Over 8 years of age Resub of Clinical
examination following
'Contact X-rays Percentage of contacts
Tuberculosis
X-ray Surveys
19160
1961
Active T.B.
318
421
inactive T.A.
387
665
Suspicious T.B.
1.043
1,002
Free of T.B.
8.766
12.390
found to have active
3.02
2.91%
153. Government conducts annually an X-ray survey of all civil servants. In addition all prisoners are X-rayed each year and other X-ray surveys are undertaken. on request, of groups of employees in commercial or industrial concerns where certain conditions are met regarding sick leave for, and re-employment of, persons found to be suffering from active disease. There are only two mobile X-ray units at present available for this purpose and they are very fully committed in dealing with radiological services to part-time clinics and to the annual and "conditional' surveys. A static X-ray Survey Centre is now being built on Hong Kong Island and another is planned for Kowloon.
154. During the year the following survey work was undertaken:
TABLE 12
X-RAY SURVEYS
Total examined
Government Employees
45.617
Prisoners
9,735
Conditional Surveys 26.809
Further clinical and large filra
examination
5.677
3.390
1.761
Active tuberculosis
Percentage of active tuberculosis
399 0.875%
485 4.98%
310
1.17%
155. Government servants undergo a pre-employment examination which excludes tuberculosis and are thereafter examined yearly. During 1961 there were 123 new cases diagnosed in Government servants who showed no signs in the 1960 survey. This represents an annual attack rate of 0.28% in what is a fairly representative cross section of the community. At the other extreme, the prison population is representative of the lowest socio-economic group 48.25% of which have an history of drug addiction when they are first committed to prison. The conditional surveys are carried out on employees working for enlightened firms which have an eye to the welfare of their employees. Thus none of these findings gives a precise indication of the incidence of active disease
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in the general population which, on present data available, is estimated to average just over 2% in the adult population.
Tuberculin Testing and B.C.G. vaccination
156. Through the Maternal and Child Health and School Health Services, tuberculin testing is carried out on children not known to have been vaccinated at birth with B.C.G. There are still some 20,000 to 30,000 unvaccinated children added to the community each year and it ir estimated that there are about 100,000 of these all told in the 0-5 age group. During the year 17,474 children were tuberculin tested in Maternal and Child Health Centres and schools of whom 7.756 were negative and were vaccinated with B.C,G. This is a disappointing figure and merely represents those who have attended the various clinics where tesling is done as a routine.
157. Children under three years of age who have not had B.C.G. but who show a positive tuberculin test are given L.N.A.H. for 12 months as a prophylactic measure in an effort to minimize the risks of a progressive primary tuberculosis. During the year 57 such children were discovered at the chest clinics and a further 90 through the Maternal and Child Health Service. There were thus 147 under treatment during 1961 compared to 180 during 1960.
158. The desirability of maintaining this measure, relatively small though it be, is underlined by the fact that for the first time in 8 years there was an increase in the infant death rate from tuberculosis. While the increase was not significant one, there can be no relaxation in any measure, however small, that will help to consolidate the gains of the past ten years.
Surgical Tuberculosis
Thoracic Surgery
159. Outpatient sessions for patients who need or have had chest surgery are held at the Wan Chai Chest Clinic by the Government Specialist in Thoracic Surgery and the Thoracic Surgeon from the Grantham Hospital. These sessions are held weekly and fortnightly respectively. In consultation with the staff of the Clinic, cases undergoing ambulatory chemotherapy who require surgical investigation or treat- ment are seen by the Thoracic Surgeons and the lines of investigation and treatment are planned. Thereafter, the patients are admitted to the Grantham Hospital; on discharge the subsequent follow-up takes place at the Wan Chai Clinic.
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