ANNEXURE G.
(1)
TUBERCULOSIS-1950.
During the year the estimated population has increased by almost 25 per cent. The majority of this additional population has found its way into the restricted built up area of the Colony, and have somehow found accommodation in the already grossly overcrowded tene ments. Although commercial conditions were good, especially in the earlier part of the year, at no time during the year was industry capable of absorbing the additional labour available through this population increase, and there must have been, although there is no statistical in- formation available in support of this statement, an increase in the numbers of persons not in employment with a consequent lowering of the general standard of living, and, while diseases due to dietetic deficiency have been rare, increases in morbidity and mortality from tuberculosis have been noted. This disease now accounts for 17.7% of the deaths from all causes as against 16% and 14.6% for the year 1949 and 1948 respectively, and is now the most important single disease in the list of causes of death. The death-rate per 100,000 has increased from 140.6 in 1949 to 144. Full details of the age and sex distribution of the popu- lation are not available and detailed statistical analysis is not therefore possible, but an analysis of a group of persons above the age of 12 years, totalling 82,499 showed a definite preponderance of males up to the age of 50 years after which females were in the majority. Examination of the deaths from tuberculosis, all forms, shows that, compared with 1949, the deaths at 5 years and over have increased by 16.6% while deaths below 5 years have increased by 41%. This progressive increase in deaths from tuberculosis under 5 years is one of the outstanding features of post-war statistics and is a reasonable yardstick of overcrowded home condition in the Colony. Evidence is accumulating to the effect that of every 50 persons living here one is suffering from active pulmonary tuber- culosis while 3 or 4 others have the disease in a quiescent form. With the density of the population such as it is, there must be few domestic floors in the working class districts of the Colony which do not house an infectious, or potentially infectious case of tuberculosis. The relatively high racial immunity of the local Chinese is becoming overwhelmed by massive infection, and in children, progressive primary and post primary tuberculosis with fatal result is becoming increasingly common. In the face of these conditions, any normal preventive or therapeutic measures can have but limited effect on the overall picture. A B.C.G. vaccination campaign might to some extent improve the position but the most obvious and urgent measure is to reduce the density of the population either by a reduction in the overall population, or by a very substantial increase in the housing accommodation.
It is probable that the figures of death returns are fairly accurate as over 94% of all deaths were certified by registered medical practi- tioners. Notifications on the other hand are almost certainly an under estimate of the true position, as a large section of the community is unable to afford to attend private medical practitioners, although public clinics are meeting the need to an increasing extent. The available figures are as follows:
TUBERCULOSIS (ALL FORMS)
NOTIFICATION & DEATHS,
Not Notifiable
Rates per 100,000 estimated population
Year
Estimated population
Notifica. tions
Deaths
D/N Ratio
1920
648,150
2.082
321.2
1921
625,116
1.894
303.1
1922
638,300
2.096
328.3
1923
667,900
2.108
315.0
1,924
695,500
2,368
339.0
1926
725.100
2,291
315.9
1926
710,100
1.912
269.2
1937
740,800
2.123
280.7
1928
766,700
2.637
330.9
1929
802,900
2,158
268.7
1930
838,800
1,984
237.7
1981
840,473
1,983
236.9
1982
900,812
2,042
228.6
1933
922,643
2,225
2412
1934
944,492
2,170
230.7
1995
066,341
2,237
231.5
1936
988,190
2.416
244.5
1937
1,281.082
4,028
$14.2
1933
1,478,619
4,920
132.7
1930
1.750,256
7501
4.443
1 to 1.7
253.8
1940
to
1945
1946
1,600,000
2801
1.752
1 to 1.5
109.5
1947
1,750,000
4855
1,861
to 2.6
106.3
1948
1,800,000
6279
1.961
1 to 3.2
108.9
1949
1,867,000
7510
2.611
1 to 2.8
140.6
1950
2,265,000
9067
3.263
1 to 28
144.0
74
75
Page