U. 8S. ARMED FORCES MEDICAL JOURNAL HEALTH SURVEY IN PACIFIC prevalent in this area, and such conditions as diseases of the swea glands, dermatitis seborrheica, and molluscum contagiosum. Rates’ were much higher in the Saipan and Marshall Islandsdistricts tha m the Palau district—246.2 and 214.2 per 1,000 inhabitants as com pared with 62.9, respectively. time because of the absence of anopheline mosquitoes. None of the rickettsioses were present. Although dengue, typhoid fever, and amebic dysentery were formerly regarded as widespread in the territory, no cases Were reported present in these three districts during the survey. Several cases of filariasis were reported from the Palau district and one case from the Saipandistrict. MISCELLANEOUS DISEASES It should be borne in mind that some of the variations occurring Prevalence rates for diseases which occurred with greatest frequency 2 among the islands may be due to the fact that examinations on the are presented by district in table 19. These diseases were diagnosed “# yarious islands were performed during different seasons of the year from the general physical examinations rather than from special tests ss and by different personnel. and examinations. Diseases of the eye. Over 4,000 cases of diseases of the eye and adnexa oculi were reported from this area; the prevalence rate was Table 19. Morbidity for selected diagnoses 198.4 per 1,000, Pterygium, conjunctivitis, and cataract were greatest (Prevalence rates per 1,000 examinations) in occurrence. The intense sunlight, fine coral sands blowing about, Bare mlLRMa? ahI Tote cat te a Total Saipan district Palau district Marshall Islands Selected diagnosis Examinations Dermatophy tosis Chronic tonsillitis and nasopharynegitis district Number Rate Number Rate Number Rate Number 22, 146 (*) 4, 999 {*) 10, 575 (*) 6, 572 (*) . 6, 611 . 208. 5 1, 899 379.9 2, 683 253. 7 2, 029 308.7 Rate Diseases of the skin and cellular tissue 3, 326 150. 2 1, 433 286. 6 555 52. 5 1, 338 2038. 6 3, 304 Pterygium 149. 2 1, 231 2, 087 246. 2 94.2 665 449 62.9 86.8 1, 408 214.2 675 63, § 963 146. 6 52, 4 900 85.1 401 61.0 Degenerative joint disease Conjunctivitis Cataract Acute respiratory Infections Neoplastic diseases Inflammatory diseases of ear ‘ 1, 563 70. 6 262 909 41.0 273 784 54.6 35. 4 87 17.4 519 49. 1 632 28.5 426 85.2 123 11,6 325 217 14.7 9.8 Opacity of cornea Vitamin deficiency 211 195 Anemia 9.5 8.8 185 8.4 60 132 82 101 64 12.9 26. 4 443 74 10 41.9 7.0 .9 193 178 83 191 78 16.4 20. 2 86 28 12.8 8.1 2.6 4 43 66 4 117 29.4 27.1 12.6 29.1-114 6.5 10.0 17.8 APRNEMRE wy “Not applicable. The most prevalent diseases in the Saipan, Palau, and Marshall Islands districts were skin diseases, diseases of the eye, and respiratory diseases. Leprosy was also of major importance. Otherdiseases of wide prevalence were degenerative joint disease, neoplastic diseases, rickets and vitamin deficiency, anemia, and inflammatory diseases of the ear. Diseases carried by mosquitoes and other arthropods do not assume the importance in the trust territory that is usual in other tropical areas. Malaria is not an indigenous disease at the present 1218 VOLUME 10, No. 10- © the use of openfires, and frequent submersion in salt water are con- sidered factors possibly contributing to the wide prevalence of pterygium and conjunctivitis. Cataracts were mostly of the senile type. Eighty-five cases of blindness were reported; 17 of these were bilateral and 68 were unilateral. It is believed that most of these =" were either congenital or resulted from physical injury. In comparison with the other districts, the Marshall Islands had a strikingly high rate for pterygium, 146.5 per 1,000 persons as compared with 89.8 for Saipan and 63.8 for Palau. Conjunctivitis was most prevalent in the Saipan district, while cataracts occurred most frequently in the Palaudistrict. Acute respiratory infections. Acute respiratory infections were in commonoccurrence throughout the three districts. The over-all prevalence rate was 28.5 per 1,000 persons. This rate was much higher in the Saipan district than in the Marshall Islands and Palau districts, 85.2 per 1,000 persons as compared with 12.6 and 11.6 respectively. The changeable humid climate, crowded living conditions, sleeping on floors, low levels of nutrition, and poor standards of sanitation were undoubtedly factors contributing to these diseases. ~ Saipan Island had an unusually large numberof acute respiratory in- fections for its examined population. Chronic tonsillitis and naso.. pharyngitis were widespread in this area. The prevalence rate for * the 3 districts combined was 150.2 per 1,000 persons. The rate for the Palau district, 52.5, was far below those for Saipan and the Marshall = Islands, 286.6 and 203.6, respectively. “. Leprosy. Eighty-six lepers from various parts of the trust territory were undertreatment at the leprosarium on Tinian Island at the time of the health survey. Of these cases, 25 were thought to be lepFOCTOBER 1959 1219