Alerted by the detection of two new polio cases in Sindh, the provincial Expanded Programme on Immunisation has decided to intensify its operation and conduct a three-day sub-national immunisation campaign, beginning on March 4, throughout the province. Sindh EPI project director Dr Salma Kauser Ali told Dawn on Tuesday that the federal EPI and the WHO had agreed to bear the additional operational cost and ensure supply of the vaccines needed for the extension of the supplementary immunisation campaign. "Earlier we had planned the administration of anti-poliovirus drops in children up to five in areas including northern Sindh and Karachi, but now the whole of Sindh, except for the desert parts of Umerkot, Tharparkar and Sanghar districts, will be covered under the campaign,' she said. Replying to a question, she said polio workers and officials in Karachi were faced with a serious challenge of being a high-risk area as a couple of its towns, including Korangi, were being considered as exporters of the polio virus. Sindh has made considerable progress in eliminating polio from its limits, but there are 5-10 per cent of the deserving children who have been missed out during the immunisation campaigns. "We plan to reach about 6.5 million children during the planned campaigns, but we also expect supports from the community so that effective vaccines are administered to children on time,' Dr Ali added. WHO polio-eradication team leader in Pakistan Dr Nima Saeed Abid has said that coordination between the health sector and other departments needed to be optimised for an improved surveillance of the polio virus in Sindh. Dr Abid, who heads a group of WHO medical officers engaged in the polio-eradication programme of Pakistan, recently attended a monthly surveillance meeting of Sindh in the city. Various heads of the surveillance system on polio at the district level made presentations and discussed issues such as detection of a case of polio in Hyderabad and another in Nawabshah, capability and sensitivity of the surveillance system to detect all cases, missing cases, reduction or elimination of the gaps in the surveillance system, compatible cases and reasons behind them. Dr Abid told health officials about the observations made at a meeting of the technical advisory group (TAG) on polio- eradication recently held in Egypt, saying that genetic characteristics of some isolated viruses and surveillance field reviews indicated sub-optimal quality in some districts. The TAG meeting also noted that there had been significant progress in social mobilisation, while the quality of management, particularly in planning and supervision in some districts in the high-risk areas and discord between the coverage figures and virus circulation were the two components of the polio-eradication programme which were not reaching acceptable standards. Talking to Dawn after the Karachi review meeting, Dr Abid said there had been lapses in the programme and it was high time that they were rectified on a top priority basis. Maintenance of vaccines quality at the optimum level was also required through proper vaccine management, he said, adding that efforts should also be made to create public demands about both routine and supplementary polio immunisation drops. He stressed the management at district levels to ensure fool-proof surveillance and support for the polio-eradication programme. "Strong political commitment should be translated into action at the delivery level,' he added.
