family and other close household contacts; those under eight years of age are tuberculin-tested and those over that age are X-rayed. During the year a total of 28,546 contacts were fully investigated, the findings being detailed in Table 16.

Under & years of age Tuberculin Test

Clinicul examination

TABLE 16

CONTACT EXaminations (962–63

(of contacts showing positive children) Positive Mantour

Negative

Positive...

Active tuberculosis

Inactive T.8.

(Undetermined)

Suspicious T.B.

Free of tuberculosis

Percentage of contacts found to have active T.B.

Results of clinical

examination

Following

'Contact' X-rays

1962

1963

611

--

3,492

308 5,632

95

205

200

404

451

395

2,800

4,628

3.45%

211%

Over 8 years of uge

Active tuberculosis

239

400

Inactive T.B.

374

346

(Undetermined)

suspicious T.B.

753

984

Free of tuberculosis

11,775

20,376

Percentage found to have active T.B.

20%

177%

Tuberculin Testing and B.C.G. Vaccination

131. Mention has been made previously of the effects of B.C.G. vaccination of the newborn. However, some 20,000 unvaccinated infants are added to the community each year, but this number is appreciably reduced through the Maternal and Child Health and School Health Services where tuberculin testing is carried out on children not known to have received B.C.G. vaccination at birth. During the year, 37,465 children were tuberculin tested in Maternal and Child Health Centres and schools of whom 13,484 were negative and received B.C.G. vaccina- tion.

132. Children under three years of age who have not had B.C.G. but who show a positive tuberculin reaction are given INAH for one year in an effort to minimize the risks of a progressive primary tuber. culosis. During the year 48 such children were discovered at the chest clinics and a further 51 through the Maternal and Child Health Service. Thus there were 99 under treatment during 1963 as compared with 188 during 1962.

Thoracic Surgery

133. 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 under- going ambulatory chemotherapy who require surgical investigation or treatment 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.

Orthopaedic Tuberculosis

134. Outpatient sessions are conducted at the Sai Ying Pun and Kowloon Chest Clinics for patients with bone and joint tuberculosis and are maintained jointly by the University Consulting Orthopaedic Surgeon, who is the Professor of Orthopaedic Surgery, and the Govern- ment Orthopaedic Specialist. Additional sessions are also held by the permanent staff at these two centres for patients requiring routine treat- ment and supervision. The surgery is carried out at the Grantham Hospital. Thereafter, routine medical treatment and ancillary services such as physiotherapy, the fitting of appliances and medical social work are carried out by the personnel attached to the relevant clinic.

135. Attendances since the beginning of this service are shown in Table 17 and the classification of cases according to site of disease is presented in Table 18.

ORTHOPAEDIC TURPRCULOSIS ATTENDANCES 1959-63

First Visits Revisits

Total

TABLE 17

1959 1960

196)

1962

1963

K

617 441 3,503 4.001 4,619 3,685

415

397

288

5,747

4,120 4,442

5,033 4,082 6,035

TABLE 18

ORTHOPAEDIC TUBERCULOSIS BY SITE 1959–63

L

1959 1960 1961 1963 1963

Spine Hip Joint Others

303

202

197

197

158

125

914

115

109

60

ལ་་

KA

189

145

103

91

70

√ ។ ..

617

441

415

397

288

Total

J

ידד

30

31

r

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