116. Case finding X-Ray surveys continue to be made on request by industrial and commercial firms who agree to certain sick leave and re-employment guarantees for employees with active disease. The number of firms taking advantage of these facilities continued to in- crease. The annual survey of all Government servants and the examina- tion of all prisoners, except those serving very short sentences, continued as in previous years. Results of such surveys are detailed in Table 12.
TABLE 12
Total examined
RADIOLOGICAL SURVEYS 1960
Re-examined clinically
Active Tuberculosis
Percentage with active tuberculosis
Government Servants 42,482 4,822
TI
372
0.88%
Private CONGEPILS 17,311 1,267
Prisoners
9,481 3.105 985 10.4%
1.25%
117. A further survey was made of all school children showing a reaction of more than 15 mms. to the standard Mantoux test. A total of 822 such children were X-rayed and subsequently examined clinically, The number of cases showing active tuberculosis was less than had been expected, only twelve such cases, or 1.4% of the total, being found. 118. Teachers in Government schools are X-rayed annually in the course of the Government surveys. In all other registered schools, teachers are required to register with the Education Department and before being passed fit to teach they have to undergo a chest X-ray, not necessarily by the Government Radiological Service. Only those teachers with positive X-ray findings are referred to the Government Chest Clinics and the numbers so referred are detailed in Table 13.
TABLE 13
TUBERCULOSIS IN SCHOOL TEACHERS 1956-60
1958
1957
1958
1950
1960
Referred to Chest Clinics owing to suspicious X-ray findings Unfil to teach on account of
pulmonary tuberculosis Percentage of referred
found unfit
455
318
249
179
338
49
53
23
32
26
cases
16.6% 10.7%
9.2% 17.9%
B
119. Those found to be unfit are offered priority of admission to bospital, but there is no compulsion and it is suspected that, in addition, a number of teachers with active disease may be teaching in onregistered schools.
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Medical Social Work
120. This is carried out by Almoners assisted by a staff of Tuber- culosis Workers. This work is of paramount importance in view of the local living and economic conditions, the absence of comprehensive social insurance and the emphasis on ambulatory chemotherapy.
121. The roles of the Tuberculosis Almoners and of the Tuberculosis Workers are complimentary, The Almoners interview all new patients in whom tuberculosis has been diagnosed to assess social and economic circumstances and they maintain a constant check on the regularity of individual attendances for ambulatory treatment. Waiting lists of patients recommended for admission to hospital, according to the category of treatment required, are kept by the Almoners who also assist in the settlement of all foreseeable social problems prior to admission. There- after they pay regular visits to patients in hospital. On discharge from hospital all patients are given a small supply of drugs to continue treatment until arrangements have been made for further care at the Chest Clinic most convenient to the patient.
122. The Tuberculosis Workers assist in the reception of patients and the maintenance of records in clinics. They maintain under the supervision of the Almoners the distribution of drugs prescribed for oral administration. A district is allotted to each Tuberculosis Worker and in it she is responsible for home visiting, health education and the organization of contact examinations. Recruited specifically for field work in connexion with the social aspects of tuberculosis in Hong Kong, the Tuberculosis Workers have no nursing training, but receive an in- service course of training lasting from six to twelve months.
123. The Almoners have available a sum of money from Govern- ment funds for the assistance of tuberculosis patients and their families. This is used to provide financial assistance to the families of those patients whose admission to hospital has caused great economic hard- ship, to give food supplements in the form of milk powder where required and to alleviate the burden caused in certain instances by such items as travelling expenses, domestic help, or orthopaedic appliances.
Tuberculosis Contacts
124. Efforts are made in the course of home visiting to have every close family contact of known cases of tuberculosis examined. The results of this work are detailed in Table 14 and it will be seen that,
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