Blackwater Fever in West Africa

For a period of 20 months we were stationed at a general hos- pital in one of the West African colonies. This hospital was situated in well-drained uplands, its precincts being practically free of the anopheline mosquito, but within two miles the hills descended-into large areas of swampy ground where subtertian malaria was rife. Most of the cases of malaria and all the cases of blackwater fever treated in this hospital came from these areas. During the 20-month period 2,355 cases of sub- tertian malaria in British and Allied personnel were admitted, the majority being from the British Army. In the same interval 7 cases of blackwater fever were admitted. There were no deaths from either disease. These cases of blackwater fever are presented because it is felt that this disease is of special importance while British and Allied troops are living and fighting in countries in which it occurs, and because it is not very rare for individuals to develop it after return to the United Kingdom from the Tropics. Such a case, rapidly fatal, was seen by one of us. An account of the clinical features and treatment of subtertian malaria in British troops in West Africa has already been given by Hughes and Bomford (1944).