Sunday, July 21, 2013

Lahore: City still at high risk for measles

The Express Tribune
Despite the government’s claims of running a successful measles vaccination drive in the province, a recently submitted Expanded Programme on Immunisation (EPI) report has declared Lahore ‘high risk’ and the Health Department has recommended monitoring and surveillance of measles in the district, The Express Tribune has learnt. The report has been drawn up by EPI Senior Medical Officers Ashfaq Ahmad Joyia and Dr Waqar Hammid, appointed observers by the Directorate General of Health Services for the measles vaccination ‘catch-up’ campaign in Lahore. The report says Ravi, Wagha and Iqbal Town are among the worst affected towns in the district. The observers have identified major weaknesses in the campaign. The report lists the names of children and areas not covered in the vaccination. “Lahore is now a high risk district because the measles virus has been here for some time. District health authorities must ensure more than 95 per cent EPI coverage among children in nomadic settlements,” the report reads. It suggests that nomadic settlements should be included in the EPI’s tour plan. It warns that the routine EPI coverage in these settlements is alarmingly poor, especially in Ravi Town’s Khokhar village. It says 94.74 per cent children have not been vaccinated and 5.26 have been only partially vaccinated in a nomadic settlement on Khokhar Road, which has been there for eight years. “The routine EPI coverage among the nomadic population in UC 12 (Iqbal Town), which lies in the vicinity of Family Health Hospital, is extremely poor. As many as 85.7 per cent children have not been vaccinated and 14.3 per cent have been partially vaccinated.” The statistics have been shared with the Deputy District Officer Health (DDOH), who has decided that those responsible for the poor coverage must be tried under the PEEDA Act [Punjab Employees Efficiency, Discipline and Accountability]. A list of names of unvaccinated children and their parents is attached to both reports. “EPI, is the single most effective tool to reduce infant mortality. It can lead to the eradication of diseases like measles. A delay in the implementation of EPI programmes at any level can expose the target population to the measles virus. This will ultimately increase morbidity and mortality due to preventable diseases, like measles,” the report adds. The observers have recommended that the district health authorities be more vigilant and vibrant. The district health management should make a distribution plan for the cold chain equipment provided by the EPI directorates, so that incidents of vaccine waste can be avoided. The DDOH and area in-charges must be held accountable if they don’t achieve more than 95 per cent EPI coverage in their areas. Union council medical officers should also be part of the campaign in their catchment areas, the report suggests. The observers have suggested stern action against the DDOHs and vaccinators responsible for vaccination in Ravi, Wagha and Iqbal Town. Copies of the report have been provided to the health secretary, director general, the EPI Director, the district coordination officer and the health district officer. EPI Director Munir Ahmad told The Express Tribune that the department had taken action against those responsible for low EPI coverage in the three towns. “When the campaign was completed, the health secretary chaired a meeting to evaluate progress on the vaccination in Lahore. The areas left out earlier, have now been covered,” he said. The anti-measles vaccination drive in Lahore took place between April 29 and May 5. As many as 190 children in the Punjab have died of measles since January including 86 of the children from Lahore. In Punjab, 22,250 measles patients have been reported, of which 5,800 have been from Lahore.

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