ENG-1972 — Page 114

HEALTH

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replaced by a regimen of twice weekly Streptomycin injections and high dosage Isoniazid tablets. This has the advantage of being a completely supervised regimen, while it is known that some patients did not take their drugs regularly when issued on a monthly basis.

As a result of a large scale trial with the Medical Research Council to assess the effectiveness of standard chemotherapy in Hong Kong, the six months of three drugs daily (PAS, Isoniazid and Streptomycin) with which treatment was usually initiated was reduced to three months. The trial also indicated the paramount need for super- vision in the taking of drugs and has led to a simplification in the management of the cases. The study to evaluate the most effective drugs for the treatment of resistant cases is almost complete and, as a result, it is now possible to treat many drug resistant cases-which previously required hospitalisation--on a completely outpatient basis. The present course of treatment for tuberculosis is long and arduous, averaging some 18 months; a study of the possibility of reducing this lengthy period is now well under

way.

The results of these many investigations are of international interest and it is hoped that they will, within the next few years, revolutionise the approach to the treatment of tuberculosis.

Hong Kong now has 1,600 beds available specifically for the treatment of tuber- culosis. The government provides 108 beds in Kowloon Hospital, but the majority are in government-assisted hospitals, notably those managed by the Hong Kong Anti- Tuberculosis and Thoracic Diseases Association. This association offers a total of 783 beds distributed between Grantham Hospital, Ruttonjee Sanatorium and Freni Memorial Home. In addition, the Junk Bay Medical Relief Council has 300 beds at its Haven of Hope Sanatorium. The Tung Wah Group plays an important role in the treatment of tuberculosis and the Chest Unit at Wong Tai Sin Infirmary has 185 beds in spacious accommodation.

Venereal disease is diagnosed and treated free at social hygiene clinics. The recorded incidence of early infectious syphilis continued to remain low in 1972, thus differing from experience in other parts of the world. Latent and late syphilis and gonorrhoea have stayed comparatively unchanged and the incidence of chancroid and lymphogranuloma remained very low. The maintenance of this satisfactory position is due, at least in part, to energetic epidemic control by contact tracing, follow-up of defaulters and routine ante-natal blood tests.

Leprosy remains a comparatively minor public health problem. Each week 20 outpatient sessions are held solely for the diagnosis and treatment of the disease, while other sessions are held at social hygiene centres in conjunction with dermatology and venereal disease clinics. The Leprosy Mission-Hong Kong Auxiliary, with the aid of a government subvention, maintains the Hay Ling Chau Leprosarium for the treat- ment of infectious cases and a small number of patients requiring reconstructive operations are also accepted. Due to the decreasing incidence of the disease, the num- ber of new cases admitted to the leprosarium has shown a notable reduction in recent years. A decision was taken in June 1971 to phase out and eventually close the lepro- sarium. Future leprosy cases requiring hospital treatment will be accommodated in