X1000307-1958-59_Part01 — Page 25

179. The large increase in total attendances is due to a combination of factors--a greater number of persons are now registered. more new and active cases have been found during the year and each new case is attending more frequently due to the introduction of daily injections. In addition the number of cases seen in Medical Officers' consulting rooms has increased by over 26,000 to 161,919. The attendance of new cases at evening clinics has been disappointing, but the number is rising slowly, mainly due to the use of these clinics by persons first seen during the day sessions but who find it more convenient to come for treatment after work. Accordingly an innovation has been the institution on a trial basis at the Wan Chai Clinic of short evening injection sessions on five nights each week for the convenience of those ambulant cases who are in full employment. These sessions, for injections only, are proving very popular and there is an average attendance of 160 at each session; it is hoped to extend this service to other main clinics during 1959 as more staff becomes available.

Radiological examinations

180. There are static X-ray units in the main chest clinics which are maintained and staffed by the Radiological Division of the Department. There is also one mobile M.M.R. unit which was unfortunately out of commission for the latter part of the year. Nonetheless the total number of exposures rose by 10% to 176,660,

Bacteriological examinations

181. All bacteriological work is carried out at the Government Institute of Pathology or one of its branches. A total of 43,071 sputum examinatious, carried out for the Tuberculosis Service, was recorded. Laryngeal swab examinations have almost entirely replaced gastric lavage, being much quicker, easier to carry out and reliable enough for routine use.

Examination of Contacts

182. Free examination is available to all contacts of known cases of tuberculosis and this is offered through the Tuberculosis Workers who visit the homes of all new cases, Contacts under 8 years of age are tuberculin tested; those positive are X-rayed while those negative are offered B.C.G. vaccination. For all contacts over 8 years of age an X-ray examination is carried out.

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183. The findings on the examination of contacts carried out during the year were as follows:

(a) Under 8 years of age

Tuberculin tests

Clinical findings

of tuberculin tested positive

Casco

TABLE 13

1957

1958

Negative

855

1.163

Positive

2.158

2.254

Active tuberculosis

031

148

Inactive tuberculosis

42

3T

Suspicious

244

384

Free of tuberculosis

1.751

1,685

Percentage of active tuberculosis

4.02%

4.33%

Results of

Active tuberculosis

451

385

examination

Inactive tuberculosis

168

183

following

Suspicious

533

746

contact X-ray Free of tuberculosis Percentage of contacts over 8 years with

7.238

7,070

active tuberculosis

5.38%

4.59%

Grand total of contacts examined

11,403

11,801

(6) Over 8 years of age

Chemoprophylaxis using INAH

AN

184. In co-operation with the Maternity and Child Health Service. INAH alone is given for 12 months as a prophylactic measure to tuber- culin positive infants under the age of three years who show no signs of tuberculous disease on examination. There were 533 infants treated thus during the year, of whom 199 were attending Maternity and Child Health Clinics. There is considerable controversy regarding the value and dangers of this measure, despite an accumulation of evidence based on controlled experimental work elsewhere which indicates that it is justifiable and worthwhile. Under the circumstances peculiar to Hong Kong any such adjunct to the prevention of active disease cannot be disregarded and this measure, initiated during 1957, is being continued. It is as yet too early to assess the results.

The Orthopaedic Clinic

185. Now in its fourth year of operation, this clinic is held at the Wan Chai Chest Clinic under the joint direction of the Consulting Orthopaedic Surgeon to Government, who is Senior Lecturer in the University Department of Surgery, and the Government Orthopaedic Specialist.

186. A plaster clinic is run in conjunction with the Orthopaedic Clinic and general treatment is mainly by ambulatory chemotherapy as for pulmonary disease in the same age groups. By agreement with the Hong Kong Anti-Tuberculosis Association and the Ruttonjee Sana-

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