• Advise people to avoid eating out, use boiled water, eliminate all sources of stagnant water
• Call for proper waste, sanitation management and regular fumigation

KARACHI: As cases of gastroenteritis and mosquito-borne diseases have significantly increased in Karachi over the past few weeks, health professionals attribute the situation to the city’s poor civic conditions — improper waste management, inadequate sanitation and supplies of contaminated water — which are leading to health risks, especially in the ongoing monsoon.

A few brief wet spells followed by persistent cloudy weather, mild temperature and moist air in the city have provided ample opportunities for flies and mosquitoes to reproduce in large numbers and infect people, the experts said.

“Patients of gastroenteritis, malaria and dengue constitute 40 to 50 per cent of the cases we are seeing at our emergency department these days. They often present with acute diarrhoea, nausea, vomiting, body aches and high fever, requiring intravenous fluids for rehydration,” said Dr Imran Sarwar, who heads the emergency department of the Dr Ruth Pfau Civil Hospital Karachi.

He added that routinely around 1,200 patients are daily seen at the department.

According to him, malaria cases are being reported in greater numbers than dengue cases.

“We get the CBC [complete blood count] test done immediately to have an idea about the infection. At the same time, blood samples are sent to the laboratory to rule out malaria and dengue that takes two to three hours,” he explained, adding that while dengue and malaria are both mosquito-borne diseases, their treatment protocol is entirely different.

“It’s also important for the general public to know that there are four human malaria parasites (P. falciparum, P. vivax, P. ovale and P. malariae). These days, we are getting vivax malaria cases in large numbers. The patients of P. falciparum (also caused cerebral malaria) are few,” he said, adding that vivax malaria could lead to severe disease and death and treatment was a 14-day protocol.

“The parasite remains dormant in the liver. It can reactivate later, causing a new infection, if the complete 14-day treatment protocol is not followed,” the doctor said.

Sharing his clinical experience, Dr Altaf Hussain Khatri, senior doctor also associated with the Pakistan Medical Association and College of Family Medicine Pakistan, said over 70 per cent of the cases being seen by most GPs comprised patients of gastroenteritis (also called infectious diarrhoea and stomach flu), dengue and malaria.

The primary complication in gastroenteritis is dehydration, more of a risk factor for children and senior citizens, he added.

He advised people to avoid eating out, use boiled water, and practice good hygiene and try to eliminate all sources of stagnant water inside the house and in the neighbourhood.

Use mosquito nets, repellents, particularly during dawn and dusk, he added.

“While individual measures do help, there has to be state measures for proper waste, drainage and sanitation management. Leaking pipes and their mixing with wastewater is a major source of disease that should be taken care of by municipal authorities. Besides, we need to have regular fumigation drives to control vector population,” he said.

Dr Shehla Naseem, senior general physician with over 30 years of experience, seconded the opinion about the spike in cases of gastroenteritis and malaria.

“I am seeing adolescents more (with gastroenteritis) as they tend to eat out more. Often, restaurants don’t have proper facilities for food storage, increasing customers’ vulnerability to illness. The other major problem is contaminated water supplies,” she said.

Published in Dawn, August 4th, 2025