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Tuberculosis Control in Hong Kong

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Handbook of Global Tuberculosis Control

Abstract

Tuberculosis (TB) is a statutory notifiable disease in Hong Kong. The TB notification rate has declined from 700 per 100,000 population in 1952 to 74.2 per 100,000 population in 2009. Multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB constitute around 1 % and 0.1 % of culture-positive TB cases, respectively. Around 1 % of TB patients are HIV infected. The substantial decline in TB notification rates and drug resistance is partly attributable to the implementation of supervised treatment since the 1970s.

Fully funded by the government, the local TB control program comprises five core components: case finding with focus on passive finding, quality DOT, treatment of latent TB infection, BCG vaccination, and health education. The bulk of TB care is delivered free of charge by the Department of Health through 18 chest clinics that are easily accessible. Health promotion messages are disseminated to the whole community as well as to defined target groups.

The last two decades have witnessed a stagnated decline in the TB notification rate in Hong Kong and nearby countries with an intermediate TB burden. This phenomenon is largely attributable to a high burden of latent TB interacting with aging of the TB epidemic, aging of the population, and socioeconomic factors. With aging of the population, frequent population movement, and global resurgence of MDR-TB, there is a continuing need to step up local TB control measures, promote community awareness and support, enhance multidisciplinary and international collaboration, and invest in research and development.

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Abbreviations

DOT:

Directly observed treatment

DOTS:

Directly observed treatment, short course

DST:

Drug susceptibility testing

HIV:

Human Immunodeficiency Virus

LTBI:

Latent tuberculosis infection

MDR-TB:

Multidrug-resistant tuberculosis

TB:

Tuberculosis

WHO:

World Health Organization

XDR-TB:

Extensively drug-resistant tuberculosis

References

  • Anderson, K. M., Keith, E. P., & Norsted, S. W. (1986). Tuberculosis screening in Washington state male correctional facilities. Chest, 89(6), 817–821.

    Article  CAS  PubMed  Google Scholar 

  • Balasangameshwara, V. H., & Chakraborty, A. K. (1993). Validity of case-finding tools in a national tuberculosis program. Tubercle and Lung Disease, 74(1), 52–58.

    Article  CAS  PubMed  Google Scholar 

  • Bayer, R., & Wilkinson, D. (1995). Directly observed therapy for tuberculosis: history of an idea. Lancet, 345(8964), 1545–1548.

    Article  CAS  PubMed  Google Scholar 

  • British Thoracic Society. (1994). Control and prevention of tuberculosis in the United Kingdom: Code of practice 1994. Joint Tuberculosis Committee of the British Thoracic Society. Thorax, 49(12), 1193–1200.

    Article  Google Scholar 

  • Chang, K. C., Leung, C. C., & Tam, C. M. (2004). Risk factors for defaulting from anti-tuberculosis treatment under directly observed treatment in Hong Kong. The International Journal of Tuberculosis and Lung Disease, 8(12), 1492–1498.

    CAS  PubMed  Google Scholar 

  • Chang, K. C., Leung, C. C., & Tam, C. M. (2009). Household contact investigation of tuberculosis in low-income and middle-income countries: Public-health impact. The Lancet Infectious Diseases, 9(1), 3–4.

    Article  PubMed  Google Scholar 

  • Chan-Yeung, M., Yeh, A. G., Tam, C. M., Kam, K. M., Leung, C. C., Yew, W. W., et al. (2005). Socio-demographic and geographic indicators and distribution of tuberculosis in Hong Kong: A spatial analysis. The International Journal of Tuberculosis and Lung Disease, 9(12), 1320–1326.

    CAS  PubMed  Google Scholar 

  • Chan-Yeung, M., Kam, K. M., Leung, C. C., Wang, J., Yew, W. W., Lam, C. W., et al. (2006). Population-based prospective molecular and conventional epidemiological study of tuberculosis in Hong Kong. Respirology, 11(4), 442–448.

    Article  PubMed  Google Scholar 

  • Dantas, O. M. S., de A. Ximenes, R. A., de F. P. M. de Albuquerque, M., da Silva, N. L. C. L., Montarroyos, U. R., de Souza, W. V., et al. (2006). A case-control study of protection against tuberculosis by BCG revaccination in Recife, Brazil. The International Journal of Tuberculosis and Lung Disease, 10(5), 536–541.

    Google Scholar 

  • Department of Health. (1975). Annual report, Tuberculosis & Chest Service of the Department of Health. Hong Kong: Department of Health.

    Google Scholar 

  • Department of Health. (2002). Annual report 2000—Tuberculosis & Chest Service of the Department of Health. Hong Kong: Department of Health. Retrieved Apr 4, 2012, from http://www.info.gov.hk/tb_chest/doc/Annrpt2001.pdf

  • Department of Health. (2013). Annual report 2011—Tuberculosis & Chest Service of the Department of Health. Hong Kong: Department of Health.

    Google Scholar 

  • Fox, W. (1958). The problem of self-administration of drugs; with particular reference to pulmonary tuberculosis. Tubercle, 39(5), 269–274.

    Article  CAS  PubMed  Google Scholar 

  • Fox, W. (1962). Self-administration of medicaments. A review of published work and a study of the problems. Bulletin of the International Union Against Tuberculosis, 32, 307–331.

    CAS  PubMed  Google Scholar 

  • Fox, W., Ellard, G. A., & Mitchison, D. A. (1999). Studies on the treatment of tuberculosis undertaken by the British Medical Research Council tuberculosis units, 1946-1986, with relevant subsequent publications. The International Journal of Tuberculosis and Lung Disease, 3(Suppl 2), S231–S279.

    CAS  PubMed  Google Scholar 

  • Friedman, L. N., Sullivan, G. M., Bevilaqua, R. P., & Loscos, R. (1987). Tuberculosis screening in alcoholics and drug addicts. American Review of Respiratory Disease, 136(5), 1188–1192.

    Article  CAS  PubMed  Google Scholar 

  • Ho, T. T., Wong, K. H., & Lee, S. S. (1999). Low yield of chest radiography in screening for active pulmonary tuberculosis in HIV-infected patients in Hong Kong. International Journal of STD & AIDS, 10(6), 409–412.

    Article  CAS  Google Scholar 

  • Hong Kong Advisory Council on AIDS. (2001). HIV/AIDS situation in Hong Kong (Report August 2000 to July 2001). Hong Kong Advisory Council on AIDS.

    Google Scholar 

  • Jensen, P. A., Lambert, L. A., Iademarco, M. F., & Ridzon, R. (2005). Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recommendations and Reports, 54, 1–141.

    Google Scholar 

  • Kam, K. M., & Yip, C. W. (2001). Surveillance of Mycobacterium tuberculosis drug resistance in Hong Kong, 1986–1999, after the implementation of directly observed treatment. The International Journal of Tuberculosis and Lung Disease, 5(9), 815–823.

    Google Scholar 

  • Kam, K. M., & Yip, C. W. (2004). Surveillance of Mycobacterium tuberculosis susceptibility to second-line drugs in Hong Kong, 1995–2002, after the implementation of DOTS-Plus. The International Journal of Tuberculosis and Lung Disease, 8(6), 760–766.

    Google Scholar 

  • Karonga Prevention Trial Group. (1996). Randomised controlled trial of single BCG, repeated BCG, or combined BCG and killed Mycobacterium leprae vaccine for prevention of leprosy and tuberculosis in Malawi. The Lancet, 348(9019), 17–24.

    Google Scholar 

  • Lee, H. (1950). BCG vaccination against tuberculosis. The Bulletin of the Hong Kong Chinese Medical Association, 43–48.

    Google Scholar 

  • Lee, N. L. S., Leung, E. C. C., & Tam, C. M. (2007). Tuberculosis in HIV/AIDS. In S. S. Lee, J. C. Y. Wu, & K. H. Wong (Eds.), HIV manual 2007. Hong Kong: Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong.

    Google Scholar 

  • Lee, M. S. N., Leung, C. C., Kam, K. M., Wong, M. Y., Leung, M. C. M., Tam, C. M., et al. (2008). Early and late tuberculosis risks among close contacts in Hong Kong. The International Journal of Tuberculosis and Lung Disease, 12(3), 281–287.

    CAS  PubMed  Google Scholar 

  • Leung, E. C. C., & Tam, C. M. (2002). Comorbidities among patients with tuberculosis in Hong Kong. Hong Kong Practitioner, 24, 170–178.

    Google Scholar 

  • Leung, R. W. M., & Tam, C. M. (2011). Tuberculosis epidemiology in relation to the ageing population in Hong Kong. Public Health & Epidemiology Bulletin, 20(1), 1–7.

    Google Scholar 

  • Leung, C. C., Tam, C. M., Chan, S. L., Chan-Yeung, M., Chan, C. K., & Chang, K. C. (2001). Efficacy of the BCG revaccination programme in a cohort given BCG vaccination at birth in Hong Kong. The International Journal of Tuberculosis and Lung Disease, 5(8), 717–723.

    CAS  PubMed  Google Scholar 

  • Leung, C. C., Yew, W. W., Chan, C. K., Tam, C. M., Lam, C. W., Chang, K. C., et al. (2003). Smoking and tuberculosis in Hong Kong. The International Journal of Tuberculosis and Lung Disease, 7(10), 980–986.

    CAS  PubMed  Google Scholar 

  • Leung, C. C., Li, T., Lam, T. H., Yew, W. W., Law, W. S., Tam, C. M., et al. (2004a). Smoking and tuberculosis among the elderly in Hong Kong. American Journal of Respiratory and Critical Care Medicine, 170(9), 1027–1033.

    Article  PubMed  Google Scholar 

  • Leung, C. C., Yew, W. W., Tam, C. M., Chan, C. K., Chang, K. C., Law, W. S., et al. (2004b). Socio-economic factors and tuberculosis: a district-based ecological analysis in Hong Kong. The International Journal of Tuberculosis and Lung Disease, 8(8), 958–964.

    CAS  PubMed  Google Scholar 

  • Leung, C. C., Chan, C. K., Tam, C. M., Yew, W. W., Kam, K. M., Au, K. F., et al. (2005). Chest radiograph screening for tuberculosis in a Hong Kong prison. The International Journal of Tuberculosis and Lung Disease, 9(6), 627–632.

    CAS  PubMed  Google Scholar 

  • Leung, C. C., Yew, W. W., Law, W. S., Tam, C. M., Leung, M., Chung, Y. W., et al. (2007). Smoking and tuberculosis among silicotic patients. European Respiratory Journal, 29(4), 745–750.

    Article  CAS  PubMed  Google Scholar 

  • Leung, C. C., Lam, T. H., Ho, K. S., Yew, W. W., Tam, C. M., Chan, W. M., et al. (2010). Passive smoking and tuberculosis. Archives of Internal Medicine, 170(3), 287–292.

    Article  PubMed  Google Scholar 

  • Mangura, B. T., & Reichman, L. B. (1999). Periodic chest radiography: Unnecessary, expensive, but still pervasive. The Lancet, 353(9149), 319–320.

    Article  CAS  Google Scholar 

  • Meijer, J., Barnett, G. D., Kubik, A., & Styblo, K. (1971). Identification of sources of infection. Bulletin of the International Union Against Tuberculosis, 45, 5–54.

    CAS  PubMed  Google Scholar 

  • Mitchison, D. A. (2005). The diagnosis and therapy of tuberculosis during the past 100 years. American Journal of Respiratory and Critical Care Medicine, 171(7), 699–706.

    Article  PubMed  Google Scholar 

  • Pang, P. T. T., Leung, C. C., & Lee, S. S. (2010). Neighbourhood risk factors for tuberculosis in Hong Kong. The International Journal of Tuberculosis and Lung Disease, 14(5), 585–592.

    PubMed  Google Scholar 

  • Rieder, H. L., Cauthen, G. M., Kelly, G. D., Bloch, A. B., & Snider, D. E. (1989). Tuberculosis in the United States. JAMA, the Journal of the American Medical Association, 262(3), 385–389.

    Article  CAS  PubMed  Google Scholar 

  • Rodrigues, L. C., Pereira, S. M., Cunha, S. S., Genser, B., Ichihara, M. Y., de Brito, S. C., et al. (2005). Effect of BCG revaccination on incidence of tuberculosis in school-aged children in Brazil: The BCG-REVAC cluster-randomised trial. The Lancet, 366(9493), 1290–1295.

    Article  Google Scholar 

  • Sbarbaro, J. A. (1990). The patient-physician relationship: Compliance revisited. Annals of Allergy, Asthma, and Immunology, 64, 325–331.

    CAS  Google Scholar 

  • Sepulveda, R. L., Parcha, C., & Sorensen, R. U. (1992). Case-control study of the efficacy of BCG immunization against pulmonary tuberculosis in young adults in Santiago, Chile. Tubercle and Lung Disease, 73(6), 372–377.

    Article  CAS  PubMed  Google Scholar 

  • Springett, V. H., & Sutherland, I. (1994). A re-examination of the variations in the efficacy of BCG vaccination against tuberculosis in clinical trials. Tubercle and Lung Disease, 75(3), 227–233.

    Article  CAS  PubMed  Google Scholar 

  • Stewart, M., & Roter, D. (1989). Communicating with medical patients. Newbury Park, CA: Sage.

    Google Scholar 

  • Stop TB Partnership. (2006). The global plan to stop TB, 2006–2015 (WHO/HTM/STB/2006.35). World Health Organization. Retrieved Apr 4, 2012, from http://www.stoptb.org/assets/documents/global/plan/GlobalPlanFinal.pdf

  • Tala-Heikkila, M. M., Tuominen, J. E., & Tala, E. O. (1998). Bacillus Calmette-Guerin revaccination questionable with low tuberculosis incidence. American Journal of Respiratory and Critical Care Medicine, 157(4), 1324–1327.

    Article  CAS  PubMed  Google Scholar 

  • Toman, K. (1976). Mass radiography in tuberculosis control. WHO Chronicle, 30(2), 51–57.

    CAS  PubMed  Google Scholar 

  • Vynnycky, E., Borgdorff, M. W., Leung, C. C., Tam, C. M., & Fine, P. E. (2008). Limited impact of tuberculosis control in Hong Kong: Attributable to high risks of reactivation disease. Epidemiology and Infection, 136(7), 943–952.

    Article  CAS  PubMed  Google Scholar 

  • WHO. (1974). WHO Expert Committee on Tuberculosis, Ninth report (WHO Technical Report Series 552). World Health Organization. Retrieved Apr 4, 2012, from http://whqlibdoc.who.int/trs/WHO_TRS_552.pdf

  • WHO. (2010). Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response (WHO/HTM/TB/2010.3). World Health Organization. Retrieved Apr 4, 2012, from http://www.who.int/tb/publications/2010/en/index.html

  • WHO Western Pacific Region. (2005). Tuberculosis control in South-east Asia and Western Pacific Regions 2005—A bi-regional report. World Health Organization. Retrieved Apr 4, 2012, from http://www.wpro.who.int/entity/tb/documents/biregionalreport05.pdf

  • WHO Western Pacific Regional Office. (2002a). Fighting TB—Forging ahead: Overview of the stop TB special project in the Western Pacific Region. World Health Organization. Retrieved Apr 4, 2012, from http://whqlibdoc.who.int/wpro/2002/i9290610174.pdf

  • WHO Western Pacific Regional Office. (2002b). Epidemiological analysis of possibly stagnated decline of tuberculosis in intermediate burden countries in the Western Pacific Region. In Third Meeting of the Technical Advisory Group. Osaka, Japan: World Health Organization.

    Google Scholar 

  • Wu, P., Cowling, B. J., Schooling, C. M., Wong, I. O. L., Johnston, J. M., Leung, C. C., et al. (2008). Age-period-cohort analysis of tuberculosis notifications in Hong Kong from 1961 to 2005. Thorax, 63(4), 312–316.

    Article  CAS  PubMed  Google Scholar 

  • Wu, P., Lau, E. H. Y., Cowling, B. J., Leung, C. C., Tam, C. M., & Leung, G. M. (2010). The transmission dynamics of tuberculosis in a recently developed Chinese city. PLoS ONE, 5(5), e10468.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Health, Tuberculosis and Chest Service, Wanchai, Hong Kong

    Kwok Chiu Chang & Cheuk Ming Tam

  2. Wanchai Chest Clinic, Wanchai, Hong Kong

    Kwok Chiu Chang & Cheuk Ming Tam

Authors
  1. Kwok Chiu Chang
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  2. Cheuk Ming Tam
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Corresponding author

Correspondence to Kwok Chiu Chang .

Editor information

Editors and Affiliations

  1. Haikou VTI Biological Institute, Boston, Massachusetts, USA

    Yichen Lu

  2. Chinese Nat’l Ctr Disease Control and Prevention, Nat’l Center for TB Control & Prevention Chinese Nat’l Ctr Disease Control and Prevention, Beijing, China

    Lixia Wang

  3. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

    Hongjin Duanmu

  4. Brookline, Massachusetts, USA

    Chris Chanyasulkit

  5. Vaccine Technologies, Inc., Wellesley, Massachusetts, USA

    Amie J. Strong

  6. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

    Hui Zhang

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Chang, K.C., Tam, C.M. (2017). Tuberculosis Control in Hong Kong. In: Lu, Y., Wang, L., Duanmu, H., Chanyasulkit, C., Strong, A., Zhang, H. (eds) Handbook of Global Tuberculosis Control. Springer, Boston, MA. https://doi.org/10.1007/978-1-4939-6667-7_4

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  • DOI: https://doi.org/10.1007/978-1-4939-6667-7_4

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