Abstract
BackgroundIntegrated rapid mapping to target interventions for schistosomiasis, soil-transmitted helminthiasis (STH) and lymphatic filariasis (LF) is ongoing in South Sudan. From May to September 2010, three states – Unity, Eastern Equatoria and Central Equatoria – were surveyed with the aim of identifying which administrative areas are eligible for mass drug administration (MDA) of preventive chemotherapy (PCT).Methods and Principal FindingsPayams (third administrative tier) were surveyed for Schistosoma mansoni, S. haematobium and STH infections while counties (second administrative tier) were surveyed for LF. Overall, 12,742 children from 193 sites were tested for schistosome and STH infection and, at a subset of 50 sites, 3,980 adults were tested for LF. Either S. mansoni or S. haematobium or both species were endemic throughout Unity State and occurred in foci in Central and Eastern Equatoria. STH infection was endemic throughout Central Equatoria and the western counties of Eastern Equatoria, while LF was endemic over most of Central- and Eastern Equatoria, but only in selected foci in Unity. All areas identified as STH endemic were co-endemic for schistosomiasis and/or LF.ConclusionsThe distribution and prevalence of major NTDs, particularly schistosomiasis, varies considerably throughout South Sudan. Rapid mapping is therefore important in identifying (co)-endemic areas. The present survey established that across the three surveyed states between 1.2 and 1.4 million individuals are estimated to be eligible for regular MDA with PCT to treat STH and schistosomiasis, respectively, while approximately 1.3 million individuals residing in Central- and Eastern Equatoria are estimated to require MDA for LF.
Highlights
South Sudan established a national programme for the integrated control of neglected tropical diseases (NTDs) in 2008, with support from the United States Agency for International Development (USAID)
The present survey established that across the three surveyed states between 1.2 and 1.4 million individuals are estimated to be eligible for regular mass drug administration (MDA) with preventive chemotherapy (PCT) to treat soil-transmitted helminthiasis (STH) and schistosomiasis, respectively, while approximately 1.3 million individuals residing in Central- and Eastern Equatoria are estimated to require MDA for lymphatic filariasis (LF)
Onchocerciasis and trachoma were not included in the protocol because the distribution of onchocerciasis had already been mapped by the African Programme for Onchocerciasis Control (APOC) [4], while for trachoma it was felt that the required diagnostic skills and the recommended sampling frame [5] were not compatible with survey methods for helminth infections
Summary
South Sudan established a national programme for the integrated control of neglected tropical diseases (NTDs) in 2008, with support from the United States Agency for International Development (USAID). A large number of NTDs are thought to be endemic in South Sudan [1], the above five were prioritised because safe and effective preventive chemotherapy (PCT) is available free of charge or at low cost due to drug donation programmes. An integrated rapid mapping protocol was developed to generate the required data to target mass drug administration (MDA) of PCT to at-risk populations [3]. Integrated rapid mapping to target interventions for schistosomiasis, soil-transmitted helminthiasis (STH) and lymphatic filariasis (LF) is ongoing in South Sudan. From May to September 2010, three states – Unity, Eastern Equatoria and Central Equatoria – were surveyed with the aim of identifying which administrative areas are eligible for mass drug administration (MDA) of preventive chemotherapy (PCT)
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