Resurgence of sleeping sickness in Southern Sudan

Human African trypanosomiasis (HAT), or sleeping sickness, has been a public health problem in Sudan for much of the 20 century. Endemic foci of Trypanosoma brucei gambiense are found in southern Sudan in a belt bordering Central African Republic, Democratic Republic of Congo and Uganda. Gambiense sleeping sickness runs a chronic clinical course and is invariably fatal if left untreated. The disease has a significant impact on the economic fabric of affected communities. An increase in the number of passively detected cases of sleeping sickness in Tambura County, southern Sudan during 1996-1997 alerted the International Medical Corps to the possibility of an epidemic. With assistance from the Centers for Disease Control and Prevention (CDC), a statistically valid population-based prevalence survey was conducted that documented epidemic levels of trypanosomiasis. The overall seroprevalence was 19.4% with one village recording a seroprevalence of 45%. This paper describes how the epidemic was identified, and provides a review of sleeping sickness including its epidemiology, diagnosis and treatment.