Summary Health experts warn that this trend reflects a growing public health crisis, largely driven by unsafe medical practices.
(Web Desk) - A concerning rise in HIV cases among children has been reported across three major hospitals in Karachi, with data from the past nine months showing a steady increase in infections.
Health experts warn that this trend reflects a growing public health crisis, largely driven by unsafe medical practices.
At the Sindh Infectious Diseases Hospital and Research Centre (SIDH&RC), the number of HIV-positive children rose sharply from 10 cases in 2024 to over 70 in 2025. So far this year, 30 infected children have already been admitted.
Similarly, the Indus Hospital recorded an increase from 144 HIV-positive patients in 2024 to 176 in 2025, with 69 cases registered in just the first quarter of this year.
Dr. Samreen Sarfaraz, Chair of Infection Control Services and infectious disease consultant at Indus Hospital, described the situation as alarming. Since August 2025, 72 children under the age of 14 have been registered, with 68 percent under five years old.
She noted that only 8 percent of these children had HIV-positive mothers, while 72 percent had a documented history of healthcare-related exposure. The remaining cases had no clearly identified source of infection.
According to Dr. Sarfaraz, most paediatric infections are linked to unsafe healthcare practices. These include the reuse of syringes and needles, contaminated intravenous equipment, poorly sterilised instruments, and transfusions of unscreened blood.
She also pointed out that lessons from the 2019 Ratodero outbreak—one of the largest child HIV outbreaks globally—have not been fully applied, and significant gaps in infection control still exist.
Dr. Sarfaraz highlighted that some healthcare providers continue to overuse injections and intravenous drips instead of prescribing oral medications, sometimes due to financial incentives. This, she warned, is exposing children to preventable yet lifelong infections. Hepatitis B and C are also spreading through similar unsafe practices.
In terms of treatment, many children are arriving at hospitals in advanced stages of illness, often with multiple infections. She emphasized the shortage of trained paediatric infectious disease specialists needed to manage such complex cases.
Additionally, shortages of antiretroviral and anti-tuberculosis medicines—linked to the suspension of USAID funding—are creating further challenges. Tuberculosis remains the most common co-infection among HIV patients in Pakistan, and drug shortages could worsen outcomes and increase resistance.
A third major paediatric hospital in Karachi has also reported rising cases, with more than 60 children—mostly from Thatta and other areas of interior Sindh—testing positive during routine pre-surgical screenings.
Many of these children had reportedly received repeated intramuscular injections over the past year, which may have contributed to the spread of the virus.
Officials at SIDH&RC noted that many HIV-positive children had previously received treatment at the Kulsoom Bai Valika Social Security Hospital in SITE Town, where a major outbreak last year affected over 80 children and caused at least two deaths.
The official added that infection control enforcement falls under the Sindh Healthcare Commission, while blood safety is overseen by the Sindh Blood Transfusion Authority, not the Centre for Communicable Diseases.
Dr. Sarfaraz also warned that Pakistan currently has the fastest-growing HIV epidemic in the World Health Organization’s Eastern Mediterranean region, with adult cases rising as well.
She urged strict enforcement of the National Action Plan for Injection Safety 2019 and called for decisive action against unsafe medical practices, including syringe reuse, improper use of medical equipment, and misuse of multi-dose vials.
