ENG-1969 — Page 162

HEALTH

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Tuberculosis remains Hong Kong's principal community health problem. It is believed from the figures which are available that approximately one per cent of the population of Hong Kong is suffering.from active pulmonary tuberculosis requiring treatment. Males are affected at least twice as commonly as females, the disease being especially common in elderly men, while drug addicts are particularly prone. Tuberculosis in the young is now relatively uncommon and the former large numbers of acute and often fatal cases of tuberculosis in infants are now no longer seen.

Government either by subvention or directly through the Govern- ment Chest Service spends more than $17,000,000 yearly on control measures. The tuberculosis control programme is a combined effort between the Government Chest Service, the Hong Kong Anti- Tuberculosis and Thoracic Diseases Association and the Junk Bay Medical Relief Council, while certain other organisations, including the Tung Wah Group and the Caritas Medical Centre also provide treatment facilities, maintained mainly with the aid of substantial government subventions. The Government Chest Service operates six full-time clinics equipped with radiological facilities and 17 subsidiary centres throughout the Colony. In addition it maintains the BCG vaccination programme and during the year 95 per cent of babies born in the Colony received BCG vaccination within 72 hours of birth. It is believed that the widespread use of this pro- phylactic has led to the precipitate fall in tuberculosis in the very young in Hong Kong.

The cornerstone of treatment in Hong Kong is ambulatory chemotherapy on an outpatient basis. The position with regard to the treatment of tuberculosis in the last 15 years has changed com- pletely, and the disease can now nearly always be cured provided that the patient is co-operative and takes his treatment regularly. Consideration is now being given to the replacement of the monthly issue of PAS/Isoniazid tablets by a regimen of twice weekly Strep- tomycin injections and high dosage Isoniazid tablets. This has the advantage that it is a completely supervised regimen whereas it is known that some patients do not take their drugs regularly when issued on a monthly basis. At present a large scale trial is under way with the Medical Research Council to evaluate the effectiveness of standard chemotherapy in Hong Kong. Consequent to the very