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Shortage of medicine exacerbating diphtheria outbreak in Karachi, Sindh

M. Waqar Bhatti
Sunday, Oct 13, 2024

islamabad: Dozens of children have died this year in Karachi, and rural areas of Sindh and Balochistan due to diphtheria, a vaccine-preventable bacterial disease, as routine immunisation continues to decline in the region, health experts and officials reported on Saturday.

In Karachi alone, approximately 100 children have so far died from diphtheria at various public and private health facilities in 2024. During last year, over 52 children died at a single public hospital in Karachi, according to an investigation by this scribe.

The Sindh health department, however, reports a much lower figure acknowledging 28 deaths from diphtheria in the province, including 10 in Karachi, out of a total of 166 cases reported this year.

The situation is particularly alarming due to the unavailability of diphtheria antitoxin (DAT), the only treatment for children infected with the deadly disease. The Sindh Institute of Child Health and Neonatology (SICHN) is the only facility that has a limited supply of DAT, which it distributes among public health facilities upon request.

“We are witnessing an unprecedented rise in diphtheria cases this year, which is both unique and alarming. I’ve never seen such a large number of cases in a single year. It’s possible that an invasive strain or variant of diphtheria is causing the surge, but we are unsure at this stage,” said Prof Jamal Raza, senior paediatrician and executive director at the SICHN.

He explained that diphtheria cases began rising in 2022 and worsened in 2023, and have now escalated further in 2024. He remarked that the surge reflected alarmingly low rates of routine immunisation across Sindh.

“Diphtheria is a vaccine-preventable disease. When its cases rise, alongside other vaccine-preventable diseases

like measles and polio, it indicates that many children are not receiving routine immunisation under the Expanded Program on Immunisation (EPI),” he added.

The SICHN procured the diphtheria antitoxin earlier this year, anticipating a rise in cases based on the 2023 trends. “Now, everyone in Karachi is relying on the SICHN for DAT, but it’s a costly treatment. A child may require several vials of antitoxin, costing between 200,000 and 300,000 rupees per patient,” Prof Raza maintained.

He called on national health institutions, such as the National Institute of Health (NIH) Islamabad, to conduct a disease outbreak investigation and genome sequencing of the strain responsible for this surge. He also stressed the need for preventive measures based on these findings.