 463 315 68.0 Madi3on Outlaw 571 120 31.0 Van Zandt Davis 485 133 27.4 Cherokee Campbell 961 565 58.8 Trinity Camp,* Trezevant 1155 573 49.6 Morris,* Franklin,* Titus, * Davis 311 82 36.4 Bowie Outlaw 307 63 20.3 Hopkins Campbell 574 136 22.0 d. Sanitary Survey Field Tvoe of Pi 'ivv ~1 1 Sanitary County Director A B C D E F Total Index TOTAL 5 1302 3580 3887 3.4 Leon Outlaw “3IT 371 0.0 Wood Davis 75 192 367 3.8 Rusk Campbell 119 188 307 3.8 Tyler Trezevant 185 83 367 6.9 Madison Outlaw 364 364 0.0 Van Zandt Davis 70 184 354 2,7 Rains Davis 133 133 0.0 Cherokee Campbell 5 81 303 389 3.3 Trinity Trezevant 322 73 394 7.5 Camp,* Morris,* Franklin,* Davis 33 353 385 1.1 Titus,* Bowie Outlaw 383 283 0.0 Hopkins, Campbell 58 334 292 1.9 Delta Trezevant 460 21 481 9.6 ♦Camp, Morris, Franklin, and Titus counties were worked as one county. TEXAS (continued) 3) WORK OF STATE LABORATORY Total Specimens Total Positive Positive to: r4 ■H s •H O a £3 Ascaris Hymeno- lepis Tricho- cephalus Oxyuris Taenia Saginata Taenia Nana Examinations for Our Staff* Examinations fox; Physicians and Miscellaneous 111 24 24 Total Exams., [ill 24 24 3) WORK OF CENTRAL OFFICE 5136 In State |No. of Physicians ENLISTING PHYSICIANS W 10 Reporting M o Reporting "Treating Uncinar’s" w Cl No. Persons Reported Trtd by Physicians ro K* No.Letters Mailed tc 3 DC M e a o > *-3 n O fci s*» t- 425 No. Pcs. Literat * Distrib1 e d OJi DH :i TV) T> i l i No. l M H o w > p< p. H 0) V)