7

(2)   The districts which recorded large decreases include Tinnevelly
(-7,171), Ganjām (-6,966), South Kanara (-5,853), South Arcot (-5,389) and
West Gōdāvari (-2,790). The following reasons have been given in explanation
of these decreases :—

(a) Tinnevelly.—Difficulty in finding unprotected cases consequent on
the systematic work done in previous years.

(b) Ganjām.—Reduction in the incidence of smallpox and lowering of
the minima required of vaccinators.

(c)  South Kanara.—Reduction in the numbers of unprotected children
and consequent lowering of the minima required of vaccinators.

(d)  South Arcot,—Reluctance of taluk boards to appoint extra vacci-
nators.

(e)   West Gōdāvari.—Absence of epidemic smallpox and consequent
reduction in the numbers of extra vaccinators.

(3)  The ratio of successful vaccinations per mille of population varied from
26.8 in Tanjore district to 96.1 in the Nilgiris district. Compared with the
previous year, increases were recorded in sixteen districts and decreases in the
rest. The largest increase ( + 6.0) was returned by the Nilgiris, and the largest
decrease ( —2.9) by Tinnevelly district.

(4)  The number of children under one year of age successfully vaccinated
totalled 689,422, as compared with 639,827 in 1926-27 and 584,137 in 1925-26.
The percentage of successful infantile vaccinations to total births varied from
34.5 in Kistna district to 91.0 in Madura district. Compared with the previous
year, 15 districts recorded increases, the largest improvements being recorded in
Madura (+22.3), Salem (+ 11.3), Chingleput (+8.2), The Nilgiris (+6.7),
Coimbatore (+ 5.8) and North Arcot ( + 5.2).

Decreases are not marked in any district, the largest being recorded in
Tanjore (— 8.0) and Ganjām (— 8.2) where defective registration is said to be
the cause. Details of infantile vaccination rates for individual districts are
furnished in Annexure A.

18. Vaccination in municipalities.—(1) The total number of vaccination
operations performed in the 81 municipalities of the Presidency fell from 202,607
in 1926-27 to 190,478 in the year under report, a decrease of 12,129. Increases
were recorded in 47 municipalities, the most marked being in Madras ( + 9,199),
Virudunagar (+1,751), Vizagapatam (+1,471), Nellore (+822), Chittoor
( + 761), Cuddalore (+ 756) and Bezwada (+ 568).

Thirty-four municipalities returned decreased figures, the most outstanding
being Madura (-18,994), Negapatam (-2,289), Coimbatore (-1,289),
Ootacamund (— 1,215), Trichinopoly (— 1,185), Cocanada (— 1,080), Narasarao-
pet (—924), Parlākimedi (—879), Vizianagaram (—643) and Chingleput
(-528).

Most of these decreases are due to a fall in the number of revaccinations,
but other reasons advanced are (1) increased difficulty in finding unprotected
cases consequent on the disposal of accumulated arrears ; (2) difficulty in main-
taining revaccination work owing to decreased incidence of smallpox ; and (3), the
granting of leave to vaccinators without substitutes being appointed. In Hospet
municipality, for instance, the vaccinator was granted sick leave in December,
1927, and no substitute was appointed although smallpox was prevalent. In
Cannanore, also, the female vaccinator was absent on leave for three months
without any substitute being appointed.

(2) The maximum and minimum success rates per mille of population
were 94.9 in Virudunagar and 19.5 in Palacole. The main reason given for low
success rates of the latter kind is absence of smallpox. Rates below 35 per mille,
which always indicate poor work, were recorded in the following towns :—Pala-
cole (19.5), Erode (25.4), Mannargudi (27.0), Chidambaram (29.5), Tiruvalur
(30.1), Cuddapah (30.2), Palni and Rajabmundry (30.6), Gudiyattam (30.7),
Dharapuram (31.1), Conjeeveram (31.4), Parlakimedi (31.7), Vizagapatam
(32.3), Villupuram (32.7), Mayavaram (33.3), Vizianagram (33.4) and Tenali
(34.2).