Table 2.

Current NTD control strategies in Southern Sudan^f

Disease	Primary Interventions Currently Used	Progress to date	Limitation of Current Intervention	Suitable for MDA?
Onchocerciasis	Annual CDTI implemented since 1995	1.3 million individuals (36% of eligible population) treated in 2007	Incomplete coverage; high attrition rate of CDDs	Yes
Dracunculiasis	Active case surveillance, detection and containment, and prevention activities including water filtration, provision of safe water, treatment of water sources and health education	In 2008, 89% of endemic villages were providing regular reports, 49% of cases were contained, and cases were reduced by 38% when compared to 2007	Incomplete coverage of surveillance and interventions	No
Soil-transmitted helminths	Single dose albendazole, distributed alongside NIDs	2.5 million doses distributed in all ten states in 2006, reaching 87% of the targeted 1-5 year olds Similar coverage achieved in 2007	Lack of prevalence data and intervention strategy	Yes
Schistosomiasis	No large scale campaigns for schistosomiasis control have been undertaken to date. Praziquantel is rarely available at health facilities	Small, ad-hoc treatment campaigns	Insufficient prevalence data and lack of large-scale intervention strategy	Yes
Lymphatic filariasis	No targeted interventions to date	Regular distribution of ivermectin in CDTI areas will have reduced infection levels in areas where LF and onchocerciasis are co-endemic	Lack of prevalence data; limited funds for surveys and to conduct MDA; no palliative care; co- endemicity of L. loa in Equatoria region	Yes
Loiasis	No targeted interventions to date. Pathology not considered worth treatment at the present time. Important because co-infection with onchocerciasis can provoke SAEs	Regular distribution of ivermectin in CDTI areas will have reduced infection levels in areas where Loa loa and onchocerciasis are co- endemic, but may have caused SAEs	Boundaries of loiasis endemic area not clearly delineated. No treatment suitable for MDA	No
Trachoma	SAFE strategy consisting of: trichiasis surgery, antibiotics for active trachoma, facial cleanliness and environmental improvements	SAFE is being delivered as an integrated component of the Guinea worm eradication program in parts of Eastern Equatoria and Jonglei States	Limited coverage and varying uptake of interventions by communities	Yes
Visceral leishmaniasis	Passive case detection at a few health facilities equipped to treat the disease; treatment with pentavalent antimonials	Case-management and supply chain of drug and diagnostic supplies improved	Limited number of facilities with equipment and skills for diagnosis and treatment; cost of drugs; emerging drug resistance; lack of awareness and prevention (LLINs) in affected communities	No
Human African Trypanosomiasis	Passive case detection at a few health facilities; treatment with pentamidine, eflornithine and melarsoprol	Number of cases reported have decreased as a result of interventions carried out since 2003 [21]	Inadequate surveillance, limited number of treatment facilities and trained health workers	No
Buruli Ulcer	Antibiotic treatment using, for example, rifampicin and aminoglycoside	Some interventions (treatment, awareness campaigns, health education) have been carried out over the last years	Disease distribution not clearly established, limited access to treatment and surgery	No
Leprosy	MDT blisterpacks provided free of charge by WHO	Some interventions (treatment, awareness campaigns, health education) have been carried out over the last years	Limited MDT coverage	No

^fAbbreviations: CDD, community drug distributor; CDTI, community-directed treatment with ivermectin; LF, lymphatic filariasis; LLIN, long-lasting insecticidal net; MDA, mass drug administration; MDT, multi-drug therapy; NID, national immunization day; SAE, severe adverse event; SAFE, strategy for trachoma control consisting of eyelid surgery (S), antibiotics to treat the community pool of infection (A), facial cleanliness (F), and environmental changes (E).