Chemoprophylaxis
125. Starting in 1958, INAH has been given for a period of one year to children under the age of three years with a positive tuberculin lest not due to B.C.G. and who shew no radiological or other sign of tuberculosis. This is part of the contact examination scheme but is also applied to other children attending the Maternal & Child Health Clinics. The number treated totalled 328 of which 200 were attending the Maternal & Child Health Clinics. In this way, acute post primary tuberculosis which constitutes a considerable proportion of infant deaths, mainly from tubercular meningitis, has also been attacked,
126. With the widening cover by B.C.G. vaccination the proportion of contacts in this group who would be suitable for INAH therapy is diminishing and is expected to continue to do so.
8.C.G. vaccination
127, A B,C,G, vaccination campaign was started in 1952 under the sponsorship of and with assistance from U,N.LC.E.F., and continued in this way until 1955. The campaign as such was then discontinued and the activities incorporated into the general organization of the Tuber- culosis Service. The personnel employed in this work were dispersed into other sections of the Tuberculosis Service where it was considered they could operate more conveniently. The central B.C.G. office has now become a supply organization with a total staff of five, under the administrative control of the Taberculosis Service and is responsible for the examination and vaccination of contacts, surveys of children in certain groups and for the operation and control of the B.C.G. campaign in new born children.
128. The B.C.G. Vaccination figures since the beginning of the campaign in 1952 are as follows:
BCG Vaccination New Born
Grand total Vaccinatru
Year
Completed
Test
TABLE 8
Tuberculin Test
Negative Vaccinated
Babies
Faccinated
1932
176,728
38,173
3,120
41,293
1953
77,422
27,024
4.803
31,907
1954
52,620
15.234
3.050
18,284
1955
58,606
15.775
9.587
25.362
1956
38.523
$.629
23,418
29.047
1937
34,737
10.074
35,149
45,223
1958
29,107
10.390
49,865
60,255
1959
16,568
8,318
62,261
70,779
Total
484,311
130,817
191,333
322,150
32
B.C.G. vaccination of New-born Babies
129. B.C.G. vaccination of new-born babies is carried out by the multipuncture method using 20 mgm/c.c. vaccine. This vaccine is freely available to all private medical practitioners, midwives and clinics.
130. The vaccinators attached to the central B.C.G. office visit the principal hospitals as often as appears necessary to achieve maximum results; in certain hospitals this entails a daily visit. The calls upon their time are increasing and to maintain the tempo further increases of staff will be required. Of the 104,579 babies born during the year, 62,261, or 59.53%, were vaccinated with B.C.G. The success of this aspect of the work can be gauged from the returns over the past eight years:
Year
1932
1953
1954
1955 1956
+44
НИЙ
1937
1958
1959
Percentage vaccinated
4.33
6.49
3.66
10.59
24.21
35.91
46.86
$9.50
131. The returns each month show a steadily mounting total and it is anticipated that the current year will show further substantial increases. This aspect of the control programme probably gives the best return for the work done in the group to which it is applied and should, if reports from elsewhere are to be believed, show excellent long term results in reducing morbidity as well as mortality.
B.C.G. Vaccination of Other Groups
132. Vaccination of other age groups is carried out by the classical method using vaccine of 1 mgm./c.c. strength. Vaccination is given to tuberculin negative contacts of known cases of tuberculosis, through the tuberculosis clinics: it is also carried out in the Maternal and Child Health Clinics and at the B.C.G. clinic operated by the Hong Kong Anti-Tuberculosis Association. A certain amount of vaccination is also carried out by the School Health Service. The total number of children vaccinated during 1959 was 8.518 out of a total of 16,568 children tested. This side of the work is steadily decreasing and, with the rapid increases in the number of B.C.G. vaccinated new-born children, should eventual- ly be reduced, it is hoped, to a minimum.
33