LAHORE: Holding Sindh responsible for transmitting measles to the rest of the country, a survey has found that the province lags well behind Punjab and Khyber Pakhtunkhwa in vaccine coverage.

According to the measles supplementary immunisation activity (SIA) coverage survey, millions of children are vulnerable to the disease and, despite facing countrywide deaths, the vaccine coverage is lower than the 95 per cent target set by the World Health Organisation.

“Pakistan has not been able to eradicate polio, nor adequately control measles and neo-natal tetanus. Large disparities exist in immunisation coverage between provinces, urban-rural populations and different wealth quintiles,” the survey report said.

It is said to be the first comprehensive local study carried out since a measles epidemic hit the country in 2012-13. Earlier, there was confusion about the factors behind the epidemics and the number of deaths caused by the disease.

Only Sindh and KP carried out anti-measles campaigns during the past year.

Punjab kicked off a drive this month, while Balochistan is yet to take the initiative, which shows that the province has learnt no lesson from hundreds of deaths of children caused by the 2012-13 outbreaks and is putting the lives of millions more at grave risk.

Funded by the WHO, the survey was conducted by the Aga Khan University’s Community Health Sciences Department.

The third-party evaluation was carried out and a 40-page report was prepared in the wake of a 12-day anti-measles campaign carried out in Sindh last year.

“The outbreak started in Sindh in 2012, killing as many as 321 children till August 2013, and later the epidemic spread to other parts of the country and took hundreds of more lives,” it said.

The report noted that the epidemics were occurring despite increasing Measles Containing Vaccine coverage over the past three decades, the highest (88pc) being reported in 2012.

“EPI Pakistan has increased the overall immunisation coverage; however, the country has not achieved the vaccination targets that were set in 2010.”

Sindh lagged well behind both Punjab and Khyber Pakhtunkhwa in overall vaccine coverage in general and against measles in particular, it said, adding that as a result Sindh had been the hub of measles outbreaks.

“A possible explanation for this could be the fact that the coverage with the second dose of MCV is still only 53pc; insufficient to prevent outbreaks as per the WHO,” the report said.

It also depicted an alarming situation regarding low coverage all over the country by quoting the recent Pakistan Demographic and Health Survey, saying that less than 30pc of children between the ages of 12 and 23 months had received all basic vaccinations.

It revealed that children in Karachi were still vulnerable to the diseases due to poor coverage in the last drive.

“The measles supplementary immunisation activity carried out by the Sindh government during May 2014 reached a vast majority of children throughout the province, except in Karachi,” it said.

Thatta, Sujawal and Tando Muhammad Khan were the only districts in Sindh outside Karachi that had overall coverage of measles immunisation in eligible children below 95pc.

“The situation in Karachi is not as encouraging as the rest of the province,” it said, adding that in half of the towns in Karachi children between the ages of six months and five years had measles immunisation rates below 95pc — Korangi, Gadap, Gulshan, Baldia, North Nazimabad, SITE (Sindh Industrial and Trading Estate), Bin Qasim, Landhi, Orangi and Saddar.

The children in Karachi were most likely to be missed during the supplementary immunisation because their parents or caregivers were unaware about the campaign or the site or timing of vaccination.

While this was also the major reason cited by parents and caregivers in other parts of the province; in Karachi the impact of this factor was much greater in terms of number of children missed during the SIA, the study said.

Published in Dawn January 29th, 2015

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