The risk and associated control problems of Human African Trypanosomosis (HAT) in the endemic foci of Greater Equatoria Region, South Sudan

ABSTRACT This study aims to analyze, map, and identify the prevalence of, service provision for, and risk distribution and control for Human African Trypanosomosis (HAT), or sleeping sickness, in the endemic areas of Greater Equatoria Region (GER), including Eastern, Central, and Western Equatoria States of South Sudan. Passive and active screening data, detection data, and existing facilities and centers for sleeping sickness were used to assess the prevalence, screening coverage, and overall risk in the region for the 2016–2018 period. In addition, historical literature and surveillance information were used. The results show that 0.43% (N = 14,552) of the total at-risk population (N = 3,399,400) of GER were subjected to passive or active screening for Gambian HAT (gHAT), which showed an infection rate of 0.30%. Out of the total area of 196,211 km2, 58.77% of the region (115,311 km2) was found to be endemic to HAT. The population remains at high or very high risk for the disease in Western Equatoria State due to a number of active historic gHAT foci. With relative peace currently prevailing in the region, there is need to reinforce the leadership of South Sudan’s health ministry with sufficient internal and external resources to support its activities.