PESHAWAR, Sept 23: The Khyber Pakhtunkhwa government devised a new strategy to focus on ‘cluster of refusals’ as two more polio cases were detected in the province and Federally Administered Tribal Areas (Fata) on Sunday.

Mohammad Asad, 48-month-old son of Mohammad Khalid, a resident of Mohallah Sultankhel in Thor Dand union council of district Karak was tested positive for polio. Likewise, Nisa Bibi, 18-month-old daughter of Siraj Khan, a resident of Mulyano Koroona in tehsil Loe Mamond of Bajaur Agency also got poliomyelitis, according to National Institute of Health Islamabad.

To cope with the refusal cases, the government decided to reach to the people, who collectively refused administering of anti-polio drops to their children, officials said.

They said that only 0.4 per cent refusals out of the five million target children was not a problem but the health department was faced with ‘cluster of refusals’ owing to which several families in different union councils refused vaccination of children on regular basis.

The officials said that in the past government focused on addressing individual refusal cases. They said that government was also planning to effectively vaccinate 48 per cent of the malnourished children, who didn’t respond to immunisation, in the province.

“If children with low immunity get vaccination during diarrhoea or dysentery, it remains ineffective,” they said. The areas where drinking water was not clean also posed threats to effective immunisation, they added.

The officials said that union council committees, which worked under direct supervision of the district coordination officer, would be tasked to talk to the families, who were opposing vaccination.

In each campaign, the province reported more than 20,000 refusals but at the end they were covered with the help of several committees working at union council level.

“We have about 17,000 chronic and permanent refusal cases in the province and most of them belong to certain clusters where vaccination was refused en masse,” officials said.

They said that they were shifting focus from dealing with isolated refusal cases to tackling them at collective level. “For this purpose, the government has planned to ask union council committees to identify ‘cluster of refusals’ and take measures to persuade them for administration of drops to children,” they said.

The officials said that under a criterion, if a vaccination team recorded five refusal cases in one day from the same are area that would be referred to ‘cluster of refusals’.

Dr Imtiaz Ali Shah, technical focal person for polio at Chief Minister’s Secretariat, told Dawn that the province was nearing eliminating polio virus owing to which strategies were being adopted to cope with the problems emerging at the final stage of the campaigns.

“Individual refusal cases are not very important because vaccination of 90 per cent children makes the remaining 10 per cent children in same locality vaccinated automatically,” he said. The main problem was chronic refusals in the community, he said.

The large number of unvaccinated children posed threats to the immunised children, Dr Shah said. He said that the clusters where vaccination was considered against Islam would be dealt with on priority basis.

“We are also considering special campaigns to convince defiant parents for vaccination of their children,” Dr Shah said.

Pakistan has registered a total of 35 polio cases in 2012. These include 14 cases from Fata, 12 from Khyber Pakhtunkhwa and three each from Punjab, Sindh and Balochistan.