KARACHI: Some 56.3 per cent of the people who tested HIV positive in Larkana district’s Ratodero town are children aged five and less, a report shared by the provincial health ministry said on Sunday.

Officials said 720 out of 877 victims were children — 15 years or less — registering an alarming percentage of more than 82.1.

They said some 30,326 persons had been screened for the deadly lifelong disease of which 877 tested HIV positive in Ratodero and surrounding areas.

This outbreak, officials and experts conceded, is one of the most remarkable of its kind in regional and global perspective.

These victims are almost equally divided gender-wise — 51.9 per cent males and 48.1pc females.

The latest report said the age group distribution among the reported HIV infection revealed most affected age group was 2-5 years. Children fall in this age group form majority of the total victims (56.3pc).

These figures are followed by the children above that age till 15 years — 17.9pc.

Some 7.5pc children are toddlers aged up to two years; thus, 82pc of the total victims are children aged 15 or less.

Another 157 victims are adults.

“All cases were reactive on rapid diagnostic test (RDT) by Sindh Aids Control Programme,” said the report.

The victims are aged as fragile as of one month and as old as 70 years, added the report.

A team of experts belonging to the World Health Organisation is already working in the affected area to know causes of the outbreak, which is so far unprecedented elsewhere.

The WHO experts have arrived in the country on the request of the federal government to investigate into the HIV incidence and help the provincial authorities in treatment.

The local authorities have also started screening of communities on limited scale in parts of Shikarpur district, which is contiguous to Larkana and has reported a few similar cases recently.

Officials said they had established a screening camp at the Taluka Headquarters Hospital Ratodero; and an HIV/Aids ART Treatment Centre had been set up at the Shaikh Zaid Children Hospital in Larkana.

They claimed unauthorised laboratories, blood banks and clinics had been closed by the anti-quackery team of the health department and the Sindh Healthcare Commission with support of the district administration.

They said awareness and health education sessions should be conducted in communities about spread and transmission of HIV/Aids; and all the high-risk groups, parents of the affected children and their close contacts in the family should be screened out for HIV.

Besides, it has been suggested that interventions are necessary for future actions and immediate action should be taken to stop quackery and unauthorised labs and blood banks with the help of health authorities and district administration.

The investigators have advised the ministry to arrange a team of field epidemiologists for intervention of cases and contact tracing with the support of the health ministry.

The Sindh health ministry, meanwhile, is set to launch an HIV behavioural and biological survey in all prison set-ups from Monday onwards as part of a plan to devise effective response to rampant HIV incidence in Larkana district.

“Such survey will begin from July onwards which would be spearheaded by the health ministry and the Sindh Aids Control Programme,” said an official.

The officials added that the HIV outbreak response plan included multiple targets like enhancing capacities of health workers and institutions for managing HIV outbreaks, strengthening health systems for continuum of prevention, treatment, care and support services for HIV/Aids, strengthening communities, social mobilisation, strategic communication and advocacy initiatives and sustained quality HIV response in the province.

“All these targets have been given specific timelines and the responsibilities have been distributed between SACP, health ministry, Sindh Blood Transfusion Authority, drug control department, drug regulatory body, Sindh Healthcare Commission and district administrations,” said an official.

He added contributing partners for all such targets were World Health Organisation, Unicef, UNAIDS, Down University of Health Sciences, population welfare ministry, UNFPA, USAID, Sindh Institute of Urology and Transplantation, Aga Khan University Hospital and Medical Microbiology and Infectious Diseases Society of Pakistan.

Officials said the outbreak response plan was initially devised by the Sindh health ministry, SACP and technical teams of the UN Partners based on the initial response of WHO HIV Outbreak Investigation Mission in Larkana.

This immediate short term plan which was based on four localised technical working groups — epidemiology, treatment and care, infection prevention control and community engagement and response — has been made fully functional with teams on ground.

Another group, a fifth component, is being included to the plan in the shape of resource mobilisation.

Published in Dawn, July 1st, 2019