KARACHI: The Sindh health department launched an emergency vaccination campaign in two regions of Hyderabad district to protect children from an outbreak of typhoid, a potentially lethal disease caused by poor sanitation and contaminated drinking water.
Around 250,000 children in Latifabad and Qasimabad, the worst-hit talukas in the district, will receive doses of the new Typbar-TCV vaccine. The vaccine is the only solution to prevent this type of typhoid as increasing resistance to antibiotics has rendered existing medication ineffective.
Larkana has the lowest immunisation coverage in Sindh
Researchers and laboratory staff from Aga Khan University (AKU), a partner in the immunisation drive, have detected over 800 cases of drug-resistant typhoid in Hyderabad alone in a period of 10 months between 2016 and 2017. This is an alarming development since only six cases of drug-resistant typhoid were found in the all of Pakistan over a five-year period between 2009 and 2014.
"We recently completed a pilot programme in the affected areas that saw high demand for the vaccine from the community and proved that the vaccine could be safely administered," said the Sind Health Director-General Dr Muhammad Akhlaq Khan.
"The pilot programme provided us with valuable insight on how to effectively scale up the campaign and we look forward to working with our private sector partners so that we can reach every child in the affected areas."
First vaccination drive of 2018 starts
The vaccination drive will be conducted over a three to four month period by 15 teams of vaccinators from Hyderabad's health department. Vaccinators will be working alongside officials from the district health department, provincial disease surveillance unit, district administration and local government officials as well as private partners such as AKU and staff from the Field Epidemiology and Laboratory Training Programme of the Centres for Disease Control and Prevention during the emergency campaign.
"This is the world's first outbreak of typhoid that is resistant to the antibiotic, ceftriaxone, which is a standard treatment for the disease around the world," said Dr Farah Qamar, an associate professor in paediatrics and child health at AKU. "Our research has pinpointed the areas of Hyderabad district with the greatest need and showed that children represent the majority of those affected by the disease. We are glad to partner with the government on this important initiative which will save lives and halt new cases of this preventable disease," she said.
250 cases of drug-resistant typhoid reported in Hyderabad
Doses of the vaccine were purchased through funding from the Bill and Melinda Gates Foundation's emergency response fund after AKU researchers presented data about the outbreak - gathered from its extensive laboratory network in Hyderabad - at an international summit in Uganda in April last year. The control and prevention of neglected tropical diseases such as typhoid is a global health priority with targets under goal 3 of the Sustainable Development Goals calling for the eradication of such diseases by 2030.
Bill and Melinda Gates Foundation Vaccine Development, Surveillance, and Enteric and Diarrheal Diseases Department Director Dr Anita Zaidi supported global efforts to generate evidence of the efficacy for this vaccine against typhoid fever.
"It is unconscionable that children are still dying by the thousands every year from diseases like typhoid that are completely preventable. We are pleased to support the Sindh government's initiative as part of our overall strategy to combat typhoid through an integrated approach, including access to clean water, improved sanitation, and immunisation," said Dr Zaidi, an AKU alumna and former chair of the department of paediatrics and child health at AKU.
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Researchers from AKU will be collecting data during the four-month vaccination drive to assess the impact of the typhoid conjugate vaccine in an outbreak setting. Findings from the study will inform efforts to tackle outbreaks of typhoid in other parts of the world and to investigate whether the vaccine should be made a part of Pakistan's national immunisation programme.
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