View report page

44
The total net increase to the register, including pulmonary and nonpulmonary
cases, was 160, a figure to be compared with that of 196 for
the previous year.
Deaths.
Thirty-eight persons (23 male and 15 female) died from pulmonary
tuberculosis during the year and two (one male and one female) from
non-pulmonary tuberculosis. This infection therefore accounted for a
death rate per thousand population of 018 and for 2.0 per cent. of the
total deaths. The corresponding figures for 1949 were 0.26 and 3.0;
and for 1948, 0.42 and 4.9.
Preventive Measures.
Although much of the improvement in the vital statistics relating
to tuberculosis occurred during the period that specific efforts of many
kinds were being directed to this disease, to what extent the improvement
can be said to be the result of this particular attention is debatable.
What is quite certain is that however important these factors may be the
real need of a community is sound nutrition and good housing, and even
good housing ought not to be purchased at the expenditure of adequate
nutrition. Chest clinics, hospital accommodation, facilities for early
diagnosis, such as mass X-ray units and immunisation schemes, all
have their part to play in the control of and ultimate virtual eradication
of this disease. But ample provision of all these is helpless unless the
basic essentials of feeding and housing are present.
During and since the war, and arising out of it, there were and are
far fewer people than before who, because of an inability to make the
necessary purchases, have been deprived of the essential food factors.
On the other hand, housing conditions for very many, and especially in
such a district as this, are very much worse than they were before the
war. In this district the Council has been generous in its allocation of
new houses to those suffering from tuberculosis, giving as many as one
in six of their new houses to this group. Before any new houses were
built after the war there were many families living in grossly overcrowded
conditions with at least one of the members suffering from open
tuberculosis, a state of affairs fraught with danger of spread to other
members of the family. The worst of these cases have been rehoused,
though there are still some families living in overcrowded conditions.
In selecting families for nomination, with a view to their being rehoused,
regard has been had to the degree to which the family, continuing to live
in these homes, would be in danger of spread of infection. The measure
was not the effect of these conditions on the patient except in so far as a
sufferer might become more infectious by remaining in those unsatisfactory
conditions.
The factor to be determined was the risk of spread of infection from
the patient to those others who were his immediate contacts. Two factors
were important: the one was the infectiousness of the patient; the other
was the degree of crowding of the house. For the assessment of the first
reliance was placed on the advice of the chest physician under whose
care the patient was. To measure the other a standard was adopted
giving the degree of crowding there would be, assuming the patient was