03643nas a2200433   4500000000100000008004100001653001600042653002100058653001000079653001500089653000900104653002200113653001100135653001400146653001800160653001100178653001000189653002000199653002100219653001000240653001200250653001000262653001500272100001500287700001200302700001400314700001300328700001500341700001100356700001300367700001400380700001900394245015600413856009000569300000900659490000600668520252100674022001403195       2009                            d10aYoung Adult10aTropical Climate10aSudan10aPrevalence10aMale10aInfection Control10aHumans10aHelminths10aHelminthiasis10aFemale10aFeces10aData Collection10aChild, Preschool10aChild10aAnimals10aAdult10aAdolescent1 aSturrock H1 aPicon D1 aSabasio A1 aOguttu D1 aRobinson E1 aLado M1 aRumunu J1 aBrooker S1 aKolaczinski JH00aIntegrated mapping of neglected tropical diseases: epidemiological findings and control implications for northern Bahr-el-Ghazal State, Southern Sudan.  uhttp://journals.plos.org/plosntds/article/asset?id=10.1371%2Fjournal.pntd.0000537.PDF  ae5370 v33 a<p><strong>BACKGROUND: </strong>There are few detailed data on the geographic distribution of most neglected tropical diseases (NTDs) in post-conflict Southern Sudan. To guide intervention by the recently established national programme for integrated NTD control, we conducted an integrated prevalence survey for schistosomiasis, soil-transmitted helminth (STH) infection, lymphatic filariasis (LF), and loiasis in Northern Bahr-el-Ghazal State. Our aim was to establish which communities require mass drug administration (MDA) with preventive chemotherapy (PCT), rather than to provide precise estimates of infection prevalence.</p>

<p><strong>METHODS AND FINDINGS: </strong>The integrated survey design used anecdotal reports of LF and proximity to water bodies (for schistosomiasis) to guide selection of survey sites. In total, 86 communities were surveyed for schistosomiasis and STH; 43 of these were also surveyed for LF and loiasis. From these, 4834 urine samples were tested for blood in urine using Hemastix reagent strips, 4438 stool samples were analyzed using the Kato-Katz technique, and 5254 blood samples were tested for circulating Wuchereria bancrofti antigen using immunochromatographic card tests (ICT). 4461 individuals were interviewed regarding a history of 'eye worm' (a proxy measure for loiasis) and 31 village chiefs were interviewed regarding the presence of clinical manifestations of LF in their community. At the village level, prevalence of Schistosoma haematobium and S. mansoni ranged from 0 to 65.6% and from 0 to 9.3%, respectively. The main STH species was hookworm, ranging from 0 to 70% by village. Infection with LF and loiasis was extremely rare, with only four individuals testing positive or reporting symptoms, respectively. Questionnaire data on clinical signs of LF did not provide a reliable indication of endemicity. MDA intervention thresholds recommended by the World Health Organization were only exceeded for urinary schistosomiasis and hookworm in a few, yet distinct, communities.</p>

<p><strong>CONCLUSION: </strong>This was the first attempt to use an integrated survey design for this group of infections and to generate detailed results to guide their control over a large area of Southern Sudan. The approach proved practical, but could be further simplified to reduce field work and costs. The results show that only a few areas need to be targeted with MDA of PCT, thus confirming the importance of detailed mapping for cost-effective control.</p>
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