Uganda is on the verge of a remarkable event: eliminating human African trypanosomiasis (HAT), also known as sleeping sickness. However, the continued instability in neighbouring South Sudan could jeopardise this important public health victory.
Hundreds of thousands of people fleeing conflict in South Sudan have been settled in northern Uganda. As of September 2016, more than 370,000 refugees had been registered, and the number continues to grow. The majority of these people come from HAT-endemic areas and are being accommodated in camps in Adjumani and Yumbe districts, which is also where the last few cases of HAT in Uganda have been reported in recent years. The result is a situation in which the risk of a HAT resurgence is growing, potentially undoing elimination efforts in Uganda.
Targeted surveillance measures to diagnose and treat sleeping sickness cases in refugee camps and settlements are essential to reduce the risk of transmission. New tools, such as the rapid diagnostic test (RDT) for sleeping sickness developed by FIND and partners, are well suited for a rapid public health response.
Towards this end, the Ministry of Health in Uganda, in collaboration with FIND, started surveillance for HAT in November 2016. As of December 2016, 3800 refugees had been screened in the camps and rapid tests were distributed in 20 health clinics that attend to refugees. No HAT cases have been reported in the refugee population to date, but the risk remains high. Screening activities are slated to continue in 2017.
Despite the conflict in South Sudan, FIND and its partners continue to work in the country. HAT screening activities have been maintained in Kajo Keji, Magwi and Pageri, three counties bordering Uganda. Ensuring screening, diagnosis and treatment of HAT in South Sudan will reduce the risk of re-introducing the disease in neighbouring Uganda.