X1000306-1970-71_Part01 — Page 12

ENTE ÇLIRANE KEN 50% pas en tag ERSUN

таб

100

FIGURE &

TUBERCULOSIS NOTIFICATIONS BY AGE & SEX 1958 - 1960 AND 1968 - 1970

M

H

ME

KOKLE DESIG

-FEMALE SPH

been little change in the vulnerability of adolescents, and there has been some reduction in the incidence of the disease amongst middle- aged adults. The high susceptibility of males, except in childhood, corresponds with the pattem recorded elsewhere in the world,

Working of the Government Chest Service

40. The Government Chest Clinics provide ambulatory chemother- apy services for the great majority of cases of tuberculosis, hospital admission being reserved for emergencies, cases requiring investigation, and those requiring second-line drugs or surgical intervention. Increasing attention is being paid to the public health aspects of tuberculosis. 72 Health Auxiliaries whose main duties consist of contact tracing and home visiting arc attached to the Chest Service. These Health Auxil- iaries are supervised by one Health Sister and eleven Health Visitors. They had all aspects of the discase thoroughly explained to them by Health Visitors and were given explanatory leadets. Regular attendance

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for out-patient chemotherapy is regarded as being of paramount impor- tance, and considerable emphasis is placed on the follow-up of defaulters and on ensuring that contacts are examined. The clinics also provide medical social work, contact tracing and supervisory services and under- take surveys of selected groups such as Government employees and prisoners, in co-operation with the Radiological Service. A regular financial grant can be made where the family depend on the patient's earnings and no other way can be found to maintain the dependants during his hospitalization,

41. During the year attendances at Government Chest Clinics remained at the high level of 1,727,930. After intensive investigation twice weekly fully supervised Streptomycin 1G with Isoniazid 750 mgm bad been introduced the previous year. The changing pattern away from unsupervised PAS/INAH tablets to supervised treatment is shown in the following figures. At the end of 1969 there were 10,796 cases on PAS/INAH tablets whilst at the end of 1970 there were only 6,126 cases; however, casca on fully supervised intermittent treat- ment rose to 4,237.

42. The bigh incidence of primary and secondary drug resistance in Hong Kong has been demonstrated by research undertaken in conjunc- tion with the Medical Research Council of the United Kingdom. The results of these investigations indicate that the level of drug resistance in Hong Kong is possibly the highest in the world, 40% of the organisms investigated showing resistance to one or more of the first-line drugs commonly used in ambulatory chemotherapy. Recent investigations suggest that there has been a fall in the level of drug resistance possibly due to the very considerable efforts which are now being made to prevent irregularity in taking treatment.

The B.C.G. Campaign

43. In Hong Kong with its density of population and comparatively high prevalence of tuberculosis B.CG. has a vital role to play in the prevention of the disease. The B.C.G. campaign is mainly directed to the new-born, school entrants and school leavers. During the year 95% of the new-born were given B.C.G. Bearing in mind that the remaining 5% usually have some contraindication to B.C.G. (for example, prema- turity) this represents an almost 100% coverage of eligible babies, perhaps the highest coverage in the world. The decline in infant mor- tality from tuberculosis which has resulted is shown in Figure 7.

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