X1000306-1959-60_Part01 — Page 20

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FIGURE JA

Graphs Showing the Rate of Decline of Death Rates from various Forms of Tuberculosis in Selected Age Groups based on 1954

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Tuberculosis Deaths All Forms

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Pulmonary Tuberculosis Deaths

FIGURE 38

Graphs Showing the Rate of Decline of Death Rates from various Forms of Tuberculosis in Selected Age Groups based on 1954

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Tuberculosis Meningitis Deaths

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Tuberculosis (Other Forms) Deaths

115. During this five year period there has been a fall of 78% in the deaths from pulmonary disease under five years of age, a fall of 94% in the deaths from other forms of tuberculosis but a comparatively small reduction in the death rate from tubercular meningitis. This latter suggests little reduction in the morbidity in the total population and that only B.C.G. vaccination is affecting meningeal tuberculosis which. unlike the other more chronic forms of tuberculosis. is practically on- affected by treatment.

116. With regard to morbidity, tuberculosis notifications bear little relation to the total problem and the stage has not yet been reached when a population X-ray survey can be conducted with the certainty of offering treatment to all active cases detected. Nevertheless, evidence accumulated as a result of surveys over the last decade gives good reason to believe that an average of 2% of the total population have active tuberculosis; a further 10% have radiological evidence of quiescent or urrested disease which may require little more than supervision. It is therefore assumed that facilities for the treatment of up to 60.000 cases of active disease will be necessary before any significant impact can be made on tuberculosis morbidity. About half this number of cases are already recorded at the Government Chest Clinics and an unknown number may be under treatment by other sources.

Agencies engaged in tuberculosis control

117. Government policy is to encourage and assist all voluntary agencies to participate in medical, social and welfare schemes which can be integrated into the programme of tuberculosis control. Because of the magnitude of the morbidity problem the greatest number of cases are being treated by ambulatory chemotherapy and most of this group are under treatment at the Government Chest Clinics. Hospital treatment on the other hand is provided largely by the Hong Kong Anti- tuberculosis Association, the Tung Wah Group of Hospitals, the Junk Bay Medical Relief Council and the Society for the Relief of Disabled Children. All these organizations receive recurrent grants-in-aid from Government; certain other hospitals also maintain a limited number of beds for tuberculosis patients. There is a close liaison between the voluntary agencies and the Government Tuberculosis Service.

118. The control programme is based on the following measures:

(i) Ambulatory chemotherapy of known cases.

(1) Prophylactic chemotherapy of young contacts.

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