X1000306-1969-70_Part01 — Page 7

Infant Mortality

9. The steady decline in infant mortality has been due to improve- ment in environmental conditions, development of maternal and child health services, and increasing public appreciation of the value of these services in the maintenance of health amongst infants and mothers. Among the major causes of infant mortality there have been great reductions in mortality from the preventable diseases, particularly bronchopneumonia, gastro-enteritis, tuberculosis and, in the recent two years, measles. There has also been a steady reduction in mortality from prematurity, due to improvement in the midwifery and maternal health services. As has been the experience elsewhere, congenital malforma- tions and other diseases of the new-bom are proving more intractable, and mortality from these causes has, as yet. been little affected. As shown in Figure 2. infant and neonatal mortality rates have remained relatively steady since 1965, with only the minor fluctuations to be expected in any community when mortality has reached a low level.

Maternal Mortality

10. Here also the statistics pertaining to Hong Kong have attained the standards prevailing in the technically advanced countries of the world. During recent years great improvements in mortality have been effected in the fields of toxaemia of pregnancy, haemorrhage and puerperal sepsis. There has been some reduction in mortality from abortion and ectopic pregnancy, and deaths attributed to other diseases occurring during pregnancy or childbirth have also decreased in numbers.

General Mortality

11. The marked social and economic changes which bave occurred in Hong Kong during the years following the Second World War are reflected in the mortality trends and patterns of diseases, which have changed considerably in the past two decades. Improvements in the general level of public health are demonstrated by the decline in propor- tionate mortality from infectious, respiratory and intestinal diseases, while the ageing of the population (which is, however, predominantly young) is reflected in the increasing mortality from heart and hyperten- sive, cerebro-vascular and neoplastic diseases.

12. The leading causes of death were cancer, diseases of the heart including hypertensive diseases, and cerebro-vascular disease, followed by pneumonia and tuberculosis. As in many countries in different parts

of the world, the death rate from cancer continued to increase, rising from approximately 30 per 100,000 population for both sexes in 1950 to 96 per 100,000 population in 1969. In the local female community the common cancer encountered is cancer of the uterine cervix, and in the community as a whole the common cancers encountered are cancer of the lung, primary cancer of the liver, cancer of the stomach and nasopharyngeal cancer.

13. The Eighth Revision of the International Statistical Classifica- tion of Diseases, Injuries and Causes of Death published by the World Health Organization came into use on 1st January, 1969. All registered medical practitioners were supplied with a supplement of the Eighth Revision and were requested to ensure that the nomenclature of causes of death given by them on death certificates agreed with those in the International Classification.

COMMUNICABLE DISEASES

(Tables 13-16)

14. The total number of notifications of communicable diseases during 1969 was 14,210, of which tuberculosis formed 77.9%. Satis- factory progress continued to be made in the control of diphtheria and poliomyelitis. The incidence of bacillary dysentery declined slightly after a successive increase in incidence in the past three years, but the incidence of enteric fever showed little tendency to decline. Trends in the incidence of these four diseases are shown in Figure 3. The incidence of measles continued to remain low since the com- mencement of the anti-measles vaccination campaign in late 1967. During the year under review Hong Kong had a short visitation of cholera.

Cholera

15. Since the last reported case of cholera in November 1966, Hong Kong remained free from the disease for more than two and a half years. The first case of cholera in 1969 was confirmed on 5th July, Thereafter in the same month a further 5 cases were reported. In August one imported case, a boat woman living in a junk at Castle Peak, was reported. One isolated case was reported in September, and the last case in 1969 was reported on 16th October. In all a total of 9 cases including one imported case was notified. With the exception of the imported case and one case from New Territories, all originated

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