2019 Sindh HIV outbreak refers to a Grade II Emergency as declared by the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

in the

Ratodero Ratodero ( sd, رتوديرو) is the capital of Ratodero Taluka, a sub-division of Larkana District in the Sindh province of Pakistan. Situated some 28 km from the district capital Larkana. Since the independence of Pakistan, the city is k ...

area of

Larkana District Larkana District (Sindhi language, Sindhi: ضلعو لاڙڪاڻو; ur, ) is a district of Sindh province of Pakistan. Its main city is Larkana on the banks of the Indus River. It is home district the of influential Bhutto family. The Larkana B ...

Sindh Sindh (; ; ur, , ; historically romanized as Sind) is one of the four provinces of Pakistan. Located in the southeastern region of the country, Sindh is the third-largest province of Pakistan by land area and the second-largest province ...

, Pakistan. It was the first of many outbreaks of HIV in Pakistan in which the majority of those infected were children. By 13 June 2019, at least 798 people including more than 650 children had tested positive for

HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...

out of the 27,000 people who volunteered for screening. By October 2019, approximately 1,100 people including almost 900 children under 12 had tested positive although the majority of the population still had not been screened at the many temporary testing centers that had been established. By 19 November 2019, there were 895 confirmed cases with 754 being children out of the 37,272 people to have been screened for the virus. The causes of the outbreak were identified by health officials as "unhygienic practices" including re-use without sterilization of medical

syringe A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...

s and needles in doctors' clinics and

blood bank A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a department of a hospital usually within a Clinical Pathology laborat ...

s, barbers' razors,

tattoo needle A tattoo machine is a hand-held device generally used to create a tattoo, a permanent marking of the skin with indelible ink. Modern tattoo machines use electromagnetic coils to move an armature bar up and down. Connected to the armature bar is a ...

s, nose- and ear-piercing tools,

circumcision Circumcision is a surgical procedure, procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin ...

blades, and

dental instrument Dental instruments are tools that dental professionals use to provide dental treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures. Examination instruments These tools allow dental ...

s. Transmission from mother to child was also cited as a possible cause. __TOC__

Background

Between 2010 and 2017 Pakistan registered a 45% increase in overall

cases. National AIDS Control Programme assumed there ~165 000 people in Pakistan who had contracted HIV, with only 15% of the number being aware of their condition, and only 17149 patients were receiving antiretroviral (ARV) therapy. In April 2019, 15 children with persistent fevers were sent for HIV testing at a government facility. Blood tests returned positive tests, while perinatal transmission in these children was ruled out. HIV screening of 4100 of the area's residents revealed 157 additional HIV positive patients, 30 of the positive cases were adults and 127 were children. An inquiry by MoNHSRC found that the cause of the outbreak could be traced back to contaminated disposable syringes, which were likely used by someone posing as a doctor.

Response

The Sindh AIDS Control Programme carried out a massive testing campaign which encompassed more than 26 000 people. By June 2019, more than 750 people were diagnosed with HIV, with children making up 80% of the number. In order to ensure an immediate access to antiretroviral (ARV) therapy, a specialized clinic was established in

Larkana Larkana ( ur, , translit=lāṛkāna; sd, لاڙڪاڻو, translit=lāṛkāṇo) is a city located in the Sindh province of Pakistan. It is the 15th largest city of Pakistan by population. It is home to the Indus Valley civilization site Moh ...

. In cooperation with the

United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be ...

, Pakistan began with the implementation of the "Sindh HIV Outbreak Response Plan, May 2019-Apr 2020”, which included both short-term and long-term steps to identify the causes of the outbreak, to address them, and prevent further infections.

References

{{DEFAULTSORT:Sindh HIV outbreak, 2019 2019 disasters in Pakistan HIV outbreak 2019 disease outbreaks 2019 HIV outbreak HIV/AIDS in Pakistan Larkana District Disease outbreaks in Pakistan Imran Khan administration