Management of a sleeping sickness epidemic in Southern Sudan

An epidemic of human African trypanosomiasis, also called sleeping sickness, was identified in Tambura County, Southern Sudan in 1997. Implementation of a sleeping sickness control program by international nongovernmental organizations (NGOs) in Tambura County resulted in a three-fold decrease in the incidence of sleeping sickness between 1997-1999. The sustainability of these interventions once the NGOs withdraw is questioned. A hypothetical community based intervention to mitigate the epidemic is proposed which supports control and surveillance activities at the village level using the community health worker as the main focus. This paper describes how this epidemic was initially managed and provides an alternative management strategy.