The

where males account for 78% of the deaths in this group. unsatisfactory housing conditions are reflected in the high percentage (31.2%) of the tuberculosis deaths that occur in the group under the age of 5 years, three quarters of these being due to tuberculous meningitis.

36. The Medical Department operates two major clinics and several branch clinics at various outlying towns and villages. In addition to the normal daily clinics held at the main centres evening clinics are also now instituted at those centres for the benefit of employed persons unable to attend during normal working hours. For the third consecutive year there has been a 50% increase in the volume of work. Each of the main clinics now has its own X-ray department, capable of dealing with most of the examinations required and this year arrangements have been made whereby the Mobile X-ray Unit There now calls once a month at the New Territories clinics. has been a marked increase in the total number of Radiological examinations made. Comparative figures for 1953/54 are as shown in Table 6 below:-

TABLE 6

are in urgent need of hospitalization. Even where home con- ditions are suitable, which is seldom the case, domiciliary care can only be minimal with the staff available, so that, though far from ideal, ambulatory treatment has to be the method adopted in the majority of cases. Although it is obviously undesirable to have seriously ill patients attending as out-patients at a clinic, the treatment given does at least help to reduce the risk of infection and the further spread of the disease to young children. Each course of treatment lasts 3 months and many patients require from 2 to 3 courses. Various combinations of drugs are given; Streptomycin, usually by bi-weekly injection, Sodium Para-amino Salicylic Acid, and Isonicotinic Acid Hydrazide, combined where necessary with collapse therapy, artificial pneumoperitoneum being the method most frequently employed.

X-ray Surveys,

38. X-ray surveys are done for three different categories, (a) Government employees, (b) private firms and institutions, and (c) detainees in H.M. prisons. All Government servants are X-rayed annually; the results of the last three surveys are set out in the following table:

1954

1953

Year

Hong Kong (including

35 0.0

52.253

48,022

faland branch clinics) -

Large film or per

16,935

23.133

10,591

Mil

Total X-rayed

Clinically examined

Kowloon (including

15,931

16.866

N.T. branch clinics)

Large film or paper............++--

19,460

18,978

3,555

NH

Incidence of active tuberculosi

TABLE T

1952

1958

1954

19,611

24.915

26.255

2,640

2.746

3,282

0.98

0-72

1.02

Treatment,

87. There are only 971 hospital beds available in the Colony for tuberculosis patients and there are at least 4,171 acutely ill active cases attending the clinics as out-patients who

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39. The increase noted this year is, unfortunately, not confined to new recruits; the disease has also been found in personnel who have been repeatedly examined. This state of affairs can hardly be said to be satisfactory. The situation is being kept under review and special investigation is made where any unusually heavy incidence of new cases is detected in any

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