TABLE 13
ORIGIN OF TUBERCULOSIS PHOTIFICATIONS 1961-63
196)
1962
Government Chest Clinics ...
Other Government Institutica m
8,957 10.691 2,056
Tung Wah Group of Hospitals Non-Government Institutions and Private
Practitioners
947
1,680 801
1963
8,794 1,660
864
...
624
1,091 1,713
Total
12,584
14,263 13,031
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124. With regard to age and sex distribution, the greatest numbers are between the ages of 25 and 50 years, and there is a marked predom. inance of males.
125. The decline in the incidence of the disease in children under five is attributed to the increasing acceptance of B.C.G. vaccination. Despite the fact that a considerable proportion of these young children loss their tuberculin sensitivity within a period of two years after vaccina- tion, it does appear that some degree of protection nevertheless persists. Investigation showed that, in common with experience elsewhere, 33% of previously-known reactors lost their sensitivity over a period of 18 months. Revaccination with B.C.G. on entry to school is still being considered and preliminary investigations are proceeding.
Work of the Government Tuberculosis Service
126. All cases attending the Government Chest Clinics are given treatment free, irrespective of origin. The volume of work undertaken at the Government Chest Clinics during the past five years is detailed in Table 14,
TABLE 14
WORK OF GOVERNMENT CHEST CLINICS 1959-63
First attendances
Cases of tuberculosis discovered....... Total attendances for treatment........ Under treatment from previous
year
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Started treatment during the year Completed treatment
1960
1950
1967 1946.7 1963 39,008 35,991 40,146 43,519 39,277 14,406 12,937 15.270 [6,541 15,036 1,655,100 2,001,960 2,204,058 1,901,425 1,414,009
13,733 16,062 16.433 17,714 17,372 11,357 12,617 12.381 12,190 9,694
3,776 4,935 4,987 5,371
127. Treatment at the Chest Clinics is by ambulatory chemotherapy, which includes daily injection of streptomycin six days each week, com- bined with oral PAS and INAH, for a period of six months. At the end of this period, the oral therapy is continued for a period of up to two years from the start of treatment. Some chronic cases with positive sputum are maintained for long periods on INAH with the aim of ultimately rendering them 'catalase negative', Hospital admission is arranged for these patients whose treatment can be expedited by surgical or other means or who, for medical or very pressing social reasons, require in-patient treatment.
128. There are four full-time Government Chest Clinics which, in addition to normal day-time working, offer one evening diagnostic session each week. Part-time clinics are maintained at twelve other centres and a sessional advisory service is provided at four other centres maintained by voluntary agencies. In addition to these specialized sessions, routine sessions are provided for the daily injections of streptomycin at a number of centres, for the convenience of patients who cannot travel regularly to the full-time clinics.
129. Case finding is not practised on any scale as the available services are already heavily committed to the care of those patients who present with active disease. All Government employees undergo an annual X-ray examination and similar surveys are undertaken, on request, of employees in industrial concerns and private institutions, subject to certain conditions concerning sick-leave and re-employment for persons found suffering from active disease. Otherwise, little case finding is performed, but this aspect of the control programme is being reviewed in the light of the Heal-Fox Report. The results of surveys undertaken during the year are shown in Table 15.
TABLE 15
X-RAY SURVEYS–1963
Government Conditional Prisoners Employees Surveys Surveys
Total examined
$1,190
41,905
4,994
Clinically examined
6,228
2,979
970
Active tuberculosis
280
338
229
Percentage active tuberculosis
0.55%%%
0,96%
4.6%
2,064 3,724
7,147
Failed to attend
5,391
4,975
5,208
Contact Tracing
Admitted to hospital from chest
clinics
1,587
1,592
...
Still on treatment at end of year.....
16,062
16,433
289 17,714
921 17,372
811
14,049
130. Following the diagnosis of a case of tuberculosis, Tuberculosis Workers visit the patient's home and arrange for the examination of the
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