ENG-1958 — Page 159

PUBLIC HEALTH

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age. The death rate has fallen to 83.8 per 100,000 persons, which is less than one half the figure recorded in 1951.

The control programme is directed mainly against the disease in infancy since at one period almost 40% of the total deaths from tuberculosis occurred before the age of 5 years. The measures adopted are (i) the vaccination of new-born children with B.C.G. before they have had a chance to become infected (approximately 50% of children born receive this vaccination on a voluntary basis within two to three days of birth); (ii) preventive treatment by means of isonicotinic acid hydrazide in young children who have been recently infected but as yet show no sign of disease; (iii) large-scale efforts to sterilize known cases of tuberculosis in the community by the use of ambulatory chemotherapy.

The main source of case finding is the Government Tuberculosis Service which operates large full-time clinics in the urban area, with smaller part-time clinics in all large population centres in the rural areas. The main line of attack is by ambulatory chemo- therapy which, for economic reasons, is most suited to this type of community. Fifteen thousand cases have received continuous therapy during the year, involving three-quarters of a million attendances. Approximately 1,800 beds are now available for the treatment of tuberculosis in the Colony; just over 1,000 of these, including 444 beds at the Grantham Hospital, are operated directly by the Government or under Government subsidy and receive their cases from the Government Tuberculosis Service. The main non- official body co-operating in the tuberculosis campaign is the Hong Kong Anti-Tuberculosis Association which administers the Grantham Hospital (540 beds), the Ruttonjee Sanatorium (230 beds) and Freni Memorial Convalescent Home (106 beds). This Association is subsidized by the Government and there is the closest co-operation with the Government Tuberculosis Service. Population tuberculosis surveys have had to be delayed until such time as facilities can be extended to meet the continuously increasing demand for treatment. Special surveys are conducted in certain industrial undertakings and amongst school teachers.

Funds are available to assist patients who have been advised by Government medical officers to give up work to undergo treatment for tuberculosis. Assistance in kind as well as in cash