159. The following table gives details of the sources of origin of new patients attending the main clinics during the year:
TABLE
1956
1957
Voluntary attendance
25.118
23,998
Referned by {
Private Practitioners
900
743
Hospitals, clinics, etc.
1,073
1,733
Contacts
*++
1.043
1.052
Government
་་་
1,473
1,694
44
43
ORI
1,481
583
567
1,458
U
452
387
-་་
425
514
32,276
32,125
Routine Voluntary
Servanta Survey
Survey Non-Goverment Private school teachers Evening Clinics
-
Total
160. The remainder of the total of 32,850 shown in Table 7 was made up by attendances at the Surgical Orthopaedic Clinic and at the Chest Clinic session for lepers, which, in deference to public opinion. are held at separate times.
161. Analysis according to the clinical findings on the first attendance of all new patients, including the branch clinics, shows the following:
TABLE 9
1956
1957
Examination incomplete {Information incomplete No evidence of tuberculosis or other lung disease Other disease
Patients did not attend
1,827
2,047
3.534
2,959
18,056
18.157
457
325
Pulmonary tuberculosis
10.733
11.428
Total
34,607
35,126
30% greater than in Kowloon, the number of active cases attending Kowloon was 36% greater than in Wan Chai and showed a much greater proportion of advanced cases. Both the number of cases attending for treatment and the gross attendances have been much greater in Kowloon, so that the new Shek Kip Mei Clinic in Kowloon supplies relief where it is most needed.
The Findings in Tuberculosis contacts
164. Contact examination is offered to all close contacts of known cases of pulmonary tuberculosis. Contacts are arbitrarily divided into two groups, (a) below 8 years of age and (b) above 8 years. Children below 8 years of age are Mantoux tested and those positive are further examined; those negative are B.C.G. vaccinated. Children above 8 years of age proceed straight to X-ray. The findings in contacts were as follows:
(a) Under 8 years of age
TABLE 11
Tuberculin tests { Negative
Percentage of active tuberculosis
(5) Over 8 years of age
1956
1957
866
$55
Positive
2.192
2,158
Clinical findings
Active tuberculosis **
109
121
of tuberculin
Inactive tuberculosis...
54
42
tested positive
Suspicious
315
244
Free of tuberculosis.
1.$14
1,751
3-45%
4.02%
Active tuberculosis
372
451
Inactive tuberculosis.
139
168
Suspicious
633
533
6,535
7,238
4.83%
5-38%
Grand total of contacts examined
10,857
11,403
***
The Orthopaedic Tuberculosis Clinic
Resulls of
examination
following
contact X-ray Free of tuberculosis Percentage of contacts over 8 years with
active tuberculosis
162. Classification of cases of pulmonary tuberculosis according to the stage and extent of disease on first attendance was as follows:
TABLE 10
Active disease
Minimal Moderate Advanced
Quiescent
Arrested
Recovered
ז'י
19:56
1957
....
1,898
2,071
1,837
1,958
1,966
1,962
3,434
3,377
1,241
1,405
357
655
163. Over 35% of active cases were found to be infectious on first diagnosis and while the number of new cases attending Wan Chai was
31
165. This clinic held at the Wan Chai Chest Clinic is now in its third year of operation. It is supervised by the Consulting Orthopaedic Surgeon to the Government and operated by his medical staff together with the part time services of a Medical Officer of the Tuberculosis Service who is able to advise on the chest condition, as well as assisting with the Orthopaedic cases. Plaster sessions are held, in conjunction with this clinic, for the convenience of patients.
166. Treatment is based mainly on ambulatory chemotherapy which is fitted into the general scheme, plus such ancillary measures as are
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