NOTIFICATIONS PER
100,000 POPULATION IN AGE GROUP
10
8
6
100
50
2000
1000
500
FIGURE 6
TUBERCULOSIS NOTIFICATIONS BY AGE & SEX
1963 &
1973
MALE 1963
MALE 1973
FEMALE 1963
FEMALE 1973
Work of the Government Chest Service
74.
The government chest clinics provide ambulatory chemotherapy services for the great majority of cases of tuberculosis, hospital admission being reserved for the special cases. Increasing attention is being paid to the public health aspects of tuberculosis, and 84 health auxiliaries, whose main duties consist of contact tracing and home visiting, are attached to the chest service. They are supervised by one senior health visitor and 12 health visitors. Patients have all aspects of the disease thoroughly explained to them by the health visitors, and are given explanatory leaflets. Regular attendance for out-patient chemotherapy is regarded as being of paramourIT importance, and considerable exphasis 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 undertake surveys of selected groups such as government employees and prisoners, in co-operation with the radiological service. regular financial grant is allowed where a family depends on the patient's earnings and no other source of income is available to maintain it during the breadwinner's hospitalisation.
At
75.
During the year, attendances at government chest clinics remained at the high level of 1,434,162. The standard treatment of tuberculosis was three months of streptomycin, PAS and INAH followed by intermittent, fully-supervised streptomycin and high dosage INAH. Intermittent streptomycin and high dosage INAH have, in the majority of cases, replaced the monthly issues of PAS/INAH tablets as the follow-up treatment of choice. the end of 1973, there were 4,746 cases on intermittent streptomycin and INAH compared with 1,169 on PAS/INAH. Although anti-T.B. drugs are extremely efficient, the total duration of treatment remained long, stretching from 18 to 24 months. If a means of shortening the course of treatment could be found, this would be of major importance.
The Bacille Calmette-Guerin (B.C.G.) Campaign
76.
With the high density of the population and comparatively high prevalence of tuberculosis in Hong Kong, B.C.G. has a vital role to play in the prevention of the disease. The B.C.G. Campaign, as in previous years, was mainly directed at the new-born, school entrants and school leavers. During the year, 97 per cent of the new-born vere given B.C.G. Bearing in mind that the remaining three per cent usually had some contraindication to B.C.G., for example, prematurity, this represented an almost 100 per cent coverage of eligible babies, probably the highest in the world. The decline in infant mortality from tuberculosis which resulted is shown in Figure 7.
77.
B.C.G. vas brought to schools by 10 inoculators divided into five teams for tuberculin testing and the administration of B.C.G. It takes approximately two years for all schools to be covered.
78.
The work of hospitals dealing with tuberculosis cases is reviewed elsewhere in this report.
4
10
15
20
25
30
35 40 45 50
55
60
65
75+
AGE GROUP
16
19
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