Smallpox inoculation in Africa

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Abstract
Inoculation for smallpox, the forerunner of vaccination, has had a long and variegated history. The earliest known descriptions of the practice in sub-Saharan Africa were given by African slaves in colonial America in the early and mid-eighteenth century. Subsequently it is mentioned in accounts from widely scattered parts of the continent. It seems to have been most extensively used in the Western and Central Sudan, Ethiopia and Southern Africa. Local diffusion patterns emerge from the evidence available at this time, but broader questions of origin must await further investigation. Similarly it is as yet impossible to assess its demographic impact in Africa although it clearly provided some defence against smallpox in spite of the risks involved.