View report page

31
Regulations to be sent to the Medical Officer of Health of the new district.
It is also the duty of a medical attendant to notify to the Medical Officer
of Health of the district in which the patient is living unless the case has
already been notified to that Medical Officer of Health. The result of
these provisions is that the name of a tuberculous patient who has moved
from one district to another might for a long time be on the register of
two or, in the case of more frequent removals, more than two authorities.
The actual number of notifications received then by an authority is not
necessarily indicative or a measure of the factors in that district which
cause tuberculosis in the population.
In any district in which any substantial numbers of people have
moved in, the number of notifications received will be higher than the
number which would have occurred in those same surroundings in a
stable population of that size and age-constitution. This will be so
because notifications may be received of cases in the transferred population
which have been first detected not in that one year but over many
years. On the other hand, when people remove from a district there will
be a lapse of time before the authority they are leaving and on whose
register the names appear, has been made aware of the transfer and so
can remove the name. A district subjected to changes in population
then, even though the total population remains roughly the same, will
have an unusually high rate of tuberculosis notifications, while the register
too will contain a greater than average number of names per thousand
population.
In 1934 when the mid-year population of the district was 132,000,
the number of new cases of pulmonary disease brought to light was 121.
The bigger numbers in the succeeding years of 1938, namely, 152, 190,
212, and 231, were roughly in proportion to the larger population. The
1939 population was slightly greater but the notification figure fell
slightly to 210, rising again to 226 in 1940. The very sharp rise to 349
in 1941 was out of all proportion to the changes in population, changes
which nevertheless were quite material, but which left the total population
largely undisturbed. The fall to 318 in 1912 has been succeeded by
another drop, the number of pulmonary cases notified in 1943 being 261.
Of these, 56 transferred here suffering from the disease, a further fall as
compared with the figures for the previous year. Of the others about
whom information has been obtained, 168 were notified first to this
district. Of these though, some 9 males and 5 females were in the
Services at the time the diagnosis was made, 3 persons had never lived
here, 2 were chronic patients in hospitals outside the district, while 2 were
cases of recrudescence or relapse. A family history amongst those who
presumably contracted infection while living here was obtained in 18 per
cent. of cases.
50 notifications (30 male and 20 female) of non-pulmonary tuberculosis
were received. Of 30 patients who presumably contracted the
infection while living here, 10 suffered from joint or bone disease, 6 from
lesions of the cervical glands, 4 from meningitis and 3 from abdominal
tuberculosis. A family history was obtained in 4 out of these cases. In
9 out of the 12 patients who transferred here suffering from the disease,
the lesion was in bone or joint.