Pakistan HIV outbreak caused by infected needles, contaminated blood transfusions: Study
New Delhi: A new study has found that use of contaminated needles and equipment during blood transfusion by healthcare professionals is behind the unprecedented outbreak of HIV, reported earlier this season, among children in Pakistan. Many of those affected are under five years old.
The research, published in The Lancet Infectious Diseases, also showed a 54 per cent increase in paediatric diagnoses of HIV over the past 13 years. The observational study of over 30,000 individuals is the first scientific report on the outbreak, first found in the town of Ratodero in April this year.
The government task force — supported by scientists and UN agencies — had earlier found that needles in private and public hospitals were being reused and blood transfusions carried out without screening for infections. This had led to the closing of three blood banks, almost 300 clinics, and the Sindh Health Care Commission.
The new report also found that due to an inadequate supply of drugs and lack of trained healthcare staff, 67 percent of the 591 children registered for HIV care started anti-retroviral treatment only by mid-July.
‘Pakistan has undergone a string of HIV outbreaks within the past two decades, but we’ve never before seen this many young children infected or so many health facilities involved,’ said one of the researchers, Fatima Mir in The Aga Khan University in Pakistan, in a statement.
‘Use of syringes and needles is widespread and Pakistan has among the greatest rates of unsafe injections in the world. Health practitioners will need to utilize intravenous therapy only when necessary, use needles just once, and monitor blood for infections before using it for transfusions,’ Mir added.
Unregulated hospitals, clinics
The Lancet report indicated that many people in Pakistan are served by the country’s private health sector, including unregulated hospitals and physicians.
For their study, the investigators had consulted reports gathered by the government task force in a screening camp in Tehsil Hospital in Ratodero in May this year.
It was found that between 24 April and 15 July 2019, 31,239 people tested for HIV. Data on their clinical history, such as previous injections, cannulations, blood transfusions, and parental HIV infection were also collected.
A total of 930 people tested positive for HIV, of whom 604 (79 percent ) were five years old or younger, and 763 (82 per cent) were younger than 16 years. Doctors had earlier observed a high quantities of paediatric investigations in their clinics, but this is the first time an analysis of the exact figures was available.
Virus spread through injections to treat diarrhoea, respiratory disease
The study also noted that by the beginning of July this year, 591 kids were registered for HIV care in Pakistan. The average age of those affected was three years old, and 478 (81 per cent) of those 591 children were five years old or younger.
Prior to March 2019, only 1,423 kids had registered for HIV care across Pakistan. And data was available for 453 out of 763 children to indicate how they became infected — 89 per cent reported becoming infected from previous injections, usually to treat diarrhoea or respiratory tract infections.
Out of these 453 kids, a smaller number (40/453 or 9 percent ) had undergone blood transfusions, usually to treat iron deficiency anaemia, while four of these were also treated for blood disorder thalassaemia.
Additionally, 15 children (out of the 453) had received neither shots nor blood transfusions. Of these, 12 of their mothers had an HIV test and all tested positive.