Historic and current trends of human African trypanosomiasis in South Sudan

Abstract

Human African Trypanosomiasis (HAT) due to Trypanosoma brucei gambiense remains a major public health problem in South Sudan. It causes substantial socio-economic impacts on the livelihoods of poor rural inhabitants. This article throws lights on a review of historic and current trends for evolution of HAT in South Sudan. Data of HAT cases were obtained from several relevant sources including World Health Organization (WHO) disease reports as of 1956-2018. Hence, HAT episodes were divided into four historical periods: The First Civil War (1955-1972); the post-Addis Ababa Accord (1973-1982); the Second Civil War (1983-2004); and the post-Comprehensive Peace Agreement (CPA) as of 2005-2018. The highest HAT cases of 16,539 (52.3%) occurred during the Second Civil War, followed by 7,708(24.37%) in post Addis Ababa Accord; 5,164(16.33%) in post-CPA, and 2,215(7.0%) during the First Civil War totaling 31,626 cases. The lowest prevalence of HAT as of the 1950s through 1960s might be due to application of effective intervention and control measures. The highest prevalence rate during the Second Civil War could be ascribed to political upheavals, instability and civil unrest. Currently, no HAT cases were reported from Akobo and Pachalla foci in Jonglei State. All the historic foci of HAT in South Sudan are still active with exception of Raga in Western Bahr El-Ghazal State. Further studies on molecular parasitology and epidemiology are needed to re-establish the endemic status of Raga, Akobo and Pachalla HAT foci. Key words: Human African Trypanosomiasis (HAT), past history, new foci, current trends, South Sudan.