PESHAWAR: With Khyber Pakhtunkhwa reporting no polio case this year despite the detection of virus in environmental samples from sewage water in several districts, including Peshawar, officials insist that shortcomings in surveillance and vaccination efforts are major reasons for the continued polio presence in the province.

“There are huge gaps in the polio eradication programme, so authorities should not celebrate the province not recording any new cases this year. Scientifically speaking, the virus is present in sewage water but the method to detect it in children is flawed,” an official of the health department told Dawn.

He said the quality of anti-polio campaigns and poor data collection from the field showed that vaccination rates were up to the mark, but in reality, vaccinators in many districts, including Peshawar, marked the fingers of targeted children without vaccination for fear of reprisals.

Another health official said the Emergency Operation Centre (Polio) had claimed 98pc coverage in every vaccination campaign, but the sewage water sample collected from Peshawar over the last 18 months showed the virus’s presence.

EOC coordinator says all-out efforts being made for polio eradication

He said 33 sewage samples from different Khyber Pakhtunkhwa districts had so far tested positive for the virus in the current year.

“The sample should have been negative in the high-risk Peshawar district, where around 4,500 vaccinators have been deployed and vaccination coverage is around 99pc,” he said.

The official said the last polio case was recorded by the province in 2020.

Documents of the health department also revealed that “poor surveillance indicators and gaps in operations were the prime causes of failure to timely notify acute flaccid paralysis cases.” They called for the effective handling of fake finger marking issues and strong vaccination monitoring at district, tehsil and union council levels.

Recently, the health department, on the directives of the chief secretary, warned a couple of district health officers for showing laxity in polio campaigns.

However, officials of the department insisted that much more was needed to be done to ensure that stool samples of the suspected polio cases are taken and tested in a timely manner.

The documents showed that overall, 2641 AFP cases were reported in 2024 up from 2,497 recorded during the same time in 2023, showing a five per cent increase.

They, however, revealed that a downtrend was recorded in Torghar (50pc), Buner (33pc), Bajaur (25pc), Battagram (29pc), Upper Kohistan (21pc) and Lower Kohistan (15pc).

Officials said every district was required to send stool samples of at least six AFP cases per 100,000 population and test the same twice in 24 hours apart within 14 days of collection. They added that if stool samples weren’t notified and tested within seven days, the virus didn’t survive and the results were almost negative.

The officials said in many cases, the samples were collected belatedly, so the results didn’t come positive.

They declared fake data of samples and AFP cases the main hurdles to anti-polio efforts and called for immediate government attention to them.

The officials said the World Health Organisation, which is responsible for operations, surveillance and monitoring of the campaigns, had deployed district surveillance officers with adequate facilities and support of respective DHOs, who were also paid additional amount, did few visits of the health facilities to ascertain information about suspected children and trace them within specified period for collection of stool samples.

They said surveillance was the backbone of the vaccination programme, which pinpointed weaknesses and gave guidelines to mitigate the issues.

The officials said the polio situation in Peshawar, Torghar, North Waziristan, South Waziristan Lower, Dera Ismail Khan, Bannu, Lakki Marwat, Bajaur, Kohistan, Mardan, was not “that good.”

They insisted that the country had so far recorded 16 polio cases in 2024 with Khyber Pakhtunkhwa being the only province that was free from it.

The officials said it was no success for the province as the virus was circulating and more cases could emerge if stool samples weren’t tested as per protocol.

They said fake finger markings were a major hurdle to the eradication of the vaccine-preventable childhood virus from the province.

When contacted, EOC coordinator Abdul Basit said all-out efforts were being made to “wipe out” polio from the province for the children’s protection.

“It is a national programme. We cannot ignore the importance of vaccination and surveillance for making the province polio-free,”hesaid.

Published in Dawn, August 29th, 2024