More than 500 people in a southern Pakistan region tested positive for HIV following a mass outbreak. Local officials say a ‘rogue doctor’ is responsibile for the outbreak after using a single, contaminated needle repeatedly.

Dr. Sikandar Memon, the regional coordinator of the Aids Control Programme, told the Pakistani publication Dawn that of the people who tested positive, over 400 are children.

Officials have screened over 14,000 individuals in and around the city of Larkana. In the latest round of tests, 29 people from Ratodero, believed to be the hotbed of the outbreak, tested positive.

The outbreak first spiked in April.

For parents, the outbreak is a living nightmare. Nisar Ahmed’s one-year-old daughter tested positive for HIV and he found himself at a clinic in search of medicine.

‘I curse [the doctor] who has caused all these children to be infected,’ he told Al Jazeera.

The doctor accused of infecting people, Dr. Muzaffar Ghangharo, who himself is HIV positive, remains in custody. Officials have charged him but he denies all allegations.

Another possible cause for the outbreak is widespread negligient medical practices, stemming from multiple sources. Officials are also looking into this possible explanation.

According to a statement and information from UNAIDS, there are concerns of 600,000 unqualified doctors operating in Pakistan. Of these hundreds of thousands of people, nearly 270,000 are believed to be in the Sindh region of the country where Larkana is located.

As of 2017, UNAIDS estimates around 150,000 people in Pakistan, including adults and children, are living with HIV.

While this number in reality may be lower, Pakistan has been facing a sharp increase of infections in recent years.

Between 2004 and 2005, the estimate of new HIV infections jumped from 1,600 to 9,400. New infections have been increasing in the country ever since, reaching an estimate of 20,000 in 2017.

AIDS-related deaths have also been steadily increasing since 2006.

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