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COVID-19 and Prophylactic Measures for HIV Children of Ratodero, Larkana

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Abstract

Ratodero is Taluka of population 224,000 in the district Larkana of Sindh, Pakistan. In the HIV outbreak (2019), 1132 HIV patients were reported in the Ratodero, amongst them, 901 (80%) were children, and the majority (735) below the age of 5 years.1 Larkana district is included among the cities where eight (8) COVID-19 carrier pilgrims from Iran were first confirmed as virus positive.2 Followed by community transmission in the area with the confirmation of the virus in the two individuals.3 There was reported shortage of the personnel protection equipment (PPEs) for the Medical Professional engaged in the tests of the COVID-19 as well as the shortage of Kits, so less number of COVID-19 tests were conducted, therefore the actual number of COVID-19 positive can abruptly raise with the availability of Kits and PPEs.4 There is a complete lockdown in the area since last week of March 2020. There is one medical University with an affiliated hospital. Collaborative efforts of the University teaching hospital and the district administration have constituted a team of experts for necessary actions to combat with expected Corona-19 outbreak. In such circumstances of the existence of HIV in Ratodero as an alarm of threats for another health risk for the poor HIV children of Ratodero Larkana. Dated 09 April 2020. there was a random selection of 20 such HIV children of Ratodero below the age 5, to have look on their physical health and to confirm the quantity/availability of ART (antiretroviral treatment) at their home. It was found that 30% of children were found physically weak. The confirmed average availability of remaining ART drugs was found available for use in the next 14 days. Generally, the children are the population of developing immunity (vulnerable age group) hence there can be increased risk if Co-Infection of COVID-19 if hits the Ratodero Taluika. Therefore the District of Larkana in general but the Taluka Ratodero, in particular, need special attention from the health administration. Following preventive measures can be useful to prevent the spread of COVID-19 among the HIV children of Ratodero, Larkana. • Better compliance of prophylactic SOPs verses COVID-19 through proper surveillance at the rural level in Ratodero. • Availability of Rashan on priority for the families of registered HIV children of Ratodero, taking into account the inclusion of all requirements of good nutrients in the daily intake. • COVID-19 screening of registered HIV children. • HIV Screening of any COVID-19 career of Ratodero if the individual is not amongst already registered HIV patients. • Establishment of a dedicated isolation ward in case of Co-Infection in these children along with the provision of special care to prevent the onset of COVID-19 symptoms in these patients. • Advance Supply of 03 to 06 month ART at home as per instructions of the World Health Organization (WHO) for such HIV patients.5
6 Journal of Rawalpindi Medical College (JRMC); 2020; 24 COVID-19 Supplement-1: 6-7
Letter to the
Editor
COVID-19 and Prophylactic Measures for HIV Children of
Ratodero, Larkana
Irshad Hussain1, Muhammad Shehzad Raza2, Saleem Ahmed Joyo3
1 Assistant Professor, SMBB Medical University,
Larkana.
2 4th Year Student MBBS, NMC, University of Health
Sciences, Lahore.
3 Pharmacist, SMBB Medical University,
Larkana.
Author`s Contribution
1 Conception of study
1 Experimentation/Study conduction
1 Analysis/Interpretation/Discussion
1,3 Manuscript Writing
2 Critical Review
Corresponding Author
Dr. Irshad Hussain
Assistant Professor,
SMBB Medical University,
Larkana.
Email: irshadpharmacist@yohoo.com
Article Processing
Received: 17/7/2020
Accepted: 25/7/2020
Cite this Article: Hussain, I., Raza, M.S. & Joyo,
S.A.(2020). COVID-19 and Prophylactic Measures for
HIV Children of Ratodero, Larkana. Journal of
Rawalpindi Medical College, 24 COVID-19
Supplement-1, 6-7.
DOI: https://doi.org/10.37939/jrmc.v24iSupp-1.1434
Conflict of Interest: Nil
Funding Source: Nil
Access Online:
Introduction
Ratodero is Taluka of population 224,000 in the district
Larkana of Sindh, Pakistan. In the HIV outbreak
(2019), 1132 HIV patients were reported in the
Ratodero, amongst them, 901 (80%) were children and
the majority (735) below the age of 5 years.1 Larkana
district is included among the cities where eight (8)
COVID-19 carrier pilgrims from Iran were first
confirmed as virus positive.2 Followed by community
transmission in the area with the confirmation of the
virus in the two individuals.3 There was reported
shortage of the personnel protection equipment (PPEs)
for the Medical Professional engaged in the tests of the
COVID-19 as well as the shortage of Kits, so less
number of COVID-19 tests were conducted, therefore
the actual number of COVID-19 positive can abruptly
raise with the availability of Kits and PPEs.4 There is a
complete lockdown in the area since last week of
March 2020. There is one medical University with an
affiliated hospital. Collaborative efforts of the
University teaching hospital and the district
administration have constituted a team of experts for
necessary actions to combat with expected Corona-19
outbreak. In such circumstances of the existence of
HIV in Ratodero as an alarm of threats for another
health risk for the poor HIV children of Ratodero
Larkana.
Dated 09 April 2020. there was a random selection of
20 such HIV children of Ratodero below the age 5, to
have look on their physical health and to confirm the
quantity/availability of ART (antiretroviral treatment)
at their home. It was found that 30% of children were
found physically weak. The confirmed average
availability of remaining ART drugs was found
available for use in the next 14 days. Generally, the
children are the population of developing immunity
(vulnerable age group) hence there can be increased
risk if Co-Infection of COVID-19 if hits the Ratodero
Taluika. Therefore the District of Larkana in general
but the Taluka Ratodero, in particular, need special
attention from the health administration.
Following preventive measures can be useful to
prevent the spread of COVID-19 among the HIV
children of Ratodero, Larkana.
1. Better compliance of prophylactic SOPs verses
COVID-19 through proper surveillance at the
rural level in Ratodero.
2. Availability of Rashan on priority for the
families of registered HIV children of
Ratodero, taking into account the inclusion of
7 Journal of Rawalpindi Medical College (JRMC); 2020; 24 COVID-19 Supplement-1: 6-7
all requirements of good nutrients in the daily
intake.
3. COVID-19 screening of registered HIV
children.
4. HIV Screening of any COVID-19 career of
Ratodero if the individual is not amongst
already registered HIV patients.
5. Establishment of a dedicated isolation ward in
case of Co-Infection in these children along
with the provision of special care to prevent
the onset of COVID-19 symptoms in these
patients.
6. Advance Supply of 03 to 06 month ART at
home as per instructions of the World Health
Organization (WHO) for such HIV patients.5
These measures can be effective for the prevention and
management of the Co-infection that can otherwise
raise the risk.
In accordance with currently available data WHO
guidelines, people living with HIV and on effective
ART are currently not at an increased risk of getting
coronavirus, or developing severe symptoms.5
However when the group of HIV patients is children
age <5 years the risk can be increased hence the added
prophylactic measures can be beneficial to lower any
such risk. It has been reported that a human child with
maturing adaptive and innate immune system is at
risk from many pathogenic viruses, bacteria, parasites,
and fungi.6
References
1. Mubarak, Naeem & Hussain, Irshad & Raja, S.A. & Khan,
Tahir & Zin, Che. (2020). HIV Outbreak of Ratodero Pakistan
Requires Urgent Concrete Measures to Avoid Future Outbreaks.
Journal of the Pakistan Medical Association. 1.
10.5455/JPMA.57221.
2. Dailytimes.com.pk/588383/two-more-pilgrims-test-positive-
for-covid-19/Date accessed 08 April 2020.
3. Dailytimes/print. Two more Coronavirus cases surface in
Larkana. Date 07 April 2020.
4.https://gulfnews.com/world/asia/pakistan/pakistans-
number-of-coronavirus-cases-could-be-much-higher-than-
given-statistics-1.70691190. Date accessed 08 April 2020
5. www.avert.org/coronavirus/covid19-HIV.
6. Hicks J, Allen G. 1999. A century of change: trends in UK
statistics since 1900. Research paper 99/111. London. UK: House
of Commons Library.
researchbriefings.parliment.uk/researchbriefing/summary/RP99
-111.
ResearchGate has not been able to resolve any citations for this publication.
pk/588383/two-more-pilgrims-test-positivefor-covid-19/Date accessed 08
  • Dailytimes
  • Com
Dailytimes.com.pk/588383/two-more-pilgrims-test-positivefor-covid-19/Date accessed 08 April 2020.
UK: House of Commons Library. researchbriefings.parliment.uk/researchbriefing/summary
  • J Hicks
  • G Allen
Hicks J, Allen G. 1999. A century of change: trends in UK statistics since 1900. Research paper 99/111. London. UK: House of Commons Library. researchbriefings.parliment.uk/researchbriefing/summary/RP99 -111.