KARACHI: Lack of community participation and negative parental attitudes remain major challenges in the fight against polio, experts shared on Tuesday as the recently launched city-wide special immunisation campaign entered its last phase.

According to officials, the campaign, which will end on July 13, has been designed as a response to the polio case recently detected in Kemari — the first in Karachi, the second in Sindh and the eighth in the country this year.

The campaign caters to all districts of Karachi, targeting around 100,000 children under the age of five, who couldn’t get their vaccine doses during the previous campaigns due to any reason, including parental refusal.

According to officials, all seven districts of the city are “infected” with poliovirus that has been repeatedly detected in the sewage samples taken from the drains located in these areas this year.

Campaign underway to vaccinate 100,000 ‘missed children’ against polio in all districts of Karachi

In 2024, 62 environmental samples collected from different parts of the city tested positive, out of the total 203 positive samples in the rest of Pakistan.

The data available from Sindh-Extended Programme on Immunisation (EPI) show, district East has the highest number of positive samples in Karachi (21) followed by Keamari (11), South (12), Central (6), Malir (6), Korangi (5) and West (1).

In the rest of Sindh, positive samples have been detected in Sukkur (8), Jacobabad (4), Qambar (1), Shikarpur (1), Jamshoro (4), Hyderabad (11), Badin (1) and Mirpurkhas (3).

The high-risk areas of Karachi include Gujro and Safoora in the East, Ittehad Town and Islamnagar in Keamari, Manghopir, Islamia College locality, Songal in the West, Muslimabad, Landhi in Malir, Alfalah, Bilal Colony in Korangi, Chakiwara, Kahkashan and Civil Lines in South.

Strengthening immunisation

Speaking about the rapid increase in the spread of poliovirus, Dr Khalid Shafi representing the Pakistan Paediatric Association said: “We can’t win the battle against polio without improving coverage of routine immunisation. Second, we need to work harder to get a better response from certain communities that have developed strong resistance against vaccination.”

“If a child gets two doses of IPV (inactivated poliovirus vaccine) at a health centre as part of routine immunisation and then four doses of OPV (oral poliovirus vaccine), there is no chance he would contract polio,” he explained, describing vaccination at a fixed facility as the best way to deliver a dose.

“You have an ideal environment there with well-maintained cold chain and trained staff. While IPV provides personal protection, the oral dose helps prevent the spread of the virus in the community,” he pointed out.

Still, he believed, the polio situation was surprisingly not bad given the large number of positive samples detected in Pakistan, including Karachi.

“For this, we need to give credit to the officials who are actively engaged in surveillance and response activities across the country,” Dr Shafi said.

Low immunity profile

Sharing details of the city’s first case, Emergency Operations Centre for Polio Eradication (EOC) Coordinator Irshad Ali Sodhar said he visited the family in Keamari and found the three-year-old girl walking without any support.

“It seems that paralysis has subsided due to previous polio vaccination and she tested positive due to low immunity profile” he said, adding that the child remained hospitalised for nine months last year and underwent surgery for the left lower limb.

District Kemari, he said, currently was home to over 12,000 ‘missed children’, though the UC 3 from where the recent case was detected didn’t fall in the high-risk areas of Karachi.

About the ongoing campaign, Mr Sodhar said both IPV and OPV had been integrated for effectiveness and so far over 52,000 “missed children” had been vaccinated.

Over 600 sites, he said, had been set up for outreach activities for coverage of children who failed to receive any polio dose or had missed IPV and routine immunisation in the city.

“The biggest challenge is to have too many stakeholders. The government can’t do it alone. Every individual and institution needs to play its part to save our children from disability,” he concluded.

Published in Dawn, July 10th, 2024