KARACHI: A total of 10 ‘high-risk’ districts in Sindh, including Karachi, have been identified vis-à-vis the consistent presence of wild poliovirus, it emerged on Sunday.

Most of the districts that have been described as high-risk areas by the provincial health authorities located in the northern Sindh areas. They are Khairpur, Sukkur, Ghotki, Kashmore, Shikarpur, Jacobabad, Kambar and Larkana. The other two districts are Hyderabad and Karachi.

In Karachi, Baldia, Gadap and Gulshan-i-Iqbal towns have been declared high-risk zones.

The volatile UC-4 of Gadap Town, where anti-polio campaigns have frequently been interrupted because of attacks on vaccinators, has been described as poliovirus sanctuary for consistent presence of wild poliovirus.

The environmental samples collected over the past seven months confirm the presence of poliovirus and these three neighbourhoods of Karachi fall in the Priority 1 areas, officials said.

Out of nine polio cases in Karachi this year, four belong to Gadap.

With one case reported from Sanghar district, Sindh’s contribution to the country’s 108 cases is 10.

In the Priority 2 areas, which have reported at least one case over the past four years, are: Ghotki, Jacobabad, Kambar, Kashmore, Khairpur, Larkana, Mirpurkhas, Naushahro Feroze, Shikarpur, Sukkur districts and Gulberg, Liaquatabad and SITE areas of Karachi.

Official figures show that at least 333 polio cases have been reported in Sindh since 2000, including 10 this year.

The annual incidence of polio in Pakistan, which was estimated to be more than 20,000 cases a year in early 1990s, had decreased to 28 cases in 2005. Officials said it was hard to believe now, but a few years ago Pakistan was on the verge of polio eradication.

“It seemed that we had almost made it…but, the number of cases increased to a fifteen-year record high of 198 in 2011, which came down to 58 in 2012 only to be shot up to 93 last year and 108 already this year,” said an official based in Islamabad overseeing polio campaign.

“We are well short of our objectives to get rid of this menace,” he conceded.

An official document compiled by Islamabad officials early this year highlights key challenges to polio eradication in the country, which includes: limited oversight and accountability on the lower government and administrative levels, access problems due to insecurity particularly in Karachi and Fata, failure to identify and focus on underserved population and mobile groups, operational and planning challenges to deliver vaccination door-to-door to more than 38 million children several times in a year and achieving high coverage at union council level; and overall campaign fatigue in public domain, rumours and negative perceptions regarding oral polio vaccine in some communities.

It said that polio vaccination coverage had remained low over the years in some parts of the country, especially Gadap, Gulshan-i-Iqbal and Baldia towns of Karachi, Balochistan’s Quetta, Pishin and Killa Abdullah districts, Khyber Pakhtunkhwa and Fata because of ‘highly mobile populations’.

“These areas have been consistently infected with poliovirus, which has turned them into reservoirs where virus breeds freely and spreads all over the country,” said the document.

“Such areas are high-risk and 80 per cent of all polio cases in Pakistan are attributed to them. Defeating polio there means ending polio almost all over the country,” it concludes.

Published in Dawn, August 18th, 2014