Related Experiment Video
Updated: Jul 2, 2025
New Tools to Expand Regulatory T Cells from HIV-1-infected Individuals
Published on: May 30, 2013
A pediatric HIV outbreak in Pakistan
Joumana Hermez1, Maha Ismail1, Oliver Morgan2
1World Health Organization Regional Office for the Eastern Mediterranean Region, Cairo, Egypt.
Insights
Unsafe healthcare practices likely caused the 2019 HIV outbreak in Larkana, Pakistan, affecting over 700 children. Improved infection prevention and control measures are crucial, especially in pediatric and antenatal clinics.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- An outbreak of human immunodeficiency virus (HIV) infection was reported among children in Larkana District, Pakistan.
- An international team investigated the outbreak's extent and cause between April and June 2019.
Purpose of the Study:
- To investigate the incidence of HIV among children in Larkana District.
- To describe the distribution of HIV cases by time, place, and person.
Main Methods:
- HIV testing was conducted on self-referred individuals using the national protocol.
- Epidemiological data were reviewed to generate hypotheses regarding HIV transmission.
- An infection prevention and control (IPC) team assessed healthcare practices.
Main Results:
- A total of 30,191 individuals were tested, with 876 testing positive for HIV.
- Of those positive, 719 (82%) were children under 15 years old.
- Unsafe medical injections were implicated, with 99% of affected children having received injections or infusions within the past year.
Conclusions:
- Unsafe healthcare practices in formal and informal settings are the most probable cause of the 2019 HIV outbreak.
- Enhanced infection prevention and control (IPC) measures are recommended.
- Specific focus on pediatric and antenatal care clinics is advised to improve patient safety.
Background:
Following reports of an outbreak of HIV infection among children in Larkana District, Pakistan, an international team investigated the extent and cause of the outbreak between April and June 2019.
Aims:
To investigate the incidence of HIV among children in Larkana District, Pakistan and describe the distribution of cases by time, place and person.
Methods:
Self-referred persons were tested for HIV using the national testing protocol. Local epidemiology of HIV was reviewed to generate hypotheses. An infection prevention and control (IPC) team conducted site visits and reviewed IPC practices.
Results:
Between 25 April and 27 June 2019, a total of 30 191 persons were tested for HIV in Larkana District, and 876 of them tested positive. Of those who tested positive, 719 (82%) were children aged <15 years. Traditional skin piercing procedures and transmission from high-risk populations to children were ruled out during the investigation. Informative interviews with parents or guardians of a convenience sample of 211 children aged <15 years showed that 99% of children had an injection or infusion for medical treatment within the past 12 months. Our investigation identified lack of HIV prevalence data for the general population including tuberculosis patients and those who attended antenatal care services.
Conclusions:
Investigations indicate that unsafe healthcare practices in formal and informal healthcare settings as the most likely cause of the 2019 outbreak of HIV infection in Larkana, Pakistan. Measures should be taken to improve IPC practices at the facility level, especially in pediatric and antenatal care clinics.
Related Concept Videos
01:26Sexually Transmitted Infections
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...