of the latter and the serum levels attained have been assessed by Professor Crofton of Edinburgh University during the year. He found that, from the clinical standpoint, they were highly satisfactory. Sampling carried out at the major Chest Clinics has shown by excretion tests that au average of 80% of ambulant patients do in fact take the PAS/INAH tablets distributed to them by the clinics.
171. The average duration of treatment of cases completing courses of therapy during the year has risen to 23 months as compared with 15 months in 1957, The institution of daily injections, although adding considerably to the work of already overburdened clinics, have proved to give encouraging results to patients and staff alike.
172. The following tabic details the work accomplished during the year:
TABLE ?
Brought forward from last year Started treatment during the year
19.57 5,887 9.132 7,964 11.546
19.58
Total under treatment during the year
13.851
20,678
Completed treatment
1,213
1,048
Failed to attend
2,868
3,048
Treatment incomplete
Admilled to hospital
495
801
Transferred elsewhere
95
1,938
Died
48
109
9.132
13,733
Still under treatment at the end of the year
173. The most disappointing feature has been the large number of patients who, despite every effort by the staff of Tuberculosis Workers, fail to complete treatment. The default occurs most commonly during the first three months of treatment and the main excuse given is too busy. The following facts emerge clearly:
(i) Some patients will attend regularly although they are not taking
the drugs prescribed.
(i) Drug intolerance, and other symptoms produced by drugs are
not an important cause of failure.
(ii) Treatment by injection, especially by daily injection produces the
best attendances.
(iv) The deterrent effect of distance from the clinic can largely be
overcome by daily injections.
(v) The education status of the patient appears to bear no relation
to willingness to attend.
34
The Work of Government Clinics
174. The attendances for the past five years have been as follows:
First ortendances;
Main Clinics Branch Clinics
Total
Subsequent uitendances:
Main Clinics Branch Clinics
Total
Grand TOTAL
19,54
TABLE 10
1955
7956
1957
1958
35,738 37.789 32,276 32,850
1,273
2,272 2,331 2.276
37.011 40,061 34,607 35.126
37,063
2,391
39,454
304.231 373,222
16,195 28,346
181,794
498,461 749,287 6,675
40.821 53,949
188,469 320,426 401,568 539,282 800.236 225,480 360,487 436,175 574,408 842.590
175. The total number of persons in attendance at the clinics during the year was 65,655 which is 10,000 more than for the previous year; of those in attendance 52,311 were registered as suffering from chest disease; 20,678 received active treatment as out-patients.
176. Analysis of the findings in new patients at the main clinics shows the following:
TABLE II
1957
1938
Patients did not attend Examination incomplete Information incomplete
2,047
3,669
2.969
2,033
No evidence of tuberculosis or other lung disease Other disca
18,357
20,937
325
Tuberculosis
11,428
10 12,805
177. Classification of tuberculosis according to the stage and extent of the disease was as follows:
TABLE 12
Active diseasc
Minimal Class I Moderate Class IJ Advanced Class IU
1957 JOSE 2,071 2,474
1,958
2,388
1,962 2,095
Quiescent
3.377
2,965
Arrested
1,405
1,671
Recovered
655
677
535
Bone and Joint Tuberculosis
178. Sputum examination of those attending for the first time showed that 29% were open cases.
35
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