athy? 134 to MOUTINE ART phe BANDAR CON
FIGURE 6
TUBERCULOSIS NOTIFICATIONS BY ACE & SEX
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1961 AND 1971
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AGE PIDU
ITHALK PATL.
Working of the Government Chest Service
MCNULLE UNIT
53. The government chest clinics provided ambulatory chemotherapy servcies for the great majority of cases of tuberculosis, hospital admission being reserved for emergencies, cases requiring investigation, and those requiring second-line drugs or surgical intervention. Increasing attention was paid to the public health aspects of tuberculosis. Seventy-four Health Auxiliaries, whose main duties consist of contact tracing and home visiting, were attached to the chest service. They were supervised by one Senior Health Visitor and eleven Health Visitors. Patients had all aspects of the disease thoroughly explained to them by Health Visitors and were given explanatory leaflets. Regular attendance for out-patient chemotherapy was regarded as being of paramount impor-
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tance, and considerable emphasis was placed on the follow-up of defaulters, and on ensuring that contacts were examined. The clinics also provided medical social work, contact tracing and supervisory services, and undertook surveys of selected groups such as government employees and prisoners, în co-operation with the radiological service. A regular financial grant was allowed where a family depended on the patient's camings and no other source of income could be found to maintain the dependants during his hospitalization.
$4. During the year, attendances at government chest clinics remained at the high level of 1,657,332. The standard treatment of tuberculosis was three months of Streptomycin, PAS and INAH followed by intermittent, fully-supervised Streptomycin and high dosage INAH. Intermittent Streptomycin and high dosage INAH had, in the majority of cases, replaced the monthly issues of PAS/INAH tablets as the follow-up treatment of choice. At the end of 1971, there were 5,281 cases on intermittent Streptomycin and INAH compared with 2,631 cases on PAS/INAH. Twice-weekly fully-supervised PAS 10 gms. and INAH 750 mgms, was a new regimen now being evaluated with, so far, encouraging indications. Although anti-T.B. drugs were extremely efficient, the total duration of treatment remained long, at 18 to 24 months. If a means for shortening the course of treatment could be found, this would be of major importance.
The Bacille Calmette-Guérin (B.C.G.) Campaign
55. With the high density of population and comparatively high prevalence of tuberculosis, in Hong Kong B.C.G. has a vital role to play in the prevention of the disease. The B.C.G. campaign, as in previous years was mainly directed at the newly-born, school entrants and school leavers. During the year, 96 per cent of the newly-bom were given B.C.G. Bearing in mind that the remaining four per cent usually had some contra-indication to B.C.G. (for example, prematurity) this represented an almost 100 per cent coverage of eligible babies, perhaps the highest in the world. The decline in infant mortality from tuber. culosis which resulted is shown in Figure 7.
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