SOCIAL HYGIENE
201. The Social Hygiene Service provides free facilities for the diagnosis and treatment of venereal disease and leprosy. It is under the direction of the Senior Social Hygiene Specialist who is also the Govern- ment Specialist in Dermatology. The service operates from six centres in the urban districts and four part-time centres in the New Territories; it also maintains the Wan Chai Female Social Hygiene Hospital which contains 30 beds and a female out-patient clinic.
Fenereal Diseases
202. During 1959, there was a rise in the number of cases of primary and secondary syphilis and of chancroid, the figure for gonorrhoea was virtually unchanged and that for lymphogranuloma venereum had de- creased. This rise in the incidence of syphilis after a period of continuous decline corresponds to experience in many other cities, where the lowest incidence of syphilis was recorded five to six years after the introduc tion of general penicillin therapy: this introduction took place in Hong Kong 1952/53. The annual incidences and trends of these diseases are shown in Appendix 6.
203. No death was recorded from congenital syphilis during the year. In 1950 the number was 29, and it was in that year that free Kahn tests were made available to all pregnant women; in 1953 the Kahn test was replaced by the more sensitive V.D.R.L. and Table 15 shows both the increasing use made of this facility and the declining sero-positive rate amongst the population.
TABLE IS
ANTE-NATAL BLOOD TESTS ON PREGNANT WOMEN
1953 7954 11,53 1956 1957
1958
1959
No. of tests Clinics &
Hospitals
% of Positive Rate
No. of lests Private
Midwives
% of Positive Rate
NIA
20,748 23.716 26,803 27,330 N/A 9.5
4.3 1.8 3.5
5.255 5.697 5.439 5,464
1.1
6.0 4.2
3.4
38,026 46,932
3,3
2.6
4.620 5.583 2.7 3.2
6,269 2.3
204. There has been little change in the incidence of the late cardio- vascular or neurological complications of syphilis.
205. Penicillin continues to be the first choice for the treatment of syphilis and gonorrhoea, but in the case of syphilis the slightest manifestation of a reaction to the drug is followed by a change to chloramphenicol. One death due to anaphylactic shock occurred in an
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elderly female patient following a penicillin-in-oil injection, a prepara- tion which has also caused a few severe reactions and which is now being replaced by an aqueous suspension,
206. Since the introduction of penicillin as the standard treatment of gonorrhoea, there has been a gradual rise in the numbers of peni- cillin-resistant gonoccocci. An interesting feature is that the present high figure in males of 23.7% resistant strains, which is obtained from laboratory results, is not found in clinical practice, there being only a 9% failure rate on the standard dosage of 400,000 units.
207. An investigation into the incidence of venereal disease in pro- stitutes attending the Social Hygiene clinics was made during the year. The following results are of interest.
No. of Prostitutes attending for the first time
1,066
Percentage
TABLE 16
No. P.D. found
Syphilis
Tare Gonorrhoea Early
Jatent Fontent
692
618
235
21.6
03
5.8
94
8.8
208. An increase in the establishment of social hygiene visitors has resulted in a considerable expansion of follow-up activities. In each casc defaulting from treatment, the patient is contacted by letter and one-quarter of those so contacted return to continue treatment. Visits are then made to the addresses of those who do not respond, when. more often than not, the address given has been a false one.
Leprosy
209. In 1954 the first clinic for treating leprosy on an out-patient basis was organized and by the end of the year 1959 ten sessions were being held weekly in eight out-patient centres, while four other sessions each week are being held at social hygiene centres in conjunction with other clinics; one session is held monthly at Tsuen Wan. Infectious cases numbering 138 were admitted to the Hei Ling Chau Leprosarium which is maintained by the Hong Kong Auxiliary of the Mission to Lepers, as were also some cases either in reaction or in need of surgical attention. A very close liaison with this institution, which is referred to in paragraph 330 of this report, is maintained by the Social Hygiene Service.
210. For routine treatment at the Leprosy Clinics, dapsone is still the drug of choice; the use of diaminodiphenyl sulphoxide which was introduced for selected cases in 1958 has been discontinued following
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