An alarming surge in HIV cases among children is being witnessed across Sindh as almost all major healthcare facilities are reporting three to four new paediatric cases every week, infectious diseases experts and officials disclosed on Monday.
Senior clinicians at the Aga Khan University Hospital (AKUH), the Indus Hospital & Health Network (IHHN), the Sindh Institute of Child Health & Neonatology (SICHN), the National Institute of Child Health (NICH), the Sindh Infectious Diseases Hospital & Research Centre (SIDHRC) at Nipa, and several labour and Karachi Metropolitan Corporation-run facilities confirmed seeing a sharp and unusual rise in HIV infections among children.
The concern deepened after paediatricians at the Kulsoom Bai Valika Hospital in SITE reported an outbreak this month involving more than 18 HIV-positive children, most of them residents of Pathan Colony in SITE Town.
Experts at the AKUH said they saw four new paediatric HIV cases last week alone. They said they have recorded 29 paediatric HIV cases from January to October. Monthly distribution shows five cases in October, eight in September, four in August, two in July, three in June, three in May, and one each in the remaining months.
Infectious diseases expert Dr Fatima Mir at the AKUH said the rise in HIV detections in November and December may be linked to pneumonia season. Many of the children brought to hospitals with severe pneumonia and severe acute malnutrition are being screened, and some are testing positive for HIV.
“Of the four children who came last week, three were already known cases while one was diagnosed here. All of them had severe pneumonia and were severely malnourished.” Dr Fatima said specialists at several facilities in Karachi and interior Sindh are witnessing the same trend and have been reporting the situation to the provincial health authorities.
Officials at the SICHN confirmed an increase in HIV-positive children across all their facilities in the province. They said they have now started screening every child who visits their facilities. They are sharing the newly diagnosed cases with the Sindh Health Department and referring patients to ART (antiretroviral therapy) centres because antiretroviral medicines are only available there.
The SICHN’s latest screening data also reveals a worrying trend, with 12 children testing positive for HIV out of 476 screened across several districts in recent weeks. The data shows three positive cases from the K-5 camp in Karachi, five from Shaheed Benazirabad, one from Sobhraj and three from Sukkur, while screenings in Azam Basti, Jamshoro and Larkana reported no positive cases.
Officials said the figures reflect only the children who were screened during targeted activities, warning that the actual number can be higher due to limited availability of reliable testing kits. Doctors at the NICH also confirmed new weekly and monthly cases but said they are not allowed to share the official figures with the media.
Paediatricians at the Sindh Employees Social Security Institution Hospital in Landhi confirmed three HIV-positive children last week. They said they are now referring every child with symptoms that commonly appear in HIV for screening.
Doctors described these symptoms as repeated chest infections, severe pneumonia that does not respond to routine treatment, persistent fever, chronic diarrhoea, failure to gain weight, severe malnutrition, oral sores, and low immunity causing frequent hospital visits. They said these signs are becoming increasingly common, and should prompt immediate HIV screening.
Clinicians at the SIDHRC, the IHHN and the Abbasi Shaheed Hospital said they too are seeing three to four HIV-positive children every week. They said all new cases are being reported to the Sindh government’s CDC directorate, formerly known as the Sindh Aids Control Programme.
Healthcare staff also complained about difficulty in obtaining World Health Organisation (WHO) pre-qualified screening kits. They warned that limited supply of reliable kits can lead to missed cases, especially at smaller facilities.
International experts from the WHO and the United States CDC who investigated the Ratodero outbreak in 2019 had linked the spread of HIV among children to unsafe injection practices, reuse of syringes and unscreened blood transfusions.
Despite repeated queries, the provincial government’s HIV programme has not issued any statement on the recent surge. A request for comment from Sindh Health Minister Dr Azra Pechuho was also sent on Monday morning, but no response had been received until the filing of this report.