80. Because of annual increases in attendance at the clinics by 50% in each of four successive years it was decided in December, 1955, to limit voluntary attenders until additional staff and premises became available. This has necessitated turning away varying numbers of voluntary attenders practical- ly every day throughout the summer season. Despite this restriction there has been a further increase in total attendances of 20%.
$1.
Attendances at the branch clinics also show increases in both new patients and old patients, but efficiency was seriously affected by the absence of X-ray facilities in the latter half of the year, due to the mobile unit, which normally provides X-ray service to the outlying clinics on the mainland once per month, being out of commission.
82.
Details of attendances were as follows:
Table G
Main Clinics
Firat Visits {Branch Clinics
1955.
195.
37,789 2,270
32.270 2,331
40,061
34,607
!
Revisits
{
Main Clinica Brunch Clinics
APUNTAMEN
304,231
16.195
478,282 22,248
220,426
401,668
300,487
436.17%
84. Analysis according to the clinical findings on first attend- ance of all new patients including branch clinics is as follows:
Table 8
1955.
1956.
Examination incomplete information not complete
Patient did not attend
2,543
1,827
3,572
3,594
No evidence of tuberculosis or other disease Lung disease other than tuberculosis Pulmonary tuberculosis
92,920
12,056
405
457
10,449
10,733
Total
39.949
34,607
------"P--
86. Classification of cases of pulmonary tuberculosis accord- ing to the stage and extent of disease on first attendance was as follows:
Table 9
Minirauch
Active disease Moderate | Advanced
Quiescent
Arrested
1965.
1966.
2,021
1,89A
2,018
1,837
1.964
2,989
3,431
1.126 1241
139
367
1,887
Total attendances
83. Due to the shortage of clerical staff in the branch clinics full details of patients attending are not available, but the following table shows the classification according to origin of new patients attending the main clinics during the year.
Voluntary attenders Contacta
Table T
1955.
1955.
30,293
25,118
1,086
1,043
Referred cages
Private practitioners.
1,020
9:00
Hospitals, etc.
KUJANKIN
1,206
1,073
Routine
Government
1,619
1.478
Voluntary
TALIANAKAKA
41
44
Survey
1.087
1.181
084
567
340
462
476
425
Total
27,789
$2,276
24
Servants
Survey, non-government
Private school teachers
Evening Clinte
Recovered
26.
41% of active cases were found to be infectious on first diagnosis.
87. It will be seen that despite the restriction of attendances the actual number of tuberculosis patients who attended the clinics way greater than in 1955 and that the fall in the number of first attendances affected only those who were free from tuberculosis. There was, however, a drop in the total number of active cases. Comparing the findings in the different clinics, Wanchai Chest Clinic, which had the biggest number of new cases, showed only 11.3% of active tuberculosis compared to 22.5% in Kowloon and 18.5% in the branch clinics. The proportion of minimal cases was greatest in Wanchai. It has been a constant finding in past years that the public on the Island attend the clinics more freely and at an earlier stage of the disease. It is also an impression that the average economic status of the Island patient is better.
38. Efforts are made by the Tuberculosis Visitors to ensure that all close contacts of known cases of tuberculosis are examined. Arrangements are usually made during the course of the visit to the home. Contacts are divided into two groups
25
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