[The tropical pathogenic complex: a new look at an old concept].
The failure of programs implemented to improve public health in the world, the poor performance of health care systems, and the difficulty in anticipating and reacting to emerging disease suggest that a more global approach to individual and community health problems is needed. Risk and disease must be correlated in space and time based on precise identification of their respective determinants, predictive factors, preventive targets, and diagnostic and prognostic indicators. For this purpose it could be useful to revive the pathogenic complex concept defined by the geographer Maximillien Sorre in 1933 in the light of new tools allowing better identification of biologic determinants (molecular genetics), of environmental factors (geographic information systems), and of behavior related to health care service activities. This concept could be used to place disease threats in a global context and to assess the consequences of current upheavals such as globalization of populations and products, exploding demographics, rapid urbanization, deforestations, rapid changes in behavior, and health care systems that can lead to both good and bad effects.
Le Bras
M
M
EA 3677 Université Victor Ségalen Bordeaux2, Bordeaux, France. lebrastregana@wanadoo.fr
Malvy
J M D
JM
D003141:Communicable Diseases; D003937:Diagnosis, Differential; D040362:Geographic Information Systems; D014943:Global Health; D006801:Humans; D017053:Infection Control; D007391:International Cooperation; D011379:Prognosis; D011634:Public Health; D012307:Risk Factors; D014330:Tropical Medicine / Q000639:trends*