Doctors in a city in Pakistan are struggling to cope with an increase in HIV-infected patients, the AIDS-causing virus, with almost 700 cases since April, most of them children.
Health officials suspect the outbreak is associated with recycled syringes and needles and improperly screened blood transfusions.
"For me, it was impossible to imagine," Nazeer said, recalling the day a doctor said his 1
"I told him," are you laughing at me, how can she get HIV? "He said in his home in Ratodero, 480km from Karachi, the capital of the southern province of Sindh.
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His daughter receives treatment, he said, adding that he did not know how she was infected.
Health officials say 681 people have tested positive for HIV in Ratodero, of which 537 are children since April 25.
More than 21.00 people have taken an HIV test at Ratodero's only screening center in a state hospital. Others have been tested at private clinics.
"I have identified the top of the iceberg. It can be in thousands, not hundreds," says dr. Imran Akbar Arbani, who runs a clinic in the city in the Lakarna district.
About 60% of Ratodero patients were infected by recycled needles and syringes or by blood transfusions that were not properly screened for HIV, Dr. Sikander Memon, head of the AIDS control program in the province.
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Police and doctors conducted an initial study and found that 123 HIV patients had been treated by a doctor before they were infected.
Dr Muzaffar Ghanghro was arrested on April 30 and has been accused of accidental murder, police said.
"The negligence and carelessness of Dr. Muzaffar Ghanghro has been the main cause of the spread of HIV at a later stage," the study team said in a report.
Reuters was not allowed to contact Ghangro in prison and could not contact his lawyer.
Imtiaz, a worker, said he had taken his three children to Ghangro because there was no pediatrician in town. All three were infected with HIV.
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"He used the same drip of 50 children without changing the needle," he said.
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Pakistan has about 163,000 HIV and AIDS patients, of whom only 25,000 are registered with provincial and federal AIDS control programs, said Zafar Mirza, a health advisor to Prime Minister Imran Khan.
At the request of Pakistan, the World Health Organization (WHO) and the American Centers for Disease Control and Prevention (CDC) have sent a team of experts to the area. They are expected to visit Ratodero on Friday.
"They'll do a proper study of how this outbreak is also placed," Mirza told reporters. "In the next few weeks I hope we will know the reasons."
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The government has ordered 50,000 HIV screening packages and establishes three treatment centers. Adult patients receive antiretroviral drugs and drugs have been ordered for children, Mirza said.
Ratodero cases underline the serious state of health in Pakistan, a nation of 208 million, where nearly a third of the population lives on less than $ 3.20 a day, and many people cannot afford expensive medical tests or drugs.
Few families can afford proper treatment for HIV, which usually involves regular trips to Karachi.
"I've sold all my valuables for treatment. Now I can't afford to go to Karachi for my children's medication every month," said Tariq, who lives in a village near Ratodero.
Tariq, his wife and daughter are HIV positive, and a nephew tested positive this month. He does not know how they were infected.
"There are 16 HIV cases alone in our village. No one has come to see our situation," he said.
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PakistanHIV / AIDSHIV outbreak