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HONG KONG ANNUAL REPORT
to 36% (1950) to 23% (1954) to 19.9% (1955). The two government clinics diagnose 70% of the total cases notified, and the majority of the rest are notified by other government or government-assisted institutions. General practitioners appear to be making very few notifications. There are just over 1,000 beds available for the treatment of tuberculosis, but to offset this acute shortage of hospital beds, ambulatory treatment has been greatly and successfully developed at the government clinics. During 1955, 5,000 cases were so treated. By means of this ambulatory treatment the following results are achieved:
(a) Patients with minimal non-cavitatory disease can receive their entire treatment while continuing to work.
(b) Patients with minor cavitation may, after ambulatory treatment, be controlled by collapse therapy after a few days or weeks in hospital, instead of 5 months, as previously.
(c) Patients with more advanced disease, requiring surgical treatment, may receive their preparatory treatment at the clinics, and have the operation within 4 weeks of admission, instead of requiring several months' preparatory treatment in hospital before operation.
(d) More advanced cases can be rendered non-infectious for long periods, thus reducing sources of infection in the community.
The danger of producing infection contacts by resistant strains of the infecting organism has been carefully consider- ed, and although the risk is recognized, it is considered that the over-all value of this method of treatment justifies the risk. In addition to this out-patient treatment, well over 2,000 cases attend the clinics each month for refill collapse therapy. The Hong Kong system of treating tuberculosis has been favourably commented on by several prominent workers in the field of tuberculosis who have visited the Colony, and has attracted the attention of the World Health Organization.
The B.C.G. campaign continued and is becoming in- creasingly popular. B.C.G. vaccination has been offered to all schoolchildren and is available through the infant welfare clinics to all infants whose parents care to bring them, and to all suitable contacts of known cases of tuberculosis. B.C.G.