HEALTH
145
cent of the adult population is in need of treatment for the disease, with a smaller percentage of active tuberculosis occurring below the age of 15. There is ample evidence that tuberculosis in infancy and early childhood is now relatively rare by 1951 standards, that the peak prevalence is in middle life and that most of the more intractable clinical problems occur above the age of 45.
The mortality rate has fallen from 208 per 100,000 in 1951 to 55.3 in 1962, and there has been at the same time a remarkable change in the age distribution. In 1951 more than one-third of the deaths occurred below the age of five. Today the proportion has fallen to one-eighth, while above the age of 45 the proportion has risen from one-fifth to more than half, with a male preponder- ance of two to one. The mortality pattern today closely resembles that in the United Kingdom but is at a considerably higher level.
In the field of prevention, improved economic conditions are having some effect but, while health education in the home, contact examinations, and X-ray surveys are proceeding, the principal specific measure aimed at tuberculosis prevention is the BCG vaccination campaign. The main emphasis of the campaign is directed to the vaccination of newborn babies.
There are 1,748 beds available in the whole Colony for the treatment of tuberculosis, of which 1,490 are in Govern- ment assisted hospitals managed by the Hong Kong Anti-Tuber- culosis Association, the Junk Bay Medical Relief Council and the Tung Wah Hospitals Medical Committee. A total of 92,205 patients were admitted for treatment in hospital during the year. Among patients who accept admission for treatment the level of co-operation is excellent, there being only a very small proportion of discharges against medical advice. In addition, a rehabilitation scheme is now in operation. It was started by the Lutheran World Service as a pilot project; this scheme, in view of its success, is likely to become a permanent part of the overall treatment programme.
During 1962, 81.6 per cent of babies born in the Colony received BCG vaccination within 48 hours of birth. The vaccine is issued free to all midwives, doctors and hospitals. Through the Govern- ment tuberculosis service all children under the age of three who are contacts of known adult cases are given prophylactic INAH for a period of 12 months if there is a tuberculin sensitivity reaction