DefinePK

Abstract

https://doi.org/10.5455/JPMA.57221

 

Dear Editor,

The outbreak of Ratodero, local scenario

Ratodero belongs to district Larkana, Sindh. The reported outbreak of HIV continues to escalate. The official number of confirmed HIV cases has been summarized in Table.1



The outbreak is unprecedented since it involved 80% children. Previously there were1200 HIV cases of children in whole Pakistan. In the wake of this outbreak, Sindh Health Care Commission (SHCC) sealed 147 clinics and blood transfusion centres in Larkana and more than 600 clinics were issued warning on questionable practices.2,3 With the grievous health crisis looming over Sindh, a WHO team classified the outbreak level as Grade-II emergency and provided technical assistance.4 The outbreak has raised serious apprehensions and the authorities must take concrete measures on the three aspects of the outbreak:

1.To offer optimal healthcare including provision of psycho-social support,and procurement of medicines and diagnostic kits. This is extremely important as the stocks of medicines and screening kits ran short.Thus, it is high time for planning to involve international organizations to sustain it.

2.There is a dire need to extend the current facilities to an optimal number which may respond to the huge influx of patients. There are only 7 HIV treatment facilities working all over Sindh (mostly in cities).

3.Local and national AIDS Control Programmes, Blood Banks and SHCC need to work in coordination to:

a. Curb the unsafe transfusion, especially through unregistered blood banks.

b. Provide interventions to stop spread from potential hotspots i.e. drug users, sex workers, transgenders and barbers' shops.

c. Develop an early warning system through effective surveillance.

d. Check the menace of quackery (the major contributor in spread of the virus).

e. Educate the masses on risk factors, consequences of spread and highly objectionable practices of using un-necessary injections and intravenous drips through national level awareness campaigns.

 

The outbreak of Kot-Imrana, Punjab

The outbreak of Ratodero is similar in many ways to the previously reported HIV outbreak in Kot-Imrana.5 The factors responsible for these outbreaks are common, for instance misuse of syringes by quack, drug addicts, multiple use of razors at barbers' shops, infected sex workers, improper disposal of hospital wastes and limited surveillance.

 

Regional scenario

In the region, India and Cambodia have demonstrated a promising decrease in the number of new registered cases through effective policy making. Contrary, in Pakistan,there is a 57% increase in the new cases of HIV (2010-18), the highest rise in the new cases of HIV in Asia.6 These outbreaks are just the tip of the iceberg. Experts believe, if vigorous actions would not be taken, Pakistan could face serious outbreaks in future for which consequences could be unimaginable.

 

Disclaimer: The part of this manuscript was uploaded on research gate for public awareness and will be updated per publication in journal.

Conflict of Interest: None.

Funding Sources: None.

 

References

 

1. National AIDS Control Program, Govt of Pakistan. HIV/AIDS Outbreak Updates, Ratodero, Larkana, Sindh, Pakistan. accessed at https://www.nacp.gov.pk/ (Date accessed 21st December, 2019).

2. Zaid M, Ali M, Afzal MS. HIV outbreaks in Pakistan. The Lancet HIV. 2019 June 13th (Date Accessed 24th December 2019).

3. https://dailytimes.com.pk/488053/1132-hiv-positive-casesdetected- in-last-six-months/ (Date Accessed 20th January 2020).

4. Bhatti MW, WHO declared HIV outbreak in Larkana as grade 2 emergency. The International News: https://www.thenews.com.pk/ latest/ 481688-who-declares-hiv-outbreak-in-larkana-as-grade-2- emergency (Date Accessed 20th January 2020).

5. Wahid B. An update on the severe outbreak of HIV in KotImrana, Pakistan. The Lancet Infec tious Diseases. 2019;19:241.

6. Country progress report Pakistan (2018). http://www.unaids.org/ s i t e s / d e f a u l t / f i l e s / c o u n t r y / d o c u me n t s / PA K _ 2 0 1 8 _ countr yrepor t.pdf. (Date Accessed 20th Januar y 2020).