INAH Prophylaxis
188. A recently published article sponsored by the United States Public Health Service has shown that the administration of INAH for a period of twelve months materially reduces the incidence of post- primary tuberculosis manifestations and is most effective in infants.
189. INAH prophylaxis was introduced in Hong Kong following a recommendation by Sir Harry Wunderly after his visit to Hong Kong (See paragraph 507). INAH is given to infants under the age of 3 years who have a positive tuberculin test but one without gross evidence of disease. It is also given to older children who are known to have become tuberculin positive within the previous six months.
190. The Maternal and Child Health Service is also co-operating in this Scheme, giving INAH to healthy tuberculin positive infants dis- covered during B.C.G. vaccination.
191. The total number of children received INAH are as follows:
Through the Tuberculosis Service
....
Through the Maternal & Child Health Service
195 92
287
oul is permitting more satisfactory arrangements to be made for the attendance of survey cases at the Clinics.
Hospital Treatment-Government Hospitals Only
195. The 287 beds in Government hospitals controlled by the Tuberculosis Service are situated in three general hospitals which are administered by their respective Medical Superintendents. Owing to the different functions of each hospital within the treatment scheme, numerous transfers of patients are necessary between hospitals, which in all cases are separated by both land and water. All beds are, for statistical purposes, regarded as a single unit, Details of admissions and discharges were as follows:
TABLE 15
Beds occupied on 1st January Admissions ...
Discharge:
1956 1957
298
314
498
395
(1) Completed treatment
{
Improved Unchanged
438
352
13
(2) Discharged against médical advice
1
1
03) Died
10
11
(4) Transferred to other hospitals Beds occupied on 31st December
3
38
314
280
192. This total represents an accumulation of cases over the latter half of 1957 only.
Collapse Therapy
193. Temporary collapse therapy still has a limited place in the scheme of treatment but is much less in use than in previous years; the need now being much reduced in view of the established value of prolonged chemotherapy combined with the increasing use of surgical measures. During the year the following treatments were carried out at the clinics:
TABLE 14
Induction Refills
Artificial Pneumothorax
Pneumo-peritoneum
Inductions
Refills
Unsatisfactory
Unsatisfactory
1956
1957
1.922
1,376
13
1
10
139
14
17,866
8.932
239 106
98
199
Abandoned {Completed treatment
Abandoned Completed treatment
194. This work is very time-consuming and constitutes a consider- able drain on the available time of the Medical Officers concerned. However, the steady reduction in the numbers of refills being carried
38
196. The figure for 1957 includes thirty three cases discharged temporarily from Lai Chi Kok Hospital owing to a landslide in May 1957 and later re-admitted.
197. The fall in the number of occupied beds at 31st December, 1957 is due to the fact that one ward in Lai Chi Kok Hospital has been temporarily surrendered for the treatment of diphtheria cases.
198. The fall in the total turnover has resulted from the increasing number of patients occupying beds for long periods while awaiting surgical treatment. This has given rise to a very considerable bottle. neck and patients are waiting up to six months to have operations. There are prospects of more beds becoming available during 1958 and they will be utilized to reduce this waiting list.
199. Details of major or minor surgical procedures carried out in the hospitals were as follows:
TABLE 16
Induction
Artificial Pneumothorax { Refills
Thoracoscopy
14
1956
1957
70
A
1.165
136
17
T