Addressing the Burden of Infectious Diseases in Pakistan

PakistanPakistan is one of several countries, which together bear 95% of the burden of infectious diseases.[i] Malaria, Tuberculosis, and Polio are among the top killers of Pakistani youth and adults. Pakistan is ranked fifth out of twenty-two on the list of high-burden tuberculosis countries.[ii] We also witness an alarming average of about one million lives claimed yearly by malaria.[iii] Worst of all, Pakistan is one of the four remaining countries where polio is still endemic.[iv] Seventy five percent of the Pakistani population lives in rural areas.[v] Malaria and TB are both diseases predominantly found in rural areas. (WPV) or the wild polio virus is not as restricted to rural regions and can affect anyone but the primary deaths are children under 5.[vi] TB rates in Pakistan are in large part due to the widespread malnutrition and access to unhygienic foods.[vii] Floods are also a factor as they’ve left behind many water ponds, which are ideal breeding sites for Anopheles mosquitoes, common carriers of malaria.[viii] The polio virus is the most dangerous and contagious of the three and typically spreads from person to person through fecal-oral transmission. All of these infectious diseases present a large death toll and burden on the population. This is significantly crippling economic growth and investments. We must increase productions of health facilities and begin training general practitioners properly. Proper care and immunization will be crucial in dealing with polio, malaria, and TB.

NATURE AND MAGNITUDE

malaria mosquito

  • In the last 3 months alone we have recorded approximately 319,000 suspected malaria cases.[ix] Together Pakistan and 5 other nations make up 95% of all malarial disease related deaths with children being the prime victim. Pakistan has two seasonal peaks where malaria is most prevalent. The first is in August and generally consists of milder cases known as vivax-malaria. The second seasonal peak is in October and consists of potentially more severe cases known as falciparum malaria. [x]
  • Over the course of the last year we’ve also recorded 420,000 cases of TB. Pakistan has an estimated mortality rate of 48 thousand deaths per year as a result of TB cases. [xi] This disease spreads easily and can be transmitted through any oral-to-oral contact with an infected patient.[xii
  • A total of 58 cases of (WPV) wild polio virus were recorded in 2012.[xiii] About half of these cases are in inaccessible areas, which prevents the effective administering polio vaccinations. While a large majority of the population is unaffected by polio the severity and rapid rate at which the disease could spread makes it extremely deadly. Efforts to eradicate polio worldwide and in Pakistan have been unsuccessful. Polio is incurable once contracted and patients have a 90% chance of transmitting the virus to adults living in the same household.[xiv]

malaria pakistan

RISK FACTORS

Your most at risk of malaria if you haven’t been immunized and you live in areas with poor sanitation. The millions of Pakistani people displaced by recent sporadic floods have become the primary victims. Pakistani’s who cannot get proper immunization, shelter, and hygiene are likely to contract the disease.[xvii] Malaria is also a disease that is predominantly found in rural areas.  An estimated 12% of the rural population is believed to carry malaria parasites in their blood without showing any physical sign or symptoms.infectious diseases

Pakistani’s living in rural areas are even more at risk of TB due to lack of access to proper medical facilities. Unfortunately, 75% of the total population lives in rural areas and 45% lives under the poverty line.[xvi] The main risk factors for TB are malnutrition and unhygienic foods. Malnutrition is mostly prevalent in the rural and poverty stricken regions of Pakistan. It follows that those living in rural areas as well as those displaced by the flood suffer the greatest risk of catching TB. Polio is extremely contagious and anyone who has not been immunized and is in proximity of a patient is at risk. Any sort of fecal to oral or oral-to-oral contact will result in infection.[xviii]

SOLUTIONS

If left unchecked these diseases could spread across the land and literally wipe out a large percentage of the Pakistani population. Higher mortality rates means more deaths, less workers, and a weaker economy. These diseases are among the biggest disablers. According to a recent study rural families with individuals suffering from malaria lose more then 40% of crop yields as a consequence.

infectious diseasesWe must focus on areas where the floods and poverty have handicapped people the most. This includes the areas where basic facilities necessary for hygienic living condition have been destroyed like sewage systems, clean water, and basic healthcare facilities.

Malaria could be avoidable and controllable at low cost if we could just start investing more in local health development programs. One example would be to pay UNICEF to provide IN nets, which are known for being extremely efficient in stopping the spread of malaria. It is imperative that we must make the information known to the public! By going through UNICEF the nets will be delivered by private NGO’s making things easier at the distribution level.[xix] Building programs to create proper shelter as a result of the flood may also want to be considered. Making sure proper vaccination is available to all would be the final goal in the fight against malaria.

malaria nets

Most recently multi drug resistance to antibiotics (MRSA) has become an issue in dealing with TB. Overcrowding, poor handing washing practices among hospital staff, and lack of effective prescriptions all contribute to the development of MRSA TB. Around 32% of general practitioners in Pakistan fail to administer the proper medication. We will solve this by creating and funding education programs and properly trained care units. This will allow us to properly treat TB patients as well as increase the quality of care general practitioners are providing the population with. This will be efficient because over 80% of Pakistani patients who suffer from TB first go to a private practitioner for diagnoses.[xx] Polio actually has no cure but a vaccine does exist. We must work diligently to assure that the entirety of the population has access to proper immunization. It is important to spread knowledge and information on the importance of immunization. This will not be enough and as such we must also train specialize health care units as well as create new health care facilities as close as possible to more inaccessible rural areas. So long as even one child remains infected with polio, children from all other countries will always be at risk of contracting the disease. Global of eradication of polio has become a goal for many private organizations. Fortunately, for this reason many INGO and private organizations are looking to help and assist us in the eradication of polio. Creating joint programs with these organizations could prove to be efficient and useful. Unfortunately, even with outside assistance polio initiatives will be costly.[xxi]

pakistan polio

End Notes

  1. [i] .Snow R. The public health burden of Plasmodium falciparum malaria, in Africa: deriving the numbers, working paper No. 11.
  2. [ii]USAID Health: Infectious Diseases, Tuberculosis, Countries, Pakistan.” U.S. Agency for International Development.
  3. [iii] Abdullah, By Syed. “0.5 Million People Suffer from Malaria Every Year in Pakistan. Report.”
  4. [iv] http://www.unicef.org/infobycountry/pakistan_51582.html
  5. [v] “Tuberculosis (TB) in Pakistan « Hasaan Foundation Articles.” Hasaan Foundation.
  6. [vi] “Polio FAQ Polio Children – Giving Hope and Dignity.” Polio Children.
  7. [vii] “Tb Disease Causes.” Urdu Pakistan.
  8. [ix] “WHO | WHO Supports Malaria Epidemic Prevention and Control in Pakistan.”
  9. [x] “Malaria Site: Anopheles Mosquito.” Malaria Site: Comprehensive Malaria Website.
  10. [xi]http://apps.who.int/globalatlas/predefinedReports/TB/PDF_Files/pak.pdf
  11. [xiii] Initiative, Polio Eradication. “Global Polio Eradication Initiative Data and Monitoring Polio This Week.” <http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx&gt;.
  12. [xv] “Tuberculosis (TB) in Pakistan « Hasaan Foundation Articles.” Hasaan Foundation. <http://www.hasaanfoundation.org/wp/?p=12&gt;.
  13. [xvii] “WHO | WHO Supports Malaria Epidemic Prevention and Control in Pakistan. <http://www.who.int/hac/crises/pak/releases/12october2010/en/index.html&gt;
  14. [xix] “Simple Solutions: Malaria Nets Uncovered.” Global Health.
  15. [xx] “Knowledge regarding Management of Tuberculosis among General Practitioners in Northern Areas of Pakistan.” JPMA.
  16. [xxi] Initiative, Polio Eradication. “Global Polio Eradication Initiative Data and Monitoring Polio This Week.”
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3 responses to “Addressing the Burden of Infectious Diseases in Pakistan

  1. Thanks for your response. These all appear to be short term preventatives rather than confering protection over a longer period. I guess the expense of these products is one key reason precluding them from being used more commonly by residents in most high risk areas? As well as some of them only being recommended for shorter term use? Are there any programs in hgih risk areas offering these preventatives? Thanks.

  2. I didn’t think there was a vaccine for malaria yet? Can you clarify for me. Really interesting what you are writing about, I will be reading more!

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