The early history of tuberculosis in central East Africa: insights from the clinical records of the first twenty years of Mengo Hospital and review of relevant literature.

SETTING: Mengo Hospital, in present day Kampala, Uganda, 100 years ago.
OBJECTIVE: To determine the presence of tuberculosis in the Bagandan population of central East Africa and elsewhere in Africa at the time of early explorations by Europeans.
DESIGN: The case records kept by Albert Cook for two decades beginning in 1897, 35 years after the first visit of Speke to this region, were reviewed for evidence of tuberculosis among Bagandans. Writings of other contemporary medical observers were reviewed for evidence of tuberculosis in pre- and early-colonial Africa.
RESULTS: Well documented cases of tuberculosis were observed by Cook beginning in 1897. A minimum total of 93 cases of tuberculosis were included in 26 806 admissions to Mengo Hospital from 1897 through 1916. No secular trend in the prevalence of tuberculosis among patients admitted was apparent. A review of the prior literature concerning tuberculosis in precolonial Africa suggests that tuberculosis may have been present in several regions prior to European exploration, but was probably absent elsewhere.
CONCLUSIONS: The concept of all of Africa and all of the people of Africa as virgin soil for tuberculosis is rooted in an archaic Eurocentric view of Africa, and cannot be supported today by available data.