Vaccine-preventable childhood diseases in Pakistan: a situational analysis

Many childhood diseases that cause great morbidity and mortality in the developing countries are vaccine preventable. Vaccines for six common diseases are available and vaccination programmes against these diseases have been a major factor in decreasing morbidity and mortality among children worldwide. The vaccination programme adopted by Pakistan as the National Expanded Programme on Immunization [EPI] in 1978 was based on World Health Organization's EPI initiative. The last two decades have seen the programme being implemented in Pakistan with lots of promises for disease prevention and/or eradication.. High goals were set but unfortunately the programme has fallen far short of goals and expectations. In this paper. we have reviewed the burden of vaccine preventable diseases in Pakistan and the current state of the EPI Programme. The possible reasons behind the relative failure of the programme are also discussed and our strategies for increasing immunization rates among our children

An outbreak of cholera in Karachi following monsoon rains 2003

An epidemic of acute gastroenteritis was observed in the province of Sindh following a heavy monsoon season in July-August 2003. In Karachi, a mega-metropolitan city, large numbers of patients were evaluated for gastroenteritis and many were severely dehydrated and needed hospitalization. This study was carried out to describe epidemiologic features of the epidemic of gastroenteritis and investigate the causative agents responsible. We reviewed the medical records of all the pediatric patients admitted to the Aga Khan University [AKU] Hospital, Karachi, with the diagnosis of "Acute Gastroenteritis" over a 3 month period [1st June 31st August 2003], and analyzed their demographic and stool culture results. Epidemiological and clinical observations were recorded and the findings were correlated with the onset of the monsoon rains. A total of 327 pediatric patients were sick enough to be hospitalized with acute gastroenteritis to the AKU hospital over the 3-month period. A 3-fold increase in the number of patients admitted with gastroenteritis was noted in the period coinciding with heavy rains [mid-July to mid-August] compared to the baseline period before the onset of rains [June 2003]. Of the 327 patients hospitalized, 134 [41%] patients had stool cultures performed. Of these 134 patients, 53 [40%] had a positive stool culture. Vibrio cholerae were isolated from 34 of the 53 [64%] positive stool cultures with an overall isolation rate of over 25% from all stool samples submitted for culture. There was a significant increase in the number of cases of gastroenteritis, specifically cholera following a heavy monsoon season in Karachi. Adequate public health measures to prevent the occurrence of outbreaks of cholera and to educate the public about the dangers of drinking contaminated water are urgently needed