ENG-1959 — Page 165

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HONG KONG ANNUAL REPORT

adult population have the disease in an active form. The chances of contact with an open case are therefore very high and it is not yet possible or practicable to segregate in institutions some 60,000 active cases. The approach to control has therefore been to protect that most vulnerable section of the population, the infants, by vaccination with B.C.G.; to treat by ambulatory chemotherapy the known cases; and to select for hospital treatment those recover- able cases who are not responding adequately to chemotherapy or whose recovery can be hastened by surgery.

Vaccination with B.C.G. is offered free throughout the Colony and during the year just under 60% of the children born received it within two to three days of birth. Young children attending the M.C.H. Centres who have not received B.C.G. but who have a positive tuberculin test without signs of active disease are given a course of isonicotinic acid hydrazide as a preventive measure.

Government operates three major full-time chest clinics in the urban area and 10 smaller part-time clinics, 6 of which are in the rural areas. These clinics are the main source of case finding and those cases with active disease are immediately started on a-full course of treatment as out-patients. During the year more than 20,000 persons were receiving continuous therapy involving some 1,400,000 attendances at the clinics. For those receiving strep- tomycin injections, night clinics have been opened at a number of strategic points so that patients who are in employment are able to receive treatment, with the minimum of loss of working time, as near as possible to their, home or place of work. A further major chest clinic is nearing completion and will be opened early in 1960; two other major clinics are proposed and are now in the planning stage.

1,846 hospital beds are set aside for the medical and surgical treatment of tuberculosis. The majority of these are maintained wholly by Government either in Government hospitals or through a recurrent subvention to voluntary agencies or missionary bodies engaged in hospital work. Patients from the Government chest clinics are admitted to Government hospitals and to hospitals maintained by the Hong Kong Anti-Tuberculosis Association which contain a total of 876 beds. There is the closest co-opera- tion between the Association and Government and 444 beds in the Association's Grantham Hospital are under the clinical

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