X1000306-1960-61_Part01 — Page 18

TABLE 7

TUBERCULOSIS NOTIFICATIONS IN CHILDREN

Under Five Years

All Forms

T.B. Meningitis

1956

1,459

454

275

Under One Year All Forms T.B. Meningitīs

126

1957

1,441

448

270

114

1958

1.137

309

224

105

1959

1960

975 660

276

190

80

181

74

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Agencies Engaged in Tuberculosis Control

96. Government policy is to encourage and assist 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 problem most cases of active disease are treated by ambulatory chemotherapy, the greatest number being 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 organiza- tions 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.

97.

The control programme is based on the following measures: (i) Ambulatory chemotherapy in known cases.

(i) Prophylactic chemotherapy of young contacts,

(ii) B.C.G. vaccination of new-born children and of older tuber-

culin negative reactors.

(iv) Hospital treatment of selected cases that will respond to

medical or surgical in-patient treatment.

(V) Limited case-finding through X-ray surveys, subject to sick

leave and re-employment guarantees.

(vi) Au annual X-ray survey of all Government employees.

GOVERNMENT TURENCULOSIS SERVICE FACILITIES

Ambulatory Chemotherapy

98. Ambulatory chemotherapy is now the standard form of treat- ment used in the Government Chest Clinics. The routine regimen is streptomycin daily by injection together with the combined P.A.S. and IN.A.H, tablets until the tuberculous lesion is apparently stable; the streptomycin is then discontinued. Thereafter, the combined P.A.S. and

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I.N.A.H. tablets are administered for a minimum period of two years. All treatment at the chest clinics is free of charge.

99. The principal problem arising out of this form of treatment is the failure of patients to follow completely the course advised. Attendance registers show that exact regularity of attendance for injec- tions is infrequent and the testing of urine samples indicates that a proportion of patients, which may be as high as twenty five per cent in certain areas, fail to take the combined P.A.S. and I.N.A.H. tablets. In addition, approximately twenty per cent of cases failed to continue treatment despite home visits and other follow-up methods. There are indications that one major reason for the latter is an influx of cases from outside Hong Kong who return home before treatment is completed.

100. The Jockey Club Clinic, Sai Ying Pun, opened during the year, contains a major chest clinic, bringing to four the number of full- time centres of ambulatory treatment; two are in Hong Kong and two in Kowloon. In addition, there are eleven part-time out-patient clinics and ten injection centres, while the staff of certain general clinics in the New Territories maintain an injection service for patients referred by the Tuberculosis Service. In all full-time centres, evening sessions are held and these are proving increasingly popular.

101. For the second successive year there was a fall in the number of persons presenting themselves for the first time at the chest clinics. Although the total number of cases of tuberculosis under active treat- ment continues to increase, the indications are that patients are presen- ting themselves earlier in the course of disease and that fewer advanced cases are being seen. Nevertheless, pressure on the clinics remains sub- stantially unchanged and the volume of work undertaken which is detailed in Table 8, continues to increase.

First attendances

TABLE &

401,568

اوی ترم تواتر

Cases of tuberculosis discovered Total attendances for treatment Under treatment from previous year Started treatment during the year Completed treatment

GOVERNMENT CHEST CLINICS 1956-60 1936 19,57 1958 34.607 35.126 39.434 10,733 11.438 12,270 *803.326

1959

39,006

35.99 |

14.406

12.907

$39.212

1.655,100

2,001.960

1,703

3.887

9.112

13,733

16,062

7,861

7,964

11,546

11.357

12,617

1,037 1,213

1,048

2,064

3.724

Failed to attend

2,022

2,864

3,048

5,391

4,975

Admitted to Hospital from Chest

Clinics

1,029

1,078

ISIL

1.507

1.592

Still on treatment at cod of year

5,807 9.132

13,733

36,062

16.433

Streptomycin course extended by dalty Injections.

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