By Opija Raduk

About 600 children in a single Pakistani district have tested positive for HIV, in an outbreak that has led to the arrest of at least one doctor and highlighted gross inadequacies in the local health care system.

Pakistani officials say 22,000 individuals have been subjected to blood screening since the outbreak was first reported in Larkana on April 25. The district, with an estimated population of 1.5 million, is located in Sindh province and it has previously also experienced repeated, though limited, outbreaks of the virus, which causes AIDS.

Following this outbreak, an international team of experts from the World Health Organisation (WHO) arrived in Pakistan on Tuesday to investigate the outbreak of HIV in Larkana in Sindh province.

The emergency visit was requested by Pakistan’s Ministry of Health after official reports confirmed that nearly 700 people had been testing positive for HIV, which includes children. The figures are expected to rise to 1,000 as screenings continue.

The WHO mission included experts in emergency response management, epidemiology, HIV clinical care, and infection prevention and control from WHO staff as well as the Global Outbreak Alert and Response Network (GOARN).

The team of around 10 experts will visit the affected areas and conduct a serious investigation along with local doctors and health department officials. The key tasks for the WHO-led team will include determining the source of the outbreak and controlling it, providing technical expertise, particularly in the areas of HIV testing, paediatric HIV treatment and family counselling; and ensuring adequate supplies of rapid diagnostic tests and antiretroviral medicines for both adults and children, as well as single-use needles and syringes.

This is not the first time Larkana’s medical system has been at the centre of an HIV outbreak. An outbreak among dialysis patients, which infected about 50 people, was reported in 2016. Years earlier, there was also an outbreak among intravenous drug users in Larkana.

Pakistan has one of the worst HIV infection rates in South Asia with an estimated 20,000 new infections each year. Only 16 per cent of the estimated number of people living with HIV had been tested.

Around 80 percent do not know their HIV status and are likely to transmit the virus to their partners and even to their unborn babies. Most of those infected with HIV come to the clinic when they are already sick and medical services become more expensive. Contact:  yunusm@who.intyunusm@who.int